Background: As global life expectancy increases, spinal disorders and the need for spinal surgery among elderly individ uals are becoming more prevalent. Postoperative cognitive decline (POCD) is a common complication in this population, adversely affecting functional recovery and quality of life. Despite substantial research, effective preventive strategies for POCD remain limited. Aim: To determine the incidence of POCD and to identify perioperative risk factors associated with its development in elderly patients undergoing spinal surgery. Materials and Methods: A prospective cohort study was conducted at the Second Affiliated Hospital of Inner Mongolia Medical University. Of 200 elderly patients who underwent spinal surgery between, 122 met the inclusion criteria and were enrolled. Preoperative clinical assessments, intraoperative surgical and anesthetic parameters, and postoperative evaluations were systematically collected. Cognitive function was assessed using standardized and validated tools both before and after surgery. Multivariate logistic regression analyses were performed to identify independent predictors of POCD. Results: POCD was observed in a notable proportion of patients postoperatively. Multivariate analysis revealed that prolonged surgical duration (OR=0.989; p=0.005), intraoperative hypotension (OR=0.964; p=0.009), higher intensity of postoperative pain (OR=10.073; p=0.015), and elevated postoperative C-reactive protein levels (OR=1.039; p<0.001) were significantly associated with an increased risk of developing POCD. Conclusion In elderly patients undergoing spinal surgery severe postoperative pain, and systemic inflammatory respons es contribute significantly to the development of POCD. Optimizing perioperative management, including minimizing surgical time, maintaining stable hemodynamics, and controlling postoperative inflammation and pain, may mitigate the risk of cognitive decline.

Introduction : Water is a vital resource for human existence and is essential for daily food processing, preparation, washing, hygiene, and sanitation. Furthermore, providing the population with safe drinking water is one of the pressing problems of the world and some regions.
In recent years, population density and the scale of commercial and industrial activities, as well as clean and dirty water consumption were increased in the capital city. As a result of these, ground and surface water resources are becoming scarce and polluted.
Therefore, assessment of daily drinking and residential water consumption of Ulaanbaatar should be determined to use drinking water properly in daily life and water loss. This study assessed the actual amount of households’ daily water consumption. Goal: The purpose of this study is to determine the daily consumption of drinking water for households in ger areas and apartments in Ulaanbaatar. Materials and Method: This study covers 30 households in ger areas and 15 apartment households, in Ulaanbaatar. Household members performed 6-10 types of measurements every day, within 7 days. As a result of these measurements, actual consumption of water quantity used for drinking and household purposes was calculated. Statistical analysis was done by SPSS Version 21 to calculate the true probability of difference between parameters. Result: 67.9% of the households in the ger areas were 4-5 family members. The average daily household consumption of drinking and domestic water were 68.3 ± 3.57 L (95% 61.3-75.3), the minimum consumption was 12 L, and the maximum was 227 L. Average of the household water consumption water was 97.6-108.9 liters during the weekends, and water consumption was statistically higher than weekdays (p=0.001; p=0.01).
The water consumption of residential households with 3 family members accounted for the majority (30.8%) in this study. The average daily consumption of drinking and domestic water was 297.67±19.7 liters. There was no statistically significant difference (p=0.96) in week. The average daily water consumption including drinking and residential was 270.3-335.97 L.
The total daily drinking and residential water consumption per person was 15.57 L for households in ger areas and 90 L for apartment households. Calculating the daily water consumption of households in ger areas, 60.3% of it is used for laundry, washing dishes, food preparation, washing face and hands, and clothes, 31% for drinking, and 8.7% for outdoor water use. While apartment households, approximately 94.1%, were used for household and 5.9% for drinking purposes. Research ethics approval : This study was discussed at the meeting of the Academic Council of the National Center for Public Health. In addition, this study was carried out according to the methods and methods discussed and approved at the meeting of the Medical Ethics Control Committee of the Ministry of Health (Resolution No. 08). Conclusion The total daily consumption of drinking and residential water per person were 15.57 litres for the households in the ger areas and 90 litres for the apartment households. It implies that it does not exceed the WHO recommendations

Background: As of September 21, 2021, 65.3 percent of Mongolia's population was vaccinated at full dose. However, as of COVID-19 confirmed cases, Mongolia is in the top five countries in the West Pacific. This indicates that there is a lack of practice to prevention from coronavirus infection in the population. Goal : This survey aims to compare the level of knowledge, attitudes, and practices of the population towards coronavirus infection with the results of the baseline survey results Material and Methods: This is a cross-sectional study. A total of 1896 people aged 15-60 years old participated in the study. The survey data were collected using quantitative (questionnaire) and qualitative (observation) methods. The research methodology was approved at the Scientific Committee of the National Center for Public Health on November 9, 2021 (Protocol № 5) and the Medical Ethics Review Committee of the Ministry of Health on January 20, 2022 (Resolution №261) was issued the Ethical permission of the survey. Results: Out of 14 knowledge questions that should be known about coronavirus infection, survey participants had known in an average of 8.27 ± 3.73 (95%CI: 8.12-8.43) correct answers, which was lower than the results of the baseline study. The average knowledge score of the surveyed participants of the follow-up survey (9.23±3.2, 95%CI: 9.09-9.38) was smaller than the baseline survey by 0.96 percent. 54.5 percent of surveyed participants believed that the pandemic is “very dangerous”. However, it has decreased by 25.6 percent compared to the baseline survey. Positive attitudes toward the right place at the onset of symptoms of COVID-19 and non-discrimination against infected people are more prevalent in a population with a high average knowledge score. In the baseline study, the average duration to wear a mask was 29 hours, while in the follow-up survey, it was 4.2 hours, which shows improvement in the correct behavior. Conclusions As the population’s level of education increased, the average knowledge score on the coronavirus infection has increased, and the statistically significant high of the participant with higher education levels was 8.81±3.53 (p=0.0001). In the baseline survey, 64.9 percent of the participants had an attitude toward a discriminant person infected with COVID-19, whereas it was declined by 41.9 percent in the follow-up survey. The practice of wearing masks in crowded places and outdoors were increased by 6.8 percent from the baseline survey. Compared to the baseline survey results, in the follow-up survey, practices of wearing masks in the workplace or indoor environment (73.0%) had increased.

Electronic cigarettes are handheld electronic vaping devices which produce an aerosol by heating an e-liquid. The e-liquid typically contains humectants and flavorings, with or without nicotine; once vaporized by the atomizer, the aerosol (vapor) provides a sensation like tobacco also smoking the heating process can lead to the generation of new decomposition compounds that may be hazardous. Heavy metals, organic compounds, and particles smaller than PM2.5 were found on the puff of the electronic cigarette, also in 2012 International agency research cancer, introduced PM2.5 human carcinogen substance. Therefore, e-cigarette liquid products should be subjected to regulatory control to ensure consistent nicotine delivery. Global youth tobacco survey Mongolia 2019 asked about e-cigarette use status and 3.5% (95% CI: 2.6-4.6) of students currently used electronic cigarettes while one in ten students (10.1%, 95% CI: 8.3-12.2) had ever used electronic cigarettes. E-cigarette advertising is on television and radio in many countries that have long banned similar advertising for cigarettes and other tobacco products and may be indirectly promoting smoking conventional cigarettes. Smoke-free policies protect nonsmokers from exposure to toxins and encourage smoking cessation. Introducing e-cigarettes into clean air environments may result in population harm if use of the product reinforces the act of smoking as socially acceptable or if use undermines the benefits of smoke-free policies.

Background: In 2021, 5981 of cancer new cases was registered in Mongolian population. Among those cases, liver cancer was commonly registered with a prevalence of 32.7%. Studies on anticancer agents with no-adverse effects and good-preventive efficacy against cancer have been attracted more attention from the researchers in the field of pharmaceutical sciences. Scutellaria baicalensis Georgi, Saussurrea amara.L, Chiazospermum erectum Berh, and Carthamus tinctorius.L are well recognized as effective agent against liver diseases. Using these raw materials, researchers have been invented a traditional prescription and named as Hepaclin-4. In this study, we aimed to investigate the qualitative study of raw materials and some biologically active sub- stances in the compounds. Purpose: To study the qualitative study of raw materials for Hepaclin-4 prescription Materials and methods: Some qualitative properties of raw materials for Hepaclin-4 prescription, including appearance, minerals, some organic compounds, total ash, water-soluble substances and fungi, were investigated according to Mongolian pharmacopeia and total flavonoid was detected by thin layer chromatography. Results: No changes were observed on the appearance of raw materials, and minerals and organic compounds weren’t detected in the prescription. No contamination with fungi and insects were identified. The moist in the raw materials were 5.9 to 8.1%, total ash was 4.7 to 13.3% and the water-soluble substances were detected 33.8 to 42.9%. Number of aerobic bacteria, fungi and E.coli, Salmonella species were detected in normal range, indicating that the prescription was matched with the requirement of pharmacopeia. According to the thin layer chromatography study of the raw materials, a yellow spot on the chromatogram were identified and same as quercetin (Rf=0.9-0.98) and rutin ((Rf=0.18-0.23)) as standard compounds, which indicated that the spot which indicated that the spot was flavonoids in the prescription. Conclusions These results showed that the appearance, moist, minerals, organic compound, water-soluble substances, ash and biologically active substances of the raw materials for Hepaclin-4 prescription was corresponded with the requirements of pharmacopeia, and flavonoid was detected in raw materials of Hepaclin-4.

Background: As a result of the previous programmes implemented by the Government of Mongolia, maternal mortality and under-five mortality rates had declined fourfold from 1990 levels to 2015 The Millennium Development Goals (50.0), shifting from a country with a high maternal mortality rate to a country with a moderate maternal mortality rate [6, 7, 8, 9]. However, as maternal and child mortality have not been steadily declining, regional disparities in care have not been eliminated, unmet needs for family planning have increased, contraception use has reduced, abortions and repeat abortions have not decreased. The quality of antenatal care is low; the continuing challenges have led to the development and implementation of the 5^th National Programme. As the programme was finished in 2016-2020, assessing its impact on Mongolia is significant. Objective: Evaluating the objectives of the National on Maternal, Child and Reproductive Health Programme, the implementation of planned activities, whether the intended results have been achieved according to the criteria was to determine future needs and the main areas of focus. Materials and Methods: Quantitative and qualitative methods were used to analyse the information required for the assessment. The activities of the programme implementation plan were evaluated in the form of activities implemented in 2016-2020 and time spent on implementation, which implemented, who was involved, the budget spent, the type and the number of beneficiaries, and the reasons for nonimplementation. Results: A total of 28 indicators of the National Program was 76.8 percent. In 2016, by the time the programme was launched, the under-five mortality rate was 20.8 per 1000 live births. However, the goal to reach 15 in 2021 was achieved to reach 12.7 by successfully implementing the programme. The program aimed to reduce the maternal mortality rate from 48.6 per 100000 live births to 25 per 100000 live births in 2021, but has not yet been achieved, reaching 30.2 in 2020 and 43 in the first five months of 2021. Initially, the program implementation plan included cooperation with more than 600 organisations, such as 9 ministries, 14 government organizations, 21 provinces, health centers, and maternity hospitals. However, an excessive number of organizations and an unnecessary amount of planned work made it impossible to identify the beneficiaries in addition to the Government of Mongolia, donors such as UNFPA, UNICEF, and WHO made a significant contribution to the implementation of the programme by providing financial and technical assistance. As of 2017-2021, no funds had been found to implement the National Programme on how much has been spent on information, publicity, and advocacy measures. According to the interviews with the programme implementers, a lack of leadership, lack of proper planning, turnover in the civil servants, and the ongoing pandemic had resulted in the lack of a transparent annual implementation plan, the insufficient time and resources for next year’s planning and implementation of the planned work, and the lack of budget resources. Conclusion As the total of 28 indicators of the National Programme was 76.8 percent, it has been evaluated as having achieved specific results.

Introduction: Mongolia’s capital hosts about half the country’s total population, and its air pollution ranks among the highest in the world during winter. Air pollution is linked to reduced fetal growth, preterm birth, low birth weight, impaired cognitive intra-uterine development, impaired cognitive development, and even spontaneous abortion. Antenatal care includes fetal development monitoring, prevention of anemia, immunization against infectious diseases, prevention of sexually transmitted diseases, and any health risk factors such as environmental pollution.
Health care measures for pregnant women and children under one year of age have the potential to be highly effective because they are directly aimed at reducing pneumonia in children. As such, we need to conduct this survey to determine whether pregnant women were satisfied with the information and advice on air pollution prevention provided by health facilities and to take evidence-based measures. Materials and Methods : The survey data were collected using quantitative and qualitative research methods. In this study, a total of 958 pregnant women participated from Songinokhairkhan district, Bayanzurkh district, and Bayankhongor province center. The overall satisfaction of health services is calculated using the three dimensions namely: satisfaction with health service, operation, and environment of the Health Organization. Satisfaction scores were assessed using an even-point scale. These are “Very Dissatisfied-1 point”, “Dissatisfied-2 point”, “Satisfied-3 point”, “Very satisfied-4 point”. The results were calculated after entering the survey data into SPSS-23, creating a database, and performing error control. The research methodology was discussed at the meeting of the Academic Council of the National Center for Public Health on December 25, 2019, and the methodology was approved by the Medical Ethics Committee of the MOH (Stagnant №2). Results : The survey covered 958 pregnant women aged 16-45 in Bayanzurkh district Songinokhairkhan district, and Bayankhongor province. During antenatal care visits, the majority of pregnant women (BZD- 56.9%, SKHD- 68.3%, BKH province - 86.7%) were advised by their health specialists to go outside for fresh air, while women in Ulaanbaatar (BZD- 18.9%, SKHD- 24.7%) received the information and advice at the lowest percentage. Pregnant women in Ulaanbaatar were less involved in air pollution training than in Bayankhongor. Participants in the air pollution prevention training rated it as “satisfied” regardless of location. 37.2% of pregnant women obtained information on protecting their health from air pollution from the board of Family Health Center and 34% from their district health centers. 86.1% of the participants were able to obtain information on air pollution on their own, while 86% of them got information from their family and friends. Conclusion The percentage of pregnant women getting medical advice, training, and information on air pollution prevention from hospitals during their antenatal care visits was the highest in rural areas. Moreover, their level of satisfaction with counseling had been rated as “satisfied”. Pregnant women often seek information on air pollution prevention from non-professional sources, such as their family and friends.

Introduction: During this pandemic, overcrowding in classroom caused by a lack of educational facilities and poor indoor air quality are the main causes of respiratory diseases among children and adolescents. Therefore, it is essential to measure and assess the indoor air quality where children spend extended periods of time such as school. Materials and methods: This study covered four schools with old buildings and four schools with new buildings in Bayanzurkh, Sukhbaatar, Khan-Uul, Chingeltei district of Ulaanbaatar. We collected PM10 and PM2.5, carbon dioxide, air temperature, humidity, and microbiological count from chosen classrooms and compared to the MNS4585:2016 standard. SPSS-24 was used to do statistical analysis on the information gathered during the evaluation. Results and Discussion: The 24-hour average PM2.5 concentration was 64.3 (95% CI: 64.1-64.5) mcg/m3, which was 4.3 times higher than the WHO guideline value and 1.3 times higher than the MNS4585:2016 standard. The 24-hour average PM10 concentration was 85.3 (95 % CI: 85.1-85.6) mcg/m3, which is 1.9 times higher than WHO guideline value. In older school buildings, the 24-hour average PM2.5 concentration was 5.6 times higher than the WHO guideline value and 1.7 times higher than the MNS4585:2016; the average PM10 concentration was 2.8 times higher than the WHO guideline value and 1.3 times higher than the MNS4585:2016. The air temperature and carbon dioxide concentration in classroom was met the MNS4585: 2016. The average relative humidity of all schools is 24.2±6.5%, which is 14-16% lower than the MNS4585: 2016. Conclusion The indoor air quality of the school in new and old buildings was similar poor, therefore a variety of steps are needed to improve it.

Introduction: Within the framework of health sector reform, the development of the organization, the responsibility of doctors and medical professionals, and the improvement of ethics, quality and safety of care and services are top priorities. Customer satisfaction is important for the implementation of this operation based on results and quality. The WHO Recommendation states that health professionals have a key role to play in providing information and advice to citizens and their families on how to prevent, mitigate and address air pollution, and how to inform the general public and decision-makers. ADB, the Ministry of Health, and UNICEF report that information and promotional materials on air pollution prevention are scarce and do not provide advice to clients. Therefore, it is the reason for conducting a survey to determine the level of satisfaction of clients receiving child health care. Materials and methods: The survey data were collected using quantitative and qualitative research methods. In this study, totally 1160 guardians of children aged 0-5 participated from Songinokhairkhan and Bayanzurkh district and Bayankhongor aimag center. The overall satisfaction of health services is calculated using the three dimensions namely: satisfaction with health service, operation and environment of Health Organization. Satisfaction scores were assessed using an even-point scale. These are “Very Dissatisfied-1 point”, “Dissatisfied-2 point”, “Satisfied-3 point”, “Very satisfied-4 point”. The results were calculated after entering the survey data into SPSS-23, creating a database, and performing error control. Research methodology discussed at the meeting of the Academic Council of the National Center for Public Health on December 25, 2019, and the methodology was approved by the Medical Ethics Committee of the MOH (Stagnant №2). Results: 84.7 percent of the respondents were parents of children aged 0-5 years. Their average age is 34, most of them have higher education, and 43.0 percent of them have a household income of 500,000-1 million MNT. Guardians of children aged 0-5 years in Bayanzurkh District were “dissatisfied” with the Family Health Center’s dressing room, wardrobe, toilet and parking lot. Guardians of children aged 0-5 years in Songinokhairkhan district were “dissatisfied” in the parking lot and toilet of the health organization. Guardians of children aged 0-5 years in Bayankhongor aimag were satisfied with the services, operation and environment of the health organization. Studies have shown that 76.5 percent of the guardians did not receive air pollution risk training. As for difficulties in preventing air pollution, 31.4 percent of the surveyed population answered that they cannot change their living and working environment to prevent air pollution. Conclusion It shows the health care organizations need to improve the hospital environment as well as to provide training how to protect children from air pollution risk for guardians.

Introduction: Mongolia is one of the most vulnerable countries to climate change due to its geographical location, climate conditions, level of development and lifestyle of the population.
The “Impact of Climate Change on Drinking Water, Health and Adaptability” study report has shown that climate change is affecting the quality and composition of drinking water, drying up many rivers and lakes and reducing groundwater levels.
There was a strong positive correlation between precipitation and air temperature and dysentery, diarrhea and salmonellosis, while there was a strong negative correlation between precipitation, air temperature and viral hepatitis. Goal: The goal of the study was to reveal correlation between meteorology parameters and some intestinal infectious diseases and human health in Mongolia. Material and Methods: We evaluated climate and certain morbidity (intestinal infections) indicators for the last 15 years (2005-2019) using descriptive survey methods. The methodology of the survey has developed and discussed at the Scientific Council meeting of NCPH, 12th of Oct, 2020. The methodology of the survey has developed and discussed at Medical Ethics Reviews Committee of MOH on 23rd. of June, 2021. Results: On the other hand, the average air temperature has intensively risen for the last three decades since 1990 with the warmest average temperature between 2001-2010, whereas the coldest average temperature has been observed between 1951-1960. In 2005-2009, the prevalence of intestinal infections per 10.000 population was 0.8 cases of salmonellosis, 11.2 cases of dysentery, 0.2 cases of diarrhea, and 39.0 instances of hepatitis A. Throughout 2015 and 2019, the prevalence of salmonellosis fell by 0.1 per 10.000 population, dysentery by 2.9, diarrhea by 0.1, and hepatitis A by 0.1. Conclusion A seasonal trend in intestinal infections was observed (p<0.001). Strong positive correlation was found between high temperature and some intestinal infections (hepatitis А, dysentery, salmonellosis) respectively.