Background: Spinal Muscular Atrophy (SMA), an autosomal recessive disorder characterized by lower motor neuron loss, leads to progressive muscle weakness and atrophy. With a neonatal incidence ranging from 1:6000 to 1:11000, individuals affected by SMA face challenges in locomotor function. The advent of newborn screening tests, early diagnostic techniques, and the introduction of gene therapy have, however, shown promise in enabling the acquisition of these motor skills. Objective: This review article seeks to shed a light on current understandings of the epidemiology, clinical presentations, diagnostic methods, and treatments for spinal muscular atrophy, highlighting cutting edge approaches within the discipline. Methods: A thorough search was conducted on PubMed, Cochrane, National Institutes of Health, and Web of Science databases for recent research articles concerning SMA’s incidence, prevalence, clinical manifestations, early detection, genetic testing and contemporary gene therapy. Results: The prevalence of SMA stands at 1-2 cases per 100,000 population, with an incidence of approximately 8 cases per 100,000 live births. Pre-1995 studies exhibited varying prevalence rates due to using non molecular-biological methods, small localized populations, diagnostic errors, and regional characteristics. Diagnosis involving Multiplex ligation-dependent probe amplification (MLPA), quantitative polymerase chain reaction (qPCR), or next-generation sequencing (NGS) analysis to confirm SMN1 and SMN2 gene status aids in identifying carriers and SMA subtypes. Countries implementing newborn screening programs have demonstrated early SMA detection in asymptomatic newborns, contributing to reduced mortality and disability rates. Currently, several types of gene therapy are being used in the treatment of SMA. Conclusion The epidemiology of SMA varies between countries and regions. It is fully possible to confirm the disease, identify carriers and subtypes. The inclusion of SMA in newborn early detection programs is crucial for reducing infant mortality and disability, and several gene therapies have received approval from relevant authorities for SMA treatment. In Mongolia, it is possible to introduce tests to confirm the disease and determine carriers and subtypes.

Background: Breastfeeding is the ideal food source for all newborns globally. Proper feeding of infants and young children promotes optimal growth and development, especially in the critical window from birth to 2 years of age. Exclusive breastfeeding for 6 months and continued breastfeeding for the first 2 years of life protects children from infection, provides an ideal source of nutrients, and is economical and safe. Objective: To assess the indicators of infant feeding practices among 0- 23 months old children. Materials and Methods: The NNS V was implemented in 21 aimags (provinces) in 4 economic regions (Central, Eastern, Khangai, Western) and the capital city of Ulaanbaatar. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design [1]. The infant and young child feeding indicators assessed in the NNS V were based on the mother’s or caretaker’s report of breastfeeding and consumption of foods and fluids by the child during the day or night prior to being interviewed. Results: 83.7% of children under 2 years started breastfeeding within 1 hour of birth and though almost all children were ever breastfed (97.9%), a slightly higher percentage of girls were ever breastfed overall and within 1 hour of birth. Children 0-5 months were categorized according to whether they were exclusively breastfed or predominantly breastfed, with the former only allowing vitamins, mineral supplements, and medicine and the latter also including plain water and non-milk liquids. Among children 0-5 months of age, 58.3% were exclusively breastfed and 65.3% were predominantly breastfed, having received other liquids or foods in addition to breast milk. The prevalence of exclusive breastfeeding was lowest in the 4th wealth index quintile (46.5%) and wealthiest quintile (54.0%) households. Conclusions Exclusive breastfeeding and early initiation of breastfeeding practices are unacceptably low in Mongolia; 20% of newborns are not breastfed within 1 hour of birth and more than 40% of infants under 6 months of age are not exclusively breastfed and therefore, not receiving optimum nutritional and immunity benefits from breast milk. Strengthening IYCF counselling in all regions and wealth quintiles to support women to practice optimal breastfeeding, along with counselling and awareness of timely and adequate complementary feeding for children under 2 years of age, should be a top priority for public health and as it is a key strategy to reduce malnutrition in children.

Background: During the historical development of traditional medicine, many books and manuscripts have been written in Mongolian medicine. The main textbook of traditional medicine states that: “The size of a bone consists of 23 bone species, 28 spinal joints, 24 ribs, 32 teeth, and 360 pieces of bone.”
However, modern medicine estimates that the human body has 206 bones. Therefore, this topic was chosen to study the source material of traditional medicine, including the structure of the human body, and the number of bones in the modern medical anatomy textbook. Purpose: Details of the number of bones in the human body in the “Four Medical Tantras” (རྒྱུད་བཞི) of traditional medicine and its commentary, as well as compare with the number of bones in the basic textbook of anatomy of modern medicine. Objectives: In order to successfully implement the research objectives, the following objectives will be implemented. These include:
1. Sampling and analyzing number of bones from traditional medicine;
2. Sampling and analyzing bone numbers from modern medical textbooks;
3. Compare the names and numbers of bones in traditional medicine and modern medicine Results: The number, classification and features of human bones were analyzed from the main scriptures of traditional medicine such as “Explanatory Tantra”, of the “Four Medical Tantras” and the “Legs bshad gser gyi thur ma” by Blo-bzang-chos-grags. In addition, the number of bones in the human body was sampled from modern medical textbooks and prepared for comparison. The number and characteristics of bones in the human body were compared by traditional medicine and modern medicine and made a conclusion.
This study reveals that the foundations for the integrated development of traditional medicine were laid long ago in Mongolian medicine. In addition, to highlight the book “Four Medical Tantras”, which is the basis of the textbook on the structure of the human body and the research work of scientists and scholars, which is considered in Mongolian mamba datsan’s contribution to the science of human anatomy. The importance of this research is to change the extremes of Western medicine and traditional medicine and increase opportunities to use its introduction and development into training and clinical practice. Conclusion
1. The main creature of body structure in traditional medicine is the “Four Medical Tantras” which generally assumes that the numbers of bones are 360 but does not specify it in detail. During the research, we identified 357 bone names to identify each bone. The names and locations of the three bones were not clearly marked in the medical sources.
2. The numbers of bones are 206 in modern medical textbooks. We recalculated 151 bones based on traditional medical sources without duplication of that.
3. Compared to traditional medicine and modern medicine, the number of bones and are higher than 154 bone names in traditional medicine because we included the number of teeth, small bones in the ears and small bones in the fingers and toes. Some cartilage was also counted as bones.

Background: Weight at birth is a good indicator of the mother’s health and nutrition status during gestation and a child’s chances for survival, growth, long-term health, and psychosocial development. Low birth weight (defined as less than 2500 grams) poses a range of serious health risks for children. Objective: To assess the prevalence of low birth weights (LBW). Materials and Methods: The NNS V was implemented in 21 provinces (aimags) in 4 economic regions (Central, Eastern, Khangai, Western) and the capital city of Ulaanbaatar. A total of 2250 children aged 0-59 months. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design. For the selection of households in urban areas, the process involved first selecting 30 khoroos (clusters), then khesegs, and then households with a child 0-59 months of age. Ethical considerations : The survey methodology was discussed at the Scientific Committee of the Public Health Institute (recently named by National Center for Public Health) and granted the PHI Directors Order on 28th June, 2016. Ethics approval for conducting the NNS V, was obtained from the Medical Ethics Committee under the Mongolian Ministry of Health. Results: Almost all (99.5%) children in the sample were weighed at birth with 5.0% weighing less than 2500 grams at birth and 12.6% weighing over 4000 grams at birth. The prevalence of low birth weight was slightly higher among girls than boys, however high birth weight was much more common in boys (15.9%) compared to girls (9.5%). Prevalence of low birth weight was highest in Western region (9.6%) and the poorest households (7.8%) while the prevalence of high birth weight was highest in Ulaanbaatar (13.8%) and wealthiest households1 (16.4%). High birth weight was more than double among children of overweight (17.5%) and obese (17.3%) mothers compared to children of normal weight (8.4%) or underweight (7.0%) mothers. Among singleton births, women <29 years of age had higher LBW rates than did those 30-39 years of age in both years, irrespective of birth order. LBW rate was more than double among mothers in kazak ethnic groups (13.8%). Conclusions The younger age of the mother was more likely to develop low birth weight, and it was twice as high among mothers in Kazak ethnic groups. Therefore, adolescents and women of reproductive age needed to improve the health education and to identify the causes and risk factors of low birth weight among mothers in Kazak ethnic groups.

Background : Overweight and obesity are conditions of over nutrition resulting from consumption of more calories than the body requires leading to excess body fat accumulation. The prevalence of both overweight and obesity is increasing globally in all age groups in high, middle, and low-income countries and is largely attributed to the “nutrition transition” with a shift from traditional diets to readily available and inexpensive, low-nutrient unhealthy foods high in energy [1].
The move away from traditional to “junk” foods often occurs at the same time as the move of populations away from daily physical activity and increase in sedentary activities such as time spent in front of a phone, computer, or television, furthering increasing the risk of becoming overweight. People who are overweight or obese are at higher risk for serious health problems including hypertension, heart disease, stroke, diabetes, some cancers, and osteoarthritis. The increase in overweight and obesity is accompanied by a dramatic increase in prevalence of above mentioned chronic conditions in the worldwide. While the long-term repercussions of overweight and obesity are severe, they are largely preventable and treatable through healthy diets and healthy lifestyle behaviors [2]. Materials and Methods: The fifth National nutrition survey (NNSV) was implemented in 21 provinces (aimags) in 4 socio-economic regions (Central, Eastern, Khangai, and Western) and the capital city of Ulaanbaatar. Given the regional differences in dietary patterns and nutrition status, target populations were stratified into 5 strata based on 4 regions and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design. In total, 1750 school children data on demographic and dietary information collected by interview methods and anthropometric measurement results were used in this study. Ethical considerations: The survey protocol was discussed at the Scientific Committee of the Public Health Institute (recently named by National Center for Public Health) and granted by order of director of Scientific committee of PHI on 28th June, 2016. Ethical approval for conducting the NNS V was obtained from the Medical Ethics Committee under the Ministry of Health of Mongolia on July 7, 2016. Participation in the survey was voluntary, oral and written informed consent were obtained from adult caregivers of each children. Results: Consumption of unhealthy or junk (high-calorie, low-nutrient) foods in the past week was nearly universal (99.0%) among school children 6-11 years of age. Over half of children (51.4%) consumed junk foods at least once per week and 45.7% consumed junk foods a few times a week. Consumption of sugar-sweetened beverages was high with 80.9% of children consuming these at least once in the past week. Overall consumption of fried foods was lower than consumption of junk foods or sugar-sweetened beverages with 22.7% of children not consuming any fried foods in the past week and only 8.5% of children consuming fried foods a few times per week. Consumption of sweet foods was high with nearly all children having consumed sweet foods in the past week, 45.9% of children 6-11 years having consumed sweet foods a few times per week.
The prevalence of overweight (BMI > +1 SD) was 22.2% and prevalence of obesity (BMI > +2 SD) was 6.4%. Overweight prevalence was higher in boys (26.6%) compared to girls (17.8%) and in urban (23.9%) compared to rural (17.6%) areas with the highest prevalence in Ulaanbaatar (25.6%) compared to other regions. Children 6 years old (26.1%) and 7 years old (25.6%) had a higher prevalence of overweight than older children. Conclusion
1. Consumption of unhealthy foods and drinks is common to 6-11 year olds group, with almost all children (99.2%) consuming any type of unhealthy foods and drinks at least once per week, in particular, 8 out of 10 children were found consuming sugary drinks and/or deep fried food.
2. The consumption of unhealthy foods was not differing by child’s sex, there were revealed significant differences between living area and regions. Proportion of the school children 6-11 years of age was relatively higher in Ulaanbaatar city and urban settings.
3. The prevalence of overweight and obesity in school children aged 6-11years sharply increased from 2010 NNS IV level and reached 22.2% and 6.4%, respectively. Among children with obesity consumption of any unhealthy foods and sugary drinks were 1.4–1.9 times higher than nonobese children, respectively.

Background: Overweight and obesity are conditions of over nutrition resulting from consumption of more calories than the body requires leading to excess body fat accumulation. The prevalence of both overweight and obesity is increasing globally in all age groups in high, middle, and low-income countries and is largely attributed to the “nutrition transition” with a shift from traditional diets to readily available and inexpensive high-energy and low-nutrient foods [1].
The move away from traditional to “Junk” foods often occurs at the same time as the move of populations away from daily physical activity and increase in sedentary activities such as time spent in front of a phone, computer, or television, furthering increasing the risk of becoming overweight. People who are overweight or obese are at higher risk for serious health problems including hypertension, heart disease, stroke, diabetes, some cancers, and osteoarthritis. The increase in overweight and obesity is accompanied by a dramatic increase in prevalence of these chronic diseases at the global level. While the long-term repercussions of overweight and obesity are severe, they are largely preventable and treatable through healthy diets and healthy lifestyle behaviors [2]. Materials and Methods: The NNS V was implemented in 21 provinces (aimags) in 4 economic regions (Central, Eastern, Khangai, and Western) and the capital city of Ulaanbaatar. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design [3]. Total participated 1944 mothers’ years of age who had a child aged 0-59 months. Ethical considerations : The survey methodology was discussed at the Scientific Committee of the Public Health Institute (recently named by National Center for Public Health) and granted the PHI Directors Order on 28th June, 2016. Ethics approval for conducting the NNS V, including obtaining biological (blood and urine) samples, was obtained from the Medical Ethics Committee under Ministry of Health, Mongolia on 7th July, 2016 with granted approval to conduct the survey and send blood serum samples to the VitMin laboratory in Germany. Participation in the survey was voluntary and oral and written informed consent was obtained from all individuals selected for the survey. Participant confidentiality was maintained during data collection, data entry, data analysis, and in the dissemination of survey findings. Results: Nearly half of mothers (46.2%) were overweight with 16.5% of mothers obese and 4.1% underweight. The prevalence of overweight in mothers was highest in rural areas (50.1%), married status (49.3%), and lowest in Ulaanbaatar (42.3%) compared to other regions (48.6% to 52.6%). The overall prevalence of anaemia among mothers was 16.2% with highest prevalence amongst Kazakh (31.9%) and other ethnic minority mothers (25.1%), mothers with secondary education (20.3%) and unemployed mothers (19.9%). Minimum dietary diversity is a proxy indicator for the nutrient content of a diet based on consumption of at least 5 of 10 food groups.¹ People who consume food items from at least 5 food groups are likely to consume at least 1 animal-source food and items from 2 or more of the fruit and vegetable food groups. In the NNS V, 70.2% of mothers met the minimum dietary diversity requirement with a higher prevalence in urban areas (74.8%) and Ulaanbaatar (77.5%). Conclusion: The prevalence of overweight and obesity in mothers of reproductive age is 46.2%, with the highest percentage of mothers with overweight and obesity being in rural areas (50.1%), which is 5.8 percentage points higher than that of urban mothers. 16.2% of mothers are anemic. Prevalence of Minimum dietary diversity among mothers is 70.2%. Food consumption is inadequate in mothers with the primary and secondary education, and in mothers in rural areas, and in poorest mothers or in mothers with the second and third wealth index. ¹FAO and FHI 360. 2016. Minimum Dietary Diversity for Women: A Guide for Measurement. Rome: FAO.

BackgroundIn Mongolia scientists have been doing research about skin disease and process of aging. Howeverthere has not enough study material about skin aging process which is the key indicator of aging andhow that affect to Mongolian people.GoalMain purpose is to study correlations between main index of skin type of the body, cardiovascularsystem, biological age, epidermal growth factor and blood plasma melatonin, within the people of Uvsprovincial center as they are relatively healthy people.Material and MethodsResearch works were done using cross sectional study model in years 2015-2016, within randomlychosen 400 citizens of Ulaangom city, counted to be relatively healthy people. Research model includes41 questionnaires, examination and blood plasma samples.Basic indexes of the body, cardiovascular system and respiratory functions were chosen by biomarkers,biological age is determined by V.P.Voytenko’s 4th version method and adaptive capacity assessment isdetermined by R.M.Baevskii’s multi-repeating regression method.Main skin type parameters such as porosity, wrinkles, pigmentation, elastics and aging is determined bythe “BOOMTECH skin diagnosis” digital equipment made in the Republic of Korea.The blood plasma MLT and EGF were measured by the method of ELISA analysis ELISA made in thelaboratory of the “AVITSENNA Science and Technology center”.The study material analysis carried out an analysis using logistic regression analysis and Pearson’scorrelation coefficient with SPSS 23.0 software.ResultThere’s an inverse weak correlation between blood plasma MLT and EGF with body wealth characteristicsof Uvs province citizens. It shows that when the blood plasma MLT and EGF decreases the body weight,body height and body weight index increase tendency.In women the decrease of blood plasma MLT and EGF also decreases the body height and body weightindex.Research on correlation between cardiovascular system and blood plasma MLT and EGF shows thatdecrease of blood plasma MLT causes in increased arterial pressures in both sexual groups, decreasedEGF in women causes decreased arterial pressure.Correlation study between skin main characteristics and blood plasma MLT and EGF shows thatdecreased blood plasma EGF in men resulted in decreased skin wrinkles, porosity, elasticity and skin aging index, in women decreased skin pigmentation and elasticity, and increased skin wrinkles, porosity and aging index in women.Research study of correlation between biological age and adaptive capacity assessment with the blood plasma MLT and EGF shows that decreased MLT and EGF in men results in increased biological age characteristics. In other words, the early aging is caused.The logistical regression analyses made using blood plasma melatonin, skin porosity, biological age,body height and sex as the risk parameters of Pearson coefficient and chi-squared parameter. Above model resulted in skin porosity and blood plasma MLT’s are becoming independent variable assessing the skin aging.Conclusions:1. The decreased MLT and EGF’s are resulted in increased body weight, body height and body weight index in men and decreased body height, body weight index in women.2. Decreased blood plasma MLT resulted in increased arterial pressure in both sexual groups and decreased EGF resulted in decreased arterial pressure in women.3. The decreased blood plasma MLT and EGF results in decreased skin wrinkles, porosity, elasticityand skin aging parameter with the increased skin pigmentation in men, as it results in decreasedskin pigmentation, elasticity and skin porosity parameters with the increased skin aging degree in women.4. When epidermal growth factor and blood plasma melatonin is decreased in men it results in increased biological age, but depends directly to the adaptive capacity assessment.5. Skin porosity and blood plasma melatonin were becoming independent variable to assess skin aging.

Although stomach cancer immunohistochemistry is similar tothe immunohistochemistry of other organ, it has great impact on diagnosis and treatment, such as its ability to reveal whether the cancer is primary or metastatic and which treatment model would be more effective in individual case. Lately, CK7, CK20 and CDX-2 immunohistochemical markers are commonly used in stomach cancers. Stomach cancer prognosis is different in each patient, depending on several factors, patients’ health status, cancer cell differentiation, and cancer cell growth. To evaluate these factors,immunohistochemic al analysis is more effective and for this purpose they use Ki-67, CD 34, BCL-2, p53, Cyclin D1, andHer- 2 markers.The evaluation of HER-2 expression should be carefully carried out, as following: 1. HER-2 expression should be evaluated on minimum 5 positive stained cells. The evaluation criteria aremicroscopic magnification and cytoplasmic membrane-stained pattern. 2. Other than the membrane-stained pattern must be excluded. HER2 gene evaluation (FISH) can confirm the HER2 IHCexpression. 3. Usage of FDA approved antibody (4B5) has the advantageof increased sensitivity. 4. The algorithm for the evaluation of HER-2 expression used for breast cancer has 50% possibility of false negativity if it is used for stomach cancer. Therefore, it is needed to beevaluated with another specific algorithm. Because HER-2 2+ and 3+ cases can improve outcome with usingTrastizumab treatment.

Background: The intraoperative smear cytology (squash preparation) is fairly accurate, simple, reliabletool for rapid intraoperative diagnosis of neurosurgical biopsies [1]. In the early 1930s, Dr Eisenhardtand Cushing introduced intraoperative cytological investigations for rapid examination of neurosurgicalspecimens and guidance of surgical treatment [2]. Besides rapid decision making during neurosurgicalprocedures, it is also to be ensured that minimum injury is caused to the normal brain structuressurrounding the intracranial neoplasm. It has become necessary for pathologists to train themselves inthe interpretation of cytomorphological features of various central nervous system lesion and used inmany neurosurgical units of all over the world [3]. Thus, to begin doing intraoperative squash cytology inour practice is the aim of this study.Aim: To study the diagnostic accuracy of squash cytology in the intraoperative diagnosis of centralnervous system tumorsMaterials and Methods: The material for this study was obtained from 30 cases of nervous systemneoplasms sent for intraoperative consultation from State Third Central Hospital, Shashtin to the thirdsection of National Center for Pathology between 7th of November 2013 to 28th of March 2014. Squashpreparation was performed on all cases and stained with hematoxylin and eosin. The diagnosis given onsquash cytology was then compared with final diagnosis given on paraffin-embedded sections.Results: Of total 30 cases of primary central nervous system tumors, neuroepithelial tumors are thelargest category of tumors (50%). The accuracy of squash cytology was 82.1%.Conclusion: This is the first study in our country where intra-operative squash cytology in brain tumorwas done and diagnostic accuracy was 82.1% as very good category. There were 4 cases had diagnosticdiscrepancy.

background: Our country’s aging for men of 30-39, 40-49 ages it was accelerated aging process and very accelerated aging process. Aging for men of 50-59, 60- 69 ages it was normal aging and slowed aging process. Aging for women 30-39, 40-49 ages it was normal end slowed aging process. Aging for women 50-59, 60-69 ages it was slowed and significantly slowed aging process. Otherwise, aging for young groups was accelerated and very accelerated aging process, aging for old groups was normal, slowed and significantly slowed aging process. The aging process of men was more quickly than women in our country [1].Aim of the stady: To define biological aging, aging indexes and adaptation potential in population of 18- 25 years old of Ulaanbaatar city.Materials and methods: In total 537 person of 18- 25 years from Ulaanbaatar city were chosen for the research study which was conducted in 2012. Biological age levels were assessed on the basis of following standards. True biological age was determined with clinical-physiologycal indexes and biological age with chronological age. Adaptation potential have been studied with the help of special indexes and analysis were made with the use of regression method. Quantative data of the study has been processed with the use of statistical data processing software SPSS- 19.Results and discussions: Body mass index of 18-25 aged men of Ulaanbaatar city was 22.2146, cachexia 7.82%, normal weight 79.32%, more weight 10.24%, obesity 2.6%, Aging for men of 18-25 ages it was significantly slowed aging process of men was observed 0.37%, slowed aging process 0.55%, normal aging 0.93%, accelerated aging process 12.47%, and very accelerated aging process was 85.66%. The portion of men with normal adaptation potential was 55.67%, adaptation functional tension was 43.76%, unsatisfactory adaptation was 0.55%.Conciusions:1. The portion of cachexia 7.82%, more weight 10.24%, obesity 2.6% of 18-25 aged men of Ulaanbaatar city.2. Health status was abnormal 98.13% of 18-25 aged men of Ulaanbaatar city.3. The portion of 18-25 aged men of Ulaanbaatar city adaptation functional tension 43.76%, unsatisfactory adaptation was 0.55%.References:1. 1 .Tuul M., Lhagva L., Sukhbaatar Ts., AmgalanbaatarD. “Aging biology of Mongolians” III book. “Admon” puplisher. Ulaanbaatar. 2009.2. Open society forum. “Policy of young” abstract. UB. 2010.3. Leonid Kalichman, Ida Malkin, Gregory Livshigts, Oleg Pavlovsky, Valery Bathvich. Variation of Skeletal Biomarkers of biological Aging in a Chuvashian Population: A Longitudinal Stady. American journal of human biology 19:74-81. 2007.4. Apanacenco G.L, Popava L.A, “Medical Valeology”. Kiev. 2000.