BACKGROUND: Acute cholecystitis is defi ned mostly as bacteria from intestinal infl ammation to gallbladder. Sometimes the inflammation can occur when bacteria and viral can fl ow by blood and lymphus. Acute cholecystitis is leading the second place of acute abdomen. (1.2.3.7.8). The acute cholecystitis complication is not decreasing(4.5.6). The mortality is 0.5-0.8%(2.4.5.9). The acute cholecystitis is comparing with cholelith. Foreign scientists are recommending that fi rst 24-48 hours to treat by drugs, and after that if infl ammation is not healing to do cholecystectomy. In our country the acute cholecystitis is taking the place after acute abdomen and appendicitis. And also, acute cholecystitis morbidity is not decreasing and indication of cholecystectomy is not decided yet. OBJECTIVE: The main purpose of this survey is to study changing of acute cholecystitis depending on time Materials and Methods We studied 58 patients who had cholecystectomy in Surgical Department of The Central Clinical Hospital for State Special Clerks between 2005 and 2008. The result analyzed by SPSS-15.0 Program. RESULT AND DISCUSSION: The patients who was studied were 14 men (24.14%) and 44 women (75.86%). For the clinical symptoms of acute cholecystitis, the result has been occurred as following: the epigastria pain is 17 (29.31±5.9), around the right rib arch is 49 (84.48±4.7), the pain spread of the right shoulder blade is 20 (34.48±6.2), and the pain spread of the right shoulder is 33 (56.89±6.5), to have a fever 6 (10.34±3.0), vomit 10 (17.24±4.9), diarrhea 7 (12.06±4.2), thirsty 16 (27.58±5.8). The pain around right rib arch, pain spread right arm and shoulder, and thirsty are the clinical features that close to the features of scientist’s Alperovich B.I., Soloviev M.M., Saveliev V.S. Acute cholecystitis depending on time 0-24 hours catarrhal 5, phlegmonous 2, necrosis 1, 24-48 hours phlegmonous 4, necrosis 10, necrosis hole 2, 48-72 hours phlegmonous 10, necrosis 8, necrosis hole 3, above 72 hours phlegmonous 2, necrosis 5, necrosis hole 6. Acute cholecystitis starts above 24 hours. CONCLUSION: 1. The acute cholecystitis has been occurred 14 for men and 44 for women. Ate the age of 30-39. These cases were determined more then 31 percent. 2. For the clinical symptoms of acute cholesystitis, the result has been occurred as following: - the epigastria pain is 17, (29.31±5.9) - around the right rib arch is 49 (84.48±4.7) - the pain spread of the right shoulder blade is 20 (34.48±6.2), and - the pain spread of the right shoulder is 33 (56.89±6.5). 3. Under the period study of the acute cholecystitis, the pus, necrosis and perforation cases have been excessively occurred specially at 48-72 hours. 4. Under the comparison study between the acute cholecystitis and its period, the acute wall cholecystitis changes have been occurred specially at 24-48 hours.

Introduction: The complete blood count (CBC) is a frequently performed laboratory test today. This study evaluated the effects of temperature and sample storage time on parameters of CBC which could produce misleading results of clinical significance. Methods: In a cross-sectional study, CBC was checked in 20 randomly selected out-patients and baseline measurements were analyzed using the XN-2000 (Sysmex, Kobe, Japan) fully automated hematology analyzer. CBC was done all samples of storage at room temperature. Values were checked at time intervals of 0, 6, and 24 hr. Results: Among CBC parameters, white blood cell, red blood cell, hemoglobin, mean cell hemoglobin (MCH), neutrophils and lymphocytes were stable at time up to 6 h. Hematocrit increased between 0 and 24 hours, averaging 41.5% and 45.2%, respectively. MCV, RDW-SD, and RDW-CV increased between 0 and 24 hours. The mean value was statistically significant. There were 85.6fL/ 93.4fL (p<0.001), 40.7fL /48.2fL (p<0.001), 13.1% and 14.2% (p<0.05), respectively.
However, the MCHC was affected by time differences. (p <0.001 at 0 and 24 hours, p <0.001 at 3 and 24 hours). Platelet PDW, MPV, and P-LCR values increased between 0 and 24 h, respectively. Conclusion Whole blood samples were stored at room temperature for 24 hours for CBC tests, there were statistically significant differences in the size of red blood cells and platelets.

Middle aortic coarctation (MAC), a variantof middle aortic syndrome, is a rare entity withonly ~200 cases described in the literature.It classically presents with early onset andrefractory hypertension, abdominal angina,and lower extremity claudication(1).A 30 years-old woman, Her systolic bloodpressure measures 180-200mm Hg and diastolicpressures measure 70mm Hg in both arms,lower extremity pressures are approximately70mm Hg. Her bilateral femoral pulses andpedal pulses are nonpalpable, but present onDoppler exam and CT-Angiography.We prepared diagnostic of CT-Angiographyand Aortography before operation. Wesuccessful operated abdominal aorticcoarctation by “Silver graft” Aortoaortic bypasson the middle aortic, left nephrectomy.She was discharged home on postoperativeday 7. Post operation is good. We werecontrolled CT-Angiography.

Introduction: About 20-30% of patients with acute pancreatitis have a severe disease and mortality rate among inpatients were 15%. There are many causes of acute pancreatitis (AP), but most common cause of AP is an alcohol. According to some studies in our country, alcohol is the number one cause of acute pancreatitis and the mortality rate is 15.3%. Very important for prognosis of disease optimal choice of treatment tactics, detection of infectious evidence of necrotizing pancreatitis. Therefore, based on the above, there is an urgent need to conduct research to address important issues and to improve the diagnosis and treatment of acute alcohol-induced pancreatic necrosis. Goal: Determine the importance of early diagnostic assessment of alcohol induced severe acute necrotizing pancreatitis. Materials and Methods: Research model and research method. We conducted our research using an observational research model and a factual research method.Sampling of research materials will be carried out by targeted sampling. From November 1, 2008 to January 1, 2020, 122 patients who were hospitalized with alcohol-inducedAP were selected and archival documents or medical histories were selected. Statistical analysis was performed using averages and regression analysis methods to calculate the laboratory parameters in the analysis related to the new evaluation system. Results: The minimum age of patients with ANP was 25 and the maximum was 71, with the majority (87.4%) aged 26 to 60 years. When the Person Correlation method calculates the relationship between alcohol consumption and mortality, it is assumed that the weaker the correlation, the higher the amount of alcohol consumed, the lower the cure and the higher the mortality. Of the 31 deaths reported in the study, 24 (77.4%) were hospitalized more than 72 hours after the onset of the disease. Late hospitalization and late treatment of patients with acute necrotizing pancreatitis (ANP) disease have been shown to adversely affect the prognosis of the disease. In our study, all parameters were significant, but procalcitonin, serum amylase, serum lipase, serum LDG8 C-reactive protein, serum glucose was found to be higher than the value specified in the evaluation system for the variable (in determining pancreatic necrosis). АNOVA analysis test showed that white blood cells, procalcitonin, serum amilza, serum lipaza, serumglucose, serum LDG, C-reactive protein were higher than those specified in the evaluation system, and that the level of significance for the variable (indicating a severe pancreatitis or poor prognosis) was higher than other test results (P <0.01). According to the new evaluation system, 12 out of 122 patients were classified as A class or 0-3, 69 (56.5%) patients were class B or 4-6, and 41 (33.6%) patients were class C or >7 points. Of the total cases, 90.1% were rated as severe form of ANP and pancreatic necrosis by the classification system we developed. When we assessed the prognosis with the new assessment system, we found that 100 percent of patients in category A were cured, 89.8 percent of patients in category B were cured, and 41.5 percent of patients in category C were cured and 58.5 percent died. Statistical calculations using the correlation analysis method for the correlation between the score and the cure of the evaluation system shows negative correlation (P <0.01) other words, the higher the score of the evaluation system, the lower the cure rate and the higher the mortality rate. Conclusion In Mongolia, relatively young men suffer from alcohol-induced pancreatitis.Factors contributing to the development of necrosis in acute pancreatitis include alcohol abuse, prolonged alcohol use, delayed hospitalization, and delayed treatment.In our study, following clinical signs and laboratory findings are effective in distinguishing severe forms of acute necrotizing pancreatitis, early diagnosis, assessment of prognosis. Laboratorytests include: increase in white blood cells, procalcitonin, serum amylase, serum LDH, serum lipase, C-reactive protein and a decrease in hematocrit, serum calcium.

Background: The assessment of patients’ quality of life has emerged as a critical metric in evaluating healthcare services. Internationally, numerous studies have been conducted to assess the QoL of individuals diagnosed with pulmonary embolism through the development of standardized questionnaires and their association with various clinical parameters. Aim: To adapt a standardized questionnaire for assessing the quality of life following a pulmonary embolism and to evaluate the quality of life of affected patients. Materials and Methods: A total of 33 patients diagnosed with pulmonary embolism and hospitalized in the Department of Pulmonology at the Third State Central Hospital in Mongolia between August 2022 and December 2023 were included in the study. An observational cross-sectional study design was used. Inclusion criteria encompassed all patients diagnosed with PE during the study period, while exclusion criteria included individuals with severe comorbidities, those aged over 85 years, and those who declined participation. QoL was assessed using the Pulmonary Embolism Quality of Life (PEmb-QoL) questionnaire, which consists of 39 questions categorized into six domains. Higher scores indicate poorer QoL. Data analysis was performed using SPSS version 16. Results: The average age of the participants was 61±15 years, and 18 (54.5%) were female. The median duration of anticoagulant therapy was 170 days (range: 27–2555 days), and the average monthly expenditure on medication was 80,000 MNT (range: 63,000–400,000 MNT). The overall mean QoL score was 69.7±23.2. The median scores for the six domains were as follows: frequency of complaints 1.6 (IQR 1.5-1.9; max 5 score), activities of daily living limitations 1.5 (1.3–1.8; max 3 score), work-related problems 1.7 (1.5–2.0; max 2 score), social limitations 2.0 (2.0–3.0; max 5 score), intensity of complaints 3.0 (3.0–4.0; max 6 score), emotional complaints 2.0 (1.5–2.4; max 6 score). The internal consistency reliability of the questionnaire was assessed, with the symptom frequency category scoring well (α=0.74), while the other categories had excellent reliability (α>0.85). A weak positive correlation was observed between overall QoL scores and age, while a weak negative correlation was identified with body mass index (r=0.14 & r= -0.13, P>0.05). Conclusion The study findings indicate a low QoL among PE patients, emphasizing the necessity for enhancements in post-diagnosis medical care and long-term management strategies to improve patient outcomes.