Today, in technologically updated world medicine, laparoscopy is more preferable than the common, open surgery procedures. There is a lack of scientific studies on laparoscopic surgery in gynecology, especially its present state and further tendencies. Therefore it served us as the background of the study.Retrospective study was conducted on 2016 laparoscopic surgery histories, which were performed in 2010-2014, at Mongolian state and private obstetric-gynecological hospitals and clinics. The study was developed by the program SPSS21.In 2010-2014 totally 2016 laparoscopic surgeries was performed: 713 – in First Maternity Hospital, 653 – in Bayangol hospital, 429 - inASE hospital, 221 – in National Cancer Center of Mongolia. The patients were classified by their age, education state, and citizenship. Mean age of these patients was 33.03 ±7.6(min 12, max 70). By educations: the 72.4% (1460) of them were high educated, 18.2%(367) has the secondary education, 4.7%(95) – college education, 4.5%(91) – 8th grade education, and 0.2%(3) – elementary school education or non-educated. The 81.8 %( 1649) patients were citizens, the 18.15 %( 366) – from rural areas. And only 0.05% (1) was the foreigner. We noted 7 %( 14) cases that shifted from laparoscopic surgery to open procedure. The post surgery average bed day was 2.7 ±1.3 (min 1, max 12), duration of the laparoscopic surgery 58.46 ±31.6 minutes (min 10, max 260). The average amount of blood loses during the surgery was 76.17 ±69.3( min 5, max 700),The relevance of the surgery duration and preoperative bleeding was(r-0.445). Various diagnoses were involved in the study: the 25.9% (524) of them had second infertility, ovarian endometriosis cyst- 10.5% (212), ectopic pregnancy- 9.4% (189), hydrosalpinx- 7.5% (152), endometrioma ≥ 4.5 cm - 6.3% (128), ovarian follicularcyst- 6.3% (128), ovarian cancer- 5.7% (115), primary infertility- 5% (101), ovarian dermoids cyst-4.3% (86), endometrioma ≤ 4.5cm- 3.4% (68), others-15.7%. Surgical procedures are classified by their purposes: 29% (584) of surgery for examine the fallopian tube using contrast for medium and divide adhesion, 17.6% (354) – to remove ovarian cyst, 12.8% (259) – to examine fallopiantube using contrast and remove ovarian cyst, 9.4% (189) – to remove fallopian tube, 7% (142)- to remove endometrioma, 6.3% (128) – to examine uterine tube using contrast dye, 6% (121)-ot do hysterectomy, 11.9%- for other reasons. The 76.7% of all surgeries were done within one hour and there was moderate correlation between duration of surgery and bleeding (r-0.445). The secondary infertility was the most common diagnosis. And the laparoscopic manage of adhesion and hystersalpingography were performed more. According to the study, non-cancerous growth of uterus was 9.7 and the 6% of it surgeries was laparoscopic myomectomy.

BackgroundHuman-induced climate change will affect the lives of most populations in the next decade and beyond. The impact of meteorological conditions on human health has been reported globally. There is a need to conduct surveys for correlation between climate change and human health.GoalTo study the impact of air temperature on human health in selected aimags and city districts.Materials and MethodsIn order to study how climate change and air quality parameters affect human health we selected Zavhan, Selenge, Dornod, and Umnugobi aimags which represent different climate zones and 2 districts of Ulaanbaatar city during 2009-2011. All data for respiratory system disease J00-J99, circulatory system disease I00-I99, were collected from soum, district’s hospital, and aimag and soum’s Department of health.ResultsDuring the study period, a total number of 8649 incidences of respiratory disease are registered. From them 74.2 percent are influenza and pneumonia (J09-J18), 17.6 percent are other acute lower respiratory infections (J20- J22), and 8.2 percent are asthma (J45-J45.9). For cardiovascular disease 15288 incidences are registered. From them 65.6 percent are hypertensive disease (I10-I15), 23.6 percent are ischemic heart disease, and 10.8 percent are cerebrovascular diseases (I60-I69). The lower the air temperature, higher the incidence of influenza and pneumonia, acute lower respiratory infections, hypertensive, and ischemic heart disease.ConclusionsCold weather is correlated with a higher incidence of respiratory and cardiovascular diseases.

Flail arm syndrome (FAS), an atypical variant of amyotrophic lateral sclerosis (ALS), is characterized by progresses slowly, predominantly proximal, weakness of upper limbs, with no involvement of the lower limb, bulbar, or respiratory muscles. In the world, 1-3 cases per 100,000 people per year are registered. Incidence is higher among whites. The peak age is 55-75 years, although it can occur at a younger age. The male gender is dominant. Signs of upper motor neuron (UMN) lesions of the cervical region in flail arm syndrome patients are rare. The lack of information regarding FAS may make differential diagnosis between flail arm syndrome, upper limb onset amyotrophic lateral sclerosis and other lower motor neuron syndromes difficult in clinical settings. The prognosis of FAS is better than that of upper limb ALS and most cases of FAS are sporadic. Therefore, a reliable differential diagnosis is essential to determine the prognosis. Compared with the other varient of ALS, clinical symptoms progress over a relatively long period of time in flail hand syndrome, with a median survival of 4 years and a 10-year survival of 17%. We report a 79 year old patient admitted to the hospital with a 1 year history of proximal weakness and 2 arm shoulder girdle muscle stiffness, wasting and 2 arm m.deltoideus fasciculations with Flail arm syndrome. It was one of the few cases of arm drooping syndrome, which begins only with weakness, stiffness, and symmetry in the proximal part of the upper limbs. Definite ALS was diagnosed based on clinical examination /neurological abnormalities/ and electromyography results.