Background: In 716 Mongolian patients who had breast augmentation surgery at Perfect Clinic during 18 years. The purpose of this study evaluates Mongolians predictors of early and late outcome after primary breast augmentation surgery. Aims of study: In this study, we aimed to clarify predictors of early and late outcome after breast augmentation surgery. Methods: We selected patients who underwent breast augmentation implant surgery between 1999 and 2017. Development of hematoma was chosen for measure of early outcome and capsule contracture was chosen for measure of late outcome. Multivariable Cox proportional hazard regression and Kaplan-Meier estimations were used to clarify independent relationship between possible predictors and outcomes. Results: A total of 716 patients were chosen and mean age was 32±7 years old. Hematoma was occurred in 43 patients (6%) and median time to hematoma was 3 days (IQR 1; 7).). According to the univariable analysis, every 1 year experience was associated with 9% decreased risk of hematoma development. (HR=0.91, 95% CI 0.84-0.99, p<0.05). Finally, Kaplan-Meier estimation was showed that hematoma free survival is higher in more experienced years and patients who had subpectoral muscle.(log rank p<0.01 and p<0.001, respectively). Capsule contracture was occurred in 38 patients (5.3%) and median time to capsule contracture was 10 months (IQR 3; 27). According to the univariable analysis, every 1 year increase of surgical experience is related to 9% decreased risk of capsule contracture (HR=0.81, 95% CI 0.75-0.88, p<0.001), and more textured implant type is associated with less capsule contracture (HR=0.47, 95% CI 0.34-0.66, p<0.001).
Multivariable hazard regression was revealed that implant type (HR=0.55, 95% 0.33-0.90, p<0.05) and surgical time (HR=1.00, 95% CI 1.00-1.01, p<0.001) were independently associated with capsule contracture after breast augmentation surgery (Table 4). Kaplan-Meier estimation was determined that capsule contracture free survival is higher in more experienced years and patients who had more textured implant and subpectoral muscle implant (log rank p<0.001, p<0.001 and p<0.001, respectively). Conclusions For breast augmentation surgery, implant type is independent predictor of capsule contracture and surgical experience is predictor for both hematoma and capsule contracture. Therefore, above mentioned predictors should be considered to prevent complications related to breast augmentation implant surgery.

Introduction: With the average longevity in men and women, sexual health concerns have become more and more important and demands for help are far more common than in the past. The percentage of aging population is increasing also. A metabolic and hormonal change occurs in male during aging.The level of total, free and bioavailable testosterone decline with aging and it leads to decrease in sexual activities, metabolism and also the life quality.The aim of this initial study was the determination of free testosterone and bioavailable testosterone and it was the novelty of our study. Data obtained from our research can be used as basic information for hormone replacement therapy in late onset hypogonadism.Research goal: To study the free testosterone and bioavailable testosterone level in aging malesMaterials and Methods: This study is a part of study: “Androgen status of aging males” which was supported by Asian Research Center, Korean Foundation for Advanced Studies. The study was approved by IRB of MoH and written consent was obtained from all participants.Fasting blood samples were collected in the morning between 8.00-10.00 AM. We used commercial ELISA kits from Magiwel CoLtd (USA) for determining the total testosterone, sex hormone binding globulin levels. Bromcresol green method was used in determination of serum albumin level. Bioavailable and free testosterone were calculated by Alex Vermeulen, Lieve Verdonk and M. Kaufman’s formula, which was recommended by International Society for the Study of Aging Male.We studied 114 healthy males aged above 40 years old, all undergone the General and Urological examination.Result and discussion: The average age was 57.48±10.48 years in our study participants. In group of 40-49 years were 29% (n=33), in 50-59 age group 23% (n=26), in 60-69 age group 27% (n=38) and in age group over 70-s were 15% (n=17).Mean total testosterone was 6.04±1.83 ng/ml, in 40-49 age group it was 6.14±1.65 ng/ml, in 50-59 age group 6.04±2.36 ng/ml, in 60-69 age group 6.05±1.80 ng/ml, and over 70’s it was 5.85±1.43 ng/ml.Mean sex hormone binding globulin was 50.22±29.97 nmol/l, in 40-49 age group 37.60±23.03 nmol/l, in 50-59 age group 47.08±29.61 nmol/l, in 60-69 age group 57.24±33.91 nmol/l, and over 70’s it was 59.22±25.38 nmol/l.Mean albumin was 40.86±6.89 g/l, in 40-49 age group 44.55±5.93 g/l, in 50-59 age group 41.85±6.93 g/l, in 60-69 age group 38.92±6.85 g/l, and over 70’s was 36.55±4.77 g/l.Mean free testosterone was 0.112±0.064 ng/ml, in 40- 49 age group 0.124±0.058 ng/ml, in 50-59 age group0.114±0.077 ng/ml, in 60-69 age group 0.107±0.072 ng/ml, and over 70’s it was 0.097±0.044 ng/ml.Mean bioavailable testosterone was 2.53±1.48 ng/ ml, in 40-49 age group 2.76±1.37 ng/ml, in 50-59 age group 2.60±1.70 ng/ml, in 60-69 age group 2.51±1.56 ng/ml, and over 70’s it was 2.04±1.05 ng/ml.Conclusion:1. In our participants aged above 40 years old, the average mean of free testosterone was 0.112±0.066 ng/ml, free testosterone index was 16.95±11.82. Free testosterone had inverse correlation with aging (r=-0.168, p=0.03) and had peer decline among aging groups.2. The average mean of bioavailable testosterone was 2.53±1.48 ng/ml, and had age related inverse correlation (r=-0.169, p=0.037), which decline was deeper in men aged over 70 years.Key words:Aging, total, free, bioavailable testosterone,free testosterone index

Introduction: With the increasing longevity in men and women, sexual health concerns have become more and more important and demands for help are far more common than in the past. The percentage of aging population is increasing also. The of this study in aging men. Late onset hypogonadism will need the testosterone replacement therapy and we hope that our study result will help to get basic information of testosterone among over 40 yearsold Mongolian men.Goal: To determine the bioavailable testosterone (BT) of aging males and correlate with aging process.Materials and Methods: This study is a part of ongoing study: “Androgen status of aging males” which was supported by Asian Research Center, Korean Foundation for Advanced Studies. We studied 114 healthy males aged above 40 years old, all undergone the General and Urological examination. Bioavailable testosterone was determined by formula suggested by ISSAM.Result: The average bioavailable testosterone level was 2.53±1.48 ng/ml, in 40-49 age group 2.76±1.37 ng/ml, in 50-59 age group 2.60±1.70 ng/ml, in 60-69 age group 2.51±1.56 ng/ml, and over 70’s it was 2.04±1.05 ng/ml. If consider the bioavailable testosterone 100%, in 40-49 age than it is decreasing 94.2% in 50-59, 90.9% in 60-69 ages and 73.9% decreased in over 70s. Respectively, it decreases approximately by 0.9% every year after 40’s.Conclusion: The bioavailable testosterone level was 2.53±1.48ng/ml in aging males and has reverse correlation with aging (r=-0.169, p=0.037).

Materials and Methods: We studied 114 healthy males aged above 40 years old, who undergone urologists examination and General practitioner. All men answered the Aging Males’ Symptom Scale questionnaire. This is part of the ongoing study Mongolian males Andrological Status sponsored by Asian Research center, Korean Foundation for Advenced Studies. Formal concent permission was obtained from all participants, which approved by Ethical Committee of MoH. We took 4 ml blood from vien between 8-11am and determined testosterone, SHBG by ELISA and albumin by liquicolor reagent. Bioavailable testosterone was calculated, using previously described mathematical modeling, suggested by ISSAM.Result: The average free testosterone level was 0.112±0.06 ng/ml, in 40-49 age group 0.124±0.05 ng/ml, in 50-59 age group 0.114±0.07 ng/ml, in 60-69 age group 0.107±0.07 ng/ml, and over 70’s it was 0.097±0.04 ng/ml. If consider the free testosterone 100%, in 40-49 age than it is decreasing 91.6% in 50-59, 83.3% in 60-69 ages and 75% decreased in over 70s. Respectively, it decreases approximately by 0.8% every year after 40’s.Conclusion: The free testosterone level was 0.11±0.06 ng/ml in aging males and has reverse correlation with aging (r=-0.168, p= 0.03).

Introduction: Erectile dysfunction (ED), also known as impotence, is defined as a consistent or recurrent inability to attain and/or maintain penile erection sufficient for sexual performance [1]. According to recent study results, ED occurs more than 50% over 60 year old males, emphasizing a need to diagnose and treat it at an earlier stage. ED may be assessed in several ways. The most widely used standardized questionnaire is the International Index of Erectile Function (IIEF) with 15 questions, which also exists in a short form with 5 questions [2]. On the other hand, ED is associated with a decreased level of androgens in aging males; the latter is often referred to as a Late Onset Hypogonadism (LOH) or Testosterone Deficiency Syndrome (TDS). In simple terms, LOH or TDS can be defined as a decreased serum testosterone level in aging males [3, 4]Objective: To detect the testosterone deficiency syndrome in aging males with erectile dysfunction. Materials and Methods. 309 males over 40 years of age who received medical care at the ADAM urological and andrological clinic from 2010 to 2011 were included in this study. An approval of the Ethical Committee of MOH was obtained at the commencement of the study. Each study participant signed a consent form at the beginning of the study. Each participant was assigned to either an ED group or a control group depending on results of the IIEF-5 questionnaire. The ED group was further divided into three groups (moderate, severe and very severe) based on a level of ED. The total testosterone (TT) levels were determined in blood serum, using a competitive ELISA analytical system UBI MAGIWELTM TestosteroneQuantitative test (GLS, USA), with C.V. (%) 6.8 and free testosterone (FT) calculated as described by Vermeulen. Test samples were collected between 8.00-11.00 am. The biochemical diagnosis of TDS was based on the Study Aging Male (ISSAM) guidelines of the International Society, particularly, if TT was _3.46 ng/ml or free testosterone FT was ≤0.072 ng/ml [5].Results: ED of moderate, severe and very severe levels were diagnosed in 199 (64.41%) out of 309 participants. There was an inverse association between an erectile function and age (r=-0.380, p <0.01). The average TT was 5.75±2.316 ng/ml and FT was 0.091±0.0084 ng/ml. Compared to the ED group, the control group had a higher TT level: 5.6440±1.177 ng/ml and 5.812±2.316 ng/ml respectively. In the control group the FT level was 0.061±0.0084 ng/ml whereas it was 0.041±0.0076 ng/ml in the ED group. Conclusion: Our study showed that most of aging males who came to the clinic had a moderate to very severe ED (64.55%). The level of TT (5.644±1.177 ng/ml) and FT (0.041±0.0036 ng/ml) was significantly lower in ED patients (p<0.05). The testosterone deficiency syndrome was detected in 24.27% of the ED group.

BACKGROUND Congenital and acquired hearing loss considered as the most common disability. According to the WHO report, 360 million people worldwide have disabling hearing loss, and 32 million of these are children. Severe to profound sensorineural hearing loss can be treated successfully with cochlear implants. Post implant Auditory Verbal Therapy/ Hearing Implant Rehabilitation is essential for the progress and better outcome. Multidisciplinary team approach, including ENT, audiologist, speech therapy, social worker, coordinator, caregiver /parent is required. The first clinical speech therapy department in Mongolia was established by the School of Dentistry, MNUMS based at the Maxillofacial Surgery Department of the MCNHC in 2006 (G. Ariuntuul, B. Bulgan, U. Azzaya). Where as the very first Cochlear Implanted child in Mongolia was received the surgery and audiology support by A. Ulziibayar, L. Byambasuren, B. Misheel, B. Narantya and the hearing implant rehabilitation treatment successfully conducted by the abovementioned speech team in 2009. Aim: To analyze current situation on speech therapy intervention for patients with hearing loss and deafness. METHODS Retrospective hospital data were collected based on the School of Dentistry, Speech therapy department between January, 2009- February, 2017. In total 70 patients’ information were retrieved for the study. Descriptive method is used for statistical analysis. RESULTS Out of 70 patients, attended speech therapy sessions 38 (54%) were males, 32 (46%) were females; where as 21 (30%) had congenital deafness and 28 (40%) acquired; 21 (30%) patients with hearing loss not known their causes of deafness. From the total of 28 (100%) cases with acquired hearing loss/deafness 11 (39%) patients cause of deafness is due to complication from infectios disease: meningitis.

The main goal of this study is to examine the development of auditory perception performances of a cochlear implanted child who receive auditory verbal therapy. Present study included a child with prelinguistic hearing loss who received cochlear implant at the Department of ENT, 1st State Central Hospital and enrolled in Auditory Verbal Therapy (AVT) in the Speech Therapy Unit of “ Aid” Clinic. This hearing impaired child participated in auditory verbal therapy with their mother and/or father for 5 months, and the family was given training programs to apply at home after each therapy session. The auditory perception performances of a child were evaluated before implantation and after: twice every week in total 32 Audio-Verval Therapy sessions were performed with the help of Medel LittlEars Auditory Questionnaire, LIP (Listening Process Profile), Ling’s Five Sound Test, the Multiple Frequency Animal Sound Test (mFAST) and MTP (Monosyllable and Polysyllable Test). The auditory perception performances of a child joining auditory verbal therapy programs increased after 5 months of implantation. According to the Ling’s test all 5 sounds are determined (20-60dB) in 1m distance, but discrimination is observed in frequency range between 40-60 dB for sounds “A”, “U” and “M”. Parents active participation as well as full attendance in the AVT treatment shows progress in auditory development of a child. Furthermore evaluation and data analysis is needed.

This study investigates cochlear implant surgical and Audio Verbal Therapy (AVT) practice patterns of patients with hearing loss (HL) based on data of “Aid” ENT Clinic and Speech Therapy Unit of School of Dentistry, Mongolian National University of Medical Sciences (MNUMS) between 2009-2018. Our aim was to describe and collect related data on surgical interventions, using cochlear implant for patients with severe hearing loss and their involvement in the AVT sessions. Hospital based registry data by audiologistwere retrospectively investigated. Descriptive statistics are used to describe the basic features of the data in the study. In total 78 patients had cochlear implantation surgery with chronological age between 2 months and 55 years. From total subjects 46 (54.59%) were male and 32 (33.41%) female. The distribution of etiology for the hearing loss showed that the majority of hearing loss 47 (60%) had due to infectious diseases, other diseases or injury, 25 (32%) congenital and 6 (8%) unknown causes. Documentation and proper registration is essential for better outcome of cochlear implantation surgery, especially teamwork of speech therapist doing AVT and audiologist in charge of fitting. Furthermore, epidemiological studies are important for evaluation and monitoring of interventions by every specialists included in the treatment team.

BACKGROUND: Pterygium is a fibrovascular wing shaped encroachment of conjunctiva onto the cornea. Although the pathogenesis remains obscure, the ultraviolet radiations (UVR), especially UVR-A and UVR-B (290-400 nm), are considered the most dangerous in developing pterygium among other environmental factors (hot, dry, windy, dusty and smoky environments and hereditary factors. The main histopathological change in primary pterygium is elastotic degeneration of conjunctival collagen. Patient complaints include foreign body feeling and visual loss due to corneal astigmatism or growth over the pupil and cosmetic problems. Anti-inflammatory drugs and lubricants have an important role minimizing the patient’s discomfort, but they do not cure the disease. After surgical removal there are still many recurrences regardless of the method used. Autologous conjunctival grafting seems to be the best method, given both the low recurrence rate and high safety. As described first by Kenyon et al. in 1985, a conjunctival autograft reported a recurrence rate of 5.3% with infrequent and relatively minor complications. The primary disadvantage of this technique is the prolonged operative time required when compared to the bare sclera technique. These disadvantages are outweighed by the lack of sight-threatening complications and the relatively low recurrence rate, which made this procedure gain popularity in many centers. The application of intraoperative 0.02% mitomycin C for the 5 minutes is efficient in reducing the recurrence rate to a minimum. METHODS: This retrospective case series, single center study was conducted on 239 patients, who underwent pterygium excision from Jan 2017 to Dec 2017 at the Department of Ophthalmology of the First Central Hospital. All patients had a detailed ophthalmic examination before the surgical intervention. Data were collected through a prepared questionnaire. Postoperative follow-up examination sheets were evaluated. Data for recurrence rate of pterygium excision were collected and analyzed by using SPSS version 17.. RESULTS: Among the 239 patients, who underwent an operation, 37.2% (n=89) were male and 62.8% (n=150) were female. Participants’ age ranged from 29 -70 years with mean age of 49.5 years old. There is no statistical significance between the stages of the disease and its post-operative outcome in the patients, who underwent pterygium excision surgery in 2017. Postoperative pterygium recurrence was in 9 patients (3.8%); 5 (55.5%) out of all 9 patients with recurred pterygium had underwent pterygium excision without conjunctival autograft. MMC was not used intraoperatively for all 9 (3.8%) patients with recurrence post pterygium excision. CONCLUSION: The relationship between pterygium stage and its post-operative recurrence was not statistically significant (P=0.683). The recurrence rate after pterygium excision with conjunctival autograft was low (P≤0.001) which showed significant statistically. There was no recurrence after pterygium excision with MMC (P≤0.001). The results of studies from Canada, Hong-Kong, India, Philippines and Iran were similar to our outcome.