The double and triple test is a prenatal screening used to identify those pregnant women who shouldbe offered a diagnostic test to identify whether their fetus has an aneuploidy. It was first described in1988, but has largely been superseded by newer tests either conducted earlier in the first trimester(ie, the combined test, using ultrasound measurement of nuchal translucency, pregnancy-associatedplasma protein A, and human chorionic gonadotrophin [hCG]) or in the second trimester (ie, thetriple and quadruple test, using α-fetoprotein, hCG, uE3, and inhibin).These newer tests have been introduced because they offer greater detection and lower screenpositive results thereby enhancing diagnosis rates, while decreasing the risk of iatrogenic harmcaused by the invasive testing required when collecting suitable sample tissue. Both first andsecond trimester screening programs have been expanded to include risk assignment for trisomy18. Targeted screening algorithms have not been developed for chromosomal abnormalities otherthan Down syndrome and trisomy 18, although it has been suggested that a trisomy13 risk might becalculated. The construction of such algorithms would require recognition of a characteristic patternfor each condition using the appropriate combination of markers. It is likely, therefore, that the doubleand triple test will continue to be used in routine antenatal care for the foreseeable future.

BACKGROUND. Head and neck cancers are related group of cancers that involve the oral cavity, pharynx (oropharynx, nasopharynx, hypopharynx), and larynx. Early-stage tumors of the upper aerodigestive tract can be cured; for late-stage disease, prognosis is poor. Nowadays microvascular free tissue transfer surgery performed at high level. Worldwide, this particular kind of operation in head and neck surgical field has become “golden standard” of treatment. Seemingly, plastic and reconstructive surgeons of developed countries widely perform forearm free flap, anteriolateral thigh free flap, fibula free flap, rectus abdominal free flap, latissimusdorsi free flap. We purpose to report our first 121 cases of Microvascular Free Tissue Transfer which had been performed at the head and neck surgical department, NCC of Mongolia. METHODS. The clinical records of first 121 cases patients who had microvascular reconstruction done between 2011 and 2017 were reviewed. The indications for surgery, choice of flap, duration of surgery and flap survival were noted. RESULTS. Our study were performed on 121 cases, among them 84.3% flaps were survived, most of defects occurred following cancer resection. Anterolateral thigh and radial forearm flaps were performed commonly for our reconstruction surgery. CONCLUSION. 84.3% free flap recorded success rate indicates our early experiences. Although the National Medical University do not have postgraduate reconstructive and plastic surgical training, we believe that meticulous planning, careful vessel selection, close flap monitoring as well as improved infrastructural support can lead us to much better success rates of microvascular reconstruction in our country.

The purpose of this study was to analyze the epidemiology of oral and maxillofacial surgery patients in Mongolia and advocate guidelines and programs to promote optimal oral health care. A fact-finding epidemiologic study on the patients who visited at Departments of Oral and Maxillofacial Surgery, at National Hospitals at Ulaanbaatar city and Province and other Central hospitals of Mongolian, from Jan to Dec, 2013.Total 12957 patients treated at inpatients care center at the above mentioned national hospitals. From Ulaanbaatar city were 4284 (36%) and from province were 7673 (64%). Patients from province were treated at FCH 69%, NTORC 6.4%, NCC 11.3%, NCMCH 27% and CMAFH 1.8%. Zero to 16 years, 17 to 36 years, 37 to 56 years and 57 or more years old patients were3072 (27.1%), 4224 (34.2%), 3218 (26.9%) and 1412 (11.8%), respectively. Males and females were 6841 (53%), 6090 (47%). Cases of the inpatients were as follows: infectious disease 5971 (49.88), benign tumor 1039 (8.01%), trauma & injury 1799 (15%), salivary gland disease 2.41%, TMJ disease 2.8%, neuralgia and muscle pain 0.8% and others. 5 provinces have no Oral and Maxillofacial Surgeon and patients were referred to other central hospitals or to the Ulaanbaatar city. This study gives a topic of conversation about undergraduate dental education, continuing education and enough specialists in the region.

The main mechanism of sand sauna therapy is lie into heated sand baths for adults 8 to 20 min and for child 7 to 15 min long, and it is performed twice a day (morning and afternoon) for 2 or 3 weeks once a year. Particularly, the sanatorium offers a type of balneotherapy through the application of thermally warmed sand and a combination of healthy micro-bioclimate, purity of the natural environment, and the presence of fresh and healthy local foods to treat a wide range of medical conditions. The sand sauna treatment most likely affect the body by means of the sand’s high temperature and the presence of chemical elements those are biologically important. One of the well-experienced health resorts is the Tavan Els kidney sanatorium. The Tavan Els sanatorium treats patients with the following signs: fatigue, shortness of breath, bone and back pain, swelling of the legs, high blood pressure (over 130/80mmHg), infrequent urination, proteinuria, and blood in the urine. Their goal is to delay progression of chronic kidney diseases prevent or slow additional damage to the patient’s kidneys, improve blood circulation, decrease the use of medicines, and educate patients about alternative therapies. Our study investigated effects of sand sauna treatment more considering some laboratory findings. There conducted totally 720 patients where 429 inpatients and 291 outpatients. This study selected 150 patients with chronic glomerulonephritis symptoms of swelling 31%, blood in urine 9%, high blood pressure (Over 130/80 mmHg) 10% and mixed conditions 50%. After the 10 days treatment, the proteinuria was decreased 52.6%, and blood in urine decreased 16, 6% from the total number of patients. Hypertension was decreased 35% of patients from 10 to 20mmHg and 45% of patients did not changed. A swelling was cleared 51%, 38% decreased and 3% did not change. 66% of patients down the weight loss about 2-4kg, and 34% of patients did not change. We observed typical changes during 15-20 minutes bathing, heart rate increased from 65±1.3 bpm at rest to 82±2.4 bpm in 45°C hot sand bath. Blood pressure increased from 132±4.0/82±2.2 mmHg at rest to 139±1.4/81±1.0 at the bathing. Body temperature was increased 1- 2°C during bathing. Because of the equipment limits, we could not check the urinary sediment, and serum creatinine. Sand sauna treatment appears to be an effective and useful method to treat financial and emotional burdens problems of patients with chronic kidney disease problems that especially for the symptoms of high blood pressure, cause of swelling, proteinuria, infrequent urine and blood in urine as well as improvements of well-being.

Background: A rare angioproliferative condition of the larynx, Kaposhi sarcoma typically affects the skin. Immunosuppressive treatment following organ transplantation and human immunodeficiency virus infection are the causes. Every type of Kaposi sarcoma has human herpesvirus-8. Laryngeal kaposi sarcoma is uncommon in immunocompromised patients; since its initial identification in 1965, 18 cases have been documented globally. A CO2 laser-assisted laryngeal microsurgery is performed through the mouth cavity to remove tumor when kaposi sarcoma of the larynx obstructs the airway. Case report: A 77-year-old woman complained of hoarseness, dry mouth, odynophagia, and dysphagia three months prior when she arrived at the Mongolian-Japan Hospital. Two years ago, she acquired hard, sensitive lumps that were palpable on her right arm, left ankle, and right thigh. At that time, she was diagnosed with Kaposiform hemangiodermatitis and treated at the National Center for Dermatology. HIV test results were negative. Immunohistochemistry: CD31 +/-, CD34 /+/. Using flexible nasopharyngeal endoscopy to get the diagnosis: There was a mass that was about 1.5–2–5 cm in diameter, bluish in color, smooth and movable, and spongy and vascular on the larynx, on the nasopharynx, behind the palatine tonsills, and supraglottic. Surgery: Through the use of Kleinsasser laryngoscopy and a 0-degree endoscope, pathological tissues were extracted under general anesthesia using a laryngeal microsurgical instrument and a laparoscopic bipolar coagulator. The tissues were then sent for histological evaluation, which revealed Kaposi sarcoma, sarcoma grade 1. Results of treatment Pain decreased and quality of life increased following surgery. Upon nasopharyngeal endoscopy, the vocal cord mobility was normal and the surgical incision was clean. Conclusion: Kaposi sarcoma is an extremely uncommon illness. A lower quality of life and further issues can be avoided with an early diagnosis and suitable therapy. It also needs to be continuously monitored because it is a potentially repeatable disease.