Introduction“Epidemiological study on prevalence of alcohol consumption, its patterns and alcohol related harms in Mongolia” was carried out in 2006 funded by the WHO as the first consolidated study involving a large scope of sampling. It confirmed that alcohol consumption and related harms became one of the most challenging social and public health problems in Mongolia. Moreover, recent studies provided some data and provided conclusions on high alcohol consumption rate in the population of Mongolia, particularly among adolescents. Alcohol drinking is the primary cause of cancers of the digestive organs, liver, esophagus and stomach in addition to the criminal rate associated with alcohol. Moreover, overconsumption of alcohol affects the human embryos. 58.4 percent of the parents of disabled children are alcohol addicts. (Psychiatric Health Department, UHS).GoalThe purpose of the survey is to study the alcohol consumption by the youth and students.Materials and MethodsA qualitative survey was carried out (focus group interviews, observations) combined with a survey of the target groups (students and youth) selected by random sampling. The target groups consist of students currently studying in universities, higher educational institutions and VTPCs and young unemployed persons aged 16-24. In total, 56 focus group interviews were carried out and 530 people were involved in the survey.ResultsI total, 530 students and young people were involved in the qualitative survey. 72.0 percent of them are the youth aged 16-24 studying in universities, higher educational institutions and VTPCs. This section explored the youth alcohol consumption by asking during the interviews questions such as for what purpose do you drink vodka, how much do you drink one time, what was the reason for your first drinking, what was your impression, where do you drink etc. The focus group interviewees were asked about the type of alcoholic beverages that their generation or peers use. Most of the survey participants started with beer, then try vodka, and then consume both vodka and other alcoholic beverages. A half of the survey participants answered that their peers started drinking alcohol when they were 16-18 and one of every three friends when they were 14- 16. 446 interviewees (84.1%) out of 530 participants have already tried vodka and other alcoholic beverages. 226 respondents (50.7%) who have already tried vodka and other alcoholic beverages consumed alcohol for the first time under peer pressures and influence during some parties or special occasions. One of every four interviewed persons (24.0%, 127) who have tried alcohol before reported that they liked vodka when they tried it first. However, 66.0 percent (350) reported not liking vodka at the first trial and 10.0 percent said they don’t know. Therefore knowledge on alcohol consumption needs to be provided since the school years. Most of the survey participants answered that they use very little alcoholic beverages per week when they were asked about the amount of alcoholic beverages that they drink per week. The majority of the participants who currently use vodka and other alcoholic beverages (56.0%, 177) disclosed that they drink in bars, restaurants and night clubs. (28.0%, 88) of the respondents visit their friends’ home to drink alcohol and (16.0%, 50) just drink on the street. By the social status of the interviewees who currently use vodka and other alcoholic beverages, the majority of the students drink in bars.Conclusions:Participants aged 16-24 who have been involved in the focus group interviews had the following knowledge and understanding about the vodka and other alcoholic beverages:1. Majority of the interviewees demonstrate a belief that alcoholic beverages mean the beverages with lower alcohol content such as beer and wine.2. According to their knowledge, “appropriate consumption” of vodka or other alcoholic beverages means the proper use of alcohols by adults.3. The respondents know that pregnant women, breast feeding mothers, disabled people, juvenile adolescents and drivers are prohibited to drink vodka or other alcoholic beverages.4. Many of the interviewees know that drinking vodka and other alcoholic beverages is legally prohibited to those who are driving.

Introduction. “Epidemiological study on the non-infectious diseases, accident and injury causes, and relevant risk factors” has been carried out in 2009 by the PHI to determine the alcohol drinking circumstances, frequency and risk factors by gender, age and residency locations. 26.7 percent of this survey participants aged 15-24 used alcohol during the last 30 days, 21.4 percent drank alcohol during last 12 months. GIA, HD (formerly named as the NHDC) carried out the alcohol consumption survey involving 2021 students from the universities, higher educational institutions and general education schools in Ulaanbaatar in 2004. According to this survey results, it is evidenced that 61.0 percent of students use alcohol. The aforementioned surveys and studies were quantitative studies and generally focused on providing cultures and habits of the alcohol consumption. Youth understanding of the alcohols, alcohol’s negative impact and consequences, some social and other factors influencing to the youth consumption of alcohols have not been previously studied.Goal. The purpose of the survey is to study the knowledge, attitude and tendency of the youth towards alcohol and its negative impact, consequences pertaining to the alcohol consumption by the youth and students.Materials and Methods. Qualitative survey has been carried out (focus group interview, observation) and survey target groups’ (students and youth), random selection methods. Target group consists of the students currently studying at the universities, higher educational institutions and VTPCs and unemployed youth aged 16-24. Total of 56 focus group interviews were carried out and totally 530 people were involved in the survey.Results. Totally 530 students and youth were involved in this qualitative survey. 72.0 percent of them are the youth aged 16-24 studying at the universities, higher educational institutions and VTPCs. 67.0 percent (355) of total respondents involved in the survey provided negative responses for the question “in your opinion, what is the vodka”. Vodka is useless chemical substance with negative impacts on human body. Without proper consumption, it can become a poison. It can venom not only body but also the heart and soul. Generally, vodka is one type of instruments to make human beings poor.Focus group interview, 20-24 years old, Female, Orkhon provinceVery small amount of participants involved in the interview responded positively to the question “what is the vodka” - such as the best of food, fluid with 380Ñ alcohol etc. 79.0 percent (419) of the survey respondents answered that alcohol consumption rate in our country is “higher” compared to other countries indicator. A half of total survey participants (272) considered lesser consumption of alcohol for personal use means “appropriate use of alcohol”. Some participants said that it is appropriate use if vodka is served 100-300 gram or 1-3 cups of beers for one serve. Some participants defined the adults as the people aged 18- 50. Most of them said that elders shall become role model if they don’t use vodka or other alcoholicbeverages. Most of the survey participants firstly use beer, secondly - vodka, and thirdly - vodka and other alcoholic beverages. Currently unemployed youth said that their peers and friends generally use vodka. 446 interviewees out of 530 participants, which is 84.1 percent have already tried vodka and other alcoholic beverages. 226 which are 50.7 percent of these youth who have already tried vodka and other alcoholic beverages drank alcohols under peer pressure and influence during some parties or special occasions. Places of drinking vodka and other alcoholic beverages were different for unemployed youth by their gender. For instance, majority of unemployed males visit their friends’ home to drink or drink at the streets, whereas women drink only during special occasions. Some participants said that where to drink vodka or other alcoholic beverages sometimes depend on the seasons – whether it is warm or cold. Conclusions:1. The majority of the students and youth have already tried vodka and other alcoholic beverages. More than half of the survey participants drank vodka and other alcoholic beverages under other’s pressure or influence during special occasions.2. General tendency of the interviewees towards vodka and other alcoholic beverages was negative due to numerous negative phenomena related to alcohols in the society.3. Participants aged 16-24 who have been involved in the FGDs had the following knowledge and understanding about the vodka and other alcoholic beverages: Majority of the interviewees thought that alcoholic beverages mean the beverages with lower alcohol ingredients such as beer and wine.

Introduction: A considerable proportionof adult living donor liver transplantation(LDLT) recipients experience biliarycomplication (BC), but there are few reportsregarding BC based on long-term studies ofa large LDLT population.Methods: The present study examinedBC incidence, from 16 adult and pediatricpatients (14 right liver and 2 left liver graft )between 2011 and 2016 First Central Hospitalof Mongolia.Results: The mean follow-up period was36±1 months. First Central Hospital has DDanastmosis (n=22) double DD (n=2) singlehepaticojejunostomy (n=3). There 3 caseshave biliary stricture after operation. One ofthe 3 cases has biliary laek 2 months laterafter the operation.Conclusion: Close surveillance for BCappears necessary for at least the first 3 yrafter LDLT. In terms of anastomotic stenosisrisk, HJ appears a better choice than DD forright liver grafts involving ducts less than 4mm in diameter.

Introduction: Various modalities oftechniques from standard discectomy,microdiscectomy, percutaneous discectomy,and transforaminal endoscopic discectomyhave been in use for lumbar intervertebraldisc prolapse1. The access to spine is keptto a minimum without stripping paraspinalmuscles minimizing muscle damage bytransforaminal endoscopic approach2.Currently in the population of the Mongoliabeen increased of the spinal nerve rootcompression, which are resulting in lumbardisc pathological changes. In other developedcountries has been successfully introducingthe spine endoscopic surgery use for thatpathological changes. In regard to our countryhad not yet implemented for until now asthese high technological surgeries3. Spinesurgery department team of the GrandMedhospital had successfully introduced that thespine endoscopic surgery.Materials and Methods: We performedtransforaminal endoscopic lumbardiscectomy surgeries on patients age of 24,38, 78 on July/23/2016 All patients withsingle nerve root compression due to Lumbardisc herniations, including sequestrated ormigrated and selected central disc at L4-5. All patients had preoperative MRI andpostoperative MRI to check the adequacy ofdecompression. All patients were operatedby 18-mm ports of the S-Gun endoscopicequipments. Procedure had done under localanesthesia. Postoperatively, all patients weremobilized as soon as the pain subsided anddischarged within 24-48 h post-surgery.Patients were followed up at 2, 6 weeks.Results: The mean follow up was 2-6weeks. The average surgical time was 70min (range 25-210 min). Average blood losswas 20-30 ml. Postoperative MRI showedcomplete decompression. All of patients hadgood-to-excellent results and straight raisingleg test (Lasegue) were 90/90 respectively.All patient is preoperatively visual analogyscale was 8±1 and then became to 1±1.Conclusion: Microendoscopic discectomyis minimally invasive procedure fordiscectomy with results of this procedure areacceptable safe and effective. However, forthis technique has required to do accuracyand experienced surgeon.

Ilioinguinal (II) and iliohypogastric (IH) nerve blocks are often performed to provide intra- andpostoperative analgesia for hernia repair in children and adults. Several techniques are describedin the literature. Recently an ultrasound guided technique for II and IH nerve blocks were describedin the international journals. The block success rates are variable specially for using anatomicallandmark blind techniques. In the present study, the anatomical variations in course of the II andIH nerves are described. Knowledge of the course of these nerves in the inguinal region, and anunderstanding of variations seen in their topography, can decrease the incidence of postoperativecomplications and adverse effects. Ultrasound guidance of block performance will shorten the time,reduce the number of needle passes and shorten the block onset time. Blocks may be performedusing lower local anesthetic doses.

The aim of this study was to evaluate of analgesic effect of ultrasound guided transversus abdomines plane block in children undergoing open appendectomy surgery and compare to children were used GA alone.Twenty children aged 5-15 years with ASA I-II classification were randomly enrolled in this study.Each group had 10 children and all children were received GA with same techniques. Study group(transversus abdomines plane block group) were assigned to receive ultrasound guided block using 0.3 ml/kg of Bupivacaine 0.25%. Intraoperative hemodynamic changes, postoperative maximum pain score, the time the first analgesic requirement, correllation between inflammatory process, surgical disease complication and pain intensity were studied. Statistic analysis was made in Excel usingdescriptive analysis, correlation and regressive analysis. A p-value<0.05 was considered significant.There was no differencies between the two studied groups regarding demographic and clinicalcharacteristics. Intraoperative systolic blood pressure changes was higher in control group than studygroup (17%), and HR and BP were more stable in the study group. Level of WBC had direct positive relationship with appendix inflammation (r=0.71 (p-утга <0.001) and weak positive correlation (r=0.44 p-утга <0.05) with pain intensity. Postoperative pain score was higher in control group and the first analgesic requirement time was 2h. In the study group had mild to moderate pain and the the firstanalgesic requirement time was 4h.Transversus abdomines plane block under ultrasound guidance was easy, safe, reliable and effective analgesic in children undergoing open appendectomy surgery.

Introduction: Biliary Atresia is a fibroobliterativedisorder of the intra andextrahepatic bile ducts in infancy, which isgoing progressively cholestatic liver disease.The failed Kasaiportoenterostomy requiresliver transplantation. The goal of this studyis to show the outcome of Kasai operation,recent improvement and correlation the datato overseas.Methods and Materials: This study wasconducted in the department of generalsurgery of National Center for Maternal andChild Health of Mongolia between 2010 and2016 on a total of 66 infancies with biliaryatresia.Results: Patient diagnosed with biliaryatresia, which performed Kasai operationwithin first 2 months the outcome is verygood early and late post-operation period.There were 3 patients with 10 year survival, 4patients with 5-10 year and 28 patients with5 year survival after Kasai operation. The mostcomport age for liver transplantation is 1 yearlater after Kasai operation in Mongolia. Livertransplantation programme is necessary forMongolian pediatric surgery, and we thoughtour team was assembled.Conclusion: The children with biliary atresiaperform the Kasai operation within 2 monthsthe outcome is very good. Children with biliaryatresia often experience long wait times fortransplant unless exception points are grantedto reflect severity of disease.In Mongolia livertransplantation done in 2 child.

BACKGROUND OF STUDY: For the past 10 years, accidents and trauma are ranking third in the cause of Mongolian population’s death. Russian scientists have defined that skull and brain trauma comprise of 40% of the total traumas and is one of the serious injuries that have damaging effect to the health. Defining its creation, injury period, death cause in the leading direction of science of forensic medicine in our country are still the urgent issues. Nowadays little research which studied case mortality due to accident and trauma has been studied, this became background of our research work. PURPOSE OF STUDY: To study cause and peculiarity of pathology of case mortality due to brain trauma, in the condition of our country and to consider the result. OBJECTIVE OF STUDY: To study the cause, some risks of head injury. To define pathology of case mortality due to head injury. MATERIAL AND METHODOLOGY: We did retrospective study in 555 case material of an autopsy of case mortality of head injury of forensic medicine and research department of national institute of forensic science. Statistical work out was done by Microsoft excel and extensive index. RESULT OF STUDY: 84.5% (n=459) is male and 15.5% (n=86) is female out of our 555 involved cases and the gender ratio is 5:1. The most or 81% of the research participants had head injuries due to hitting with firm and dull stuffs and 15.9% head injury as a result of traffic accident follows in the second place. To analyze from the characteristics of mortality, 93% is subarachnoid hemorrhage, subdural, epidural hematoma, 64% is brain tissue injury were detected. CONCLUSION: Young manhood men mortality that has head injury resulted from the firm and dull things occupies most of the percentage in our research. The head injury can lead to the mortality of his ordinary process.