Introduction: Delayed or wrong diagnosis in patients with appendicitis can result in perforation and consequently increased morbidity and mortality. Serum total bilirubin may be a useful marker for appendiceal perforation. The aim of this study was to determine and compare pre-operative total bilirubin level and other diagnostic tools (patient age, duration of symptoms, Alvarado score, white blood cell, C-reactive protein, ultrasound and contrast enchanced CT scan) in cases of acute appendicitis in order to improve the clinical decision making. Materialsand methods: We identified 102 patient with acute appendicitis after excluding those with other causes of hyperbilirubinemia among the 180 patients that underwent a laparoscopic or an open appendectomy from June, 2011 to March, 2015 in UB Songdo Private Hospital. These cases were also subjected to liver function tests and clinical diagnosis was confirmed perioperatively and postoperatively by histopathological examination. According to histological results, these cases were classified two groups: positive(acute appendicitis with perforation and/or gangrene) and negative(acute appendicitis without perforation or gangrene). Their clinical and investigative data were compiled and analyzed. Statistical analysis was performed using independent sample t test, Chi square test, and direct logistic regression. The level of significance was set at P< 0.05. Results: Serum total bilirubin was found to be significantly increased(1,5mg/dL) in case of negative group and much higher (3,6mg/dL) in cases of positive group (P <0.001). The level of total bilirubin was higher than 3 mg/dL in cases of gangrenous/ perforated appendicitis while in cases with acute appendicitis it was lower than 3 mg/ dL. Also Alvarado score (P <0.01), C-reactive protein (P <0.001) and contrast enchanced CT scan (P <0.05) were statistically significant diagnostic tools for acute appendicitis. Conclusion: Assessment of preoperative total bilirubin is useful for the differential diagnosis of gangrenous/perforated appendicitis.

Introduction: Delayed or wrong diagnosisin patients with appendicitis can result inperforation and consequently increasedmorbidity and mortality. Serum total bilirubinmay be a useful marker for appendicealperforation. The aim of this study wasto determine and compare pre-operativetotal bilirubin level and other diagnostictools (patient age, duration of symptoms,Alvarado score, white blood cell, C-reactiveprotein, ultrasound and contrast enchancedCT scan) in cases of acute appendicitis inorder to improve the clinical decision making.Materialsand methods: We identified102 patient with acute appendicitis afterexcluding those with other causes ofhyperbilirubinemia among the 180 patientsthat underwent a laparoscopic or an openappendectomy from June, 2011 to March,2015 in UB Songdo Private Hospital.These cases were also subjected toliver function tests and clinical diagnosiswas confirmed perioperatively and postoperativelyby histopathological examination.According to histological results, these caseswere classified two groups: positive(acuteappendicitis with perforation and/organgrene) and negative(acute appendicitiswithout perforation or gangrene). Theirclinical and investigative data were compiledand analyzed. Statistical analysis wasperformed using independent sample t test,Chi square test, and direct logistic regression.The level of significance was set at P< 0.05.Results: Serum total bilirubin was foundto be significantly increased(1,5mg/dL) incase of negative group and much higher(3,6mg/dL) in cases of positive group (P<0.001). The level of total bilirubin washigher than 3 mg/dL in cases of gangrenous/perforated appendicitis while in cases withacute appendicitis it was lower than 3 mg/dL. Also Alvarado score (P <0.01), C-reactiveprotein (P <0.001) and contrast enchanced CTscan (P <0.05) were statistically significantdiagnostic tools for acute appendicitis.Conclusion: Assessment of preoperativetotal bilirubin is useful for the differentialdiagnosis of gangrenous/perforatedappendicitis.

BACKGROUND. The 84.4 percent of newly diagnosed patients with diabetes have obesity in Mongolia. Nowadays, prevalence of obesity has increased steadily in Mongolia. Diabetic patients with viral hepatitis has high risk of having liver cirrhosis. Therefore, screening of fatty liver and liver fibrosis in diabetic patients is more important. The main diagnosing method of fatty liver and liver fibrosis is liver biopsy and histology but so far, we are able to detect viral infection using viral marker and determine fibrosis stage of NAFLD in patients who has diabetes mellitus type 2. Using noninvasive method determining liver fibrosis involve many researches to reveal new biomarkers and technics to find out liver fibrosis. Japanese researchers has found The Wisteria floribunda agglutinin- positive human Mac-2-binding protein (WFA+-M2BP) was recently shown to be a liver fibrosis glycobiomarker with a unique fibrosis-related glycoalteration.This biomarker helps to determine liver fibrosis stage in fatty liver disease and viral hepatitis. There is no research to reveal viral infection, fatty liver and liver fibrosis in diabetic patients in Mongolia, so far. So it is necessary to study revealing viral infection, fatty liver disease and to determine stages of fibrosis using WFA+-M2BP to screen liver fibrosis in diabetic patients. OBJECTIVE. To identify viral infection, HCV/HBV in patients with diabetes and to compare liver function and diabetes control for diabetic patients with liver disease. METHODS. We collect data from 25thNovember, 2015 to October of 2016. We got permission of research from the patients by handwriting signature who diagnosed Diabetes mellitus in National University Hospital. Haemotology, biochemistry test, coagulogramm, immunology test are evaluated in 415 patients in clinical laboratory of National university hospital. By the objective, the diabetes patients with viral hepatitis will attend to second step of research. We used HISCL 5000 apparatus of Sysmex Japan to do immunology tests. Also we use SPSS 19.0 and EXCEL program. RESULT. There were 294 patients and by WHO classification of ages 20-29 aged patient (n=4), 30-39 aged(n=19), 40-49 aged(n=65), 50-59 aged(n=126), 60-70 aged(n=48), over 70 aged(n=14)or 53.24±9.43. 146 patients are male,148 patients are female.By BMI 29.9±1.14.By blood test, thrombocytes counted 256.6±11.7;in coagulogramm the prothrombin time was 111.7±31.4; in biochemistry test total bilirubin 16.46±10.6; AP 364.7±192.3;AST 35.7±45.7; ALT 42.8±45.5; GGT 86.53±123.4;albumin 42.06±23.95;total cholesterol 6.04±2.47;triglyceride 5.72±34.5;HbA1c 8.83±5.92; in immunology testsanti-HCV 29.37±18.87 (n=58); HBsAg 590.134±1013.7 (n=23); M2BP (COI) counted 2.24±2.19. CONCLUSION. There were 58 diabetic patients with C viral infection and 23 diabetic patients with B viral infection. By WFA+-M2BP glycobiomarker, we found that diabetic patients with viral hepatitis has more liver fibrosis.

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.

Background: Chemotherapy-related acute exacerbation or hepatitis flares related to HCV positive B cell non-Hodgkin’s lymphoma (B-NHL) is one of the significant clinical issues Material and Method: We studied anti-HCV incidences among patients newly diagnosed with B-NHL, from 2015 to 2018. Survey data were collecting from medical history, electronic medical record system of First Central Hospital was acquired and collected according to the research ethics (approved by Ethics Committee of Ministry of Health, No.4 on June 19, 2017). Also, cases of chemotherapy-related acute exacerbation (AE) for HCV-RNA positive cases were studied. Student’s t-test or nonparametric statistics were utilized to test for statistically significant differences in continuous variables, whereas the chi-square or Fisher’s exact test was used for categorical variables. p<0.05 was considered statistically significant. Results: The study showed that 39.5% of 233 cases with B-NHL are anti-HCV positive. Anti-HCV positive prevalence among B-NHL subjects was significantly higher compared to the general population. Chemotherapy-related AE occurred in 21.05% for the anti-HCV positive group and 36.36% for HCV-RNA positive group. Furthermore, before chemotherapy alanine aminotransferase (ALT) median was 15.2 for the group without AE, whereas it was 48.2 for the group with AE (p<0.01). Conclusions Our study showed that the prevalence of anti-HCV positive among B-NHL patients was significantly higher than the general population prevalence. For all cases of AE, HCV-RNA was positive, and these patients were treated with only chemotherapy without any anti-viral treatment. Anti-viral therapy needs to be introduced urgently to prevent AE since liver fibrosis is aggravated quickly after AE.