Trough WHO recommendation hysteroscopy is the golden standart technique of uterine cavity evalution. First Maternity Hospital of Mongolia have been implemented gynecological laparoscopic surgery since 2009, then from 2013 we have started diagnostic and operative hysteroscopy. A hysteroscopy may be done to find the cause of abnormal bleeding or bleeding that occurs after a woman has passed menopause. It also may be done to diagnose infertility. Also a hysteroscopy can be used to remove growths in the uterus, such as fibroids or polyps. We evaluated results of gynecological diagnostic and operative hysteroscopy, which was done in First maternity hospital.We took special questionnaires from 39 women and did prospective analyses.39 patients, who were done hysteroscopy were involved our study from November 2013 to January 2015. 51% of participants were reproductive age women. Under 20 years old participants who underwent diagnostic hysteroscopy due to hyperplasia of endometrium were 3%, they were performed biopsy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. After diagnostic and operative hysteroscopy, 97% of patients had no symptoms, but last 3% of patients had lower abdominal pain. If clarify diagnosis which is approved after diagnostic and operative hysteroscopy 51.3% was displaced IUD, 35.9% was endometrial polyp, 2.6% was hyperplasia endometrium, 10.3% was infertility. Complication was 2.6% through postmenopausal participants if compared with premenopausal women. Diagnostic and operative hysteroscopic procedure has benefits for synehia, septum of uterus, endometrial hyperplasia, abnormal uterine bleeding, submucosal myomectomy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. Hysteroscopy was done when displaced IUD (51.3%), polyp of endometrium (35.9%), hyperplasia of endometrium (2.6%), and infertility (10.3%).Complications after hysteroscopy depends from menopause.

Introduction: We began treatment of multi drug resistant tuberculosis first from 2003. At that time there was a 1960 cases and most of the cases were from Ulaanbaatar, Darkhan, Selenge, Tuv, Dornod provinces. From all the cases only 62% or 1058 cases were included in treatment. From that 336 patient or 19% deceased, 296 patient or 18% didn’t get a treatment. We did this study because there were never done any research or study of surgical treatment of multi drug resistant tuberculosis in Mongolia. Materials and Methods: We studied cases of patients who undergone lobectomy, since 2007. There were 48 cases of 46 patients, 2 patients surgery were done on both sides. Respondents aged between 14- 45, 25 male (52%), 23 female (48%), all patients got a first - line anti-tuberculosis treatment, such as cat-1, cat-1+cat-2 and 10 variants of these drugs. It was done based on sputum culture test results of NCCD TB surveillance and research department’s laboratory. Results: From the all patients only 77.08% had undergone surgery within the first 3 years. 92% patients were diagnosed with multi drug resistance TB only with the sputum and sputum culture test results, and the rest of the patients were diagnosed using a tissue analyses on the above tests. It was revealed that HR resistant -91.66%, HR+(Z,E,S) -3 drugs resistant -18.78%, HR+(ZSE)-4 or 5 drugs resistant. In the patients TB lesion locations was on the right upper lobe 54%, left upper lobe 31%, on a both upper lobes 85%, cavernous fibrosis tubercles 60%, combined TB lesions 77%, tubercles 21%.87.5% of total patients received a multi - drug resistant TB treatment between 7 - 24 months prior surgery. All 48 patients had a totally 69 surgeries. Surgeries included 9% pneumonectomy, 28% lobectomy, 30% Wedge resection, 23% pleurectomy decortication, 7% Wedge resection on both sides, one bilobectomy. There were no complications during the surgery but 5 of patients had an empyema after surgery. No fatal cases.Three patients out of 5 who had a surgery due to pulmonary hemorrhage developed an empyema after surgery. Drainage tubes were taken after the surgery within 2-3 months.Therewere no complication and escalations in the patients who received a surgical treatment, after the surgery from 6 months to 5 years. Conclusion: In study it shows that surgical treatment is effective to do after 6 months of anti-tuberculosis drug treatment in multi -drug resistant TB patients.Also it shows that combining of medical and surgical treatment is healing up to 98% in the patients who were rightly chosen according to surgical indications.This research result shows that in our country multi - drug resistant TB surgical treatment complication is only 10.41%, which is below in the other countries who have same anti-tuberculosis drug treatment.

Complete seizure control is the single most important determinant of good quality of life for patients with epilepsy and the chronic nature of the disorder requires that antiepileptic drugs (AEDs) be administered for many years, often for a lifetime. Therefore, long-term experience is of particular importance in evaluating the efficacy and safety of an AED. Valproic acid increases γ-aminobutyric acid (GABA) synthesis and release and potentiates GABAergic transmission in specific brain regions and it also has also been found to reduce the release of the excitatory amino acid β-hydroxybutyric acid and to attenuate neuronal excitation mediated by activation of N-methyl-D-aspartate (NMDA) glutamate receptors. In addition to these effects, valproic acid exerts direct actions on excitable membranes, including blockade of voltage-dependent sodium channels. Valproate is generally regarded as a first-choice agent for most forms of idiopathic and symptomatic generalised epilepsies. Many of these syndromes are associated with multiple seizure types, including tonic-clonic, myoclonic and absence seizures, and prescription of a broad-spectrum drug such as valproate has clear advantages in this situation. The elimination half-life is in the order of 9 to 18 hours, but shorter values (5 to 12 hours) are observed in patients comedicated with enzymeinducing agents such as phenytoin, carbamazepine and barbiturates. The most commonly reported adverse effects of valproate include gastrointestinal disturbances, tremor and bodyweight gain. Other notable adverse effects include encephalopathy symptoms (at times associated with hyperammonaemia), platelet disorders, pancreatitis, liver toxicity and teratogenicity. According to the some study results, endocrine manifestations of reproductive system disorders, including polycystic ovary syndrome, may be more common in women treated with valproate than in those treated with other AEDs.

Trough WHO recommendation hysteroscopy is the golden standart technique of uterine cavity evalution. First Maternity Hospital of Mongolia have been implemented gynecological laparoscopic surgery since 2009, then from 2013 we have started diagnostic and operative hysteroscopy. A hysteroscopy may be done to find the cause of abnormal bleeding or bleeding that occurs after a woman has passed menopause. It also may be done to diagnose infertility. Also a hysteroscopy can be used to remove growths in the uterus, such as fibroids or polyps. We evaluated results of gynecological diagnostic and operative hysteroscopy, which was done in First maternity hospital.We took special questionnaires from 39 women and did prospective analyses.39 patients, who were done hysteroscopy were involved our study from November 2013 to January 2015. 51% of participants were reproductive age women. Under 20 years old participants who underwent diagnostic hysteroscopy due to hyperplasia of endometrium were 3%, they were performed biopsy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. After diagnostic and operative hysteroscopy, 97% of patients had no symptoms, but last 3% of patients had lower abdominal pain. If clarify diagnosis which is approved after diagnostic and operative hysteroscopy 51.3% was displaced IUD, 35.9% was endometrial polyp, 2.6% was hyperplasia endometrium, 10.3% was infertility. Complication was 2.6% through postmenopausal participants if compared with premenopausal women. Diagnostic and operative hysteroscopic procedure has benefits for synehia, septum of uterus, endometrial hyperplasia, abnormal uterine bleeding, submucosal myomectomy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. Hysteroscopy was done when displaced IUD (51.3%), polyp of endometrium (35.9%), hyperplasia of endometrium (2.6%), and infertility (10.3%).Complications after hysteroscopy depends from menopause.

Introduction: We began treatment ofmulti drug resistant tuberculosis first from2003. At that time there was a 1960 cases andmost of the cases were from Ulaanbaatar,Darkhan, Selenge, Tuv, Dornod provinces.From all the cases only 62% or 1058 caseswere included in treatment. From that 336patient or 19% deceased, 296 patient or 18%didn’t get a treatment. We did this studybecause there were never done any researchor study of surgical treatment of multi drugresistant tuberculosis in Mongolia.Materials and Methods: We studiedcases of patients who undergone lobectomy,since 2007. There were 48 cases of 46patients, 2 patients surgery were done onboth sides. Respondents aged between 14-45, 25 male (52%), 23 female (48%), allpatients got a first - line anti-tuberculosistreatment, such as cat-1, cat-1+cat-2 and 10variants of these drugs. It was done basedon sputum culture test results of NCCDTB surveillance and research department’slaboratory.Results: From the all patients only77.08% had undergone surgery within thefirst 3 years. 92% patients were diagnosedwith multi drug resistance TB only with thesputum and sputum culture test results, andthe rest of the patients were diagnosedusing a tissue analyses on the above tests.It was revealed that HR resistant -91.66%,HR+(Z,E,S) -3 drugs resistant -18.78%,HR+(ZSE)-4 or 5 drugs resistant. In thepatients TB lesion locations was on the rightupper lobe 54%, left upper lobe 31%, ona both upper lobes 85%, cavernous fibrosistubercles 60%, combined TB lesions 77%,tubercles 21%.87.5% of total patientsreceived a multi - drug resistant TB treatmentbetween 7 - 24 months prior surgery.All 48 patients had a totally 69 surgeries.Surgeries included 9% pneumonectomy,28% lobectomy, 30% Wedge resection,23% pleurectomy decortication, 7% Wedgeresection on both sides, one bilobectomy.There were no complications during thesurgery but 5 of patients had an empyemaafter surgery. No fatal cases.Three patientsout of 5 who had a surgery due to pulmonaryhemorrhage developed an empyema aftersurgery. Drainage tubes were taken afterthe surgery within 2-3 months.Therewere nocomplication and escalations in the patientswho received a surgical treatment, after thesurgery from 6 months to 5 years.Conclusion: In study it shows that surgicaltreatment is effective to do after 6 monthsof anti-tuberculosis drug treatment in multi -drug resistant TB patients.Also it shows thatcombining of medical and surgical treatmentis healing up to 98% in the patients whowere rightly chosen according to surgicalindications.This research result shows that inour country multi - drug resistant TB surgicaltreatment complication is only 10.41%,which is below in the other countries whohave same anti-tuberculosis drug treatment.