BackgroundThe prepuce (foreskin) is a simple fold of skin formed from an outer keratinized layer and inner mucosallayer, lining a preputial sac and provides functions such as protective, erogenous, and immunologic. Theprepuce is normally non-retractile during neonatal development, as the inner epithelial lining of prepuceand glans adhere each other. Non retractile prepuces are common among young boys and normalpart of preputial development. However, unnecessary circumcision is widely practiced among youngadolescents due to poor understanding of foreskin and lack of medical indication.GoalTo assess preputial retractibility in Mongolian boys at various ages to determine natural process ofpreputial separation.Material and MethodsWe evaluated 1697 Mongolian boys aged 2 to 12. Preputial condition was classifi ed into 5 types basedon preputial retractability: type I-phimosis, type II–partial phimosis, type III–adhesion of prepuce, IV–normal, V–circumcised. We also prospectively evaluated 30 histological materials of patients (2-12 yearsold), who were treated by complete circumcision. The materials were fi xed 10% solution of formalin,embedded in paraffi n, stained with hematoxylin-eosin and examined by 3 pathologists.ResultsThe incidences of type I was 67.9% in 2 years old, 12% in 6years, and 4.1% in 10 years and1.1% in12 years old, respectively. On the contrary, the incidences of type IV were 15.4% in 2 years old, 29.8%in 6 years, 74.7% in 10 years and 91.6% in 12 years. Thecircumcisionswere0% in 2 years old, 5.7%in 6 years old, 2.9% in 10 years old and 5% in 12 years old. Most patients (76.7%) did not have anyhistological alterations of the skin and infl ammatory alteration, not lichen sclerosis, were observed in23.3% in histological examination followed by circumcision.Conclusion: Preputual separation increases with ages in boys and surgical treatment of the phimosisshould be performed with cautions.

Introduction: The introduction of minimally invasive surgery has revolutionized multiple disciplines of surgical practice. Objectives: This meta-analysis of matched case control studies aimed to compare the perioperative outcomes of video-assisted thoracic surgery (VATS) with open thoracotomy for patients with early-stage non-small cell lung cancer (NSCLC). Methods: We searched from PubMed and Embase electronic database and revealed seven relevant studies. Endpoints included perioperative mortality and morbidity, postoperative complications and duration of hospitalization. Two investigators (L.S and D.N) independently reviewed each retrieved article. The values of RR and 95% CI were estimated. We used the fixed and random-effects models to estimate the size of the treatment benefit. Results: Results indicate that perioperative mortality was similar between VATS and open thoracotomy (RR-0.62(95%CI 0.39-0.98). However, patients who underwent VATS were found to have fewer overall complications (RR-0.68(95%CI 0.59-0.78), and patients who underwent VATS had a significantly shorter length of hospitalization compared with those who underwent open thoracotomy (MD= -2.98(95%CI-4.09:-1.87)). Conclusions The present meta-analysis demonstrated superior perioperative outcomes for patients who underwent VATS, including overall complication rates and duration of hospitalization. Therefore, our study suggests that VATS should be performed widely to treat patients with lung cancer in the future.

Background: The relationship between alcohol consumption and sleep disorders is a complex issue. Although alcohol has a sedative effect in small doses, this effect diminishes when alcohol consumption exceeds an average of 7 grams per hour. Aim: To assess the sleep quality of individuals dependent on alcohol. Materials and Methods: A quantitative study was conducted using a survey-based research design. A total of 120 men participated in the study, including 60 alcohol-dependent individuals and 60 in the control group without alcohol dependence. The study utilized demographic questionnaires, the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality, and the Alcohol Use Disorders Identification Test (AUDIT) to determine the level of alcohol dependence. Results: The average age of alcohol-dependent participants was 45.3±42.4 years, while the control group had an average age of 42.4±5.1 years. The AUDIT score for the alcohol-dependent group was 25.6±9.8, indicating a high level of dependence, whereas the control group scored 7.2±3.2, suggesting low consumption levels. This difference was statistically significant (t=3.98, p=0.001). In the alcohol-dependent group, sleep latency was prolonged (p=0.042), sleep efficiency scores were lower (p=0.012), and sleep disturbances were more frequent (p=0.039) compared to the control group. The overall PSQI score was 9.82±2.8 for the alcohol-dependent group, whereas it was 4.1±1.2 for the control group. A correlation analysis revealed that poor subjective sleep quality (p=0.023), sleep latency of more than 30 minutes (p=0.012), sleep efficiency below 75% (p=0.021), and sleep disturbances (p=0.019) were significantly associated with higher AUDIT scores. Conclusion Alcohol dependence negatively affects sleep quality, particularly in terms of subjective sleep perception, sleep latency, and sleep efficiency, leading to sleep disorders.

Background: Healthcare-associated infections represent a global concern, with an average of 8.7% of hospital patients suffering infectious complications. Surgical site infections (SSIs) are particularly common and are regarded as preventable complications. Aim: To assess the staff skills in the SPD unit of district hospitals. Materials and Methods: We conducted the study using a descriptive research method and assessed the staff skills in the SPD unit of district hospitals using the WHO Safe Surgery checklist. Results:: The average age of the staff included in the study was 46.69 ± 6.5 years. Of the participants, 97.4% (38 individuals) were women, and 2.6% (1 individual) were men. A total of 39 staff members were evaluated over 156 observations using four different criteria sheets. These evaluations were conducted periodically, with assessments occurring four times. The first criteria sheet focused on the proper use of protective clothing. Out of the 156 observations, 71 instances (45.5%) showed that staff had fully covered their hair, while 99 instances (63.6%) indicated that staff wore closed shoes as required. The second criteria sheet evaluated the performance of sterilization procedures, including the use of chemical and biological indicators, recording, and signing sterilization records. In this category, performance was exemplary, with 100% compliance observed. Finally, the staff’s adherence to disinfection control protocols was assessed. The results indicated that staff demonstrated a strong understanding and execution of these practices, reflecting good overall performance in this area. Conclusion When assessing the sterilzer staff skills in district hospitals, it was noted that the use of protective clothing among sterilization staff was inadequate. Many staff members did not fully adhere to the recommended guidelines for wearing appropriate protective gear during sterilization procedures. Regarding the performance of steam sterilization instruments, the results were generally average, indicating that while the equipment was used appropriately in some instances, there were areas that required improvement in terms of efficiency and thoroughness. In terms of monitoring and disinfection after each sterilization cycle, the staff showed relatively good performance.

Background: Nurses spend the most time with patients when providing medical care, making them a crucial factor in ensuring appropriate and effective treatment. Their assessment skills play a vital role in pain management. Aim: This study aims to determine the validity and reliability of the Mongolian version of the Knowledge and Attitudes Survey Regarding Pain (KASRP). Materials and Methods: A cross-sectional, quantitative study was conducted using the Knowledge and Attitudes Survey Regarding Pain (KASRP) questionnaire. A total of 145 nurses from the surgical, emergency, and intensive care units of the National Trauma and Orthopedic Research Center (NTORC), the National Cancer Center of Mongolia (NCCM), and the National Center for Maternal and Child Health (NCMCH) participated in the study. Statistical analysis was performed using SPSS-25 software. Results: The study included 115 female and 30 male nurses, with an average age of 37.21±7.50 years and an average work experience of 13.43±7.57 years. The face validity index (FVI) for each item ranged from 0.81 to 1.00. The content validity index (CVI) for each item ranged from 0.66 to 1.00. The internal consistency of the questionnaire was assessed using Cronbach’s alpha, which was found to be 0.88. Conclusion The Mongolian version of the KASRP demonstrates satisfactory face validity, content validity, and reliability, making it suitable for practical application.