Introduction: The theory that usingmobile bearing (MB) design for total kneereplacementsurgeries can reduce the riskof tibial component loosening compared tofixed-bearing (FB) designs is still unclear.Arthroplastic surgeries developed rapidlywithin recent 10 years, but there is no similarstudy performed yet. This randomized studyinvestigated the impact of prosthesis design toloosening of components at 2 years for totalknee replacement surgeries.Materials and Methods: 479 patientswho underwent total knee arthroplastyin FirstCentral Hospital of Mongolia were allocated toeither FB or MB tibialarticulation.We comparedour results to similar studies which performedabroad due to there is no such a studyperformed before in Mongolia.Results: There is no significant differenceby age, sex, weight, height, body mass index,operation side (right or left) in both groups.Pre- and postoperative range of motionwasalmostsame for MB and FB groups.Butloosening complication was higher for the FBgroup (1.16%) than MB group (0%).Conclusion: Using MB design for total kneearthroplasty has less loosening complicationthan using FB design in Mongolians. Bonemineral density (dual energy absorptiometry)and radiostereometric analysis are necessaryfor widening studies in field of total kneereplacement surgeries in the future.

Background: The Incidence of Intracranial haemorrhage (ICH) in childhood compare to adulthood not very common. The multifactorial etiology ICH may involve coagulation disturbance, venousinfarction, infection, heart congenital abnormalities, birth asphyxia and trauma. ICH is a major cause of morbidity and mortality in neonates and it’s related to vitamin K deficiency. The previous studies have shown, that 37.8% of children with Cerebral Palsy and 31.2% of infants with hypoxic-ischemic encephalopathy had ICH and 48.2% of dead premature infants due to ICH. The number of infants with ICH are increasing year by year. Therefore, the aim of this study was to identify and explore influential factors and causes of ICH among infants in own country.Materials and Methods: The present study was conducted atseveral departments such as PICU, neurology, and cardiology of the State Maternal and Child Health Research of Mongolia. Sixty one patient with ICH involved in the case group and one hundred twenty two infants were involved in control group.Statistical methods. The Mann Whitney U and Fisher’sexact tests were used to compare clinical characteristics of thecontrol infants and infants with ICH. Ethics. The present study was approved by the ethics committee of the MoH and MCHRC. Informedparental consent was obtained for each patient before entry into the study.Results: Among children with ICH 95.1% were under one year and just 4.9% were aged 1-5 years. The following causes of ICH in infants aged under one year were identified: hemorrhagic disorder-39.7%; HIE-13.3%, trauma- 10.4%, unknown reason-12.1% and congenital heart abnormality- 3.4% and Intrauterine infection – 3.4%. However, most common cause of ICH among children aged 1-5 years was trauma – 66.7%, and 33.3% were related to infection.Conclusion:1. The incidence of ICH is high among infants.2. The most common cause of ICH among children were hemorrhagic disorder-37.7%; HIE-13.1%; trauma-13.1%; infection-sepsis -14.8%; intrauterine infection- 9.9%; congenital abnormality of the brain- 3.3% and congenital heart defect-3.3%.3. Influential factors of ICH are preeclampsia (OR=8.6), CS (OR=3.4), newborn asphyxia (OR=3.3) and pathological jaundice (OR=6.8).

Introduction: Orthopedic surgery is a highrisk of surgical formation of thromboemboliccomplications.Many researchers are exploringprevent surgical complications.Anticoagulanttreatment is the first choice to preventthromboembolic complications.Artificial jointreplacement surgery has been made in 2008,in National First Central Hospitals (NFCH).Wehave not guideline of anticoagulant treatmentafter surgery and have not principle of choisefollow-drug treatment and unclear testingschedule to monitor anticoagulant treatment,that has become the basis for this study. Westudied by comparing a comparative benefitfor anticoagulant treatment of unfractionatedand low molecular weight heparin results.And studied thromboembolic complications,monitoring test of anticoagulant treatment,fatal bleeding, changes hemostasis ofanticoagulant therapy in both groups. Thesurvey results in practice is doing researchaims to introduce and review the results of thelong-term results.Materials and Methods: Included in thesurvey about 1,400 patients, who had kneeand hip replacement surgery in 2008-2016, inJoint Center of NFCH. All patients are dividedin three group. The first group is control group,do not use anticoagulation treatment, in thesecond group used unfractionated heparin andin the third group used low-molecular-weightheparin.Each group studied comparativewhether thromboembolic complications anddeath caused by thromboembolic, fatalbleeding.Between surgical complication andanticoagulant therapy relationship to investigatethe relationship the correlation is likely trueof 95%. Caused by other thromboemboliccomplications detected cases were removedfrom the study.Results: Control groups has not hospitalmortality, but has 3 cases of sudden death ina after discharge.Hemostasis is longer (INR1,3-1,5) in the second group. There hospitalmortality occurred in 1 (cardiac infarction),and thromboembolic complications 1 (arterialthrombosis in the jugular) in the third group.Low molecular weight heparin are no changeshemostasis, it is strongly dependent (r=0,8).Also in this group there is no fatal bleeding.Conclusions: Orthopedic surgery isnecessary for prevention of thromboemboliccomplications are showing from in controlgroup has sudden death.2 groups have not fatalbleeding when used heparin in normal doses.Other countries researchers conclude lowmolecular-weight-heparin is more effectivethan unfractionated heparin, our study is notvisible correlation reliability.When used lowmolecularweight heparin, hemostasis is notchanged is showing a strong dependence.

Introduction: We performed more than1200 arthroplasty surgeries at National FirstCentral Hospitalfrom 2008, so we haveour surgical technique and experiences.Thepurpose of this study is to assess our surgicalresults and complications after surgery forfemoral neck fracture made in Joint Center,National First Central Hospital, and tocomparingsimilar studies in other countries,and to develop the best optionsurgicaltherapy.Materials and Methods: Between 2008-2015, hip replacement surgery accountedatotal of 168 cases, that was 13.9% allof replacement surgery. A retrospectiveanalysis of patient database based onhospital discharge data and medical recordswas performed. The medical records ofthese patients were reviewed to confirmthe presence of a surgical site infection asdescribed by the Centers for Disease Control(CDC)/NNIS guidelines.Results: Between 2008-2015, in theJoint Center,National First Central Hospital,are seeing increasing number of patientswith hip replacement surgery each year.The cause for hip replacement surgery isaseptic necrosis (42%), at second is femoralneck fractures (22%). Joint Center,NationalFirst Central Hospital currently not providedemergency trauma care center. Therefore,younger patient with femoral neck fracturewas not to happen duringresearch. Olderthan 60 year patients with osteoporosis and,in some cases with nonunion, was doneforhip replacement surgery. The averageage of 75.7 (61-87).Bipolar hip arthroplastywas 14 cases all of 36 patients with femoralneck fracture.9 (5,31%), complications ariseall of hip replacement surgery (168 cases).Including: Infection - 1 (0.59%), sliding - 1(0.59%), dislocation - 2 (1.78%), fracture- 2 (1,18%), nerve injury - 2 (1,18%) andpostoperative mortality - 1 (0.59%).Conclusion: Internal Fixation- for patientage under 60 andgood bone quality. Thatoperation complication is femoral headnecrosis, not healing /nonunion/ delivery ofa lot of research that shows focus. Further,most surgery for femoral neck fracture is hipreplacement that is expected to be widelyavailable.

Introduction: Artificial joint replacementsurgery started in 2008, in Joint centerof National First Central Hospital. Hasexperienced a variety of post-surgicalcomplications.Postoperative infectiouscomplications, prevent and investigate thecauses of the research is carried out todetermine whether the opportunity.Materials and Methods: Facilitiesrandomly selected cases difficult patientswith postoperative septic, and analyzedby descriptive method. In all cases,Bacteriological analysis of the clinicallaboratory department of joint fluidsamples received. We determined artificialjoints causes of postoperative infectiouscomplications and artificial joints determinethe factors of postoperative infectiouscomplications. Calculate the treatment ofinfectious complications.Results: Since 2008, done a total1200 with an artificial joint replacementsurgery. Each year, a surgical number isincreasing. 82% of all cases were kneeartificial joint replacement surgery and18% were hip artificial joint replacementsurgery. There are 20 cases of postoperativeinfectious complications.Most suppurativecomplications (14 cases, 70%) are earlycomplications, that directly related to thesurgery and hospital infections are likelyto be. Pathogenic bacterial samples weredetected 10 cases. An assay blanks dependon laboratory capacity and the number ofsamples. Open surgery is 83,3% effective,when early infectious period. No mortalitydue to infectious complications in our center.Conclusion: The main reason of thepostoperative infectious complications ofartificial joint surgery is S. Aureus (99%).14 cases (70%) of all postoperativecomplications are early complications, thatdirectly related to the surgery and hospitalinfections are likely to be. The main factorsaffecting disinfection of the surgical roomand trauma.

joints with severe defects of the medialtibia usually progress as varus or valgusdeformities, with daily functional handicapssuch as, limping, aches and instability. Duringthe last seven years, in total 1200 knees ofpatients were treated by both bilateral andunilateral total knee arthroplasty in the Jointcenter of National First Central Hospital. Thisresearch shed a light on patients that weretreated by unilateral total knee arthroplastyto correct large defects of tibia.Materials and Methods: The objectiveof this paper is to compare patients whowere treated with auto bone graft withpatients who were treated without auto bonegraft, in order to assess the effectiveness ofthe auto bone graft technique through theretrospective method.Results: The unilateral total kneearthroplasty was operated on 553 patients,30 (5,42%) of whom were treated withautobone graft and 523(94,58%) of whomwere treated without the auto bone graft.Postoperative complication was observed in3 cases (9,9%) among the first group ofpatients, and in 25 cases (4,5%) amongthe second group of patients. As patients,diagnosed with osteoarthrotic knees withsevere tibial bone defects, were treatedthrough the auto bone graft, it could beconcluded that more complications wereobserved on patients with large tibialbone losses. However, no complicationwas observed in other 27 cases that weretreated with the bone graft during the postoperativefollow-up period ranged fromtwelve to eighty four months.Conclusion: In conclusion, total kneearthroplasty using auto bone graft forpatients with severe tibial bone defects iseconomically as well as clinically effectivetechnique for our country.

mmon clinical scenario [1]. The prevalenceof thyroid nodules is ~18-40% in Chineseadults [2]; however, only 5-10 percent of allthyroid nodules are malignant. Although withthe development of the ultrasound technique,several ultrasonographic characteristics havebeen associated with thyroid malignancy[3], individual ultrasound features arenot accurate predictors of thyroid cancer.Thyroid fine-needle aspiration [FNA] hasbeen recommended by various organizationsfor the more precise preoperative diagnosisof thyroid nodules [4]. Non-diagnostic rateof FNA comparison and estimate betweenthe other studiesMaterials and Мethods: We performedover 100 FNA using one pass of the 21-Gneedle attached to a 10 ml syringe withoutlocal anesthesia in 2015. All the FNAswere performed without the guidance ofultrasound. Recent study 100 cases of themwere not selected for a specific method.Results: In total there were 100 patientsrecruited in the study with a mean ageof 45.94±13.13 years and 83.0% femalepatients.The Non-diagnostic rate was comparedbetween groups with different needlesizes and methods. In the 22 G group,non-aspiration showed a decreased NDrate as compared to aspiration [44.21 vs.76.76%, P<0.001;]. In the non-aspirationgroup, a lower ND rate was revealed in the25-G needle group compared to the 22-Gneedle group [34.97 vs. 44.21%, P=0.032;].Notably, the ND rate in the 25 G group wassignificantly lower than in the all 22 G group[34.97 vs. 58.13%, P<0.001;]. In the 21 Ggroups, aspiration showed a decreased NDrate as compared to aspiration [44.21 vs.76.76%, P<0.001;]. 21G aspiration groupshowed decrease twofold ND rate ascompared 22G aspiration group [31.63 vs.76.76%, P<0.001;]Conclusion: There have been studiesusing various needle types [regular needle,needle with a stylet or spinal needle [5]and different needle sizes from [21 G to27 G] with or without aspiration duringthe procedure. Numerous factors influencethe diagnostic rate in thyroid FNA, amongwhich the nodule component is an extremelyimportant factor [6]. In general, the morecystic the percentage of each nodule, thehigher the rate of non-diagnostic, with the lowest ND rate in the solid nodule using a25-G needle at 26.77% and the highest inthe cystic nodule using 22 G aspiration at85.19%. A similar trend was found in eachgroup with lowest rate of ND in the 25 Gnon-aspiration group and highest in the 22G aspiration group.

BackgroundThere are 137 soums of 17 provinces have plague foci in Mongolia. The 51.7% of them is case, 23.4%- low, 9.5% - high, 0.7% - hyper active. Main host of plague foci is marmot in Mongolia. According last20 year’s surveillance study, about 75.5% of Y.pestis was isolated from marmot, marmot carcassesand their flea. Human plague cases has been caused illegal hunting marmot in Mongolia. Even legaldocument which prohibited marmot hunting was appeared since 2005, people has been hunting marmotfor selling marmot meat, skin and other products. It is depends economy crises and other public issues inMongolia. Also influenced increase risk of human plague and being reverse result in plague preventionactivities.Materials and MethodsStudy was used data of rodent for zoonotic diseases suspicious which tested plague in National centerfor zoonotic disease (NCZD) in 2005-2015 and 13 local center for zoonotic diseases in 1988-2015. Datawas kept in NCZD and National archival authority. For mapping we used Arc View 3.2.ResultsTotally 397 event information of suspicious rodents and other animals was received in NCZD from 8 districtsof Ulaanbaatar city in 2002-2015. Most of information was received from Songinokhairkhan-64.2%district and smallest number was from Nalaikh district-0.3%. 92.2% of them were marmot, 0.1% of themwere marmot raw products for treatment purpose. Totally 1285 animal samples were tested by plaguedisease and the result was negative. Five hundred thirty tree marmots were carried to Ulaanbaatar from10 provinces. In that time plague foci were active and Y.pestis was isolated in provinces which marmotwas carried to Ulaanbaatar.In 1988-2015, totally 257 marmots and animals of 515 event information was received in15 provinces.Including 13.2% of them were birds, 84% of them marmot, 1.6% of them were livestock, 1.2% of themother animals. About 216 marmots were tested by plague. 51.2% of them were detected positive results.We develop conclusion based laboratory investigation result even it need high cost to take earlyprevention and response measures.Conclusion1. It is high risk to spread plague by carrying suspicious animal in urban area. Therefore, it is importantto take early response measures even it high cost. In further, increase cost and support rapid test ofhigh technology.2. To organize rational advertisement and increase knowledge of population about not doing illegalhunting, not selling marmot raw products in urban area, not using marmot raw products for treatmentuse and avoid contact with marmot carcasses.3. It is important to cooperate joint response measures with policeman, inspection agency andveterinary and human health sectors in Mongolia.

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.

Introduction: Mongolia is one of the most vulnerable countries to climate change due to its geographical location, climate conditions, level of development and lifestyle of the population.
The “Impact of Climate Change on Drinking Water, Health and Adaptability” study report has shown that climate change is affecting the quality and composition of drinking water, drying up many rivers and lakes and reducing groundwater levels.
There was a strong positive correlation between precipitation and air temperature and dysentery, diarrhea and salmonellosis, while there was a strong negative correlation between precipitation, air temperature and viral hepatitis. Goal: The goal of the study was to reveal correlation between meteorology parameters and some intestinal infectious diseases and human health in Mongolia. Material and Methods: We evaluated climate and certain morbidity (intestinal infections) indicators for the last 15 years (2005-2019) using descriptive survey methods. The methodology of the survey has developed and discussed at the Scientific Council meeting of NCPH, 12th of Oct, 2020. The methodology of the survey has developed and discussed at Medical Ethics Reviews Committee of MOH on 23rd. of June, 2021. Results: On the other hand, the average air temperature has intensively risen for the last three decades since 1990 with the warmest average temperature between 2001-2010, whereas the coldest average temperature has been observed between 1951-1960. In 2005-2009, the prevalence of intestinal infections per 10.000 population was 0.8 cases of salmonellosis, 11.2 cases of dysentery, 0.2 cases of diarrhea, and 39.0 instances of hepatitis A. Throughout 2015 and 2019, the prevalence of salmonellosis fell by 0.1 per 10.000 population, dysentery by 2.9, diarrhea by 0.1, and hepatitis A by 0.1. Conclusion A seasonal trend in intestinal infections was observed (p<0.001). Strong positive correlation was found between high temperature and some intestinal infections (hepatitis А, dysentery, salmonellosis) respectively.