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.

About 10-15% of infertility among reproductive aged couples. According to the Centers for Disease Control, 1/3 of the women among 30 over aged, ½ of the women among 40 over aged women have infertility. Infertility rate is in Europe 10%,in USA 15%, in Russia 17 % (Speroff L. Endocrinology and Infertility. 2005). Female infertility is 45.6%, caused by damage to fallopian tubes is 61%, hormonal causes infertility is 30-40%. In Mongolia the report of study in 1997, infertility rate was 13.06%, report of IVF laboratory of Bayangol hospital infertility rate was 8-10% in 2010, the female infertility was 40-60%. We have first time to study female infertility risk factor among our gynecological department. Aim of study is to identify the some risk factor of female infertility We separated the women into 2 groups by fertile (normal 48 women and infertility 48 women). Hormonal findings was obtained from all women and had survey of questionnaire to risk factor. Statistical analysis did SPSS 20, data were given as mean±SD, the frequencies of the alleles and genotypes in patients and controls were compared with X2 analysis. Odds ratio (OR) and 95% confidence intervals were calculated.The mean age was 33.4±6.1 and mean years of infertility was 7.0±4.5. The primary infertility was 27.1% (n=13), secondary infertility was 72.9% (n=35). The 1.2% (n=15) were given birth, the 33.3% (n=16) had miscarriage and 58.3% (n=28) had abortion of total women. The mean BMI was 24.7±4.6 and 23% were overweight and 13% women were obesity among infertility women. The mean length of uterus was 5.1±1.1 sm, width was 4.0±0.8 sm, mean length of ovaries was 3.1±0.6 sm, mean width was 2.3±0.6 sm among infertility women. Also estradiol mean level was 41.6±22.1 pg/ml, FSH was 15.6±6.1mIU/ml, LH 5.5±1.7mIU/ml, and prolactin 14.4±10.6 ng/ml, progesteron mean level was 0.6±0.1 ng/ml among infertility women. These hormonal level was same in normal women. The risk factor of infertility were sexually transmitted disease (p=0.007, OR=7.667, CI 1.612-36.455), and curettage of uterus (p=0.024, OR=1.357, CI 1.156-1.1819). Secondary female infertility rate was (72.9%) and the women with STD 7.6 hold and women with previous had curettage of uterus will get 1.3 hold the risk of infertility.

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.