The stereo-structure of the orbit is affected by several orbital diseases, e.g. congenital orbital dysplasia, orbital fracture, and intraorbital tumor. The three-dimensional (3D) reconstruction technique serves as a practical tool in diagnosis, surgical planning, and outcome prediction of plastic and reconstructive surgery. In our study, the morphologic features of the Mongolianadult orbit were described by 11 anatomic parameters using a 3D reconstruction technique and quantitative morphometry. The morphologic parameters of orbit such as bony orbital volume, orbital foramen area and orbital rim perimeter were measured on 3D models using this technique. Three-dimensional (3D) reconstruction based on high-resolution spiral computed tomography (CT) scans has been used for more than 10 years to reveal the anatomic location and morphologic features of orbital abnormalities and plays a important role in diagnosis, surgicalplanning, and outcome prediction. The findings of the study would allow for quantification of the orbital features of Mongolian adults and provide parameters for preoperative planning and prediction of postoperative outcome.

Foundation of the research: The issues of safety and qualified medicine industrial, supplyment and maintenance is the counterpart of national security policy about any nations. Mongolia has been importing over 80% of domestic demand of medicine.New drugs have accessed into marked and medicine distributors or suppliers, pharmacies have established as many, thus its generating the needs to improve the legal environ for to reach the new level of quality control, medicine suppliers structure and activities, then also to verify the safety of imported or local medicine.May having formulize the requirements of medicine warehouse, remodify the standard of Medicine Supply Organization can be the first step to solve the problems which Medicine Supply Organization has been facing.The purpose and goals of research work: Submitting following goals in the frame of the purpose to analyze the condition of the Medicine Supply Organization’s warehouse, study the foreign country’s GSP and utilize the standard instruction of medicine warehouse by determine the method of access it into Mongolian bigger Medicine Supply Organization. Thereof:1.Make analysis and assessment on the current condition of Mongolian Medicine warehouse.2.Conduct the research work based on the guidance of World Health Organization, European UnioN warehouse standard and other foreign country’s warehouse standard.3.To utilize the medicine warehouse standard guidance for Mongolia.The methodology: Have selected and incorporated with 5 top company which are operating as medicine importer based on value of imported products for last 3 years and 3 The pharmaceutical wholesale center which had lesser scope and totally means 8 companies.We used following methods such as observation study, open review survey, schematic and comparative study, method of interview and review and documentation method.THE RESULT OF RESEARCH WORK: Even though,those research involved organizations have met with the requirements of MNS 5530:2009 Medicine Supply Organization Standard by 71%, and risk assessment was in low risk category as by 20% under the State Specialized Inspection Agency, but accordingly with the World Health Organization’s formulized GSP’s guidance, it haven’t freezing and cooling chain storage condition of medical product storage. Research involved The pharmaceutical wholesale center provides activity supervision indication of GSP’s guidance by 30%, required parts of warehouse structure by 43% and supportive parts of warehouse operation by 22%.CONCLUSION:1. However, that research involved the pharmaceutical wholesale center have reached 71% of the requirement of MNS 5530:2009 standard of Medicine Supply Organization and fitted in low risk category as 20% according with the risk assessment of State Specialized Inspection Agency, but was lower by 68% than building construction standard and activities according with the GSP’s guidance.2. Have determine the solutions for resolvable factors which are unreached the requirements of GSP based on the study of World Health Organization, European Union GSP requirements, Kazakhstan, Bulgaria, Germany and Russian by linked it with the condition of research involved organizations.Utilized the Mongolian medicine warehouse standard guidance.

LASIK is the most popular treatment method for correction of the refractive errors of ophthalmology its development in 1990 and number of patients has continued to increase.The safety and efficacy of LASIK surgery have been reported several times by numerous researchers and doctors, but all studies have made abroad. This time we have summarized postoperative outcomes of LASIK surgery, which have performed in our country. Consequently 103 patients (206 eyes) who underwent LASIK surgery in “Bolor-Melmii” eye clinic between 2007 and 2011 were enrolled. The retrospective method of study was used to evaluate postoperative outcomes. Preoperative UCVA of 0.04-0.4 improved to 0.5-1.2(decimal) at 1 day after surgery and during 1 year after surgery revealed minimal but wasstable. Preoperative mean sphere equivalent of 2.2+/-0.72D improved at the 1 year by +/-0.5D in 161 eyes (78.15%), by +/-1.0D in 39 eyes (18.9%) and by +/-2.0D in 6 eyes (2.9%)after surgery. Mean sphere equivalent and astigmatism improved to -0.46 +/-0.4D and -0.43+/-0.34D respectively at 1 year after surgery. Improvement of the sphere equivalent and its stability during a year period of study proves that LASIK surgery is an effective with stable improvements and safe procedure for correcting myopia/myopic astigmatism. No severe complications occurred during and after surgery.

Aim: The aim was to determine etiology and clinical presentation of pediatric cataract during 1 year period Methods: NCMCH is tertiary and referral center for all pediatric patients with cataracts in 21 provinces and UB. Database contains cases during 1 year period. We have recorded the following data from the medical histories of these patients: family history, current age, age at diagnosis, age at surgery either eye, morphology of cataracts, laterality, associated findings and other investigations which were performed as clinically indicated. We have operated 80 children in total during 1 year period, however the study included 68 patients (91), eyes excluding 12 patients. Results: Of 68 children with cataract 76.% were non traumatic, 21,15% hereditary, 51,9% were congenital/infantile, 35.8% were unilateral, 44% were associated other ocular findings, 25% were associated systemic disease. 33.3% were diagnosed and operated 0-12 months. 73% of congenital/infantile cataract patients were nystagmus. Of traumatic cataract 76,5% due to penetrating trauma. Conclusions Patients of pediatric cataract 1/3 were usually diagnosed in 0-12 months. 1/3 of these patients were diagnosed congenital cataract whereas 1/4 were nystagmus. To add up associating congenital/infantile cataract with Down syndrome weren’t rare.

To evaluate the efficacy and safety of bevacizumab monotherapy or combined with laser versus laser monotherapy in Mongolian patients with visual impairment due to diabetic macular edema.Prospective, randomized, single-center, a 12 month, laser-controlled, clinical trial. Participants: One hundred twelve eligible patients, aged ≥18 years, with type 1 or 2 diabetes mellitus and best corrected visual acuity (BCVA) in the study eye of 35 to 69 Early Treatment Diabetic Retinopathy Study (ETDRS)letters at 4 m (Snellen equivalent: ≥6/60 or ≤6/12), with visual impairment due to center-involved diabetic macular edema (DME). Methods: Patients were randomized into three treatment groups:(I) intravitreal bevacizumab monotherapy (n=42), (II) intravitreal bevacizumab combined with laser (n=35), (III) laser monotherapy (n=35). Bevacizumab injections were given for 3 initial monthly doses and then pro re nata (PRN) thereafter based on BCVA stability and DME progression. The primary efficacy endpoints were the mean change in BCVA and central retinal subfield thickness (CRST) from baseline to month 12.Bevacizumab monotherapy or combined with laser were superior to laser monotherapy in improving mean change in BCVA letter score from baseline to month 12 (+8.3 and +11.3 vs +1.1 letters; both p<0.0001). There were significant difference detected between the bevacizumab and bevacizumab combined with laser treatment groups (p=0.004). At month 12, greater proportion of patients gained ≥10 and ≥15 letters and with BCVA letter score >73 (Snellen equivalent: >6/12) with bevacizumab monotherapy (23.8% and 7.1% and 4.8%, respectively) and bevacizumab + laser (57.1% and 28.6% and 14.3%, respectively) versus laser monotherapy. The mean central retinal subfield thickness was significantly reduced from baseline to month 12 with bevacizumab (−124.4 μm) and bevacizumab + laser (−129.0 μm) versus laser (−62.0 μm; both p<0.0001). Conjunctival hemorrhage was the most common ocular events. No endophthalmitis cases occurred.Bevacizumab monotherapy or combined with laser showed superior BCVA improvements over macular laser treatment alone in Mongolian patients with visual impairment due to diabetic macular edema.

Kidney transplantation is the best alternative treatment for end-stage renal disease and health-related quality of life and survival of the patients are improved compared with dialysis. Worldwide, more than 1.4 million patients with CKD receive renal replacement therapy with incidence growing by approximately 8% annually.1 Unfortunately, despite significant improvement in graft function, kidney transplants can still fail due to acute rejection and chronic allograft nephropathy.2 Kidney biopsy after transplantation, which has evaluated by Banff 09 classification is usefull method for diagnose of transplanted kidney disease.3,4Kidney graft rejection was diagnosed in 10 renal allograft biopsy specimens (bs) obtained from transplant patients followed up at our institute between 2015 and 2016. All specimens were evaluated as satisfactory which show more than 8 glomerulus under the light microscopy. Each renal cortical tissue was divided into two tips: one piece for routine H&E stain and special stains, including Masson’s trichrome, and PAS stain; another piece for immunofluorescence by frozen section, which were stained with IgA, IgM, IgG and complement component (C3, C4, C1q, C4d). All the renal biopsies were examined by the same pathologist.Out of 117 transplantations, 10 episodes of rejection selected. Among the 10 patients, 30% had an acute T cell rejection and 70% had a chronic allograft nephropathy. Interstitial inflammation (i1-7) was present in 7 bs (70%), tubulitis (t1-4,t2-2) in 6 bs (60%), transplant glomerulitis (g1-1, g2-2, g3-1) in 4 bs (40%), transplant interstitial fibrosis (ci1-2, ci2-2, ci3-2) in 6 bs (60%), tubular atrophy (ct1-6, ct2-2, ct3-1) in 9 bs (90%), mesangial matrix increase (mm1-5) in 5 bs (50%), vascular fibrosis intimal thickeness (cv1-3) in 3 bs (30%), arteriolar hyaline thickening (ah1-5) in 5 bs (50%), tubulitis (ti1-6, ti2-3, ti3-1) in 10 bs (100%) and peritubular capillaritis (ptc1-1, ptc2-2, ptc3-1) in 4 bs (40%). C4d deposition was present very mild in wall of the vessels and peritubular capillaries. Because of not good working Methenamin silver stain, we couldn’t demostrate glomerular basement membrane changes (cg) fully.We suggest that histopathological changes of transplant glomerulopathy might be accompanied by inflammation of the microvasculature, such as transplant glomerulitis and peritubular capillaritis. C4d deposition in the wall of the vessels and peritubular capillaritis is not always present in biopsy specimens of transplant glomerulopathy.

Background: Central serous chorioretinopathy (CSCR) is described by researchers as a condition that results from fluid under the retinal pigment epithelium, originating from the choroid of the eye. This disease usually affects the central part of vision and may resolve on its own over time, though in some cases, it can persist for long periods or recur. In our country, there is a lack of research regarding this condition, which led to the motivation for gathering and reviewing existing works on this topic. Aim: To collect and analyze a review of the studies on central serous chorioretinopathy (CSCR). Methods: We reviewed and analyzed literature related to CSCR published in electronic sources such as Thomson Reuters, PubMed-central database, and Google Scholar using literature review methods. Results: CSCR is most commonly seen in individuals aged 35-55 years, with a significantly higher prevalence in men (9.9/100,000) compared to women (1.7/100,000). Researchers found that the prevalence of CSCR is nearly the same among populations in Europe, Africa, and Asia. CSCR typically affects one eye, but it occurs in both eyes in up to 40% of cases. Weenink A (2001) studied the family members of 27 patients with bilateral CSCR, finding that 52% of family members had been diagnosed with CSCR, and 27.5% of them had chronic CSCR in at least one eye. This suggests a potential genetic predisposition to CSCR. According to researchers, while CSCR can be diagnosed clinically, additional imaging techniques like fluorescein angiography and optical coherence tomography are frequently used to rule out other diagnoses and guide treatment. Conclusion CSCR generally has a favorable prognosis, but recurrences and its effects on visual function indicate the need for effective management strategies. To maintain long-term visual improvement, it is essential to provide healthcare services tailored to the patient’s specific conditions and risk factors.

Background: TED (thyroid eye disease) is an inflammatory disease of the orbit caused by autoimmune diseases of the thyroid, which adversely affect the vision, appearance, and quality of life. Exophthalmos and eyelid retraction are the main features of TED, which can lead to ocular motility, diplopia, optic neuropathy, and permanent vision loss. The study aims to determine the most common clinical signs of TED in Mongolians and define whether there is a correlation with the levels of thyroid autoantibodies. Methods: The study involved 102 patients with TED and 81 patients with Graves’ ophthalmopathy. The clinical features of TED were identified and evaluated by activity score (CAS) and severity of GO using the European Group of Graves’ Orbitopathy (EUGOGO). Results: The mean age of TED patients was 42.6±11.2, which was younger than GD patients (P=0.012). The current smoker was 24 patients (23.5%) with TED, which is relatively higher than GD (P=0.0001). The most common ocular signs were eyelid retraction 80 (78.4%), proptosis 77 (75.5%), diplopia 14 (13.7%) and 4% vision loss. There were no differences in proptosis between the right (18 mm, median) and left eye (17.8 mm, median) (P>0.05). The mean CAS score was 3.09±1.72 and varied depending on gender and smoking. According to EUGOGO, 62.7% of the patients were moderately severe. Only 7 % of the patients were in the sight-threatening stage, presenting optic neuropathy and corneal breakdown. The mean TSI level in patients with TED was 37.95 ± 35.41 IU / ml, which was 2.7 times higher than the mean in patients with GD. Conclusions Eyelid retraction and exophthalmos are the most common clinical signs of TED. Early diagnosis of these features can prevent complications of the disease. Determining serum TSI levels will help in the treatment and monitoring of TED.

Background: Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services. Aim: To assess the quality indicators in gastrointestinal endoscopy unit. Materials and Methods: A retrospective single-center study was conducted by collecting data from the Intermed hospital’s electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of four quality indicators measured monthly; b) sample survey data from five categories of quality indicators. Results : Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was 5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes, Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate risk was 0.28% by the TROOPS evaluation during procedural sedation. Conclusion The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.