Outcomes of the retinopathy of prematurity screening and treatment in Mongolia Background: Retinopathy of prematurity (ROP) is a disease characterized by abnormal retinal vasculature that can have devastating visual consequences. Despite evidence that early detection and treatment can prevent blindness, ROP remains a leading cause of pediatric blindness worldwide. We aimed at investigating the outcomes of ROP screening, intravitreal anti–vascular endothelial growth factor (VEGF) and laser surgery in the treatment ROP and describe an evidence-based and specific process for identifying birth weight and gestational age screening guidelines in Mongolia utilizing telemedicine. Materials and methods: This was a retrospective of prematurity infants screened ROP from 2012 September to July 2020 and prospective cohort study of premature infants with treatment-requiring ROP who received intravitreal injections, laser surgery and combined therapy from 2015 December 01 to January 31, 2017. Demographic factors, diagnosis and clinical course were recorded in a de-identified manner using REDCap, a secure, web-based platform to collect image and demographic data. The IRB approved the study protocol not requiring parental consent due to the de-identified nature of the data which was used for program monitoring purposes. Indirect ophthalmoscopy and Retinal imaging was performed using RetCam (Natus Medical, Pleasanton, CA) and images were uploaded to the web-based platform which could be accessed by the Mongolian ophthalmologist for reference. Each eye was evaluated by the local Mongolian ophthalmologist for the presence or absence of ROP, zone of vascularization, stage, plus disease, and aggressive posterior ROP (AP-ROP). The diagnosis and classification of ROP for this current study were determined by examination using indirect ophthalmoscopy, and treatment plans were determined according to the International Classification for ROP and the Early Treatment for ROP Study (ET-ROP).2,13 Regression analysis to determine association between BW and GA and the development of ROP. Results: A total of 9126 premature infants with BW ≤ 2500 g and/or GA ≤ 36 weeks were screened for ROP during the study period. 327 (3.5%) of the 9126 infants screened required treatment. The193 infants who received ROP screening had a mean GA of 30.09 ± 1.7 weeks, and mean BW of 1500.3 ± 125.42g. The BW of infants in this study ranged from 750g to 2000g, and the GA at birth ranged from 25 to 35 weeks. The BW of infants in this study ranged from 750g to 2000g, and the GA at birth ranged from 25 to 35 weeks. There were 96 boys (49.7%) and 97 girls (50.3%). Among infants receiving treatment, the highest BW was 2000g (born at 31 weeks GA), and the oldest was 34 weeks (with a BW of 1300g). The distribution of birth weight and gestational age in Mongolia was similar to other low-middle income countries, with higher birth weight and older gestational age. As birth weight and gestational age decreased, relative risk of developing ROP increased. Conclusions: After treatment, resolution of ROP was noted in approximately 90 % of the patients who had treatment-requiring ROP. 10 % of patients treated with IVB, IVR, Laser surgery and combined therapy however, did not respond and progressed to retinal detachment. This prospective study provides information about the development of ROP in preterm infants in the capital city of Mongolia. The distributions of BW and GA among infants developing ROP in Mongolia differ from those found in higher-income countries, and are comparable to other low and middle-income countries. We used a secure, web-based data collection and retrieval system that could be extended to multiple countries, which is now equipped with a telemedicine platform enabling remote grading of fundus images.

BACKGROUND The occurrence of facial injuries tends to be high compared to injuries in other parts of the body, because the face is without a protective covering, and the chin mandible is the most prominent bone in this region of the body. According to several studies, mandibular fractures account for 59% of all facial fractures. Mandibular fractures usually occur in 2 or more locations because of the bone’s U shape. This article aims to analyze retrospectively the age, gender, etiology, and anatomic distribution of mandibular fractures. METHODS The data for this study were obtained from the medical records of 1217 cases treated at Department of Oral and Maxillacial Surgery at National First Central Hospital of Mongolia in 2016. Information was collected from the clinical notes of each patients with mandible fractures. The demographic variables such as age, gender and clinical information included diagnosis, etiology, and anatomical distribution of fractures was assessed. RESULTS The total of 229 subjects had mandible fractures, out of which 209 were males and 20 were females. The mean age of the participants was 32,2±10. The major cause of fractures was assault 79% , followed by road traffic accident – 11%, sport injuries – 5%, accidents at work or home – 3%, other – 2%. Mandible fracture incidence were high during in August. By the time referred to a physician from day of injury were 1-5 days 72,1%, 6-10 days 25,7%, delayed more than 10 days were 2,2% of the cases. Unilateral fractures were 77,4%, bilateral fractures 21,7%. Mandible left side were 158 (65,9%) mostly injured. The most common fracture site was angle- 112 (53%), condyle- 58 (27,5%), body- 21 (9,9%), parasymphysis- 16 (7,6%) and at least common site were ramus- 2 (1%) and symphysis - 2 (1%) of mandible. Among multiple fractures most common sites were condyle-parasymphysis which 24 cases and angle – parasymphysis were 21 cases. CONCLUSION The following conclusions have been drawn from the foregoing study. The mandible fractures were more common in males 209 (91,3%) than females 20 (8.7%). Assaults were the most common cause of the fracture. 77,4% fractures were unilateral fractures. The most common site of fracture was mandible angle- 112 (53%) and common multiple fractures were condyle-parasymphysis. By the time referred to a physician from day of injury were 1-5 days 72,1%, 6-10 days 25,7%, delayed more than 10 days were 2,2% of the cases.

Hemangiomas are common benign vascular tumors which about 70% to 80% of the lesions are found in the head and neck region. This study was conducted on 36 children with hemangioma who were referred to Orofacial Surgery Cabinet of Dental School of Health Sciences University of Mongolia and Orofacial Surgery Cabinet of National Center for Maternal and Child Health of Mongolia between 2013 and 2015.Of the 36 children referred for assessment, 72% were female, 55% were infants of 4 to 9 months old, and 83% of them were citizens. 58% of patients underwent cryotherapy,and 57% of patients underwent cryotherapy had 2 therapy sessions. 25% of patients receiver sclerotic therapy, and 67% of them had 2 therapy sessions. According to the locations of hemangiomas 30% of them were localized in infraorbital area. 72% of the participants are women and 55% are children age of 4-9 month which 83% of all participants were living in city. 58% of children with hemangioma are treated with cryotherapy which 57%of treatment finished by second visit. And 25% were treated by dehydration treatment which 67% were finished by second visit.