Surgical result of velopharyngeal insufficiency Background: The main purpose of primary cleft palate (CP) repair is to reconstruct anatomical structure with minimal impairment of maxillary growth and normalize velopharyngeal function and feeding process. One of the most common complications after the primary CP repair is velopharyngeal insufficiency (VPI), which leads to the subsequent surgery. The velopharyngeal function assessment characterizes speech development in children. Researches noted that VPI causes in 5-86% after primary CP repair. Early diagnosis of VPI and prompt surgical treatment are essential to prevent the development of speech disorders in children. Methods and Material: A retrospective longitudinal study was completed. The patients who diagnosed VPI after primary CP repair in the Department of Maxillo-facial surgery of the National Center for Maternal and Child Healt and had velopharyngeal function assessment were recruited to the study. The results were compared with pre and postoperative nasopharyngoscopy ratio. Results: A total of 133 patients with VPI were included: 75.9% had Furlow Z plasty, 24.1% had pharyngeal flap surgery. The patients ranged in age from 3 years 6 months to 17 years. VPI ratio was 17.3% - severe, 19.5% - moderate. Postoperative VPI ratio were 97.0% normal in the Furlow group and 84.4% in the pharyngeal surgery group (p=0.02). Nasal emission was 94.0% before surgery and 31.6% after surgery, a statistically significant difference (t = -14.2, p <0.0001). Conclusions: The Furlow Z plasty and pharyngeal flap surgeries were superior for maintaining velopharyngeal function.

The prevalence and type of congenital cleft of the lip and palate in mongolia, affiliation of the patients Background: The prevalence of congenital cleft lip and palate is different internationally. There are some research papers which identifying the rate of this abnormality in Mongolia, the latest one shown the result that one cleft case for 1072 live births (Ayanga GN et all, 2012). Aim: to determine/update the prevalence and types of congenital cleft lip and palate in Mongolia Materials and methods: we include the data from all cleft patients who were born between 01 of January, 2011-31 of December, 2021 to this survey retrospectively. We used the e-history for cleft patients, which developed by the department of Maxillofacial surgery since 2011. Results: Totally 1308 cleft patients included to our survey. The prevalence is one cleft cases for 652 live births in Mongolia, and 34,1% is cleft of the lip, 41,4% is cleft of the lip and palate, and 24,5% is cleft palate only of all cases. Also the rate was differently among provinces, as one for 429 live births in Khuvsgul province, and one for 1223 live births in Uvs province. Conclusions: the prevalence of cleft lip and palate in Mongolia 1000:1.5 or one for 652 live births. The highest rate established in Khuvsgul province, and the lowest in Uvs province.

Background: The main purpose of primary cleft palate repair is to reconstruct anatomical structure with minimal impairment of maxillary growth and normalize velopharyngeal function and feeding process. One of the most common complications after the primary cleft palate repair is velopharyngeal insufficiency, which leads to the subsequent surgery. The velopharyngeal function assessment characterizes speech development in children. Researches noted that velopharyngeal insufficiency causes in 5-86% after primary cleft palate repair. Therefore, it is essential to choose an adequate primary surgical method for each particular type of cleft palate. Objective: To compare velopharyngeal function using nasopharyngoscopy after primary CP repair Materials and Methods: The patients who with congenital cleft palate and, underwent primary cleft palate repair in the Department of Maxillo-facial surgery of the National Centre for Maternal and Child Health and had velopharyngeal function assessment were recruited to the study. Patients with wound dehiscence and oronasal fistula postoperatively were excluded from the study.
Cleft palate was classified according to the Veau system and Golding-Kushner scale of nasopharyngoscopy was used to assess patient’s velopharyngeal function in order to associate with cleft types and the primary palatoplasty techniques. Pearson’s chi-squared analysis and Fisher exact test were used for statistical analysis. Results: A total of 335 patients were included in the study. The mean age at primary palate repair was 22.9±13.6 months. There were 56, 42, 177, and 60 patients with Veau-I type, Veau-II type, Veau-III type and Veau- IV type respectively, whereas for primary palatoplasty 65 patients underwent Furlow technique, 148 patients – Mongolian technique, 108 patients – Two flap technique, 34 patients – Von Langenbeck technique.
Nasopharyngoscopy assessment of adequate velopharyngeal function was as followed as by “Furlow” technique in 89.4% cases, ”Mongolian” technique in 62.2% cases but by “Two flap” technique only in 48.1% and Von Langenbeck technique in 47.1% cases. Conclusion The Furlow and Mongolian techniques were superior for maintaining velopharyngeal function after primary palatoplasty.

Nutrition is a key factor in the normal functioning of the immune system, and malnutrition is one of the most common causes of immunodeficiency worldwide today. However, the public health policies on immune system and infection lacks the nutritional strategy to ensure the optimal functioning of the immune system Loss of cellular immunity, phagocyte function, blood protein complex, cytokine synthesis, and A-immunoglobulin secretion are generally associated with protein-energy deficiency.
Some vitamins and minerals, such as A, B6, B12, C, D, E, folic acid, zinc, iron, selenium, magnesium, and copper, plays an important role in the immune system function. Deficiency or low levels of micronutrients can negatively affect the immune system and reduce the ability to fight infections.

Velopharyngeal function: a comparison result of primary palatoplasty by various techniques Introduction: The main purpose of primary cleft palate repair is to reconstruct anatomical structure with minimal impairment of maxillary growth and normalize velopharyngeal function and feeding process. One of the most common complications after the primary cleft palate repair is velopharyngeal insufficiency, which leads to the subsequent surgery. The velopharyngeal function assessment characterizes speech development in children. Researches noted that velopharyngeal insufficiency causes in 5-86% after primary cleft palate repair. Therefore, it is essential to choose an adequate primary surgical method for each particular type of cleft palate. To compare velopharyngeal function using nasopharyngoscopy after primary CP repair Materials and methods: The patients who with congenital cleft palate and, underwent primary cleft palate repair in the Department of Maxillofacial surgery of the National Centre for Maternal and Child Health and had velopharyngeal function assessment were recruited to the study. Patients with wound dehiscence and oronasal fistula postoperatively were excluded from the study. Cleft palate was classified according to the Veau system and Golding-Kushner scale of nasopharyngoscopy was used to assess patient’s velopharyngeal function in order to associate with cleft types and the primary palatoplasty techniques. Pearson’s chi-squared analysis and Fisher exact test were used for statistical analysis. Results: A total of 335 patients were included in the study. The mean age at primary palate repair was 22.9±13.6 months. There were 56, 42, 177, and 60 patients with Veau-I type, Veau-II type, Veau-III type and Veau- IV type respectively, whereas for primary palatoplasty 65 patients underwent Furlow technique, 148 patients – Mongolian technique, 108 patients – Two flap technique, 34 patients – Von Langenbeck technique. Nasopharyngoscopy assessment of adequate velopharyngeal function was as followed as by “Furlow” technique in 89.4% cases, ”Mongolian” technique in 62.2% cases but by “Two flap” technique only in 48.1% and Von Langenbeck technique in 47.1% cases. Conclusions: The Furlow and Mongolian techniques were superior for maintaining velopharyngeal function after primary palatoplasty.

In United States, person is diagnosed with blood cancer in every 3 minutes. In 2015, there were 1.665.540 total cancer cases and 9.4% of them lymphoma and leukemia . In 2015, there were 95 cases of lymphoma in Mongolia when compared 4 times increase to 2015 from 2010 . Bone marrow examination is an established diagnostic modality in the evaluation of various hematological disorders. BM examination can serve to establish or confirm a primary diagnosis of lymphoma or to determine the extent of disease dissemination for staging purposes. Biopsy is essential for diagnosis in a dry tap or blood tap which occurs when the marrow is fibrotic or densely cellular. Only a biopsy allows a complete assessment of marrow architecture and pattern of distribution of any abnormal infiltrates. In 2015.01-2016.01 fifty five bone marrow biopsies were retrieved from the files of the National First Clinical Hospital-Department of Hematology. These all statistical analysis was performed using by SPSS 17. Bone marrow processing and staining: The hematologist is instructed to place the freshly obtained BMTB specimens directly into buffer substance fixative and transport it immediately to the histopathology department, on the same day as the procedure.The next morning (after 20–24 h), the solution is decanted (with a strainer) and the biopsy specimen is washed in distilled water for 30 min. The biopsy specimens are left to decalcify for about 6 h before being processed and embedded in paraffin wax, with procedures similar as for other specimens.Sections, 1-mm thick (microtome set for 1 mm sections), are cut from the paraffin-wax blocks with the routine rotary microtomes in the laboratoryA total of 55 cases were reviewed from December 2014 to November 2015. The age of the subjects ranged from twenty two years to seventy eigth years with a male predominance (1.7:1). Data of 55 trephine biopsies were reviewed. The percentage of trephine biopsies in different length ranges was calculated. Twenty two biopsieswere of recommended length, i.e., ≥1.5 Cm while remaining 33 were less than the recommended length. The rate of positivity for diagnosis was 95.4% in group-1, 94.1% in group-2, 63.6% in group-3 and 40% in group-4 In all cases in our study 73% (n=40) were satisfactory and 27%(n=15) unsatisfactory slides .Our study showed that 40% trephan biopsies were of revommended length i.e >=1.5cm with 95.4% positive of diagnosis. However biopsies measuring 1-1.4 cm also had comparable result 94.1% .

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.

The persistent high-risk human papilloma virus(HPV) infection is a necessary cause for developing cervical carcinoma. Although carcinogenic HPV types are found in virtually all invasive cancer, with types 16 and 18 being found in approximately 70 percent of cases. High risk HPV types’ Е6 and Е7 oncogenes have a pivotal role in cervical carcinogenesis. The p16, the cyclin-dependent kinase inhibitor and p16 overexpression in cervical neoplasia is a surrogate marker of high risk HPV E7 mediated pRb catabolism reflecting disruption of mechanisms that control cell proliferation and indicating persistent infection with high risk of development of neoplasia.Thus in worldwide p16 had been identified as the novel biomarker in pre-invasive cervical lesions. Objective: For the purpose to detect for cervical cancer risks we examined HPV16/18 and cell cycle protein p16 expression in cervical lesions.A total of 96 specimens enrolled in this study and 50 were diagnosed as LSIL and 46 were diagnosed as a HSIL. To detect HPV16/18 and p16 in cervical lesions used immunohistochemistry. Statistical analysis was performed using SPSS 16.0. Descriptive analysis was performed by Chi- Square test and also determined sensitivity and specificity.Positive stainingfor p16 and HPV16/18 were observed whole cell, within both the nuclear and cytoplasmic subcellular regions by immunohistochemistry. 63% of specimens had only HPV16 infection and 22% of specimens had only HPV18 infection.Also 14% specimens had co-infection with two viral types and 28% specimens had not above two most HPV infection. There were a significant difference for HPV16 positivity (X2 = 4.93, P < 0.05) and were not significant difference for HPV18 positivity (X2 = 0.28, P > 0.05) in HSIL and LSIL groups. There were not a difference for p16 in HSIL and LSIL groups.(X2 = 0.23, P > 0.05), respectively.P16, yielding a diagnostic sensitivity for HPV 16/18 were 82% and 30%, specificity for HPV 16/18 were 40% and 80%, respectively. In conclusion it is possible to detect high risk HPV types and persistent infection by immunohistochemistry in cervical intraepithelial squamous cell lesions. There is still critical need to use HPV testing and other molecular surrogate markers of HPV such as p16 in primary screening program.

The timing and technique for palatoplasty is very controversial, recent literature advocates for early repair, between six and eighteen months of age, facilitating normal speech and language development, and avoiding hearing loss. It is using three main kinds of techniques for palatoplasty in the worldwide, two flap pushback, Furlow double opposing z-plasty, and two-step palatoplasty.Cases presenting later in life to the Mongolian National Center for Maternal and Child Healthprovide Mongolian surgeons′ with the challenge of wider defects which are difficult to manage successfully using traditional palatoplasty techniques.Oro-nasal fistula formation is an one of most documented postoperative complication, and it`s rate is reported between 6-42,3% in the literature. In Mongolia patients often present in older than recommended age for palatoplasty,it provide surgeons with the challenge of managing wider defects, which have higher rates of fistula formation and wound dehiscence. There were 30% of ONF in our practice. So, in 2000 we established new modified Mongolian technique for primary palatoplasty for improved outcomes across all age groups. And ONF rate reduced from 30% to 5.9 % in our department. Objective: To determine velopharyngeal function after primary palatoplasty by Mongolian method in connective with age at repair and cleft type.In our study were included over four year’s old patients, who underwent primary palatoplasty by Mongolian method at the authors` centre. We excluded syndromic cases, and patients who had an oronasal fistula postoperatively, and no cooperation with speech therapist. This study, we use video records of nasopharyngeoscopy to evaluate for cleft lip and palate patient’s velopharyngeal function associated with type of clefts, the timing of palate repair and cooperation with speech therapist.There were included totally 28 patients who are 4-23 years old (mean age 10.2 years) at the time of study, were performed primary cleft palate repair by Mongolian technique at NCMCH. The mean age at palate repair was 38 months (14 months-18 years). Overall, 39.2% (11) of patients were performed palate repair at 18≥ months old and 60.8% (17) patients were operated palate repair at 18< months. In the first group, VPI was demonstrated 27,3%, and in the second group 41,2%. Also, there were demonstrated VPI for 66,7% of Veau 1 type, 45,5% of Veau 3 type, and only 10% of Veau 4 type, after Mongolian method. Better velopharyngeal result for Veau 4 type and wide cleft palate after Mongolian method than other types. We should continue this study in wider screen for recognition this results.

BACKGROUNDProstate cancer is the most frequent malignancy among men nowadays.METHODSImmunohistochemical expression of prostate-specific antigen (PSA) was retrospectively investigated in 10 patients admitted with clinical suspicion of the prostate cancer. Slides were collected from archived biopsiesandthey were stained for PSA.The final reaction product was evaluated as negative (0), weak/moderate positive (1), and intense positive (2).RESULTSGlandular prostate carcinoma was found in 40% (n=4) and undifferentiated carcinoma in 60% (n=6). The immunoreaction for PSA was intense positive in 30% (n=3), weak/moderate positive in 50% (n=5) and negative in 20% (n=2) of total cases.CONCLUSIONSWe concludethat PSA immunoreaction is helpful for the differential diagnosis based on our results.