Background: As global life expectancy increases, spinal disorders and the need for spinal surgery among elderly individ uals are becoming more prevalent. Postoperative cognitive decline (POCD) is a common complication in this population, adversely affecting functional recovery and quality of life. Despite substantial research, effective preventive strategies for POCD remain limited. Aim: To determine the incidence of POCD and to identify perioperative risk factors associated with its development in elderly patients undergoing spinal surgery. Materials and Methods: A prospective cohort study was conducted at the Second Affiliated Hospital of Inner Mongolia Medical University. Of 200 elderly patients who underwent spinal surgery between, 122 met the inclusion criteria and were enrolled. Preoperative clinical assessments, intraoperative surgical and anesthetic parameters, and postoperative evaluations were systematically collected. Cognitive function was assessed using standardized and validated tools both before and after surgery. Multivariate logistic regression analyses were performed to identify independent predictors of POCD. Results: POCD was observed in a notable proportion of patients postoperatively. Multivariate analysis revealed that prolonged surgical duration (OR=0.989; p=0.005), intraoperative hypotension (OR=0.964; p=0.009), higher intensity of postoperative pain (OR=10.073; p=0.015), and elevated postoperative C-reactive protein levels (OR=1.039; p<0.001) were significantly associated with an increased risk of developing POCD. Conclusion In elderly patients undergoing spinal surgery severe postoperative pain, and systemic inflammatory respons es contribute significantly to the development of POCD. Optimizing perioperative management, including minimizing surgical time, maintaining stable hemodynamics, and controlling postoperative inflammation and pain, may mitigate the risk of cognitive decline.

Abstract Epilepsy, a neurological disorder characterized by recurrent seizures, affects millions of people worldwide. Significant advancements in both diagnostic and therapeutic approaches have greatly improved outcomes, particularly for individuals with drug-resistant epilepsy. Modern neurostimulation techniques such as Responsive Neurostimulation (RNS), Deep Brain Stimulation (DBS), and Vagus Nerve Stimulation (VNS) have demonstrated effectiveness in reducing seizure frequency in these patients. Additionally, emerging technologies like gene therapy and optogenetics are being explored to better understand the underlying mechanisms of epilepsy and hold promise as future treatment modalities.Traditional imaging techniques often fail to detect subtle epileptogenic zones. However, the introduction of ultra high-field 7T MRI scanners represents a major breakthrough. These advanced scanners use eight transmitters to generate higher-resolution images, reducing signal dropout and enabling the identification of previously undetected lesions. In one study involving 31 patients, 58% had their treatment plans modified based on 7T MRI findings, highlighting its potential to inform surgical decision-making. In terms of pharmacological treatment, newer medications such as sultiame, cannabidiol (CBD), and non-pharmacological approaches like the ketogenic diet have emerged as additional therapeutic options for drug-resistant epilepsy. These developments contribute to more effective, personalized management strategies for epilepsy. In summary, the landscape of epilepsy diagnosis and treatment is rapidly evolving. Innovations in imaging and therapeutic interventions are offering new hope for patients with drug-resistant epilepsy. Ongoing research and clinical trials remain essential to further refine these approaches and improve patient outcomes.

Background: A blood product is any therapeutic substance derived from human blood, including whole blood and other blood components for transfusion, and plasma-derived medicinal products. Medicinal (medical therapeutic) products derived from human donations of blood and plasma play a critical role in health care. Safe, effective and quality-assured blood products contribute to improving and saving millions of lives every year, as they: address child mortality and maternal health, dramatically improve the life expectancy and quality of life of patients suffering from life-threatening inherited disorders, such as haemophilia, thalassaemia and immune deficiency, and acquired conditions such as cancer and traumatic haemorrhage and support complex medical and surgical procedures, including transplantation. An insufficient or unsafe blood supply for transfusion has a negative impact on the effectiveness of key health services and programmes to provide appropriate patient care in numerous acute and chronic conditions. Ensuring access of all patients who require transfusion to safe, effective and quality-assured blood products is a key component of an effective health system and vital for patient safety.
Although the number of blood donors is increasing, there are still insufficient human and financial resources for encouraging the growing demand of blood and blood products and new blood donors. Material and Methods: We collected secondary data by using using the order forms of hospitals that used blood and blood products registered in the National Center for Blood Transfusion Research in 2017-2019 in accordance with the retrospective survey method.
In total 34,119 hospital order information sheet was entered into computer in excel program, and converted into SPSS 23 software, descriptive parameters were calculated and analyzed. Results: Compare to the 2017 (n=9076), the demand of blood product was increased by 21.8%, and 54.8% in 2019. There are 51.9% (95%CI: 51.2-52.5) of total users are male, which is statistically significant. The mean age of blood product users were aged 48.58±21.32, the youngest user was aged 1 and the oldest age was 99. The demand of blood products were increased by growing of the age of users. The product usage of age group of 46-55 was 17.8% and has trend to increase year by year. In total, 11.3% of total blood product was utilized for children and 72.3% of them were aged less than 5 years old. 73.0% of total blood products were utilized in specialized hospitals, 14.6 % of them were used in aimag and district level hospitals and 11.3% of them were used in private clinics. 24.4% of blood products utilization was used for diseases of digestive system (К00-К93), 22.1% of them were used for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism, and 19.5% of them were used for the cancer (C00-C97) disease patient’s treatment. Conclusion Since after new treatment guidance was introduced the blood and blood products usage had been increased.

Background: Blood is an important resource, both for planned treatments and urgent interventions. It can help patients suffering from life-threatening conditions live longer and with a higher quality of life, and supports complex medical and surgical procedures. According to WHO recommendation at least 1% of the population of any country needs to donate their blood to accommodate the basic clinical needs of the country. Accordingly, we aimed to assess existing attitudes of the general population towards on blood donors. Materials and Methods: The survey identified attitude of the population on blood donation and factors influencing them, using quantitative and qualitative methods. The survey covered a population aged 18-60 years. SPSS software version 21 was used for data analysis of the survey. The survey protocol and methodology were reviewed and approved by the Scientific Committee at the NCPH. The Medical Ethical Committee at the MOH reviewed the survey materials and issued an approval (2015/3). Results: The survey covered in total 3,782 people and there are 59.2% of surveyed respondents said they have never thought of becoming a voluntary blood donor. Positive attitude on blood donation is higher with statistical significance among women (59.0%), 18-25 years old (43.7%) and UB residents citizens with higher education. As education level increases the number of respondents who thought about donating blood is also increases. 16.1% of them had a history of blood donation before and 38.2% said they never thought about it. Twenty point four percent of respondents thought blood donation brings some kind of risk. Nevertheless of the education level of surveyed respondents, the percentage of answer blood donation is not risky for a person was the most common answer. But respondent who is only literal and uneducated were don’t know about whether it has a risk or not (385.37=2א, p=0.000001). Also, respondents failed to donate their blood because the family not allowed, afraid, risk of infection, doesn’t want and had a busy schedule. Conclusion There is a high tendency to donate blood populations of young people aged 20-29, women, residents of Ulaanbaatar, and uneducated and highly educated. The majority of respondents agreed that blood donating is charity and a good deed. The leading causes of blood donation is the education, gender, the desire of doing a good deed, peer influence and health condition.

Thrombosis is a term for a blood clot occurring inside a blood vessel. R. Virchow postulated that abnormalities in blood flow, hypercoagulability of the blood, and injury to the vessel wall are causally related to thrombus formation. Many of the risk factors for deep vein thrombosis aretrauma for 9.3- 18.8%, birth for 16-17.3%, surgery for 14.3-30.3%, infection disease for 9.7-15.9%, cancer for 3.5%, heart disease for 4.6% and 6.9-11.8% of deep vein thrombosis is an indistinct cause. Pain, swelling, warmth, edema and redness in the affected leg are common symptoms.The diagnosis of deep vein thrombosis of the leg can be difficult with clinical findings and history being unreliable. The National Institute of Health and Care Excellence has evidence based recommendations on the prevention and management of a wide range of health conditions. Here: incorporation of a clinical predication score, D-dimer, and venous duplex ultrasound. The D-dimer blood test measures degraded fibrinogen, which is raised in patients with a clot. However, it cannot confirm deep vein thrombosis, as D-dimer can be raised in other conditions including malignancy, infection, pregnancy, post-surgery, inflammation, trauma, disseminated intravascular coagulopathy, and renal impairment. There are two types venous ultrasound as the first line investigation for suspected deep vein thrombosis. The aim of treatment for deep vein thrombosis are:
• The prevention of a thrombus progress
• Decrease the risk of the pulmonary embolism
• The reduction of the thrombus expansion or resolution.
• The prevention of the post thrombotic symptoms
• Decrease the mortality of vein thrombosis
Guidelines from NICE and ACCP recommended direct oral anticoagulants as first line treatment for deep vein thrombosis. Direct oral anticoagulants include direct factor Xa inhibitors apixaban, rivaroxaban, and edoxaban, and a direct thrombin inhibitor dabigatron

This survey had conducted for determining respiratory system disease and mortality trend of Ulaanbaatar city population and for developing evidence based recommendations. In accordance with the methodology we had done meta-analysis and statistical analysis on data 2004-2008. For the data analysis we used SPSS and parametric and non-parametric tests were used for determining disease changes and differences of seasonal, age and gender. In recent 5 years, in Ulaanbaatar, respiratory system disease cases are continuously leading 5 leading causes of disease. In 2008, respiratory system disease cases were 865.0 per 10000 populations and it is compare to 2004 increased by 10-30 percent. Children and women are more tend to attend to hospitals due to diseases cases. The survey also revealed that incidence of pneumonia (116.7-145.8 per 10000 populations) was the most visited case from other ICD10 causes of diseases.The mean age of mortality of respiratory system disease was 36.6±31.8 and the oldest age was 101 and the youngest was under 1 year old during 2004-2008 in Ulaanbaatar. During spring season, acute respiratory system disease, chronic bronchitis pneumonia and others respiratory system disease cases were more admitted from the respiratory system disease. Whereas, during autumn season, emphysema, during winter season bronchitis were the leading causes of respiratory system disease admission (x2=33.779, p=0.013).CONCLUSION: The statistics, 2004-2008 in Ulaanbaatar, were showing respiratory system disease trend constantly and continuously increasing. Age, gender and seasonal characteristics were signifi cantly correlated with the respiratory system disease. During these 5 years, 932 deaths were recorded and mean age of dying was 36.6±31.8.