Background: According to the World Health Organization (WHO), approximately 2,000 types of congenital anomalies affecting the human body have been identified, among which craniofacial anomalies rank between second and fourth in prevalence. Hearing impairment occurs in approximately 1.62 per 1,000 live births, while congenital malformations of the external and middle ear occur in about 1.6 per 10,000 live births. The WHO epidemiological report (2022) indicates that severe combined congenital malformations of the external and middle ear, including microtia and aural atresia, occur in approximately 2.35–7 per 10,000 live births. The prevalence of microtia is relatively higher in certain regions of Asia and South America (1 per 1,500–3,000 live births), whereas lower rates have been reported in Europe and Africa. Aim: To evaluate the feasibility and outcomes of surgical reconstruction of the auricle and the external auditory canal–tympanic cavity (meatotympanoplasty) in patients with combined congenital malformations of the external and middle ear. Materials and Methods: Audiological evaluation revealed an air conduction hearing loss of 75–80 dB. Computed tomography grading showed scores of 5–6, corresponding to grade III congenital malformation of the external and middle ear, and classified as type III according to the Nagata–Weerda classification.In cases of unilateral combined congenital external and middle ear malformations (auricular deformity with associated aural atresia), auricular reconstruction and external auditory canal formation were performed in two surgical stages with a 6-month interval. At postoperative day 21, removal of the external auditory canal stent revealed no evidence of canal stenosis, and epithelialization of the skin graft had begun. Result: Postoperative audiological assessments conducted at 30, 45, and 60 days demonstrated a statistically and clinically significant improvement in hearing thresholds, which correlated directly with the healing status of the newly reconstructed tympanic membrane. Conclusion The findings of this study suggest that in patients with combined congenital malformations of the external and middle ear, simultaneous reconstruction of the auricle and the external auditory canal–tympanic cavity in a single surgical stage may be feasible. This approach has the potential to reduce overall treatment duration, surgical burden, and psychological stress for patients. However, further studies involving larger patient cohorts and long-term follow-up are required to evaluate hearing stability and the incidence of postoperative complications, including restenosis and secondary tympanic membrane changes.

Background: Adhesion small bowel obstruction (ASBO) is a common complication following abdominal surgery and can significantly impair postoperative recovery. This condition necessitates the exploration of more effective therapeutic approaches. Aim: The aim of this study was to evaluate the clinical efficacy of Traditional Mongolian Medicine (TMM) combined with acupuncture in the management of postoperative ileus secondary to adhesion-related small bowel obstruction. Case Presentation: We report the case of a 47-year-old female patient who developed postoperative ileus. The therapeutic intervention consisted of a combined regimen of traditional herbal pharmacotherapy and electroacupuncture. The clinical outcomes were assessed based on the resolution of symptoms and the restoration of gastrointestinal function. Result: Following the administration of the integrated treatment, the patient exhibited a marked reduction in abdominal pain. Objective clinical improvement was noted through the successful restoration of intestinal peristalsis and the normalization of flatus and defecation. Conclusion The findings of this case study suggest that Traditional Mongolian Medicine, particularly when integrated with electroacupuncture, may be an effective and viable modality for promoting the recovery of gastrointestinal motility in patients with adhesion-related small bowel obstruction.

Background: Hearing loss (HL) is one of the most common sensory disorders, affecting over 5-8% of the world's population. Approximately half of HL cases are attributed to genetic factors. In hereditary deafness, about 75-80% is inherited through autosomal recessive inheritance, and common pathogenic genes include GJB2 and SLC26A4. Pathogenic variants in the SLC26A4gene are the leading cause of hereditary hearing loss in humans, second only to the GJB2 gene. Variants in the SLC26A4gene cause hearing loss, which can be non-syndromic autosomal recessive deafness (DFNB4, OMIM #600791) associated with enlarged vestibular aqueduct (EVA) or Pendred syndrome (Pendred, OMIM #605646). DFNB4 is characterized by sensorineural hearing loss combined with EVA or less common cochlear malformation defect. Pendred syndrome is characterized by bilateral sensorineural hearing loss with EVA and an iodine defect that can lead to thyroid goiter. Currently, it is known that EVA is associated with variants in the SLC26A4 gene and is a penetrant feature of SLC26A4-related HL. Predominant mutations in these genes differ significantly across populations. For instance, predominant SLC26A4 mutations differ among populations, including p.T416P and c.1001G>A in Caucasians, p.H723R in Japanese and Koreans, and c.919-2A>G in Han Taiwanese and Han Chinese. On the other hand, there has been no study of hearing loss related to SLC26A4 gene variants among Mongolians, which is the basis of our research. Aim: We aimed to identify the characteristics of the SLC26A4 gene variants in Mongolian people with Enlarged vestibular aqueduct and Mondini malformation. Materials and Methods: In 2022-2024, We included 13 people with hearing loss and enlarged vestibular aqueduct, incomplete cochlea (1.5 turns of the cochlea with cystic apex- incomplete partition type II- Mondini malformation) were examined by CT scan of the temporal bone in our study. WES (Whole exome sequencing) analysis was performed in the Genetics genetic-laboratory of the National Taiwan University Hospital. Results: Genetic analysis revealed 26 confirmed pathogenic variants of bi-allelic SLC26A4 gene of 8 different types in 13 cases, and c.919-2A>G variant was dominant with 46% (12/26) in allele frequency, and c.2027T>A (p.L676Q) variant 19% (5/26), c.1318A>T(p.K440X) variant 11% (3/26), c.1229C>T (p.T410M) variant 8% (2/26) ) , c.716T>A (p.V239D), c.281C>T (p.T94I), c.1546dupC, and c.1975G>C (p.V659L) variants were each 4% (1/26)- revealed. Two male children, 11 years old (SLC26A4: c.919-2A>G) and 7 years old (SLC26A4: c.919-2A>G:, SLC26A4: c.2027T>A (p.L676Q))had history of born normal hearing and progressive hearing loss. Conclusions 1. 26 variants of bi-allelic SLC26A4 gene mutation were detected in Mongolian people with EVA and Mondini malformation, and c.919-2A>G was the most dominant allele variant, and rare variants such as c.1546dupC, c.716T>A (p.V239D) were detected. 2. Our study shows that whole-exome sequencing (WES) can identify gene mutations that are not detected by polymerase chain reaction (PCR) or NGS analysis.

Background: Meniere's disease is a condition caused by disturbances in the auditory and vestibular systems. It is characterized by symptoms such as dizziness, nausea, vomiting, and tinnitus. In the United States, the prevalence of Meniere's disease has been found to be 84 cases per 100,000 women and 56 cases per 100,000 men. Regionally, it is more common in less populated areas, and research has confirmed that the prevalence increases with higher household income. Aim: To evaluate the effectiveness of traditional medicine treatments and therapies for Meniere's disease. Results: The patient is a 43-year-old male, with symptoms of dizziness, vomiting, and tinnitus. Since 2023, he has sought care at the Central Hospital of Mongolian Medicine, where he received traditional medicine treatments including herbal therapy and other traditional therapies on three occasions. As a result, the frequency of dizziness has decreased and other clinical symptoms have improved. Conclusion Traditional medicine treatments have been shown to be effective in managing Meniere's disease by extending the interval between relapses, improving quality of life, and significantly reducing clinical symptoms.

Introduction: Antimicrobial Resistance (AMR) has emerged as a significant public health and economic issue worldwide, affecting both developed and developing countries. Our research has been motivated by the increasing prevalence of carbapenem-resistant P. aeruginosa, A.baumannii, and K. pneumonia in recent years. Goal: To determine antibiotic susceptibility of the pathogens isolated from wound infection and to detect its multidrug resistance. Material and Method: Samples were collected from patients with wound infections. Pathogens were identified by using the traditional culture methods and the API system with serotypes determined phenotypically. Antibiotic susceptibility was assessed using the disk diffusion method and the MIC to analyse antibiotic resistance. Results: In the study, among 11,221 recorded cases of wound infections in 2023, bacterial pathogens were detected and identified at the species level in 10,339 cases (92.1%).
For identification results showed that A. baummannii were detected from 138 cases (1.3%), 216 cases (2.08%) of Ps. aeruginosa, 5 cases (0.04%) of B. cepacia, 1,383 cases (13.4%) of Enterobacteriaceae, 205 cases (2.0%) of Enterococcus spp., 8,329 cases (80.5%) of Staphylococcus spp., and 63 cases (0.6%) of Streptococcus spp.
Antibiotic susceptibility of these bacteria was assessed and determined multidrug resistance. We found the followings: For A. baumannii were resistant with MDR in 68 cases (49.3%), MRSA in 4,243 cases (51.1%), MDRSta. aureus in 1,805 cases (29.4%), VRE in 34 cases (16.5%), ESBL in 4.6%, KPC in 26 cases (11.1%), FRNF in 24 cases (11.6%), and CRPA in 13 cases (6.3%). Conclusion
1. Of all wound infections reported in 2023 in 92.1% there were detected pathogenic bacteria, of which S.aureus were in 80.5% and E. coli was in 13.4%
2. 60.7% of the pathogenic bacteria detected in wound infections were multidrug-resistant, with MRSA accounting for 51.1% and MDR A.baumannii accounting for 49.3%, indicating high antimicrobial resistance(AMR).

Introduction: Amenorrhea has still been listed as one of common diseases among women in Mongolia. Some traditional prescription for amenorrhea, used commonly in Mongolian traditional medicine, needs more attention to dig out its scientific proof of therapeutic effect on pathogenesis of some diseases. Therefore, we aimed to research Shimshin-6 traditional prescription to develop a granule formulation for amenorrhea and other female reproductive diseases, and study its qualitative and quantitative characteristics. Material and method: In this study, Shimshin-6 traditional prescription was randomly collected from 5 pharmaceutical manufacturers named as “Х-1, Х-2, Х-3, Х-4 and Х-5”. The collected prescriptions were granulated and optimized by a wet-granulation method. Then, granule spill weight and flow quality were detected in obtained granule formulation. Result: 20 types of granule formulation from Shimshin-6 were obtained by using 8% and 10% of gelatin, 6% and 8% of polyvinylpyrrolidone as a binder in these formulations. As a result, the suitable binder in this formulation was detected 6% of polyvinylpyrrolidone after researching the granule spill weight and flow rate. For the granule formulations of X-1, X-2 and X-5 prescriptions, the polyvinylpyrrolidone was chosen as the suitable binder due to the result from granule spill weight of the formulation. As for the X-3 and X-4 prescriptions, gelatin was the suitable binder in these formulations. After studying the flow quality of newly obtained granule formulations from “Х- 1, Х-2, Х-3, Х-4 and Х-5”, the most suitable binder was polyvinylpyrrolidone. Conclusion Altogether, these results showed that the most suitable binder for granulating Shimshin-6 traditional medicine was 6% of polyvinylpyrrolidone due to the results from granule spill weight and flow rate.

Assessing children with disabilities using who international classification of functioning (ICF) Background: In 2021, according to the World Health Organization (WHO), over 1 billion people are estimated to experience disability. The number of children with disabilities globally is estimated at almost 240 million, according to a new UNICEF report. There are approximately 43 million children with disabilities in East Asia and the Pacific. In the 2020 population and housing census of Mongolia, a total of 106.4 thousand people with disabilities were counted, of which 7.6 percent or 8.1 thousand children aged 0-14 were counted. People with disabilities lose some of their ability to labor. WHO recommended that assessment of children with disabilities using both ICD and ICF. Thus, we aim to assess children with disabilities who have neurological disease using International Classification of Functioning and evaluate the validity of this classification. Materials and methods: This was a cross sectional analytical study based on NCMCH. Study materials were collected from children and guardians through standard questionnaires. The questionnaire consisted of 2 groups: general information of the participant and indicators of the scope of the D code of the "ICF" to assess the childhood disability. According to the indicators of the D code range, activity limitations and participation restriction, disabilities were evaluated. Each question in the questionnaire was measured on a 5-point Likert scale from 0 to 4. The statistical analysis was performed using R 3.5.1 program. Validity was assessed using the Rasch model for each question. Questionnaire reliability was assessed by Cronbach's alpha test. Results: The study included 32 children aged 2-15 years. Male children were 62.5% of participants, the mean age was 8±3.1 years. Correlation between questions was high (r = 0.79) and reliability was adequate (α=0.94). As a result of Rasch analysis, the mean and standard deviation of the 36 selected parameters were not significantly different from the standardized mean. 3 indicators that did not meet the analysis criteria were removed, and a total of 33 indicators were used to measure childhood disabilities. Mean infit MNSQ was 1.06, mean outfit MNSQ was 0.93. MNSQ of all participants were 1.0 – 2.0. As a result of Rasch analysis, the mean of 33 indicators of disability is -1.6, the standard deviation is 1.2, the upper limit of the mean is 3.6, and the lower limit is -3.4, and the indicator of D code was stable enough to measure disability. The mean code scores were 2.45±1.3. The mean score of disability level of children diagnosed with cerebral palsy was 2.9±1.09, and children hospitalized with seizures and meningitis was 0.5±0.3. Also, the total mean score was 2.61±1.2 in the group with disability and receiving care, and 1.8±0.21 in the group not receiving care, which was a statistically significant difference. Conclusions: Inter-indicator correlation was good and reliability of the questionnaire was adequate in field use of the 38 indicators of the activity limitations and participation restriction of the International Classification of Functioning, Children's Version (ICF-CY) code range “D”. When evaluated by Rasch analysis, 33 questions were evaluated as structural and stable. The International Classification of Functioning can be used to assess children's disabilities. Discussions: Niels Ove Illum et al. (2015) found that The World Health Organization International Classification of Functioning, Disability and Health child and youth version d code data can provide a coherent measure of severity of disability in children across various diagnoses, ages, and genders. Results were similar to our study.

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.

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.

Tuberculosis disease is directly proportional to a country’s socio-economic situation and standard of living. Studies have shown that in Mongolia the inflation, unemployment, poverty and migration that have emerged as a consequence of the socio-economic changes in 1990s have influenced the spread of the disease.The Global Fund to Fight AIDS and Tuberculosis Project was initiated by the UN and launched in our country in 2003. In relation to an expected completion of the project in 2016, the need has been determined to include the funds required for AIDS and tuberculosis (TB) treatment into the state budget and, therefore, the necessity to conduct a detailed study of TB drug usage to validate this need has become the basis of this research.[3,5,6] Materials and methods: Patient history of 200 inpatients in (NCCD). Registration of drug expenditure of pulmonary tuberculosis and multi-drug resistant tuberculosis (MDRTb) and statistic survey data.As WHO recommended determining drug consumption by disease and mathematic statistic method. Purpose:Multi-drug resistant drugs tuberculosis used in the treatment of estimated needs, and to be determined by the main anti-tuberculosis drug spending.Results: 1. 50 patients diagnosed as MDRtb by the NCCD used 9 main types of drugs, Out of these 5 were most widely used. 2. 1,211,700,0±546,008,9million was spent on treatment of MDRtb in inpatient facilitiesКey words:Multi-drug resistant tuberculosis