Background: Multiple sclerosis (MS) is an autoimmune inflammatory neurodegenerative disease of the central nervous system and a major cause of disability in young adults. MRI is essential for diagnosis and monitoring, while early evaluation of structural brain changes is important. Aim: To evaluate brain volumetric changes using automated MRI analysis in patients with MS. Materials and Methods: This case–control study included 50 MS case patients and 50 controls patients examined between 2020–2023 at the Third State Hospital. T1-MPRAGE images were analyzed using volBrain automated segmentation software. Result: The mean age of MS patients was 45.5±11.8 years. Compared with healthy controls, the MS group showed significantly lower total grey matter volume (p=0.002), cortical grey matter volume (p<0.001), subcortical grey matter volume (p=0.006), and cerebral volume (p=0.02). Significant volume reductions were also observed in the temporal (p=0.006) and occipital (p<0.001) lobes. Deep grey matter structures, including the thalamus (p=0.001), caudate nucleus (p=0.009), putamen (p=0.008), and nucleus accumbens (p<0.001), also showed significantly reduced volumes. Disease duration was negatively correlated with total grey matter volume (r=−0.30, p=0.02), thalamic volume (r=−0.28, p=0.04), and occipital lobe volume (r=−0.43, p=0.002). Disease duration was also significantly associated with spinal cord involvement (p=0.01) and grey matter volume (p=0.04). The number of relapses was negatively correlated with total brain volume (r=−0.28, p=0.046). Conclusion Patients with MS demonstrated decreased grey matter volume, particularly within deep grey matter structures, along with increased abnormal white matter volume, suggesting the coexistence of neurodegeneration and demyelination in MS. Brain volume loss in MS appeared to occur independently of aging. Automated quantitative MRI analysis may provide important diagnostic value in detecting structural brain changes associated with MS.

Introduction: Orthopedic surgery is a highrisk of surgical formation of thromboemboliccomplications.Many researchers are exploringprevent surgical complications.Anticoagulanttreatment is the first choice to preventthromboembolic complications.Artificial jointreplacement surgery has been made in 2008,in National First Central Hospitals (NFCH).Wehave not guideline of anticoagulant treatmentafter surgery and have not principle of choisefollow-drug treatment and unclear testingschedule to monitor anticoagulant treatment,that has become the basis for this study. Westudied by comparing a comparative benefitfor anticoagulant treatment of unfractionatedand low molecular weight heparin results.And studied thromboembolic complications,monitoring test of anticoagulant treatment,fatal bleeding, changes hemostasis ofanticoagulant therapy in both groups. Thesurvey results in practice is doing researchaims to introduce and review the results of thelong-term results.Materials and Methods: Included in thesurvey about 1,400 patients, who had kneeand hip replacement surgery in 2008-2016, inJoint Center of NFCH. All patients are dividedin three group. The first group is control group,do not use anticoagulation treatment, in thesecond group used unfractionated heparin andin the third group used low-molecular-weightheparin.Each group studied comparativewhether thromboembolic complications anddeath caused by thromboembolic, fatalbleeding.Between surgical complication andanticoagulant therapy relationship to investigatethe relationship the correlation is likely trueof 95%. Caused by other thromboemboliccomplications detected cases were removedfrom the study.Results: Control groups has not hospitalmortality, but has 3 cases of sudden death ina after discharge.Hemostasis is longer (INR1,3-1,5) in the second group. There hospitalmortality occurred in 1 (cardiac infarction),and thromboembolic complications 1 (arterialthrombosis in the jugular) in the third group.Low molecular weight heparin are no changeshemostasis, it is strongly dependent (r=0,8).Also in this group there is no fatal bleeding.Conclusions: Orthopedic surgery isnecessary for prevention of thromboemboliccomplications are showing from in controlgroup has sudden death.2 groups have not fatalbleeding when used heparin in normal doses.Other countries researchers conclude lowmolecular-weight-heparin is more effectivethan unfractionated heparin, our study is notvisible correlation reliability.When used lowmolecularweight heparin, hemostasis is notchanged is showing a strong dependence.

Introduction: We performed more than1200 arthroplasty surgeries at National FirstCentral Hospitalfrom 2008, so we haveour surgical technique and experiences.Thepurpose of this study is to assess our surgicalresults and complications after surgery forfemoral neck fracture made in Joint Center,National First Central Hospital, and tocomparingsimilar studies in other countries,and to develop the best optionsurgicaltherapy.Materials and Methods: Between 2008-2015, hip replacement surgery accountedatotal of 168 cases, that was 13.9% allof replacement surgery. A retrospectiveanalysis of patient database based onhospital discharge data and medical recordswas performed. The medical records ofthese patients were reviewed to confirmthe presence of a surgical site infection asdescribed by the Centers for Disease Control(CDC)/NNIS guidelines.Results: Between 2008-2015, in theJoint Center,National First Central Hospital,are seeing increasing number of patientswith hip replacement surgery each year.The cause for hip replacement surgery isaseptic necrosis (42%), at second is femoralneck fractures (22%). Joint Center,NationalFirst Central Hospital currently not providedemergency trauma care center. Therefore,younger patient with femoral neck fracturewas not to happen duringresearch. Olderthan 60 year patients with osteoporosis and,in some cases with nonunion, was doneforhip replacement surgery. The averageage of 75.7 (61-87).Bipolar hip arthroplastywas 14 cases all of 36 patients with femoralneck fracture.9 (5,31%), complications ariseall of hip replacement surgery (168 cases).Including: Infection - 1 (0.59%), sliding - 1(0.59%), dislocation - 2 (1.78%), fracture- 2 (1,18%), nerve injury - 2 (1,18%) andpostoperative mortality - 1 (0.59%).Conclusion: Internal Fixation- for patientage under 60 andgood bone quality. Thatoperation complication is femoral headnecrosis, not healing /nonunion/ delivery ofa lot of research that shows focus. Further,most surgery for femoral neck fracture is hipreplacement that is expected to be widelyavailable.

Introduction: Artificial joint replacementsurgery started in 2008, in Joint centerof National First Central Hospital. Hasexperienced a variety of post-surgicalcomplications.Postoperative infectiouscomplications, prevent and investigate thecauses of the research is carried out todetermine whether the opportunity.Materials and Methods: Facilitiesrandomly selected cases difficult patientswith postoperative septic, and analyzedby descriptive method. In all cases,Bacteriological analysis of the clinicallaboratory department of joint fluidsamples received. We determined artificialjoints causes of postoperative infectiouscomplications and artificial joints determinethe factors of postoperative infectiouscomplications. Calculate the treatment ofinfectious complications.Results: Since 2008, done a total1200 with an artificial joint replacementsurgery. Each year, a surgical number isincreasing. 82% of all cases were kneeartificial joint replacement surgery and18% were hip artificial joint replacementsurgery. There are 20 cases of postoperativeinfectious complications.Most suppurativecomplications (14 cases, 70%) are earlycomplications, that directly related to thesurgery and hospital infections are likelyto be. Pathogenic bacterial samples weredetected 10 cases. An assay blanks dependon laboratory capacity and the number ofsamples. Open surgery is 83,3% effective,when early infectious period. No mortalitydue to infectious complications in our center.Conclusion: The main reason of thepostoperative infectious complications ofartificial joint surgery is S. Aureus (99%).14 cases (70%) of all postoperativecomplications are early complications, thatdirectly related to the surgery and hospitalinfections are likely to be. The main factorsaffecting disinfection of the surgical roomand trauma.

Introduction: The theory that usingmobile bearing (MB) design for total kneereplacementsurgeries can reduce the riskof tibial component loosening compared tofixed-bearing (FB) designs is still unclear.Arthroplastic surgeries developed rapidlywithin recent 10 years, but there is no similarstudy performed yet. This randomized studyinvestigated the impact of prosthesis design toloosening of components at 2 years for totalknee replacement surgeries.Materials and Methods: 479 patientswho underwent total knee arthroplastyin FirstCentral Hospital of Mongolia were allocated toeither FB or MB tibialarticulation.We comparedour results to similar studies which performedabroad due to there is no such a studyperformed before in Mongolia.Results: There is no significant differenceby age, sex, weight, height, body mass index,operation side (right or left) in both groups.Pre- and postoperative range of motionwasalmostsame for MB and FB groups.Butloosening complication was higher for the FBgroup (1.16%) than MB group (0%).Conclusion: Using MB design for total kneearthroplasty has less loosening complicationthan using FB design in Mongolians. Bonemineral density (dual energy absorptiometry)and radiostereometric analysis are necessaryfor widening studies in field of total kneereplacement surgeries in the future.

joints with severe defects of the medialtibia usually progress as varus or valgusdeformities, with daily functional handicapssuch as, limping, aches and instability. Duringthe last seven years, in total 1200 knees ofpatients were treated by both bilateral andunilateral total knee arthroplasty in the Jointcenter of National First Central Hospital. Thisresearch shed a light on patients that weretreated by unilateral total knee arthroplastyto correct large defects of tibia.Materials and Methods: The objectiveof this paper is to compare patients whowere treated with auto bone graft withpatients who were treated without auto bonegraft, in order to assess the effectiveness ofthe auto bone graft technique through theretrospective method.Results: The unilateral total kneearthroplasty was operated on 553 patients,30 (5,42%) of whom were treated withautobone graft and 523(94,58%) of whomwere treated without the auto bone graft.Postoperative complication was observed in3 cases (9,9%) among the first group ofpatients, and in 25 cases (4,5%) amongthe second group of patients. As patients,diagnosed with osteoarthrotic knees withsevere tibial bone defects, were treatedthrough the auto bone graft, it could beconcluded that more complications wereobserved on patients with large tibialbone losses. However, no complicationwas observed in other 27 cases that weretreated with the bone graft during the postoperativefollow-up period ranged fromtwelve to eighty four months.Conclusion: In conclusion, total kneearthroplasty using auto bone graft forpatients with severe tibial bone defects iseconomically as well as clinically effectivetechnique for our country.

Background:Laboratory test are done on clinical specimens in order to get information about the health of a patient as pertaining to the diagnosis, treatment and prevention of disease. Laboratory test gives 70% of information to get a right diagnosis. By some study, physiological factors such as diet, stress, exercise and sample collection techniques are influencing 32%-75% of test accuracy and reliability. That is why we want to studyhow nurses follow standard of sample collection techniques in UB.Our study conducted in 5 different hospitals. We observed nursesway of collecting sample from 150 patientsResult:Nurses did not identify patients ID in 80% of patients and did not ask test preparation and diet of 100%. They prepare necessary items to blood draw 95%. Also nurses did not fully follow blood draw standard in such way: hand sterilization, asepticize place of puncture and using bandage. Conclusion:Nurses don’t follow standard of draw blood from vein and did not clarifies patients test preparation. Pre-analysis process is the most influencing factor in the test result. So we have to train nurses to follow their standard of sample collection procedure.