Background: Parry-Romberg syndrome (PRS) is a rare acquired neurocutaneous disorder characterised by progressive hemifacial atrophy involving subcutaneous tissue, muscle, and occasionally bone. Linear scleroderma (also known as Mophea en coup de sabre) is a subtype of focal scleroderma, characterised by thickening and hardening of the skin due to excessive collagen deposition in the skin and subcutaneous tissue. Both disorders occur together, although rarely. We present a case of Parry-Romberg Syndrome with Linear Scleroderma, which initially started on the left side of the face but gradually progressed over the years and, in recent years, has spread to the right side of the face and tongue, and is being treated with immunosuppressive therapy. Case Presentation: A woman in her 30s presented with progressive soft-tissue atrophy of the left side of the face, extending from the forehead and parietal region to the cheek and mandible, with associated left frontal pain and facial asymmetry. The condition had begun at approximately 10 years of age with localized alopecia and gradually progressed over several years, later involving the left side of the tongue. Examination revealed marked left-sided facial soft-tissue atrophy, tongue muscle atrophy, enophthalmos, and facial asymmetry. Electroneuromyography demonstrated chronic myogenic changes in muscles innervated by the left trigeminal, facial, and hypoglossal nerves. Brain magnetic resonance imaging showed thinning of the skull and subcutaneous soft tissues in the left frontoparietal region, with associated reduction in the size of the left orbital soft tissues and globe. Based on the clinical and imaging findings, Parry–Romberg syndrome associated with linear scleroderma was diagnosed, and immunosuppressive therapy was initiated with longterm follow-up. Conclusion Parry-Romberg syndrome is a rare, slowly progressive disorder that can involve the skin, subcutaneous tissue, muscles, bone, eyes, and nervous system. In patients presenting with progressive hemifacial atrophy, detailed neurological examination and appropriate imaging studies are important for establishing the diagnosis and identifying associated neurological involvement. This case highlights the clinical importance of recognizing Parry–Romberg syndrome and its association with linear scleroderma.

Background: Tick-borne encephalitis is human viral infection involving the nervous system and transmitted by the bite of infected tick. The TBE Virus is distributed in different geographical areas by three widespread subtypes of the virus: The Far East, Europe, and Siberia. The Far East type has a mortality rate was 30-35%, the European type has a mortality rate of 2.2%, and the Siberian type has a mortality rate of 6-8% (A.G. Pletnev, 1998) [2].
In recent years, human cases of tick-borne infections have been reported in 19 European countries and four Asian countries (Mongolia, China, Japan, and South Korea) [3].
Human cases of tick-borne encephalitis, tick-borne rickettsiosis, and tick-borne borreliosis have been registered in Mongolia since 2005. Deaths have been reported year by year [5].
During 2005 to 2021, tick-borne rickettsiosis (71.6%), tick-borne encephalitis (17.3%) and tick-borne borreliosis (52.9%) were confirmed by epidemiological, clinical and laboratory tests at the NCZD.
Tick-borne encephalitis was registered in 63 soums of 15 provinces and 9 districts of the capital city, of which 90% were infected with tick bites in Selenge and Bulgan provinces. The average mortality rate is 4.9% (14), of which 28.6% in Bulgan province and 2.7% in Selenge province.
Tick-borne encephalitis is the leading cause of death in Bugat soum of Bulgan province and more infected men about 40 years of age [7]. Purpose : Collect ticks from selected soums of the provinces, identify tick species, species composition, distribution, tick densities, pathogens of tick-borne diseases, conduct population surveys to assess the risk of tick-borne infections, and identify tick-borne infections. Material and Method: Ticks were collected by flag from birch trees in birch forests and meadows with biotope and overgrown berries, determined morphological analyze and molecular biological investigation for detecting tickborne pathogens.
Questionnaires were collected from selected soum residents according to a specially designed randomized epidemiological and clinical survey card, collected information and forms were submitted to soum hospitals with a history of tick bites (according to clinical criteria). Serological tests were performed to detect IgG-specific antibodies to the collected serum mites. Result and conclusion Collected 121 ticks (120 I. persulcatus and 1 D. nuttalli) and not wound egg, larvae, nymphs. By molecular biological investigation detected 3.5% of I.persulcatus from Khutag-Undur soum of Bulgan province, 3.5% of anaplasmosis, and 14.1% of I.persulcatus mites from Bugat soum. 1.5% borreliosis, 3.1% anaplasmosis.
Detected DNA of 100% tick-borne rickettsiosis from D.nutalli ticks and determined circulation of infection among tick in Bugat and Khutag-Undur soums of Bulgan province.
247 people were surveyed, 56 blood serum from cases. Detected Q fever, erysipelas, and anaplasmosis, tick-borne borreliosis 3 (5.4%), tick-borne rickettsiosis 26 (46.4%), Japanese encephalitis 3 (5.4%), tick-borne encephalitis tick-borne rickettsiosis 6 (13.0%), tick-borne rickettsiosis tick-borne borreliosis 1 (1.8%), tick’s rickettsiosis Japanese encephalitis 1 (1.8%), tick-borne encephalitis tick-borne borreliosis 1 (1.8%).
By investigation, vaccination (88%) and wearing long-sleeved shirts and pants (81%) were the most effective ways to prevent tick bites (81%) [15]. According to our research, the percent of population knowledge in Bulgan province was insufficient (40.9%) which there is a lack of information, training and advertisement among the population in the province.

Introduction: Determining stages of liver fibrosis in chronic liver disease is essential for clinical practice such as decision making on medical treatment, setting the interval of follow-up examination for its complication, screening intervals for hepatocellular carcinoma. Goal: We compared non-invasive fibrosis markers among the patients with chronic hepatitis Delta. Materials and Methods: Totally 70 patients with chronic hepatitis D enrolled into this study. The blood samples were examined for complete blood count, liver function test and serum M2BPGi level. Non-invasive markers such as AAR, APRI, Fib-4 scores were calculated. Those with AAR >1, APRI >0.7, FIB-4 >1.45 were considered with advanced fibrosis. All patients underwent liver stiffness measurement using FibroScan M2 probe. The cutoff values of FibroScan for advanced fibrosis were 9 kPa for patient with normal transaminase level and 11 kPa for patients with elevated transaminase. Results: Advanced fibrosis was observed in 25.7%, 38.6% and 38.6% by AAR, APRI and Fib-4 score, respectively. When cut-off levels of serum M2BPGi for advanced fibrosis was 2.2 COI, 35.7% had advanced fibrosis. FibroScan tests showed 34.4% had advanced fibrosis. The AUROC of M2BPGi were 0.894 and 0.827 for predicting advanced fibrosis and liver cirrhosis. Conclusion Serum M2BPGi and FibroScan would be reliable diagnostic tool for identifying liver fibrosis in Mongolian patients with chronic hepatitis D.

Introduction: One of the quality assurance measurements for medical schools is the achievement of students who have graduated in the assessment of the knowledge, skills and attitudes they are trained in. Goal: To analyze assignment of theoretical and practical exam and to identify the level of кknowledge students who have graduate at “Ach” Medical University during 2015-2016 academic year. Materials and Methods: The study was conducted on a cross sectional and descriptive study through the based on the task of analyzing the 261 graduate students theoretical and practical exam performance of the bachelor degree in Medicine, Dentistry, Traditional Medicine and Nursing of Ach Medical University of Mongolia /AMU/ and was assessed and to identify a reliability coefficient, difficulty factor, discrimination index, Hoffsten’s score. Results: The reliabiliy coefficient of graduate exam meets requirement when it’s 0.94-0.96. According to the analysis of the 300 test of the each classroom of graduates was 70 percent (n=202) with weak dicrimination index, difficallty factor was more than 50 percent too easy, The Hoffsten’s score to which exam was passed of Medical graduates is 70 percent, traditional medicine is 87 percent, dentistry is 79 percent, the nursing is a Hoffsten’s score was 80 percent. Conclusions The reliability coefficient the theoretical exam of the graduates’ knowledge is convenient for all occupations, and whole field examines the weak difficulty index (DI≤0) for all field examinations. The Hoffsten’s score is 70% above the medical field. Graduate assignments can not discriminate graduates’ knowledge and skills levels and the difficulty factor graduate examination was very easy.

Introduction: The curriculum development is important issue, especially sudent’s evaluations for the implementation of the curriculum. Accordingly this time we conducted this survey to determine the level of satisfaction of students, which is a key factor in implementation of curriculum at the “Ach” Medical University. Goal: To determine student’s satisfaction level in the curriculum implementation of “Ach” Medical University Materials and Methods: Study was conducted descriptive study design using quantitative research methodology. The Likert scale (1-5) used for the assessment of satisfaction score. Total 1105 students were included in the study. Study questionnaire included 2 groups with 17questionnaires. Results: Students’ satisfaction level is 3.22 point on average and students gave lowest points 2.77 on the quality of classroom, school environment, training equipment and books and course materials. Conclusions The average satisfaction score was 3.22 above the average but the some factors including classroom capacity, study environment, training equipment and books and course materials, textbooks were below average.