Epithelioid sarcoma is a rare aggressive soft tissue sarcoma, which can be distal or proximal types. The classic form (distal-type) of epithelioid sarcoma mainly occurs in teenagers and young adults. A rarer form, called large-cell (proximal-type) epithelioid sarcoma, tends to be more aggressive and mainly affects adults. The proximal subtype mostly arises from the proximal pelvis, limbs, and genital tract. We report case of a 24 -year-old female, presented the Uvurkhangai RDTC in 2024. The histological study showed a multinodular tumor was seen comprising sheets of oval to polygonal cells with moderate amount of cytoplasm. Interspersed were larger, rhabdoid cells with abundant eosinophilic cytoplasm and prominent nucleoli.

Introduction: In Mongolia, data on the etiology and risk factors of cardioembolic stroke (CES) is scarce and few clinical studies have been performed to date. Timely identification and control of cardiovascular risk factors are priority objectives for adequate primary and secondary prevention of CES. Goal: The goal of this study was to describe risk factors for CES in our setting. Results: The case-control study enrolled a total of 525 subjects. CES was detected in 63 (35.7%) out of 176 (33.5%) ischemic stroke patients with a predominance in age group of 60-69 and men (33%). The main risk factor of CES was non-valvular atrial fibrillation (AF). AF especially paroxysmal AF increased the risk of CES by 4.6 times (p=<0.0001, OR 4.6, 95% CI 1.4-44.6). The second main cerebrovascular risk factors were hypertension and dyslipidemia. Conclusion CES accounted for 1/3 of ischemic stroke. The commonest underlying medical conditions were non-valvular atrial fibrillation, hypertension, dyslipidemia, alcohol consumption and obesity. Hence, all patients with hypertension and non-valvular AF should be meticulously screened for prevention of CES.

Introduction: In gallstone diseases, common bile duct stones and thickened bile could cause hepatitis or other difficulties. Therefore intraoperative cholangiography is helpful in many operations besides detecting and diagnosing the gallstones in common bile duct. Materials and Methods: Out of 266 patients who had undergone Laparoscopic Cholecystectomy surgery in GrandMed Hospital, 14 patients were found to have jaundice and cholestasis after undergoing laboratory and radiology tests. Results: These 14 patients have all undergone IOC. 7 out of 14 patients were found to have positive cholangiogram and the other 7 - negative. Biliary tract tumor and anatomic anomalies were not identified among these patients. Conclusion: Making analysis using only laboratory data is not adequate for directly detecting choledocholithiasis. IOC not only shows bile tract obstruction and determines cholestasis causes, but it also identifies the anatomy biliary tract, which is a procedure that facilitates dissection. Therefore IOCcan prevent the most serious complication of laparoscopic cholecystectomy - common bile duct injury. The sensitivity of IOC ensures the gathering of important information on time, so suggest to use it for every suspicious case.

Introduction: In gallstone diseases,common bile duct stones and thickened bilecould cause hepatitis or other difficulties.Therefore intraoperative cholangiography ishelpful in many operations besides detectingand diagnosing the gallstones in commonbile duct.Materials and Methods: Out of 266patients who had undergone LaparoscopicCholecystectomy surgery in GrandMedHospital, 14 patients were found to havejaundice and cholestasis after undergoinglaboratory and radiology tests.Results: These 14 patients have allundergone IOC. 7 out of 14 patients werefound to have positive cholangiogram andthe other 7 - negative. Biliary tract tumorand anatomic anomalies were not identifiedamong these patients.Conclusion: Making analysis usingonly laboratory data is not adequate fordirectly detecting choledocholithiasis. IOCnot only shows bile tract obstruction anddetermines cholestasis causes, but it alsoidentifies the anatomy biliary tract, whichis a procedure that facilitates dissection.Therefore IOCcan prevent the most seriouscomplication of laparoscopic cholecystectomy- common bile duct injury. The sensitivityof IOC ensures the gathering of importantinformation on time, so suggest to use it forevery suspicious case.

Introduction: Various modalities oftechniques from standard discectomy,microdiscectomy, percutaneous discectomy,and transforaminal endoscopic discectomyhave been in use for lumbar intervertebraldisc prolapse1. The access to spine is keptto a minimum without stripping paraspinalmuscles minimizing muscle damage bytransforaminal endoscopic approach2.Currently in the population of the Mongoliabeen increased of the spinal nerve rootcompression, which are resulting in lumbardisc pathological changes. In other developedcountries has been successfully introducingthe spine endoscopic surgery use for thatpathological changes. In regard to our countryhad not yet implemented for until now asthese high technological surgeries3. Spinesurgery department team of the GrandMedhospital had successfully introduced that thespine endoscopic surgery.Materials and Methods: We performedtransforaminal endoscopic lumbardiscectomy surgeries on patients age of 24,38, 78 on July/23/2016 All patients withsingle nerve root compression due to Lumbardisc herniations, including sequestrated ormigrated and selected central disc at L4-5. All patients had preoperative MRI andpostoperative MRI to check the adequacy ofdecompression. All patients were operatedby 18-mm ports of the S-Gun endoscopicequipments. Procedure had done under localanesthesia. Postoperatively, all patients weremobilized as soon as the pain subsided anddischarged within 24-48 h post-surgery.Patients were followed up at 2, 6 weeks.Results: The mean follow up was 2-6weeks. The average surgical time was 70min (range 25-210 min). Average blood losswas 20-30 ml. Postoperative MRI showedcomplete decompression. All of patients hadgood-to-excellent results and straight raisingleg test (Lasegue) were 90/90 respectively.All patient is preoperatively visual analogyscale was 8±1 and then became to 1±1.Conclusion: Microendoscopic discectomyis minimally invasive procedure fordiscectomy with results of this procedure areacceptable safe and effective. However, forthis technique has required to do accuracyand experienced surgeon.