Background: Reconstruction of mandibular and maxillary defects resulting from malignant tumors has remained a complex challenge in recent years. Defects caused by tumors—as well as trauma, inflammatory diseases, and congenital anomalies—lead to impaired essential functions such as mastication, swallowing, and speech. Prior to the 1950s, reconstruction of maxillofacial hard tissue was not commonly performed. Instead, metal plates were used to reestablish bony continuity, and surrounding tissues were utilized to close soft tissue defects, without effectively restoring function. With modern advances in three-dimensional (3D) virtual planning, it is now possible to accurately plan free bone flaps for reconstructing jaw defects. During surgery, manually bending reconstruction plates to fit donor bone precisely is often not feasible. Preoperative 3D planning allows for precise fabrication of surgical guides and fixation plates, improving accuracy and significantly reducing operative time. Additionally, incorporating dental implant planning into the reconstruction process facilitates restoration of both structural and functional outcomes. Aim: To evaluate the outcomes of mandibular defect reconstruction using scapular free flaps in Mongolia and explore potential approaches to optimize the technique. Materials and Methods: This was a case study series. Data from reconstructive surgeries performed at the National Cancer Center of Mongolia, Central Dental Hospital, and the Mongolia-Japan Hospital were collected. Variables included patient age and sex, etiology of the mandibular defect, size of the scapular bone segment, operative time, ischemia time of the free flap, number of vascular anastomoses performed, and pedicle length. For 3D planning, CT scans of the patient's head and lower limb (slice thickness <1 cm) were used to generate 3D models via the 3D Slicer software. Cutting guides for the mandible and scapula (ASIGA), as well as the reconstruction models (AMS), were printed using a 3D printer. Results: A total of 400 free flap reconstructions were performed during the study period. Of these, 29 cases involved reconstruction of mandibular defects using scapular free flaps. The mean age of patients was 40.0 ± 18.3 years, with 52% (15 patients) being female. The etiologies of the defects included malignant tumors (13 cases, 45%), benign tumors (6 cases, 21%), and pre-existing defects (10 cases, 34%). In one case, tumor resection and mandibular reconstruction were performed using 3D planning. The total operative time was 9 hours and 30 minutes, and the ischemia time was 2 hours and 40 minutes. Conclusion Between 2012 and 2025, a total of 29 mandibular reconstructions using scapular free flaps were performed in Mongolia. Traditional reconstruction methods were associated with prolonged ischemia time. The use of 3D surgical planning has shown potential in significantly reducing ischemia time and improving surgical outcomes.

Background: Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services. Aim: To assess the quality indicators in gastrointestinal endoscopy unit. Materials and Methods: A retrospective single-center study was conducted by collecting data from the Intermed hospital’s electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of four quality indicators measured monthly; b) sample survey data from five categories of quality indicators. Results : Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was 5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes, Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate risk was 0.28% by the TROOPS evaluation during procedural sedation. Conclusion The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.

Introduction: Factors such as social and economic conditions, technological development, modern urbanization, lifestyle, physical activity, nutrition, and air pollution affect physical growth and development. Aim: To study the physical development of Mongolian children. Objectives: 1. To measure the physical indices (weight, height) of children aged 6-17 years old with some influencing factors. Material and method: Using a random sampling method, children's body height and weight were examined at a particular point in time using widely accepted methods. Statistical analysis was performed using the "SPSS ver.25" program. Result: The growth of children's height and weight is progressing according to general patterns of age and gender. Girls grow rapidly between the ages of 10-13 and stabilize after wards, while boys a sharp growth spurt between the ages of 13-17, with the average height of 17-year-old boys being 171.44 cm and 160.25 cm for girls, which is slightly higher than previous studies (Otgon G, 2006, Munkhzaya M, 2020). The trend of weight growth is more prominent in boys. However, compared to international standards (Russia, WHO, CDC), our children's height and weight are lower. The statistics show that parental education, income, exercise, and living environment positively influence growth and development, whereas excessive television watching and air pollution negatively affect it (p< 0.05). Conclusion 1. Children's growth is normal, but observed increase of the body weight of boys. Having healthy and well educated parents, as well as engaging in physical activity positively influences children's height. A lack of physical activity negatively affects height and increases weight. Mongolian children are shorter and lighter compared to foreign children (from Russia and America - CDC).

Introduction: In 2018, the overall colorectal cancer (CRC) incidence rate was 3.6%, according to the National Cancer Center of Mongolia (NCCM), and the incidence of colorectal cancer has increased slightly in recent years. According to cancer stages, late stage cancer has a 5-year survival rate of 51%, while early stage cancer has a 5-year survival rate of 79%. The overall survival rate of colorectal cancer in Mongolia has not been studied in precisely. In Asia, the 5-year survival rate for colorectal cancer was 60%. Therefore, this study investigated the colorectal cancer survival rate and prognostic factors at NCCM. Methods: A total of 108 patients diagnosed with CRC at NCCM’s General Surgery Department from 2013 to 2015 were used in this retrospective cohort study. The Kaplan-Meier method was used to develop the survival graphs, which were then compared using the Log-rank test. Results: The median survival time was 42 months, with a 95% CI (38.55-45.66). A 5-year period, the overall survival rate for CRC was 61.2%. Survival rates at the I, II, III, and IV stages were 100%, 75%, 65.4%, and 13.5%, respectively. There was a significant difference in CRC survival rates across all stages (p=0.0001). There was a statistically significant difference in determining the relationship between adjuvant chemotherapy and survival rate (p=0.0003). Conclusion The outcome of the surgery is determined by the CRC stage. The postoperative survival rate (61.2%) is directly related to tumor stage, peripheral glandular metastasis, distant metastasis, and chemotherapy effects.

BACKGROUND. Congenital Cleft Lip and/or Palate (CL/P) is a common craniofacial birth defect and occurs 1 per 500-700 live births in average. Children with CL/P at a higher risk for speech/language problems due to the anatomical and structural differences in the oral and nasal cavities, Velopharyngeal Insufficiency causing speech disorders with articulation, phonation, and resonance, respectively. It leads to long-lasting adverse outcomes, influencing quality of life and causes obstacles in child’s socialization. Speech in 2007 Therapy team of School of Dentistry ( G. Ariuntuul , B. Bulgan, U. Azzaya, B. Batsukh, M. Bat-Erdene), Mongolian National University of Medical Sciences (MNUMS) (former Health Sciences University of Mongolia) established and successfully conducted a first clinical speech therapy sessions for children with clefts in Mongolia based on the Department of Oral and Maxillofacial Surgery (G. Ayanga et al.) of National Maternal and Children’s Health Center (NMCHC). Since 2012 the speech therapy team of School of Dentistry, officially transferred the equipped operating speech room to NMCHC and speech pathologist B. Bulgan, supervised and trained by Ariuntuul G. recruited by NMCHC for a full time position and working as a member of multidisciplinary team till present. OBJECTIVES. To assess and analyze registry data of children with clefts, visited speech therapy sessions of speech pathology team of School of Dentistry, MNUMS during 2007 through 2012. MATERIAL AND METHODS. Registry based retrospective study was conducted to obtain demographic and speech disorder related data of children with clefts, visited speech therapy sessions between 2012-2017 at the NMCHC. RESULTS. In total 203 participants are attended the speech therapy sessions: 103 male (51%), 100 female (49%). Out of total 203 children 144 (71%) had Cleft Lip and Palate (CLP), 44 had cleft palate only (22%), 15 had cleft lip (7%), respectively. Average age for primary cleft surgery was 1y13m, where as for secondary was 4y22m. CONCLUSION. For speech therapy session for children with clefts boys were dominant compared to girls (1:1.03). By the types of clefts children diagnosed with Cleft Lip and Palate was prevalent to attend treatment classes. There is a need in early CL/P diagnosis, using birth screening and furthermore, traning of speech therapists/pathologists are important for development of multidisciplinary team, surgery outcome and improvement of quality of life of children with clefts.

Introduction: Sarcopenia is a prevalent condition characterized by decrease in muscle strength and loss of body function which result from the decrease of muscle mass in older age. In 2014, the Asian Working Group for Sarcopenia developed the diagnosis criterion for sarcopenia. The measurements were changed to accommodate for the physical characteristics of asians. The loss of muscle mass increases after age 40 and decreases by 8 percent every 10 years. After age 70 this number is increased to 15 percent every 10 years. Goal: Assess the prevalence of sarcopenia among men by comparing body height and mass Materials and Methods: The study included 196 older men aged 40 and above chosen by random sampling from the geriatric and rehabilitation cabinets of the Mongolian National Gerontology Center.
Sarcopenia diagnosis was made based on the criteria from the Asian Working Group for Sarcopenia using methods by Janssen I and others to compare body mass and height. Results: Comparing body muscle mass and height 11.7 percent of participant aged 40-86 had sarcopenia. When comparing body muscle mass and weigth 33.2 percent had sarcopenia. Conclusion Determining sarcopenia among Mongolian men by comparing muscle mass and body mass resulted in 33.2 percent sarcopenia. When compared with height, 11.7 percent had sarcopenia.

BackgroundChildren’s congenital hip dislocation is ranked first, accounting for 49,4% among other skeletal anomalieswhich cause to physical disability.There is a tendency that the number of newborn with the congenitalhip dislocation is going to be increased in recent years, 5000:1 were in 1976 and 1000:1,3% in 1998.Bilateral dysplasia accounts for 50-62% of the total incidences. In unilateral cases,left hip seems to beinvolved 2 times more than the right,and the sex ratio is 2,5:1. Some cultures who swaddle their infantstightly with their legs straightened have a far greater incidence of developmental dysplasia of the hip. Aresearch indicated that discouraging this traditional swaddling method has reduced the prevalence ofdevelopmental dysplasia of the hip and congenital hip dislocationby 6 times in America. It is noted thatthis methodhas also been implemented in Japan and Turkey.Aim.This research aimed to study about the prevalence of congenital hip dislocation, developmental dysplasiaof the hip and other anomalies among the children who were underwent treatment at Pediatric Traumaand Orthopedic Department of National Trauma and OrthopedicResearch Centre of Mongolia in 2013-2015 and children served by outpatient visit in the clinics in 2011-2015.The following objectives were defined in the scope of the research. Herein:1. Evaluate and determine the percentage and prevalence of congenital hip dislocation anddevelopmental dysplasia of the hip among the children who undergo treatment in Pediatric Traumaand Orthopedic Departmentof National Trauma Orthopedic Research Center of Mongolia.2. Evaluate and determine the percentage and prevalence of congenital hip dislocation, developmentaldysplasia of the hip and other anomalies among children who are being served by outpatient visit inClinics of National Trauma and Orthopedic Research Center of Mongolia.Materialis and MethodThis research were studied the prevalence of congenital hip dislocation, developmental dysplasia of thehip and other anomalies among the children who were underwent treatment at Pediatric Trauma andOrthopedic Department of National Trauma and OrthopedicResearch Centre of Mongolia in 2013-2015and children served by outpatient visit in the clinics in 2011-2015.ResultTotal of 40559 inpatients underwent treatment in National Trauma andOrthopedic Research of Mongolia;of which 12217 were inpatient in Pediatric Trauma and Orthopedic Department, aged 0-19;of which1351 has been registered with birth defects of hip; of which 248 has been diagnosed with developmentaldysplasia hip, 869 with congenital hip dislocation. Sex ratio of cases of congenital hip dislocationinmales to female is around 1:4.Total of 633 (13,8%) examinations were performed in the clinics in 2011;704 (15,3%) in 2012;962 (20,9%)in 2013;1013 (22%) in 2014;1287 (28%) in 2015 respectively. It shows an increase in the number ofexaminations year by year.Total of 4142 (90,1%) cases were diagnosed with congenital hip dislocation and developmental dysplasiain both hips; left hip has been dislocated 2 times more than the right, 162 (3,5%) with congenitaldislocation of right hip; 292 (6.4%) with congenital dislocation of left hip.ConclusionTo conclude, the analysis above shows that the prevalence of developmental dysplasia of the hip andcongenital hip dislocation is still high in Mongolia. Therefore, number of diagnosis with congenital hipdislocation has rapidly increased in the recent 2 years.

Atherogenic dyslipidemia comprises a triad of increased blood concentrations of small, dense low density lipoprotein (LDL) particles, decreased high-density lipoprotein (HDL) particles, and increased triglycerides. A typical feature of obesity, the metabolic syndrome, atherogenic dyslipidemia has emerged as an important risk factor for cardiovascular disease. We have determined levels of serum lipid profiles in 1861 older people who lives 5 regions in Mongolia. The concentrations of total cholesterol, triglycerides and high density lipoprotein cholesterol (HDL-C) were measured using a biochemical reagents by biochemical fully automated analyzer. The levels of LDL-C were calculated by the Friedewald equation. Overall prevalence of dyslipidemia was 4.3% in men and 3.0% in women. Logistic regression showed that Odds ratio of the atherogenic dyslipidemia was OR=1.3, p=0.001 (CI 95% 0.93-2.47) for body mass index, OR=1.6, p=0.02 (CI 95% 1.0-2.88) for waist circumference, OR=1.76, p=0.03 (CI 95% 1.12-3.54) for waist hip ratio. Odds ratio of the atherogenic dyslipidemia was OR=0.98, p=0.001 (CI 95% 0.34-1.05) for gender and OR=1.0 p=0.001 (CI 95% 0.65-1.03) for age. Overall, 3.3% of older people had atherogenic dyslipidemia and 4.3% of men and 3.0% of women had atherogenic dyslipidemia. An increase of physical parameters are getting a risk factor of atherogenic dyslipidemia.

INTRODUCTION:Alcohol (EtOH) use disorders (AUDs) represent a substantial public health problem worldwide. Over 76million people present with AUDs 2.5 million deaths were attributed to alcohol (World Health Organization,2010). Channadshelshi has been used for treatment of alcohol-related, liver disease and intoxication intraditional medicine.GOAL:To determine effect of channadshelshi on voluntary alcoholic wistar rats.MATERIALS AND METHODS:To examine acute toxicity of Channadselshi were used V.P.Prozorovsky express method (1978) andOECD (2001).Voluntary EtoH consumption measurement (two-bottle choice, intermittent access to EtOH paradigm inwistar rats). Water and 20% ethanol were presented in 200 mlgraduated plastic cylinders with stainlesssteeldrinking spouts.The experiment period was 10 weeks total. EtOH consumption was expressed asgrams of EtOH consumed per kilogram of body weight/day.Elevated plus maze. Anxiety associated with EtoH withdrawalwas measured on EPM The mazewaselevated 1 m above the floor and contained four 50 cm long, 10 cmwidearms arranged at rightangles. The closed arms had opaque walls 30cm high, extending the length of the arm. At the time of thetest, eachanimal was placed in the center of the maze facing an open arm andallowed to explore for a5 min session. During this 5 min test session, theanimal’s number of arm entries and time spent in eacharm per entry was recorded on a camera.Pentylenetetrazol (PTZ) 100 mg/kg dose used in this study was determined as the dose that inducedseizures and protection against mortality in miceThe experimental protocol was approved by the Ethics Committee of the MNUMS. (№ 14-11/1À)RESULTS:LD50 of Channadselshi extract was found to be LD50=2.58 (2.1-3.2) gr/kg by V.P.Prozorovsky expressmethod (1978). Channadselshi was no acute toxic by OECD (2001).Ten and four weeks oral administration of Channadselshi (200 mg/kg) significantly (P<0.01) decreasedthe consumption of ethanol and significantly (P<0.01) increased time spent in open arm (EPM) involuntary alcoholic wistar rat compare to control.The time (sec) of latency the generalized convulsion were significantly (P<0.01) increased ofChannadselshi compare to control. The percent of protection against mortality were 80% in PTZinduced seizure in mice.CONCLUSIONS:1. Our study showed that Channadselshi hasreduced consumption of ethanol in voluntary alcoholicwistar rat.2. Channadselshi has central nervous system protection effect against PTZ induced seizure in mice.

As the proportion of aged population has been increasing worldwide by the rapid development of socio-economy, health science, and educational level that affect the policy against health service and social welfare, one of the urgent issues of Mongolian society and medical science facing is to develop healthy aging process and prevention of pathological aging. As we know, healthy aging process depends upon several factors such as heritage, biological and physiological internal factors, living condition, climate, geography, socio-economy, nutrition, drinking water, lifestyle etc,. Thus, the development of healthy aging and its influential factors is an immediate issue of Mongolian medicine and society.A cross-sectional regression analysis has been used to measure socioeconomic and physiological factors for longevity. Total of 1897 participants aged less than 80 are randomly collected from Ulaanbaatar city and Mongolian 4 regions.Total of 1897 participants, less than 80 years old are involved in this study. People in an urban area are higher than those in countryside. About housing condition, 63.5% of total participants are in apartment at UB and 37.8% is in House and 44.3% in Mongolian Ger. Estimating participant’s income, 25% of relatively healthy population is below than the minimum of subsistence. However 50% of elderly people aged between 75-80 is below than minimum of subsistence. Comparing income level by age and gender income is decreased while age is increased, males are relatively higher than females. Middle income people are by 20.9%, high income people are by 57.7% less the risky than low income people. Unhealthy status is increased by 1.0% while a year of smoking, LDL by 96.5%, HDL by 94.7%, Triglycerid by 71.2%, CAVI by 91% increase risks respectively.Below indicators are more influential for the healthy aging of Mongolian elderly people as follows, education level (ρ-0.001), household income (OR=0.423, ρ<0.0001), living conditions (OR=0.326, ρ<0.05), LDL (OR=0.035, ρ<0.0001), HDL (OR=0.053, ρ<0.0001), glucose (OR=0.014, ρ<0.0001), CAVI (OR=0.090, ρ<0.0001). Higher density of healthy aged populations is found in the central region of Mongolia where altitude is 1000-1500 meters above than sea level (MASL) and temperature is between 0-6 Celsius.