Healthcare is a rapidly growing industry as medical treatments become more sophisticated, more in demand due to increasing incidence of chronic disease and more widely available worldwide. As the amount of healthcare waste continues to increase, there is a need for further research in the field to meet the global demand for proper disposal of healthcare waste. The growing healthcare consumption, driven by various factors, is contributing to the rise in hospital waste, which in turn is putting pressure on current waste management systems.Currently, healthcare institutions manage waste by segregating at the source, safely transporting infectious waste, and disposing of it through incineration, autoclaving, or landfill methods. Both incineration and autoclaving processes have negative environmental and human health impacts. To reduce the amount of healthcare waste generated, it is necessary to train healthcare workers to properly segregate waste according to its type, following established standards.
Governments can take action to improve waste disposal practices, reduce the generation of infectious waste, and ensure that all types of healthcare waste are properly disposed of. This can include:
• Governments should have clear and standardized definitions for both infectious and non infectious healthcare waste, and enhance the regulatory and legal framework to prevent illegal disposal of waste.
• Healthcare institutions should be provided with incentives, financial support, and other measures to reduce hospital waste, with a particular focus on reducing infectious waste in local health institutions.
• Governments should provide research grants to support studies aimed at reducing and managing healthcare waste disposal effectively.
These measures would help improve the overall management and reduction of healthcare waste and ensure a safer and more sustainable approach to waste disposal.

Introduction: Colorectal cancer remains one of the critical healthcare challenges nowadays. There are a lot of studies done on colonic polypectomy around the world, and mostly diagnosis with dysplasia change, so we consider to chose to study this topic. Aim: In this study, we aimed to compare the between cold snare polypectomy (CSP) and hot snare polypectomy (HSP) of removing colon polyps. This method helped us to investigate which of the two methods is most prevalent for polypectomy. Materials and Method: The research was carried out using a targeted sampling method from the cases where colonoscopy was performed between 2022 and 2023, based on the Center for Imaging Diagnostics and Pathology of Third General Hospital of Mongolia with a colon polyps less than 5mm in size should be removed using the cold snare method according to the recommendation, and polyps between 5-10 mm should be removed using the hot snare method. After polypectomy, we assessed deep mucosal lesions using the Sydney classification. Result: The average age of the 81 cases included in the study was 57.9 years, and the male-female ratio was 1:1.2.149 cases (75.6%) of slightly elevated type 0-IIa according to the Paris classification, according to the morphological structure revealed by endoscopy, while 79 cases (75.6%) were tubular adenoma according to histological analysis. (38.9%), low grade dysplasia 52 (25.6%) and high grade dysplasia 3 (1.5%) cases are noteworthy. Average polyp was 5-9 mm. Most of polyps removed was left side of colon especially in sigmoid colon. Bleeding rate was higher in hot snare method 11.5%. (1/149, 0.7%, 5/52, 9.6%; P = 0.6). There was no recurrent rate and no perforation in our study. Conclusions In our study, average size of 5-9 mm were removed and slightly elevated (0-IIa), sessile (0-Is) type of polyps were commonly found in the sigmoid colon. There is a higher risk of bleeding due to mucosal damage in hot snare polypectomy. A combination of hot and cold methods is equally effective for resection of colon pollyps up to 1 cm in size.

Colorectal cancer remains one of the critical healthcare challenges nowadays. Most patients’ disease, especially colorectal polyps develop via the adenoma carcinoma sequence; using colonoscopy with polypectomy reduces both mortality and incidence by removing precancerous adenomas, which are called polyps. In recent years, colorectal cancer tends to increase among Asian population. There are only limited studies that have been conducted in Mongolia regarding colorectal polypectomy and its complications. Both cold polypectomy and hot polypectomy are accepted methods. In this study, we aim to compare the complications (bleeding, perforation) between cold snare polypectomy (CSP) and hot snare polypectomy (HSP) of adenomas and hyperplastic polyps. After the procedure, repeated endoscopy will be performed to compare the incomplete resection rate (IRR) and complete resection rate (CRR) of mucosal residual and presence of recurrency. This will help us to investigate which of the two methods is most prevalent for polypectomy.

Introduction: Colorectal cancer remains one of the critical healthcare challenges nowadays. Most patients’ disease, especially colorectal polyps develop via the adenoma carcinoma sequence; using colonoscopy with polypectomy reduces both mortality and incidence by removing precancerous adenomas, which are called polyps. In recent years, colorectal cancer tends to increase among Asian population. There are only limited studies that have been conducted in Mongolia regarding colorectal polypectomy and its complications. Both cold polypectomy and hot polypectomy are accepted methods. In this study, we aimed to compare the complications (bleeding, perforation) between cold snare polypectomy (CSP) and hot snare polypectomy (HSP) of adenomas and hyperplastic polyps. After the procedure, repeated endoscopy was performed to compare the incomplete resection rate (IRR) and complete resection rate (CRR) of mucosal residual and presence of recurrency. This method helped us to investigate which of the two methods is most prevalent for polypectomy. Materials and Method: The research was carried out using a targeted sampling method from the cases where colonoscopy was performed between 2020 and 2022, based on the Center for Imaging Diagnostics and Pathology of Third General Hospital of Mongolia with a colonoscopy with a high-performance Olympus EVIS EXERA III brand NBI from Japan. In this study, we selected only hyperplastic polyps and adenomas <10 mm in size. Polyps less than 5 mm in size should be removed using the cold snare method according to the recommendation, and polyps between 5-10 mm should be removed using the hot snare method. After polypectomy, we assessed deep mucosal lesions using the Sydney classification. Result : According to the results of the study, in terms of age, the percentage of people having a polyp removed was relatively low among 15-39 year olds compared to the other age groups, while it was higher in those aged >65 years. In terms of body mass index, 75% of the total number of people who had a tumor removed were overweight, indicating that overweight or obese people are at higher risk of developing a colorectal polyps. In terms of gender, 63% of people who had a polyp removed were male, indicating a male predominance in polyp prevalence. The percentage of tumor questionnaires in the total study population was 0% or absent. Early detection of adenomas and hyperplastic polyps, which are precursors of tumor, is the main way to prevent the development of cancer. A slightly raised polyp was present in 53 or 79.1% of the polyps, while a broad-based polyp occurred in 13 or 19% of the polyps, indicating the predominance of the slightly raised polyp in the population. In terms of location, polyps occurred more often in the descending colon and the sigmoid colon, and complications (perforation, bleeding) related to the anatomical structure and location are more likely to occur in these parts of the colon. However, the likelihood of relapse is very low. The procedure time was 17.6 minutes on average, and in 14 cases, hemostatic clamps were placed to prevent the risk of bleeding, and in 5 cases, epinephrine was injected for hemostasis. Early detection of colorectal diseases (endoscopy), changes in the lifestyle of clients, and regular preventive examinations are the main factors to reduce the risk of cancer development, and early start of treatment as well as complete removal of adenoma, an antecedent to cancer, will have a significant impact on cancer prevention and mortality reduction. Conclusions
1. Left sided polyps were commonly diagnosed among study participants.
2. Correlation between the probability of recurrence and the anatomical location of the polyps was very low.
3. Our results suggest that HSP and CSP techniques can be effectively used for the complete removal of 4–10mm colorectal polyps. Moreover, there was no significant difference between CSP and HSP in terms of overall complications.

ABSTRACT. Recurrent aphthous stomatitis, or RAS, is common oral disorder of uncertain etiopathogenesis for which only symptomatic therapy is available. This article reviews the current clinical features of RAS among study patients and the result of therapeutic effects of the herbal preparation Akhizunber. Over the past four years we have treated 61 RAS patients with different clinical forms by herbal preparation Akhizunber or Alumekatin. The distribution of clinical forms RAS RAS among study patients were minor aphthae -75.4%, major aphthae -16.4% and herpetiform ulcers -8.2% respectively. The healing time of treated Akhizunber was in minor aphthae -9.28±4.82 days, major aphthae -14 days and herpetiform ulcers -12 days. Of the total study participants, the patients treated by Akhizunber reported a rapid and complete recovery from RAS during treatment compared with treated patients by Alumekatin. Treatment with herbal preparation Akhizunber can be effective for patients suffering from RAS in any clinic form, regardless of their ulcer number and size.

BACKGROUND. To identify the prevalence of oral lesions in HIV positive group of patients, and to compare their CD4 cell count and viral load to stages of disease progress. MATERIAL AND METHODS. In the present study, we evaluated 30 HIV+ adult patients, attended to the AIDS/STI Department of National Center for Communicable Diseases, Ministry of Health Mongolia. Each patient was clinically examined for detection of oral mucosal lesions. In addition, CD4 cell count was determined by Flow Cytometry, as well as viral load by RT-PCR (Amplicor HIV- RNA, TM test 1.5, Roche) RESULTS. 46% of all examined HIV/AIDS patients had oral lesions. Oral Candidiasis constituted the most common lesion, representing 35%, Herpes 22%, followed by Oral Leukoplakia 17%, Necrotizing ulcerative periodontitis 9%, Aphthous Recurrent Stomatitis 13%, Kaposi’s sarcoma 4%. The patients, who have a viral load high exhibited oral lesions related to HIV, independent of CD4 cell count, although patients with CD4+ levels of 233 cel/mm3 were more susceptible to develop these lesions. СONCLUSION. The most common oral lesion was Oral Candidiasis, followed by Oral Leukoplakia and Necrotizing ulcerative periodontitis. A high viral load was strongly associated to the oral lesions occurrence independently of CD4+cell count..

BACKGROUND. Periodontal regeneration is the reconstruction of periodontal tissues and restoration of functions, which is achieved through techniques, such as soft tissue grafts, guided tissue regeneration, bone replacement grafts, root bio-modification, and a combination of these techniques. Chitosan is a natural biopolymer with several beneficial properties, including excellent biocompatibility, low toxicity and corresponding degradation rates and hemostatic activities. This systematic review assessed the efficacy of biopolymer membrane (chitosan) for guided tissue regeneration (GTR) in animal and human studies. MATERIAL AND METHODS. The Cochrane Oral Health Group specialist trials, PubMed, MEDLINE, and EMBASE databases were searched for articles published before January 2017. Animal and human studies that used chitosan for GTR, which had a follow-up period of ≥6 weeks and 6 months, respectively, were retrieved. The following outcomes were analyzed: new bone (NB) and new cementum (NC) formation for animal studies and probing pocket depth and clinical attachment level changes for human studies. RESULTS. After a full-text review,six animal studies and three human studies were found to be eligible for this study. All included animal and human studies demonstrated that the use of chitosan for GTR exerts a positive effect on periodontal defects. Subgrouping meta-analysis outcomes of three dog studies revealed that GTR with pure chitosan membranes has a positive effect on NB (14.36%) and NC (10.21%) formation. CONCLUSION. Within the limitations of the present study, there is little evidence to demonstrate the efficacy of chitosan for GTR either in animal or human studies. Chitosan should rather be used as an adjunct component for membrane production.

Aphthae are common oral lesions that affect approximately 10% to 20% of the population. Recurrent Aphthous Ulcers (RAU) are usually classified into three different types: minor, major and herptiform RAU. The etiology of aphthous stomatitis is unknown but according to increasing evidence, its development has an immunogenic process that causes the ulceration of the involved oral mucosa. Similar-appearing lesions may arise in following systemic disorders: 1. Behcet’s disease 2. Sweet’s syndrome 3. Cyclic neutropenia 4. Benign familial neutropenia 5. MAGIC syndrome 6. A periodic syndrome with fever and pharyngitis 7. Various nutritional deficiencies with or without underlying gastrointestinal disorders Several studies from the UK, United States, and Spain have demonstrated that hematinic deficiency (iron, folic acid, or vitamin B12) are twice as common in RAS patients than incontrols. Case report: A 10 year old male patient presented a 3-year history of episodes of multiple minor recurrent Ulcers, this year major aphthae on the anterior ventral surface of the soft palate. Patient had difficulty in eating and in speech. Clinical examination revealed multiple symptomatic ulcers with a perilesional erythematous halo covered with a pseudomembrane. The size of major aphthae was than 20 mm in diameter. The ulcers were not associated with any type of discharge. The ulcers were tender on palpation. The medical history and the family history were non-contributory. A clinical diagnosis of major aphthous ulcers was made on the basis of the history and the clinical examinations. The patient was subjected to a therapeutic regimen consisting of daily topical application of Prednizoloni 0.05%, topical lidoksor and systemic vitamin and Cefatoxime Natrii, Immunomodulators Biferon, Amphotericin B. Recurrent aphthous stomatitis (RAS) or recurrent aphthous ulcers (RAU) remains a common oral mucosal disorder in most communities of the world. Proper systemic evaluation is important before prescribing the medication.

65 Non-bacterial originated tooth wear is a normal process which occurs throughout lif. If the rate of loss is likely to prejudice the survival of the teeth, or is a source of concern to the patient, then it may be considered ‘pathological’. Robb reported that the prevalence of pathological loss of tooth tissue in patients less than 26 years of age was greater than in many older age groups. Tooth surface loss was classified into 4 groups: attrition, erosion, abfraction and abrasion. To find the prevalence of four different types of tooth wear among patients visited Digital Dental Office, Ulaanbaatar, Mongolia and investigate their dental attrition severity. Methods: From total of patients visited Digital Dental Office clinic between September 2016 and September 2017 adults aged 16-62 who was found with any type of tooth wear were explored by 4 types. Those patients with attrition were chosen and severity was determined by Bardsley’s simplified tooth wear index (TWI). There were total of 5432 patients examined and treated during this period of time. From them total of 1002 patients aged 16-62 presented some degree of tooth hard tissue wear/dental attrition. Most of the patients were with combination of 4 types of tooth wear: attrition, abrasion, abfraction and erosion. Attrition (At) was found in 68 patients which was only 6.7%, Abrasion (Ab) in14 people-1.3%, Abfraction (Abf) in 4-0.3%, Erosion (Er) in 2 -0.1% alone. The combination of these types of tooth hard tissue was dominant. At+ab+abf+er in 59 patients of total 1002 (5.8%). At+ab+er in 58 (5.7%). Ab+abf in 29 (2.8%). At+er in 25 patients (2.4%). Er+ab in 27 (2,6%). At+abf+er in 264 people (26.3%). At+abf in 452 (45.1%), which was the most prevalent combination. Dental attrition severity in these 1002 patients were shown as following: -0-0- No loss of contour. -1-229 people (22.8%) - Loos of enamel surface characteristics. Minimal loss of contour. -2- 505 people (50.3 %) - Loss of enamel exposing dentine for less than one third of surface.Loss of enamel just exposing dentine. Defect less than 1 mm deep. -3- 211 people (21 %) - Loss of enamel exposing dentine for more than one third of surface.Loss of enamel and substantial loss of dentine. Defect less than 1-2 mm deep. -4-57 people (5.6%) - Complete enamel loss - pulp exposure - secondary dentin exposure.Pulp exposure or exposure of secondary dentine. Defect more than 2mm deep - pulp exposure - secondary dentine exposure. In this descriptive study showed patients with some degree of tooth wear were around 19% from total patients visited during 1 year of period. Four types of tooth hard tissue wear shown as a different combination, very low percentage was in these types alone. Most of the attrition patients were with mild to moderate degree of enamel loss. This kind of study should be continued to explore harmful dentofacial change

Introduction: This article provides areview about techniques and pitfalls of arterialand venous reconstruction during kidneytransplantation. Main reasons of our clinicalstudy are to evaluate vascular variationsof kidney, posttransplantation vascularcomplication incidence and present status ofsurgery outcome.This retrospective researchbased on cross-sectional assessmentofconsecutive 102 kidney transplantation cases,which performed from 2006 to 2015 at theFirst Central Hospital of Mongolia.Materials and methods: Statisticalprocessing andanalysis on posttransplantionpatient history data are made byMicrosoftExcel, SPSS19.0software.Results: Despite rising technicaldifficulties caused by vascular variations,pelvic and inguinal morphology of recipientand the existence of multiple renal arterieskidney transplantation is a safe and highlyefficient procedure.On this article wereexplained 44 kidney transplantation caseswith reconstruction using microvasculartechniques to reconstruct renal arteriesand veins. About 10 different kinds ofreconstructions were done in our practice.Due to investigation of consecutive 102kidney transplanted recipients, 24,51% had avascular anatomical variations. And describedabout 44 vascular reconstructions used inour hospital in case of vascular variations.According to the lit., vascular complicationsranges from 1 to 16%. In our hospital,vascularcomplication of kidney transplantation withmultiple vessels is 4,0-12,0%. Also, incidenceof vascular complication in group with singlevessels from 1.3 to 2.6% and in group withmultiple vessel 4 to 12%.Even it is highcomparing with other international articles;it’s almost in same results. But lymphaticcomplication is higher than others; it showsneeds of careful and accurate dissection ofrecipient site anastomosing vessels.Conclusion: Multiple renal graft’sveselshave been associated with a higher rateof vascular complications, including arterialstenosis and lymphorrhea. It shows needs ofcareful and accurate dissection of recipientsite anastomosing vessels.