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: Azoospermia is the most severe form of male infertility, affecting approximately 1% of male population and 10–15% of infertile men. In azoospermia cases, sperm retrieval from the testis or epididymis through surgical procedures is used for assisted reproductive treatments. When no sperm is retrieved, recent approaches in medicine suggest using immunohistochemical methods to evaluate spermatogenesis in testicular tissue and plan further treatments. Aim: To evaluate spermatogenesis in testicular tissue of azoospermic patients using immunohistochemistry and compare the findings with the clinical outcomes of sperm retrieval procedures. Materials and Methods: This study included 71 azoospermic men who underwent micro-TESE procedures at the IVF center (RMC) between 2019 and 2023. The excised testicular tissues were fixed, processed histologically, and evaluated using Johnson’s score. The presence of spermatozoa in seminiferous tubules was detected by immunohistochemical and immunofluorescence staining, using markers such as TEX101 and LDHC. Results: Johnson’s score was categorized into three groups: poor, moderate, and good spermatogenesis. These were statistically compared with hormonal levels and surgical sperm retrieval outcomes. There were significant differences in Johnson’s scores and serum FSH and LH levels among the three groups (p < 0.005). TEX101 and LDHC proteins were strongly expressed in the good group, weakly in the moderate group, and absent in the poor group. The success rate of sperm retrieval was 100% (17/17) in the good group, 96.29% (26/27) in the moderate group, and only 29.62% (8/27) in the poor group. Conclusion Histological evaluation of spermatogenesis in azoospermic patients can help predict the outcome of surgical sperm retrieval, indicating its clinical value in treatment planning.

Background: Osteoporotic fractures remain a major concern for public health and the economy. Osteoporosis is a chronic disease characterized by reduced bone density due to genetic, hormonal, mineral, and lifestyle factors. Although often asymptomatic, its primary complication is fractures, which lead to disability and loss of work capacity, impacting individuals, families, and society. In Mongolia, no long-term study has examined bone density changes and fracture risk factors, which forms the basis of this research. Aim: To assess 10-year changes in bone density and identify risk factors for fractures. Materials and Methods: This prospective cohort study was conducted at the Department of Pathophysiology, School of Biomedicine, MNUMS. We have re-enrolled 133 adults from Ulaanbaatar between November 2023 and January 2024, originally part of the ‘Study of some risk and pathophysiological factors of osteoporosis in the Mongolian population’ funded by the Ministry of Health and the Science and Technology Fund of Mongolia. Data collection included questionnaires, anthropometric measurements, bone mineral density assessments using the ‘Sunlight Mini-Omni’ bone sonometer (Beammed, USA) Results: The mean age of participants was 54.4±9.6 years (N=133), with 33.1% (n=44) male and 66.9% (n=89) female. Among the participants, 51.1% had a history of bone fractures, with forearm fractures comprising 10.5% and other types of fractures accounting for 40.7%. The bone fractures was significantly higher among elderly individuals and those diagnosed with osteoporosis (p<0.05). The T-score was significantly lower in the fracture group than in the non-fracture group (p<0.05). Vitamin D deficiency was identified as a significant risk factor for fractures (p<0.05). Conclusion All participants’ bone density has decreased over the decade. Bone fractures are more common in elderly and people with osteoporosis. Inadequate vitamin D intake is a significant risk factor for bone fractures.

Background: Thyroid hormone disorders have an adverse effect on human spermatogenesis. Thyroid function has regulated by hypothalamic-pituitary-thyroid axis and thyroid stimulation hormone is a critical measurement of thyroid disorders. This study aimed to investigate the relationship between thyroid stimulating hormone and sperm parameters. Methods: This study has conducted 99 man who have visited RMC and Ojinmed IVF centers. Serum level of thyroid stimulating hormone (TSH) was measured by automated immunoassay analyzer (TOSOH AIA-360, Japan). Semen analysis was done in all the participants and evaluated by World Health Organization’s guidelines(2010). Results were calculated by SPSS 26 program. Results: The average age was 35.2±5.76. The mean serum TSH level was 1.37±0.57 and 1.85±1.16 normal subjects and spermatogenesis dysfunction group, respectively. Furthermore, serum TSH level and sperm parameters were significantly different between two groups (p<0.05). Logistical regression analysis showed that increased TSH level negatively affected the motility (r=-0.28; p<0.05) and progressive motility (r=-0.34;p<0.05) of sperm more than other parameters (r=-0.34; p=0.035). There was no correlation between serum TSH and other sperm parameters. We analyzed binary logistic regression for TSH with spermatogenesis dysfunction in case control groups. According to the analysis, elevation of serum TSH level increases the risk of spermatogenesis dysfunction by 5.0 times (OR=5.06, p<0.05). Conclusions Subclinical hypothyroidism adversely affect some sperm parameters, including motility and progressive motility. Subclinical hypothyroidism increases the risk of spermatogenesis dysfunction.

Purpose: Researchers suggest that the prevalence of infertility varies between developing and developed countries, with differences in infertility care, socioeconomic status, lifestyle, and reproductive disorders such as pelvic inflammatory disease and sexually transmitted infections being the main risk factors. The research project aims is to define risk factors for female fertility in the Mongolian population. Methods: This study was conducted between 2016-2018 using a cross-sectional survey of analytical research. Participants were randomly selected from Ulaanbaatar and the Central, Western, Eastern, and Khangai provinces according to Mongolia’s regional geographic model. The contents of a questionnaire were comprised of 5 units with 95 questions including socio-economic, geographical, lifestyle, health education, reproductive health indicators, sexual behavior. General physical characteristics were measured according to the standard. Results: The prevalence of the female fertility rate in the Mongolian population is 7.4%. Female participants were classified into 2 groups, namely infertile and fertile, and we developed a case-control study. Among the socio-economic factors influencing infertility, primary education aOR: 1.6 (95% CI 0.98-2.66), monthly household income lower than the average aOR: 1.1 (95% CI 0.77- 1.66), living in rural areas OR: 2.3 ( 95% CI 1.46-3.68) were crucial risk factors. As for reproductive and general health indicators, STIs aOR: 1.8 (95% CI 0.98-3.50), especially gonorrhea OR: 2.8 (95% CI 1.14-6.91), and thyroid disorders OR: 1.7 (95% CI 1.03). -2.97), grade 3 obesity OR: 3.8 (95% CI 1.05-13.95) are estimated risk factors for infertility. Conclusions Of all potential socio-economic factors, residence status, education and financial situation are significant for female infertility meanwhile reproductive health indicators include sexually transmitted infections, thyroid disease, and obesity.

BACKGROUND: According to International osteoporosis foundation report, osteoporosis is a multifactorial condition associated with an increased risk of fracture and is caused by social, behavioral and physiological factors. Overall incidence is increasing in every country due to people’s life style changes, diet and increased life expectancy. OBJECTIVES: To evaluate the some hormonal effects in bone mineral density among Mongolian population. METHODS: Bone density was measured in the distal one third of radius using the Sunlight Omnisense (Sunlight Medical, Rehovot, Israel) and classified into 3 groups according to WHO osteoporosis criteria. Normal participants were selected into control group and osteoporotic participants were selected into control group. We have evaluated PTH, calcitonin, 25-hydroxy vitamin D in case-control group. RESULT: The prevalence of osteoporosis was 25.7% and 25.3% of participants were osteopenic. It was clear that PTH elevated group (>30.3pg/ml) had more risk of osteoporosis. CONCLUSION: The prevalence of osteoporosis was 25.7% and 25.3% of participants were osteopenic. PTH elevation is risk factor in men.

BACKGROUND: According to the World Health Organization (WHO), 10-15% of couples of reproductive age have infertility. According to researcher D. Sukhe (1999), hormonal infertility in the reproductive age of women was 33.6%, which was a large part of the cause of infertility. In recent years, the number of cases of endocrine disorders, including malignancy and sexually transmitted infections, has been increasing year by year. According to WHO reports, thyroid disorders have a prevalence of 49.3% for active reproductive age (30-50). According to the report of the Health Development Center in 2016, since the thyroid disorders are the second most common disease in endocrine gland disease, our study found that the infertility in reproductive age of women can be substantial due to the loss of thyroid gland. METHODS: The study was carried out by the couple of 20-45 year-olds and modeled as an analytical study model. The questionnaire was used for the couple’s interviews and some of the measurement of body and serum use of TOSOH Corporation AIA-360, Tokyo, Japan. On the serum, anti-TPO and аnti-TG carbohydrates are identified by the Cobas e-411 analyzer under the manufacturer’s accompanying protocol. RESULTS: 76.7% of women were diagnosed with infertility euthyroid, 0.7% hyperthyroidism, 22.6% hypothyroidism (3.8% with overt hypothyroidism and 18.8% subclinical hypothyroidism). Prevalence of TAI, in 6.7% isolated positive anti-Tg were found, and 14.3% had isolated positive TPO, In 3.7% of cases, both types of autoantibodies were present. We analysed binary logistic regression for anti-TPO and anti-TG autoantibody in the positive and negative group in past obstetrics history, evidence of positive of anti-TPO and anti-Tg was increased risk of miscarriage 2.2 times (OR = 2.2, p <0.01). CONCLUSIONS: Women with disorders in our study have high percentage of subclinical hypothyroidism and have higher rate of thyroid autobodies in serum which may be a problem for women with infertility and pregnancy complications due to the loss of thyroid gland. There is a need to develop a principle of recovery and treatment.

BACKGROUND. According to the International osteoporosis foundation, the incidence of osteoporose in men is increasing rapidly. Some investigations mention the serum testosterone hormone decreases by aging and may cause of osteoporose. Our study was aimed to evaluate relation between serum total testosterone and bone mineral density in men. MATEREALS AND METHOD. Relatively healthy 624 men aged between 18-87 were randomly selected from Mongolian 4 provinces and Ulaanbaatar city. Specially designed questionnaire was used in the survey. And some of measurement, Weight, height and BMI, was measured. Bone mass density was diagnosed according to the WHO criteria by the T-score. Serum total testosterone level were described by using ELISA kit (Eucardio Laboratory, Inc. USA) at the laboratory of MHI.The statistical result was analyzed by SPSS 22 program. RESULTS. The subjects mean age was 48.56±16.63, with a range of 18-87. The mean SOS was -4055.23±228.89. And the osteoporse was 14.6% (n=91) in all of participants. 152 participants were randomly selected from all participants and classified 2 groups(case and control) according to WHO osteoporosis criteria and evaluated relation between serum total testosterone and bone mineral density. The mean of serum total testosterone level was significantly low (8.80±2.67) in case group than (9.33±2.44) control group (p<0.05). Our study showed that positive correlation between bone mass density values at testosterone hormone (r=0.17 p<0.034). CONCLUSION. Our study showed decreased serum total testosterone hormone affected to decrease of bone mineral density.

BACKGROUND. According to the World Health Organization (WHO), 10-15% of couples of reproductive age have infertility. According to researcher D. Sukhe (1999), hormonal infertility in the reproductive age of women was 33.6%, which was a large part of the cause of infertility. In recent years, the number of cases of endocrine disorders, including malignancy and sexually transmitted infections, have been increasing year by year. According to WHO reports, thyroid disorders have a prevalence of 49.3% among active reproductive age (30-50) group. According to the report of the Health Development Center in 2016, since the thyroid disorders are the second most common disease in endocrine gland disease, our study has found that the infertility in reproductive age of women can be substantial due to the loss of thyroid gland. OBJECTIVE. To study the relationship between the thyroid gland antibodies and female infertility. MATERIAL AND METHODS. The study was carried out in 20-45 year old couples and was modeled as an analytical study model. The questionnaire was used for the couple’s interviews, antroplogical measurements, and serum was analysed. On the serum, anti-TPO and аnti-TG carbohydrates were identified by the Cobas e-411 analyzer under the manufacturer’s accompanying protocol. RESULTS. Prevalence of TAI, in 6.7% positive anti-Tg were found, and 14.3% had positive TPO. In 3.7% of cases, both types of autoantibodies were present. We analysed binary logistic regression for anti-TPO and anti-TG autoantibody in the positive and negative group in relation to the past obstetrics history. A=Accoding to the analysis, evidence of positive anti-TPO and anti-Tg increased the risk of miscarriage by 2.2 times (OR = 2.2, p <0.01). CONCLUSION: Women with infertility in our study have high percentage of subclinical hypothyroidism and have higher rate of thyroid autobodies in serum which could be a problem for women with infertility and pregnancy complications due to the loss of thyroid gland. Thus, there is a need to develop intervention guidelines for recovery and treatment of these types of infertility.

Osteoporosis is a disease in which the density of bone is decreased with consequent increase in bone fragility and susceptibility to fracture risk. Vitamin D deficiency may cause secondary hyperparathyroidism and low bone mineral density. Our study was aimed to assess relation between vitamin D status and parathyroid hormone and bone density in adults. Relatively healthy 369 participants aged between 20-60 were randomly selected from Ulaanbaatar city. Specially designed questionnaire was used in the survey. Bone mass density was diagnosed according to the WHO criteria by the T-score. Respondents serum calcium and phosphorus levels were described by the fully automated analyzer (Cobas Integra 2800, Germany). Serum parathyroid hormone and 25-hydroxivitamin D levels were described by using ELISA kit (Eucardio Laboratory, Inc. USA) at the Molecular biology laboratory of MNUMS.The statistical result was analyzed by SPSS 21 program. The subjects mean age was 47.61±12.92, with a range of 20-83. The mean T-score was -0.60±2.17. Our study showed that negative correlation between bone mass density values at parathyroid hormone (r=-0.58, p<0.05), 25-hydroxyvitamin D (r=-0.48, p<0.05) and serum calcium (r=-0.21, p<0.05). Our study showed increased serum parathyroid hormone led the releasing calcium from bone and decreasing bone mass density.