Background: Due to the geographical location, population, and climatic characteristics of Mongolia, ear, nose, and throat diseases have not decreased to a certain extent, and non-communicable diseases, which are the main causes of morbidity and mortality, are increasing year by year in many countries. Urbanization, population density, environmental and air pollution, unhealthy lifestyles, and harsh working conditions have a significant impact on human health and increase the risk of developing non-communicable diseases. In our country, the study of ear, nose, and throat diseases among emergency workers who work continuously in all weather conditions throughout the four seasons of the year is relatively rare, which was the reason for conducting this study. Aim: Emergency services in some aimags and soums in the Central and Khangai regions have been working to identify and diagnose ear, nose, and throat diseases among employees. Materials and Methods: Using an organization-based prospective study method, clinical examinations were conducted from September 25 to October 18, 2024, among employees of the Central and Khangai regions of Orkhon, Selenge (6 soums), Tuv (4 soums), Khuvsgul (5 soums), Arkhangai (2 soums), Darkhan (1 soum), Bulgan (3 soums), 7 aimags, and 21 soums. The diagnosis of ear, nose, and throat diseases was made using ICD codes, and the data was analyzed using EXCEL software. Results: Among the employees and workers of the emergency services of the aimag, soum who participated in the survey (n=984), 139 (14%) were female and 845 (86%) were male, with an average age of 31.7 years and an average number of years of service of 10.3. The frequency of diseases classified by ICD code as a percentage of occurrence was as follows: J34.2: 211 (21%), J35.1: 96 (9.75%), J31.0: 58 (5.89%), H90: 15 (1.5%), H61.2: 14 (1.4%), H72.0: 10 (1.01%), H65.4: 6 (0.6%), J34.89: 5 (0.5%), K21.0: 5 (0.5%), H61.81: 3 (0.3%), D11.0: 2 (0.2%), 119 (12%) with comorbidities, and 426 (43.3%) diagnosed as healthy without ENT diseases. Conclusion 43.3% of the employees of the National Health Insurance Agency of some aimags and soums of the Central and Khangai regions were diagnosed as healthy or without ear, nose and throat diseases, and deviated nasal septum (J34.2), enlarged tonsils (J35.0), chronic rhinitis (J31.0), and conductive and sensorineural hearing loss (H90) were commonly found.

Introduction: Despite several techniques for corrective osteotomy in congenital radioulnar synostosis (CRUS) the published literature lacks a guide for radiographic planning and rationale for the site and level of the osteotomy. The primary objective of this study is to report a technique of radiographically controlled corrective osteotomy using the axis of rotation of the forearm in CRUS. Materials and methods: Children with CRUS underwent corrective osteotomy based on radiographic planning; the extent of rotational correction and functional outcomes were assessed at a mean of 27 months after the operation. Results: Seven forearms in six children of an average of 6.25 years were assessed for correction and functional outcomes. The average pre-operative pronation deformity was 71.5°. The average correction achieved was 64°. At follow-up, there were five excellent and two good functional outcomes. All children could perform daily tasks besides eating with hand and personal hygiene. Conclusion: Radiographic determination of the osteotomy sites by the method described is effective, consistent, and reproducible in achieving optimal functional outcomes in congenital radioulnar synostosis.

Introduction: Unstable ankle injuries require anatomical reduction and stabilisation for optimal outcome. In spite of adequate care, a few patients have poor outcome. In this study, we assessed the risk factors that predict the clinical outcomes in surgically treated unstable ankle fractures. Material and methods: This prospective cohort study was conducted on 68 patients who underwent surgical management for an unstable ankle injury. Demographic details, fracture type and associated medical comorbidities were recorded. Pre-operative radiographic assessment was done for all patients. At the end of one year follow-up, clinical (American Orthopaedic foot and ankle societyAOFAS and Olerud-Molander ankle - OMAS) scores and radiological parameters were assessed and analysed. Results: Fracture dislocation (0.008), diabetes mellitus (0.017), level of alchohol consumption (0.008) and preoperative talocrural angle (TCA) > 100° (0.03) were significant predictors of poor outcomes as per AOFAS. Fracture dislocation (0.029), diabetes mellitus (0.004), preoperative TCA > 100° (0.009), female gender (0.001), age more than 60 years (0.002) and open injuries (0.034) had significantly poor outcome as per OMAS. Other parameters (smoking, hypertension, classification, syndesmotic injury, medial clear space and tibiofibular overlap) did not affect the outcome significantly. Conclusion: Our study showed that poor outcome predictors in unstable ankle fractures are age >60 years, female gender, diabetes mellitus, alcohol consumption, fracture dislocation, open fractures and pre-op TCA >100°.

Introduction: Anatomical femoral tunnel placement is critical for anterior cruciate ligament reconstruction (ACLR). Tunnel placement may vary with different surgical techniques. The aim of this study was to compare the accuracy of femoral tunnel placement between the Anteromedial (AM) and Anterolateral (AL) visualisation portals on post-operative CT scans among a cohort of ACLR patients. Materials and methods: This cross-sectional study was conducted from January 2018 to March 2020 after obtaining ethics clearance. Patients who went for arthroscopic ACLR in our institute were divided into an AM (group 1) and an AL (group 2) based on the visualisation portal for creating the femoral tunnel and a 3D CT scan was done. The femoral tunnel position was calculated in deep to shallow and high to low direction using the Bernard Hertel grid. Femoral tunnel angle was measured in the 2D coronal image. Statistical analysis was done with the data collected. Results: Fifty patients with an average age of 26.36 (18-55) years ±7.216 SD were enrolled in the study. In this study, the AM technique was significantly more accurate (p<0.01) than the AL technique in terms of femoral tunnel angle. Furthermore, the deep to the shallow position was significantly (p= 0.018) closer to normative values, as determined by the chi-square test. The chances of error in tunnel angle in femoral condyle are 2.6 times greater in the AL technique (minimal clinical difference). Conclusion: To conclude, in ACLR the anteromedial visualisation portal can facilitate accurate femoral tunnel placement compared to the anterolateral visualisation portal.