Background: Recurrent inversion injuries are a major contributor to chronic ankle instability (CAI), resulting in long-term functional limitations, reduced physical activity, and diminished quality of life. While both arthroscopic and open surgical techniques are routinely employed worldwide, their outcomes remain unstudied in Mongolia. This study aimed to describe the national epidemiology of ankle ligament injuries and provide foundational data to inform future clinical and surgical research. Aim: To determine the prevalence, patterns, and associated demographic and environmental factors of ankle ligament injuries recorded in Mongolia between 2014 and 2023, and to conduct an epidemiological analysis. Materials and Methods: We performed a cross sectional, single-center epidemiological analysis using anonymized secondary data from the National Trauma and Orthopedic Research Center (NTORC), Mongolia’s national tertiary referral hospital. Patient records from January 2, 2014, to December 28, 2023, were extracted from the E-Health national database and coded using ICD-10. Eligible cases included malleolar fractures, ligament sprains, dislocations, nerve injuries, and other lower limb traumas. Data on age, sex, residence, admission date, length of stay, and injury mechanism were categorized into 167 specific etiologies and 14 major groups. Result: Falls were the predominant injury mechanism (71.1%), particularly among females (83.3%) and urban residents (76.4%). A seasonal peak occurred in winter, with 8.1% of injuries linked to ice- and snow-related falls. Rural males had a higher proportion of transport-related injuries, notably involving motorcycles. The anterior talofibular ligament (ATaFL) was the most frequently affected structure. Individuals aged 15–44 years represented the largest proportion of ligament injury cases. Conclusion Between 2014 and 2023, 4,757 ankle ligament injuries were recorded in Mongolia. Males accounted for 57.7% of cases, with the highest incidence observed in individuals aged 15–44 years (68.8%). Seventy-five percent of injuries occurred in Ulaanbaatar. Falls were the leading mechanism (>70%), particularly during winter, followed by road traffic accidents. Emergency department visits increased over time, while hospitalization rates remained low and stable.

Background: Plants rich in essential oils belong to more than 50 families, including Asteraceae, Rutaceae, and Lamiaceae. These plants are widely used in food, traditional and modern medicine, perfumery, cosmetics, and pharmaceutical industries. Approximately 3,000 types of essential oils have been identified, of which more than 300 are utilized for industrial and commercial purposes. Essential oils exhibit antimicrobial, anti-inflammatory, anticancer, cytotoxic, and antioxidant activities and are therefore widely applied in medical research. In Mongolia, the extreme climate, distinct ecological regions, and the prevalence of pastoral livestock husbandry provide a scientific basis for investigating essential oil–containing plants, their chemical composition, and biological activities. Among them, Juniperus Sabina L. is of particular theoretical and practical interest. Aim: To determine the non-toxic dose of essential oil extracted from Juniper Sabina L. on neural cells. Materials and Methods: This study was conducted at the Institute of Bio-Medicine, MNUMS. Ethical approval was obtained from the Research Ethics Committee of MNUMS (Meeting date: November 21, 2025; Protocol No. 2025-26/0301). BV2 microglial and N2a neuronal cell lines were cultured under standard conditions at 37°C in a 5% CO₂ incubator. Cells were maintained in appropriate culture media, and their growth and morphology were monitored microscopically before experimentation. Cell viability was assessed using the MTT assay. BV2 microglial cells were seeded into 96-well plates at a density of 2×10⁴ cells/well and incubated for 24 hours. Essential oil was added at concentrations ranging from 50–500 µg/mL and incubated for an additional 24 hours. After treatment, MTT reagent was added and incubated for 3 hours. The resulting formazan crystals were dissolved in dimethyl sulfoxide (DMSO), and absorbance was measured at 630 nm. Cell viability was calculated based on absorbance values to determine the non-toxic concentration of the essential oil. Result: The cytotoxic effects of the essential oil were evaluated in BV2 microglial and N2a neuronal cells using the MTT assay. In N2a neuronal cells, concentrations of 50, 100, 200, and 300 µg/mL did not significantly affect cell viability, whereas 400 and 500 µg/mL reduced cell viability, indicating cytotoxic effects. Conclusion According to MTT assay results, the essential oil of Juniperus sabina showed no cytotoxic effect on N2a neuronal cells at concentrations of 50, 100, 200, and 300 µg/mL, while cytotoxic effects were observed at 400 and 500 µg/mL. In BV2 microglial cells, concentrations of 50, 100, and 200 µg/mL were non-toxic, whereas concentrations above 300 µg/mL exhibited cytotoxic effects.

Background: Anterior cruciate ligament (ACL) rupture is one of the most common sports-related knee injuries among young and physically active individuals, often leading to knee instability, functional impairment, and delayed return to sports. Although hamstring tendon (HT) autografts are widely used in ACL reconstruction, the optimal graft choice remains controversial. The superficial rectus femoris (SRF) tendon has recently emerged as a potential alternative autograft with favorable biomechanical properties. This study aimed to compare the clinical stability and functional outcomes of ACL reconstruction using SRF and HT autografts. Aim: This study aimed to characterize the epidemiology and risk profile of knee joint injuries in Mongolia over a 10-year period, and to evaluate the comparative clinical efficacy and functional recovery following ACL reconstruction using hamstring tendon (HT) versus superficial rectus femoris (SRF) autografts. Materials and Methods: A randomized parallel-group clinical study was conducted at the Sports Injury Center of the National Trauma and Orthopedic Research Center. Fifty patients aged ≥18 years with complete ACL rupture were enrolled and randomly assigned to undergo ACL reconstruction using either a superficial rectus femoris autograft (SRF group, n=25) or a hamstring tendon autograft (HT group, n=25). The primary outcome was mechanical knee stability. Secondary outcomes included functional performance assessed using three-dimensional motion analysis, as well as patient-reported outcomes measured using the International Knee Documentation Committee (IKDC) and Lysholm scores. Clinical and functional assessments were performed preoperatively and at 1, 3 and 6-month postoperative follow-up visits. Comparative analyses were conducted to evaluate differences in recovery patterns between the two groups. Result: Patients in the SRF group demonstrated significantly lower early postoperative pain levels and faster functional recovery compared with the HT group (p<0.01). Three-dimensional motion analysis revealed earlier restoration of limb symmetry and improved dynamic knee stability in the SRF group during the early postoperative period. These objective biomechanical findings supported the clinical observation of accelerated rehabilitation following ACL reconstruction using SRF autografts. At six months postoperatively, however, no statistically significant differences were observed between the SRF and HT groups in terms of mechanical knee stability or patient-reported functional outcomes. Conclusion ACL reconstruction using a superficial rectus femoris autograft demonstrated superior early functional recovery compared with the traditional hamstring autograft while achieving comparable short-term clinical stability. These findings suggest that the SRF autograft may represent a promising alternative graft option for patients requiring accelerated rehabilitation and earlier return to physical activity.

Background: Bone mineral density (BMD) is a key indicator reflecting bone strength and resistance to fracture. It is influenced by multiple factors, including age, sex, genetic background, body composition, nutrition, and physical activity. During young adulthood, peak bone mass is actively formed; therefore, identifying early variations in this period is essential for predicting future skeletal health risks. Accordingly, assessing BMD and evaluating its relationship with physical characteristics among first-year nursing students provides a scientific rationale for this study. Aim: To examine the relationship between bone mineral density and selected physical parameters among students. Materials and Methods: A total of 297 first-year students aged 17-35 years from the School of Nursing, Mongolian National University of Medical Sciences were included. Bone mineral density was assessed by measuring the speed of sound through the radius using an ultrasound bone densitometry device. Handgrip strength was measured using an electronic dynamometer. Physical parameters including age, sex, height, and body weight were measured using standardized procedures, and statistical analysis was performed. The study was approved by the Research Ethics Committee of MNUMS on November 21, 2025 (No. 26/1) and March 28, 2026 (No. 26/03-B02), with no ethical violations identified. Results: According to T-scores, 37.1% (n=110) of participants had normal bone status and 62.9% (n=187) showed reduced bone density. Based on Z-scores, 52.5% (n=159) were normal, while 45.6% (n=138) had decreased values. T-score values were 1.87±0.69 (<20 years), 1.44±0.55 (20–30 years), and 1.10±0.31 (>30 years), while Z-score values were −0.73±1.38, −0.43±1.23, and −0.02±1.27, respectively. ANOVA analysis revealed statistically significant differences among age groups (p<0.01). A positive correlation was observed between T-score and age, whereas no significant correlations were found with other physical parameters. Z-score showed a positive correlation with handgrip strength. Conclusions 1. A high prevalence of reduced bone mineral density was observed among the students, which may be associated with incomplete attainment of peak bone mass in adolescents and young adults. 2. A significant difference in bone mineral density was found between age groups (p<0.01), indicating that age is an important factor influencing bone mineral density.

Background: Of the 7,678 plant species growing in Mongolia, more than 1,230 are considered medicinal plants; however, around 900 of these remain unstudied, and only about 200 species are currently used in medical practice. In recent years, the use of natural products in therapy has increased, and research in this field has been rapidly developing. Schizonepeta multifida (L.) Briq., a plant belonging to the Lamiaceae family, is widely distributed in Mongolia, Siberia, and East Asia, and is traditionally used to treat colds, fever, and inflammatory diseases. Phytochemical studies have shown that its essential oil contains terpenoid compounds such as pulegone and limonene, as well as flavonoids. These compounds are known to exhibit antioxidant, anti-inflammatory, and neuroprotective effects; however, comprehensive studies on these activities of Schizonepeta multifida growing in Mongolia are limited. Aim: To determine the antioxidant activity, cytotoxicity, and anti-inflammatory effects of Schizonepeta multifita Briq. essential oil and to evaluate its anti-stress effects in an experimental chronic stress animal model. Materials and Methods: The study was conducted at the Institute of Bio-Medicine, Mongolian National University of Medical Sciences. The aerial parts of Schizonepeta multifida were subjected to hydrodistillation using a Clevenger apparatus to obtain essential oil, and the yield was calculated. Antioxidant activity was measured at 517 nm using a spectrophotometer (Agilent BioTek Epoch 2). Cytotoxicity was assessed in BV2 and N2a cell lines using the MTT assay, after which inflammatory markers (IL-6 and TNF-α) were determined in cell cultures using ELISA. For the induction of chronic stress, C57/BL6 mice were divided into healthy control, negative control, and experimental groups. A total of 10 different chronic stress models were randomly applied twice daily for 28 days. Anti-stress effects were evaluated using the forced swim test. Data analysis was performed using Prism 10 software. Results: The yield of essential oil from Schizonepeta multifida was 0.3±0.03%. The antioxidant activity, assessed by the DPPH radical scavenging method, showed an IC₅₀ value of 262.7±2.95 µg/mL, indicating antioxidant potential. Cytotoxicity assays in BV2 and N2a cell lines showed toxic effects starting from a concentration of 200 µg/mL. The essential oil significantly reduced inflammatory markers IL-6 and TNF-α at concentrations of 50, 100, and 200 µg/mL (p<0.05). In the forced swim test, there was a statistically significant difference (p<0.05) between the disease control group and the experimental group. Conclusion The essential oil of Schizonepeta multifida exhibits antioxidant, anti-inflammatory, and anti-chronic stress effects.

Background: During inversion injuries of the ankle joint, the anterior talofibular ligament (ATFL) is the most commonly injured structure. Injuries to the lateral collateral ligaments of the ankle, either in isolation or in combination with injury to the calcaneofibular ligament (CFL), account for approximately 60-65% of all ankle ligament injuries. In recent years, several studies have examined the impact of lateral ankle ligament injuries on lifestyle and overall health. Repeated inversion injuries-particularly those occurring three or more times-can lead to chronic ankle instability (CAI). In the treatment of ankle instability, both open and arthroscopic surgical techniques are widely used internationally. In Mongolia, there is an increasing clinical need to evaluate and compare the outcomes of arthroscopic versus open surgical repair of lateral ankle ligament injuries. This need forms the basis of the current study. Aim: The comparative studies on open vs arthroscopic anterior talofibular ligament (ATFL) repair are limited. This study aimed to compare the early therapeutic efficacy and cost between the traditional open Broström-Gould repair and all-arthroscopic anatomical repair of the ATFL for chronic lateral ankle instability. Materials and Methods: A total of 40 patients with chronic lateral ankle instability undergoing repair of the ATFL be tween September 2024 and February 2025 were retrospectively included with a traditional open surgery (n=10) group and an arthroscopy (n=17) group. The surgery duration, surgical cost, postoperative complications, and the preoperative/postoperative American Orthopaedic Foot & Ankle Society Score (AOFAS) and Karlsson-Peterson score were compared between groups. Results: Compared to the anatomical group, the non-anatomical group had significantly shorter surgery and hospitalization durations. Three months after the operation, the AOFAS and Karlsson scores significantly improved in both groups. Nevertheless, there was no significant difference in the AOFAS and Karlsson scores between groups at both preoperative and postoperative assessments. No significant difference was found in the incidence of postoperative complications between the two groups. Conclusion 1. These results suggest that open Broström-Gould repair and all-arthroscopic anatomical repair of the ATFL have comparable therapeutic efficacy for chronic lateral ankle instability. 2. The arthroscopic surgery had a smaller incision, while the open Broström-Gould had a shorter surgery duration and lower cost.

Background: Vitamins are nutrients essential for human health. They act as coenzymes that help trigger important chemical reactions necessary for energy production. Reference values for vitamins help physicians evaluate the health status of patients and make clinical decisions. The aim of this study was to determine the mean values and reference intervals for some water-soluble vitamins of Mongolian adults. Materials and Methods: Three hundred and forty healthy adults (170 males and 170 females) of 17 to 69 years of age were selected for the study based on CLSI C28-P3 criteria Defining, establishing & Verifying reference interval in the clinical laboratory; Proposed Guidelines. The study was approved by the Resolution No.76 of 2018 of the Medical Ethics Review Committee of the Ministry of Health. Informed consents were taken from the selected individuals. Morning blood samples of the participants were collected under aseptic conditions. Levels of vitamins B₆, B₉, B₁₂ and vitamin C were measured using a high performance liquid chromatography method. The lower- and upper reference limits were defined as the 2.5th and 97.5th percentiles, respectively. The data were analyzed using SPSS and Excel programs. Results: The mean blood level of vitamin C was 11.88 mg/L (95% CI 10.47-13.29) for men and 9.62 mg/L (95% CI 8.11-11.13) for women. The calculated reference interval for males was 1.40-19.40 mg/L and 1.17-18.04 mg/L for females. The mean concentration of vitamin B₁₂ in the blood of males was 938.45 ng/L (95% CI 747.22-1129.68) and that of females was 864.03 ng/L (95% CI 603.81-1124.25). The reference interval for vitamin B₁₂ was 233.03-1597.00 ng/L in men and 132.45-1623.86 ng/L in women. The mean level of vitamin B₉ was 8.47 ng/mL (95% CI 5.64-11.30) for men and 6.91 ng/mL (95% CI 4.89-8.93) for women. The calculated reference interval for this vitamin in males was 1.04-24.74 ng/mL and that in females was 1.04-21.46 ng/mL. As for vitamin B₆, the mean concentration for men was 44.42 ng/mL (95% CI 37.01-51.83) and for women was 34.67 ng/mL (95% CI 29.97-39.39) with the reference intervals of 5.90-79.02 ng/mL for men and 5.27-61.72 ng/mL for women. Conclusion The reference values for vitamins B₆, B₉, B₁₂ and vitamin C of Mongolian adults do not differ significantly from those observed in other populations. The calculated reference intervals can be used in the practice of health laboratories.

Purpose: The etiology of Legg-Calve-Perthes disease (LCPD) remains unknown until today. A few studies have suggested passive smoke inhalation may be a risk factor, although the association is not confirmed and a causal relationship has not been established. Most mothers who smoke during pregnancy may continue smoking after giving a birth, it would be difficult to determine to what extent passive smoke inhalation adds to the risk of LCPD in these children. The causes of Legg-Calve-Perthes disease are largely unknown, but this pediatric disease seems to result from interruption of the blood supply to the proximal femur and is considered a vascular disease. Because maternal smoking during pregnancy influences fetal development and is associated with cardiovascular diseases in offspring, we hypothesized that this exposure and passive Tabaco smoke exposure are risk factors for Legg-Calve-Perthes disease and also investigated other markers of impaired fetal development and early-life exposures. Methods: We prospectively recruited total 96 patients, among those 32 patients with LCPD as a case group and 64 patients attending the hospital for other orthopedic complaints as control group. Conditional logistic regression was used to assess the association between the exposures and risk of LCPD. Results: The main risk factors for LCPD were family background, indoor use of a wood stove, having a family member who smoked indoors (passive smoke) and smoke during pregnancy. Children from the middle socioeconomic group appeared to be at a greater risk of developing LCPD. Conclusions This study provides further evidence that environmental tobacco smoke is associated with an increased risk of LCPD. Family background and exposure to wood smoke also appears to be risk factors. Maternal smoking during pregnancy and other factors indicated by impaired fetal development may be associated with an increased risk of Legg-Calvé-Perthes disease. However, it remains unclear why there are profound differences in the incidence of the disease between regions when the prevalence of smoking is comparable and why bilateral involvement is infrequent, and it needs further study.

Background: Treatment of adult tibiofibular fractures, especially severely comminuted fractures, is technically challenging due to the lack of reduction markers and difficulty in restoring the alignment. Fixation of the fibula can facilitate reduction of the tibia fracture and restoration of the lower extremity alignment. Methods: Between 2018-2019 we have operated on 50 patients who have lie on the same plane of tibiafibular fractures. Measures of angulation were obtained from radiographs taken immediately after the surgery, a second time 3 months later, and at 3-month follow-up. The analysis was performed with STATA. Results: Fixating fractures of tibia and fibula at same level were not shown to have complications on the development of nonunion including fibular shortening, hindfoot alignment, slow process of nonunion and unstableness. Conclusions We recommend fibular fixation in all 50 distal fractures when both fractures lie on the same plane and the tibial fracture is relatively stabilized.

Background: Minerals are important for the proper body functioning. They also play a role in preventing and fighting diseases. Reference values for minerals help physicians evaluate the mineral status of patients and make clinical decisions. The aim of this study was to determine the mean values and reference intervals for some minerals to be used for evaluation of the nutrition status of Mongolians. Materials and Methods: Two hundred and forty healthy adults (120 males and 120 females) of 17 to 70 years of age were selected for the study based on CLSI C28-P3 criteria Defining, establishing & Verifying reference interval in the clinical laboratory; Proposed Guidelines. The study was approved by the ethical committee of the Ministry of Health of Mongolia. Informed consents were taken from the selected individuals. Morning blood samples of the participants were collected under aseptic conditions. Levels of iron (Fe), zinc (Zn) and copper (Cu) were measured by graphite furnace atomic absorption spectrometry. The lower and upper reference limits were defined as the 2.5th and 97.5th percentiles, respectively. The data were analyzed using SPSS and Excel programs. Results: The mean level of blood iron was 30.50 µmol/L (95% CI 29.71-31.29) for men and 30.91 µmol/L (95% CI 30.03-31.79) for women. The calculated reference interval for males was 21.39-37.72 µmol/L and 19.87-39.67 µmol/L for females. The mean concentration of zinc in the blood of males was 11.00 µmol/L (95% CI 10.69-11.31) and that of females was 11.79 µmol/L (95% CI 11.39-12.19). The reference interval for blood zinc was 8.20-14.92 µmol/L in men and 8.52-16.67 µmol/L in women. The mean level of blood copper was 15.28 µmol/L (95% CI 14.64-15.89) for men and 18.08 µmol/L (95% CI 17.30-18.86) for women. The calculated reference interval for copper in males was 9.72-22.34 µmol/L and that in females was 11.18-27.27 µmol/L. Conclusion The reference values for zinc, copper and iron of Mongolian adults do not differ significantly from those observed in other countries. The calculated reference intervals can be used for evaluation of the nutrition status and making clinical decisions.