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: 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: Cancer is not only a physiological disease but also a complex condition that profoundly affects an individual’s psychological well-being and social relationships. Misconceptions about cancer within the public, including its association with death and the tendency to attribute blame to patients as being “personally responsible,” contribute to the development of social stigma among cancer survivors. This stigma negatively impacts patients’ engagement in treatment and their quality of life, highlighting the need to assess societal attitudes based on survivors’ lived experiences. Aim: To examine the everyday lived experiences of cancer survivors, measure perceived social stigma, and identify psychological challenges as well as sources of support. Materials and Methods: A mixed-methods design was employed. In the quantitative component, the Cancer Stigma Scale (CASS) and the Attitudes Toward Cancer Questionnaire (ATCQ) were translated and their content validity was evaluated by an expert panel using the Content Validity Index (CVI), followed by pilot testing to confirm feasibility (FVI). In the qualitative component, focus group discussions were conducted with cancer survivors, and coping ability was assessed using psychological assessment tools. Result: A total of 207 participants (68% female; mean age 33.82±13.7 years) were included in the quantitative study. Participants experienced a moderate level of cancer-related stigma, with negative attitudes most strongly associated with perceptions of disease severity and individual responsibility. Qualitative findings revealed that physician communication and family support played a decisive role in psychological responses at the time of diagnosis disclosure. Excessive sympathy or social distancing increased psychological distress, whereas normal interpersonal interaction and realistic encouragement were identified as the most effective forms of support. Conclusion To improve psychosocial support for cancer survivors, it is essential to enhance healthcare professionals’ communication skills, promote accurate public understanding of cancer, and strengthen the sustainability of survivor support group activities.

Background: Helicobacter pylori (H.pylori) infection is highly prevalent worldwide, with an overall infection rate of 50% of the total population. Effective and accurate eradication treatment for H.pylori is considered one of the most important preventative measures against gastric cancer. However, the increasing prevalence of clarithromycin-resistant H. pylori strains has significantly compromised the success rates of standard eradication regimens. In recent years, many countries have adopted molecular diagnostic methods to detect H.pylori infection and assess clarithromycin resistance. These approaches, which are often non-invasive, enhance both diagnostic accuracy and the ability to tailor treatment strategies. Although numerous studies have investigated methods for detecting H. pylori and clarithromycin resistance using gastric tissue specimens, relatively few have focused on the clinical application of stool-based diagnostics, despite their potential advantages in non-invasive testing. Aim: To detect H.pylori infection and clarithromycin resistance using molecular biological methods from both gastric tissue and stool samples, and to comparatively evaluate the diagnostic outcomes. Materials and Methods: The hospital-based cross-sectional study was conducted at the Gastroenterology department of the Mongolia-Japan Hospital. A total of 125 dyspeptic patients aged 18-80 years were enrolled. Eligibility criteria required the H.pylori infection to be confirmed by at least two diagnostic methods. Each participant underwent both invasive (histological examination, gastric biopsy-based real-time PCR) and non-invasive (urea breath test, stool antigen test, stool-based real-time PCR) methods. Gastric biopsies and stool samples were analyzed by real-time PCR to detect H.pylori and identify clarithromycin resistance-associated 23S rRNA point mutations (A2143G, A2142G, A2142C) Results: Among the study participants, 60.0% (n=75) were female and 40.0% (n=50) were male, with a mean age of 39±1 years. Comparative evaluation of the diagnostic methods for H.pylori infection demonstrated that the stool antigen test, performed in 104 individuals, yielded positive results in 91 cases (87.5%), whereas the urea breath test, performed in 51 individuals, was positive in 45 cases (88.2%). Using real-time polymerase chain reaction (PCR), H.pylori was detected in 76 of 101 stool samples (75.2%) collected in ENAT transport medium, and in 43 of 87 raw stool samples (49.4%). The estimated diagnostic sensitivities were 94% for the urea breath test, 91% for the stool antigen test, 78% for real-time PCR using ENAT-preserved stool, and 49% for real-time PCR using raw stool specimens. Clarithromycin resistance was found in 36 participants (28.8%), while 89 participants (71.2%) carried H.pylori strains susceptible to clarithromycin. Clarithromycin resistance was detected in 27.6% of stool samples and 30.5% of gastric biopsy specimens. Among the clarithromycin-resistant isolates identified from gastric tissue, 35 cases (97.2%) carried the A2143G point mutation, while the A2142G mutation was detected in only 1 case (2.8%). All resistant cases detected from stool samples carried the A2143G mutation, whereas the A2142G mutation was not observed. Conclusion Real-time PCR demonstrated high efficacy for the detection of H.pylori infection and clarithromycin resistance in gastric biopsy specimens. While the sensitivity of stool-based real-time PCR was comparatively lower, detection rates improved with the use of ENAT transport medium. These findings highlight the potential of stool-based real-time PCR as a non-invasive diagnostic tool; however, further investigations are warranted to optimize assay performance through rigorous standardization and refinement of sample processing protocols for the accurate detection of clarithromycin-resistant H.pylori.

Background: Uterine leiomyomas are smooth muscle tumors and are the most common type of pelvic tumors in women. Uterine myomectomy, the surgical removal of uterine leiomyomas, is one of the most frequently performed procedures in gynecological surgery. From 2022 to 2024, uterine myomectomy accounted for 29.3% of all surgical procedures performed in the Gynecology Department of the Mongolia-Japan Hospital. Although research in this field has been undertaken in our country, there is a marked paucity of evidence regarding the use of vasoconstrictive agents during laparoscopic myomectomy, which underscores the rationale for the present study. Aim: Present study was aimed to A study of effectiveness of vasopressin for the patients undergoing laparoscopic myomectomy. Materials and Methods: The study was conducted after receiving ethical approval from the Research ethics committee of the Mongolian National University of Medical Sciences (No.24-25/06-02, March 24, 2025). The study data was collected from electronic medical records using a five-category card and was performed using a descriptive research design. Between 2022 and 2024, a comparative study was conducted at the Gynecology Department of the Mongolia-Japan Hospital of the Mongolian National University of Medical Sciences. The study compared the effectiveness of two groups undergoing laparoscopic myomectomy for uterine leiomyoma: 74 cases (Group 1) where vasopressin was used, and 20 cases (Group 2) where traditional vasoconstrictor agent were administered. Data was collected quantitative and qualitative data were coded and analysed using SPSS 26.0 version. Difference of proportions between qualitative variables were tested using chi- square test and numerical variables were tested using independent t-test as applicable. Results: The average age of the participants was 40.48±6.01 years. Among these patients 52.1% (n=94) cases had single uterine fibroid nodules, 34% cases had two to three uterine fibroid nodules, and 13.9% cases had multiple uterine fibroid nodules. Of the study participants 6.4% (n=94) were asymptomatic upon hospital admission, while 93.6% had one or more symptoms related to uterine leiomyoma, with two or three symptoms appearing together. When comparing the average intraoperative blood loss during surgery between the two groups, the traditional vasoconstrictor agent group had 291.5±189.8 ml, while the vasopressin group had 160.6±82.5 ml (95% CI: 74.1-187.6, p=0.000). The surgical duration time for the vasopressin group was 112.4±39.2 minutes, and for the traditional vasoconstrictor agent group, it was 138.2±55.6 minutes (95% CI: 4.1-47.4, p=0.02). The rate of conversion from laparoscopic to open myomectomy was 5% (n=1) in the traditional group, while it was 0% (n=0) in the vasopressin group. Blood transfusion rates were 0% (n=0) for the vasopressin group and 10% (n=2) for the traditional vasoconstrictor agent group (p=0.006). Conclusion The local use of a vasopressin injection during laparoscopic myomectomy for uterine leiomyoma resulted in a shorter surgical duration time and less intraoperative blood loss. Furthermore, it is significant for reducing the use of blood products during surgery. In addition, it significantly reduces the common complications of myomectomy, such as bleeding and the conversion of laparoscopic to open surgery.

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: Helicobacter pylori (H. pylori) is a gram-negative, microaerophilic bacterium that colonizes the human gastric mucosa, with an estimated global prevalence exceeding 50%. The increasing resistance of H. pylori to clarithromycin, a key antibiotic in eradication regimens, has led to a decline in the efficacy of standard treatment to below 80%. Consequently, international guidelines advocate for susceptibility-guided therapy to optimize treatment outcomes. Detection of clarithromycin resistance-associated mutations, including A2143G, A2142G, A2142C, and A2144G, is essential for improving therapeutic efficacy and mitigating the propagation of antimicrobial resistance. Aim: To evaluate the efficacy of tailored H. pylori eradication therapy based on clarithromycin resistance profiling. Materials and Methods: A total of 125 treatment-naïve patients diagnosed with H. pylori infection were enrolled in this study. The infection was confirmed through upper gastrointestinal endoscopy with histopathological analysis, the urea breath test, and stool antigen detection. Clarithromycin resistance-associated mutations were identified using polymerase chain reaction (PCR) analysis on gastric biopsy and stool samples. Based on the presence or absence of resistance mutations, patients were stratified into two treatment cohorts and received targeted eradication therapy. Treatment success was assessed 28 days post-therapy using a stool antigen test to confirm H. pylori eradication. Results: Among the 120 patients who met the inclusion criteria and completed treatment, 41.6% (n=50) were male, and 58.4% (n=70) were female, with a mean age of 39±9.1 years. Clarithromycin resistance-associated mutations were detected in 36 patients (30%), with A2143G identified in 35 cases (97.2%) and A2142G in 1 case (2.7%). In the clarithromycin-sensitive cohort, 84 patients underwent eradication therapy, and among the 60 who completed post-treatment assessment, the eradication rate was 91.6%. In the clarithromycin-resistant cohort, 36 patients received treatment, and among the 20 who completed post-treatment assessment, the eradication rate was 80% (p=0.038). Conclusion A substantial prevalence of clarithromycin resistance-associated mutations was observed among the study population. Susceptibility-guided eradication therapy demonstrated superior efficacy, with eradication rates exceeding 90%. These findings underscore the necessity of implementing resistance-based treatment strategies to optimize clinical outcomes and limit the further dissemination of antimicrobial resistance. Future investigations should focus on refining therapeutic approaches for H. pylori strains exhibiting clarithromycin resistance.