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: Carpal tunnel syndrome (CTS) is a disease caused by compression of the median nerve in the carpal tunnel and is considered to have an individual, occupational, and socioeconomic impact. Aim: To study the risk factors for CTS among hospital floor cleaners. Materials and Methods: A cross-sectional study was conducted among floor cleaners at the Third State Central Hospital. Clinical and electrophysiological severity of CTS were evaluated using standardised scales, and symptoms were assessed with the self-administered Boston Questionnaire (BQ). Demographic and non-occupational factors, as well as durations of current and previous occupations, were recorded. The diagnosis was confirmed by electrophysiological analysis. Each assessment was categorised as mild, moderate, or severe. Statistical analysis was performed using SPSS 27.0. Result: The prevalence of CTS among floor cleaners was 39% (32/82) (p < 0.001). In the simple logistic regression, comorbidities (OR, 2.50 [95% CI, 1.02-6.16]), smoking (OR, 3.90 [95% CI, 1.12-13.57]) and in the multiple logistic regression, only comorbidities (OR, 2.90 [95% CI, 1.03-8.16]) were the predictors of CTS. Conclusion The risk of developing CTS among hospital floor cleaners is influenced by BMI, smoking, and comorbidities, including diabetes mellitus.

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: 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.

Introduction: Coronavirus infection 2019 (Ковид-19) is an infection caused by a novel virus and induces severe ARDS. КОВИД-19 pandemic has rapidly spreaded in 221 countries, 245,373,039 cases and 4,979,421 mortalities have been reported. Pulmonary and renal thrombotic angiopathy occur in patients with complications of ARDS, sepsis, and multi-organ failure. Elevated D-dimer in КОВИД-19 patients has been reported firstly by doctors in Wuhan, China. In addition, many studies have revealed that elevated D-dimer has been associated with the severity of the diseases, an increased rate of poor prognosis. Objective: We aim to determine D-dimer in КОВИД-19 patients, and patient condition a decrease of D-dimer level after administration of anticoagulant therapy. Case report: We introduce a rare case of КОВИД-19. Laboratory test results and the effect of anticoagulant therapy have been evaluated during the infection. 85 aged women were admitted with a diagnosis other than КОВИД-19. PCR for SARS-Cov-2 was negative on the previous day of admission, and Sars-Cov-2 Ag rapid test was also negative on the admission day. However, the D-dimer test result was much higher with 7120 ng/мл and X-ray and CT revealed a similar pattern to the КОВИД-19 patient. Then anti-Sars-Cov-2 test was positive with 4,08 COI. Based on laboratory test results of D-dimer, LDH, CRP, and CT pattern the patient was diagnosed with post-КОВИД-19 pneumonia, and anticoagulant therapy was initiated additionally to prevent hypercoagulation induced by КОВИД-19. D-dimer test taken before administration of anticoagulant therapy increased more to 10910 ng/мл. 3 days later D-dimer level decreased to 8180ng/мл and the patient’s condition was improved. Conclusion The evaluation of D-dimer of the patients with КОВИД-19 is highly significant. Anticoagulant therapy might be necessary for КОВИД-19 patients with high D-dimer level in serum. Further studies are needed to assess the long-term outcome of the illness and mortality.

Introduction: Bile reflux gastritis is due to an excessive reflux of duodenal contents into the stomach. The increasedenterogastric reflux may provide the basis for increased mucosal injury. In clinical practice the symptoms of bile reflux gastritis are nonspecific than the other gastritis. Only endoscopy and biopsy can confirm the diagnosis. Observation demonstrates that, in practice there is tendency to increase the bile reflux gastritis. However, in Mongolia there are much less research and studies in this area. Goal: Evaluate the endoscopical and histological changes caused by duodenal reflux on the gastricmucosa Materials and Methods: We included in our study 70 patients with bile reflux gastritis admitted in Second General Hospital in Ulaanbaatar. In all cases we performed an upper gastrointestinal endoscopy and at least 4 biopsyspecimens were done from antral mucosa and the histological features were scored in accordance with the Sydney system. Results: The average age of the patients with bile reflux gastritis was 61.64±9, 69 years. Reflux gastritis was noted to 15 males and 55 females. Gastroduodenal reflux after chlocystoectomic surgery was noted in 46 cases (65.71%), and biliarytract disease was noted in 16 cases (22.85%). The average time interval from original operation tothe discovery of the bile reflux gastritis was 9.22 years after chlocystoectomic surgery. The commonest endoscopic alterations were: erythema of the gastric mucosa in 41 cases (58.57%),gastric antral atrophy in 20 cases (28.57%), gastric diffuse atrophy in 27 cases (38.57%), thepresence of bile into the stomach in 70 cases (100%), erosions in 3 cases (4.28%), gastric ulcer in2 cases (2.85%), intestinal metaplasia in 10 cases (14.28%).The histologic alterations observed from tissues collected during endoscopic examination were chronic super facial gastritis in 19 cases (27.14%), chronic atrophic gastritis in 51 cases (72.85%),an intestinal metaplasia in 32 cases (14.28%), gastric erosions and ulcer in 4 cases (5.71%),dysplasia in 1case (1.42%), Helicobacter pylori infection in 14 cases (20%). Conclusions The most frequent risk factors for bile reflux gastritis were chlocystoectomic surgery and biliary tract disease. Histological findings of patients with bile reflux gastritis revealed gastric cancer precursor lesions, therefore follow-up endoscopic examinations and early treatment of bile reflux are essential.

To evaluate the efficacy and safety of bevacizumab monotherapy or combined with laser versus laser monotherapy in Mongolian patients with visual impairment due to diabetic macular edema.Prospective, randomized, single-center, a 12 month, laser-controlled, clinical trial. Participants: One hundred twelve eligible patients, aged ≥18 years, with type 1 or 2 diabetes mellitus and best corrected visual acuity (BCVA) in the study eye of 35 to 69 Early Treatment Diabetic Retinopathy Study (ETDRS)letters at 4 m (Snellen equivalent: ≥6/60 or ≤6/12), with visual impairment due to center-involved diabetic macular edema (DME). Methods: Patients were randomized into three treatment groups:(I) intravitreal bevacizumab monotherapy (n=42), (II) intravitreal bevacizumab combined with laser (n=35), (III) laser monotherapy (n=35). Bevacizumab injections were given for 3 initial monthly doses and then pro re nata (PRN) thereafter based on BCVA stability and DME progression. The primary efficacy endpoints were the mean change in BCVA and central retinal subfield thickness (CRST) from baseline to month 12.Bevacizumab monotherapy or combined with laser were superior to laser monotherapy in improving mean change in BCVA letter score from baseline to month 12 (+8.3 and +11.3 vs +1.1 letters; both p<0.0001). There were significant difference detected between the bevacizumab and bevacizumab combined with laser treatment groups (p=0.004). At month 12, greater proportion of patients gained ≥10 and ≥15 letters and with BCVA letter score >73 (Snellen equivalent: >6/12) with bevacizumab monotherapy (23.8% and 7.1% and 4.8%, respectively) and bevacizumab + laser (57.1% and 28.6% and 14.3%, respectively) versus laser monotherapy. The mean central retinal subfield thickness was significantly reduced from baseline to month 12 with bevacizumab (−124.4 μm) and bevacizumab + laser (−129.0 μm) versus laser (−62.0 μm; both p<0.0001). Conjunctival hemorrhage was the most common ocular events. No endophthalmitis cases occurred.Bevacizumab monotherapy or combined with laser showed superior BCVA improvements over macular laser treatment alone in Mongolian patients with visual impairment due to diabetic macular edema.