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.

Background: To evaluate changes in liver function in patients with alcohol use disorder and propose preventive measures. Methods: In this study, 118 people were examined between January 2024 to December 2024. Results were analyzed SPSS. Result: The mean subject age was 48.6± 10.3 years, male: female ratio was 5:1. Mean arterial pressure was 104±12.8 mmHg, ALT 86.7 ± 93.8 (U/L), AST 89.3±82.8 (U/L), GGT 213.8±252.3 (U/L). A statistically significant correlation was found between AST and ALT levels (R² = 0.562). However, no significant correlation was observed between body mass index (BMI) and blood glucose levels (R² = 0.002). The AST/ALT ratio was also statistically significant (p = 0.0001). Conclusion Excessive alcohol consumption increases the levels of liver enzymes AST 89.3 ± 82.8 (U/L), ALT 86.7 ± 93.8 (U/L), and GGT 213.8 ± 252.3 (U/L), leading to increased liver cell damage. Therefore, it is necessary to reduce alcohol consumption and implement preventive measures.

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: Studying the human embryonic and fetal organ systems development patterns and determining their quantitative indicators is of scientific and practical importance in medicine and health in every nation.
Distortions and pathologies during the development of the embryo are the causes of congenital disabilities. Among the congenital malformations, facial malformations are the 3rd place, including cleft lip and palate in 70% and Srouzon's syndrome in 30%. In addition, abnormalities due to changes in the size, shape, and position of the jaw are also mentioned in the 2021.04.21 issue of Morphology magazine in the study "Morphometric parameters of the bones of the skull and face during the development of newborns and fetuses". In our country, Ariuntuul G (2005) determined that cleft lip and cleft palate occur at 0.76/1000 or 1 in 1314 live births, while Ayanga G (2012) found that it occurs at 1 in 1072 live births or 0.93/1000. Moreover, the eye cup dimensions of Mongolian fetuses aged 16 36 weeks have a positive linear relationship with the gestational age determined using ultrasound by Nandintsetseg B (2015) et al. Compared with the other countries, the eyecup is slightly wider, and the outer edge distance is similar, whereas the inner edge distance is shorter. Purpose: To summarize research work and determine the embryonic development of bones involved in the formation of the face and facial parts, the period of bone formation, the point of ossification, and the period of formation. Methods: During fetal development, human organ systems grow and develop at different rates but in a particular relationship. This feature of growth and development is also clearly observed in the structure of the head and facial bones, and the results of researchers who have studied this aspect are selected in the articles. Results: Embryonic and fetal development of bone are clinically significant not only from the point of view of its morphogenesis but also from the point of view of congenital disabilities. Conclusion In the analysis of the sources, most of the works on the prenatal period of the development of the same body have studied the development of specific structures of the face and facial area, such as the palatine bones and nasal bones, or have generally covered the development of particular systems in the embryo and fetus, and face, there are relatively few works that show the entire dynamics of growth and development of facial bones.

Result the subtypes and effectiveness of functional endoscopic sinus surgery(FESS) using a microdebrider Introduction: Chronic rhinitis in children has been on the rise in recent years, and polyps account for the majority of benign nasal cancers in children. Surgery is necessary when drug treatment is ineffective. We use pediatric rhinoplasty. Aimed at calculating the subtypes and effectiveness of Functional endoscopic sinus surgery(FESS) using a microdebrider. Material and methods: The survey was conducted between March and April 2020, based on the Otolaryngology Surgery Department of the National Center for Maternal and Child Health, using the cross-section of analytical design under Objectives 1 and 2 and the longitudinal design under Objective 3. Under Objectives 1 and 2, participants' information was collected from a pre-prepared questionnaire from their medical history. The questionnaire has four chapters that provide general information about the patient, clinical signs, surgical structure, and biopsy results. The pain was assessed by the “Sino-Nasal Outcome Test (SNOT-20)”. A total of 98 patients were included in the statistical analysis of the survey results using the STATA 15.0 program, and the results of the surgery were evaluated by 20 patients. Results: In children with chronic rhinitis, the SNOT20 test showed a statistically significant difference of 1.6 ± 0.6 before surgery and an average of 0.51 ± 0.11 after surgery. Conclusion: In chronic rhinitis, FESS with microdebrider surgery is an effective treatment for children.