Introduction: Congenital talipes equino-varus (CTEV) is amongst one of the most common paediatric foot deformities. Ponseti’s method is the standard way of treatment, however, some patients are left with residual or partially corrected deformities. Dynamic supination is one amongst them, where the foot supinates in swing phase of the gait cycle. It is due to a strong tibialis anterior and its weak antagonist. Materials and methods: We undertook a prospective interventional study in thirty patients of CTEV with residual dynamic supination deformity and treated them with tibialis anterior tendon transfer (TATT) using a button anchor. Minimum follow-up was six months after the surgery. Functional, subjective and objective evaluation was done using foot posture index (FPI), disease specific instrument (DSI) for clubfoot, clinician satisfaction grading and videotaped functional gait analysis. Statistical analysis was done using paired ‘t’ test and calculating p values. Results: We achieved good to excellent results in 93.3% of our patients and fair in 6.66%. None of our patients had poor results. Mean FPI improved from -1.93 to +0.3, DSI values also showed a significant reduction from 18.17 +/- 1.09 to 13.37 +/- 1.54 after surgery. A total of 90% had satisfactory gait post-surgery at 6 months follow-up. Conclusion: Tibialis anterior tendon transfer using a button anchor is effective in treatment of residual dynamic supination deformity.

Introduction: The primary issue following lumbar discectomy for disc herniation is the risk of reherniation in the post-operative period. Many surgical techniques have been proposed to treat disc reherniation, however, the optimal one remains variable. This meta-analysis aimed to investigate the prevalence of symptomatic reherniation after using a Bone-anchored annular closure device following lumbar discectomy and the contributing factors. Materials and methods: Identification of published literature was performed on PubMed, Google Scholar, Scopus, and Web of Science databases. Studies published until 14 February 2024 reported the prevalence of symptomatic reherniation after using a Bone-anchored annular closure device following lumbar discectomy and the associated contributing factors. A random effects model was used to conduct Bayesian frequentist network meta-analysis and pair-wise meta-analysis, with the assessment based on standardised mean difference (SMD) and 95% confidence interval (CI). Results: Eleven studies published in 2012 − 2022 recruiting a total of 5195 patients were included in the meta-analysis. The prevalence of reherniation in ACD and control groups was 23.2% (95% CI: 18.2% − 28.1%) and 36.4% (95% CI: 28.2% − 44.5%), respectively. The moderator effect of sample size is significant for pooled data of the ACD group (p-mod=0.002), but not for the control group (pmod=0.278). After the adjustment with sample size, the prevalence rates were 13.6% (95% CI: 6.2% − 21.1%) and 29.6% (95% CI: 14.9% − 33.2%) for ACD and control groups, respectively. Conclusion: Comparatively to lumbar discectomy alone, using a Bone-anchored annular closure device following lumbar discectomy decreased the symptomatic reherniation rate and post-operative complications, as well as the necessity for subsequent surgeries.

Giant Cell Tumour (GCT) of bone is a benign, locally aggressive neoplasm. GCT of the foot is rare, comprising of about 5% of cases of all GCTs. GCT of Calcaneus is exceedingly rare, comprising of 1.2% of all calcaneal tumours. Due to its uncommon occurrence at this site, diagnosis can be delayed. In this report, we present the case of a Campanacci Grade 3 GCT of calcaneus in a 43-year-old female patient with 8 months history of worsening pain and disability. We treated her successfully by resection of Oscalcis and reconstruction with a femoral head allograft and K-wire fixation, a relatively cheaper and technically lesser challenging method of reconstruction. Three years’ postsurgery, she remains disease free, and her graft has healed. She continues to walk independently and remains disease free clinically and radiologically. We discuss a comparison with other reported cases where surgeons have opted for detailed intra-lesional curettage (DILC) and cementoplasty to fill the defect for a Grade 2 disease, some have even used a sural for soft tissue coverage with a maximum follow-up of two years. While in our patient we went for Calcanues resection and reconstruction with allograft because of a Grade 3 disease that poses greater risk of local recurrence with just DILC. Our patient has a three-year follow-up where she remains disease free

Purpose: Adjuvant radiotherapy (RT), while effective in reducing cancer recurrence and improving survival rates, often comes with radiation toxicity that can adversely affect the patient’s quality of life (QoL). Evaluating toxicity after RT is crucial because it helps to identify and manage adverse effects that can significantly impact a patient’s QoL. By monitoring toxicity, we can adjust treatment plans to mitigate these effects, improve patient comfort, and ensure a better overall outcome. Therefore this study aimed to evaluate and compare QoL following 3D-conformal hypofractionated RT in breast cancer patients. Methods: We included twenty-one Malaysian women with unilateral breast cancer treated with lumpectomy (n=15) or mastectomy (n=6) followed by 3D-conformal hypofractionated RT. QoL was evaluated using the EORTC QLQ-BR45 questionnaire before, during, and after RT. Results: During RT, there was a significant increase in the mean score of the breast symptoms scale compared to baseline (p=0.002), with the most common symptoms being skin problems, followed by swelling and oversensitivity. However, these symptoms were generally mild for most patients. The other quality of life scales remained stable during RT. Post-RT, most QoL scales showed improvements compared to both baseline and during RT, with significant enhancements in the mean breast symptoms score and breast satisfaction score (all p<0.05). Conclusion: Radiotherapy negatively impacted the QoL of our breast cancer patients, specifically on the breast symptoms scale. However, these symptoms improved after 4 months, resulting in high breast satisfaction and indicating a near-excellent cosmetic outcome. Future studies with larger cohorts are essential to validate these findings, as the small sample size (n=21 at baseline; n=13 post-RT) may have limited the detection of more subtle changes

Kanser payudara kekal sebagai salah satu punca utama morbiditi dan kematian berkaitan kanser di seluruh dunia. Kepelbagaian molekul dan genetiknya yang kompleks menjadi cabaran besar dalam membangunkan rawatan yang berkesan. Terapi konvensional seperti kemoterapi, terapi hormon, dan ubat sasaran sering menghadapi rintangan seperti kerintangan terhadap ubat dan kebolehan tumor untuk berulang. CRISPR/Cas9, satu teknologi penyuntingan gen yang revolusioner, telah muncul sebagai alat yang berpotensi untuk memajukan rawatan kanser payudara. Ulasan ini meneroka bagaimana CRISPR boleh digunakan untuk merawat kanser payudara dengan menumpukan kepada tiga aspek utama: menyasarkan onkogen bagi menghentikan pertumbuhan tumor, memulihkan fungsi gen penindas tumor yang sering dinyahfungsi akibat mutasi, dan mengatasi rintangan terhadap ubat. Selain itu, kami membincangkan inovasi terkini dalam sistem penghantaran CRISPR yang meningkatkan ketepatan dan kecekapannya. Walau bagaimanapun, seperti mana-mana teknologi canggih, terdapat cabaran yang perlu ditangani, termasuk kesan luar sasaran dan pertimbangan etika berkaitan penyuntingan genom. Dengan ketepatan CRISPR, penyelidik kini sedang membangunkan strategi terapeutik baharu yang boleh menjadikan rawatan kanser payudara lebih berkesan dan disesuaikan dengan individu. Seiring dengan perkembangan bidang ini, CRISPR berpotensi untuk mengubah landskap rawatan kanser payudara, memberikan harapan kepada pesakit untuk terapi yang lebih tepat.

Background: Currently, colorectal cancer (CRC) ranks as the third most common cancer and the second leading cause of cancer-related mortality worldwide. CRC frequently metastasizes to the liver (50%), lungs (10–15%), peritoneum (4%), bones (10.7%–23.7%), brain (0.3%–6%), and spinal cord. Approximately 35% of CRC cases are diagnosed before distant metastasis, 36% upon lymph node involvement, and 23% after distant organ metastasis. Although several studies have established primary tumor models in mice in our country, there are limited studies on experimental lung metastasis models, prompting the need for this research. Aim: To establish and evaluate a lung metastasis model of colorectal cancer in C57BL/6J mice using the MC38 cell line. Materials and Methods: This study was conducted at the Institute of Biomedical Sciences, Mongolian National University of Medical Sciences. Approval was obtained from the Ethics Review Board of the Mongolian National University of Medical Sciences (2023/3-09) and all laboratory safety regulations and protocols were strictly followed. Male C57BL/6J mice bred at the Experimental Animal Center of Mongolian National University of Medical Sciences were used. MC38 murine colorectal carcinoma cells were cultured and injected intravenously (via the tail vein) at a concentration of 0.25×10⁶ cells per mouse (n=12) to induce lung metastasis. Histological analysis was subsequently performed. Results: Histological examination revealed significant alterations in lung tissue architecture, characterized by areas of dense infiltration by pleomorphic, hyperchromatic cells, disrupting the normal alveolar structure. No histological abnormalities were observed in other organs. Conclusion Intravenous injection of MC38 colorectal adenocarcinoma cells into the tail vein of C57BL/6J mice successfully induced lung metastases, characterized by hyperchromatic, pleomorphic cell infiltrates forming glandular structures within the lung parenchyma.

Background: In recent years, scientists have found that certain natural compounds have significant potential in cancer prevention and early-stage cancer treatment. Flavanones, a class of polyphenolic compounds found in plants, vegetables, seeds, fruit peels, and flowers, have been identified to possess anticancer, antioxidant, anti- inflammatory, and antibacterial bioactivities. Cancer has become a major global challenge in terms of both economic and public health concerns. Global statistics indicate that 22.8% of deaths are attributed to non-communicable diseases, and 16.8% are caused by cancer, accounting for one in four and one in six deaths, respectively. Aim : To investigate anticancer effects of Iris Tenuifolia-derived flavanone on cancer cell lines. Materials and Methods : The study was conducted at the Bio-Medical Research Institute of the Mongolian National Uni versity of Medical Sciences, investigating the effect of flavanones on cancer cell viability under in vitro conditions using the MTT assay. In the study, colon, liver, and lung cancer cells were cultured, stabilized, and used for the experiments. Colorectal cancer cells (MC38), liver cancer cells (HepG2), and lung cancer cells (A549) were revived, cultured, and stabilized for use in the experimental procedures. Statistical analysis of the results was performed using Microsoft Excel 2010, and graphs were generated using GraphPad Prism 8. Differences between groups were analyzed using Student’s t-test, and a p-value of <0.05 was considered statistically significant. Results : We treated MC38, HepG2, and A549 cancer cells with different concentrations of flavanone (2.5 µM, 5 µM, and 10 µM) for 24 to 48 hours to evaluate cell viability. Flavanone inhibited A549 cell viability by 2.5 μM-10%, 5 μM-25%, and 10 μM-38%, respectively. For HepG2 cells, flavanone treatment at concentrations of 5-10 µM reduced cell viability by 28–58%. No statistically significant effect on the viability of MC38 cells was observed following treatment with flavanone at concentrations ranging from 2.5 to 10 µM. Additionally, although MC38 inhibited cell viability in a dose-de pendent manner in cell cultures, it had a statistically significant effect at higher concentrations of 30-200 μM (p<0.01). Conclusion Flavanone inhibits the cancer cell viability in a dose and time dependent manner

Background: As of 2024, digestive system diseases rank fourth among the causes of mortality in Mongolia. Among these, hepatocellular carcinoma (liver cancer) accounted for 20,501 deaths, leading in total mortality rates. In Traditional Mongolian Medicine, Scutellaria baicalensis Georgi is used to cool blood heat, clear internal heat, and regulate imbalances; Saussurea amara L. is used for its antibacterial, anti-infective, and anti-inflammatory properties; Carthamus tinctorius L. serves for disinfection, pain relief, fever reduction, and detoxification; and Chiazospermum erectum L. is used to eliminate toxic heat and febrile conditions. Studies have confirmed that the Hepaclin-4 formulation exhibits antioxidant, membrane-stabilizing, hepatoprotective, anti-necrotic, detoxifying activities, and reduces the accumulation of harmful byproducts from excessive peroxidation. Therefore, developing a solid dosage form from the raw herbal materials of Scutellaria baicalensis Georgi, Saussurea amara L., Carthamus tinctorius L., and Chiazospermum erectum L.in the He paclin-4 formula forms the basis of our research. Aim: To formulate and develop a tablet dosage form based on the compound prescription of Hepaclin-4 Materials and Methods: The raw materials of Scutellaria baicalensis Georgi, Saussurea amara L., Carthamus tinctorius L., and Chiazospermum erectum L.were weighed at a 1:1:1:1 ratio and extracted with 40% ethanol at a 1:10 ratio using the remaceration method. Ethanol was evaporated using a vacuum evaporator to obtain a thick extract, and quality indicators were determined. From the obtained thick extract, granules were prepared using two types of excipients through the wet granulation method, and their quality characteristics were studied. Based on the most suitable granules, tablet and capsule dosage forms were prepared and standardized according to the methods outlined in the Mongolian National Pharmacopoeia. Results: The Hepaclin-4 tablets were found to be round, well-formed, smooth, with intact edges, a slight characteristic odor, no unpleasant taste, and light yellow in color. The friability resistance of the 0.5 g tablet was 99.6±0.08%, hardness was 1.07±0.12 MPa, weight variation ranged from -2.6% to +3.9%, all within the acceptable 5% limit. The disintegration time was 4.23±0.05 minutes, and dissolution was 95.4±0.47%, meeting the permissible standards. When flavonoids in the tablets were detected by Thin Layer Chromatography (TLC), brownish-yellow spots appeared at Rf values identical to standard quercetin (Rf=0.94) and rutin (Rf=0.48). The total flavonoid content, determined by Spectrophotometric Method (SPM), was 0.165±0.01%. Conclusion Tablets were successfully developed from the thick extract of the Hepaclin-4 herbal compound. Upon eval uation, the tablets met all the required technical specifications.

Background: Globally, approximately 684,000 deaths occur annually due to falls. In Mongolia, 47 individual aged between 45 and 85 have died as a result of falls. Therefore, there is a pressing need to assess fall risks among the general population in Mongolia and identify risk factors to prevent accidents and injuries. Aim: To assess the risk of falls among individuals aged 45 years and older who are receiving care at tertiary-level referral hospitals in Ulaanbaatar, Mongolia. Materials and Methods: A cross-sectional study was conducted involving 408 participants aged 45 years and above who were attending tertiary-level hospitals in Ulaanbaatar. Fall risk was assessed using the internationally recognized Falls Risk Assessment Tool (FRAT) questionnaire. Data were analyzed using SPSS version 26.0. Results: The mean age of the participants was 59.24±6.54 years; 40% were male and 60% were female. Among the participants, 45.3% (n=185) were categorized as low risk, 33.6% (n=137) as moderate risk, and 21.1% (n=86) as high risk for falls. Logistic regression analysis was performed to identify significant risk factors associated with falls. Key factors included: slippery shoe soles (OR=0.226, 95% CI: 0.119–0.428, p=0.001), performing unexpected hazardous movements while changing positions (OR=0.262, 95% CI: 0.143–0.480, p=0.001), use of assistive walking devices (OR=0.209, 95% CI: 0.110–0.397, p=0.001), anxiety or unstable mental status (OR=0.276, 95% CI: 0.148–0.514, p=0.001), tendency to resist instructions or behave stubbornly (OR=0.330, 95% CI: 0.183–0.596, p=0.001), difficulty in recognizing the surrounding environment (OR=0.354, 95% CI: 0.187–0.671, p=0.001), and a history of previous falls (OR=4.737, 95% CI: 2.151–10.429). Conclusion 1. Based on the FRAT assesment, 45.3% of participants had low fall risk, 33.6% moderate risk, and 21.1% high risk. 2. Risk factors such as sudden movements, the use of assistive devices, and emotional instability significantly influence fall risk assessment, and individuals with a history of previous falls are 4.7 times more likely to experience another fall.

Background: Insomnia is one of the most prevalent neurological disorders in the United States, affecting up to half of primary care patients and often necessitating psycho-behavioral interventions. Acupuncture, a key component of traditional Chinese and Mongolian medicine, has been increasingly studied as a treatment for insomnia in recent years. Aim: Evaluating the effectiveness of acupuncture for insomnia Materials and Methods: The study was conducted using a randomized controlled clinical trial design. 148 participants, aged 18-65 years, with a diagnosis of Nonorganic Insomnia (F51.0) according to the ICD-10, and Pittsburgh Sleep Quality Index (PSQI) >7, were divided into the transverse acupuncture, conventional acupuncture, and the control group. The results were analyzed using a Cardiopulmonary Coupling - CPC machine before and after treatment in the 3 groups to assess 1. Total sleep (hours), 2. Deep sleep (hours), 3. Light sleep (hours), 4. REM (hours), 5. Wake time (minutes), 6. Time to first fall asleep (minutes), 7. Sleep rate (%), 8. Number of apneas, and sleep quality was assessed using the Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) questionnaires. The research approval was reviewed and granted by the Research Ethics Review Committee of the Mongolian National University of Medical Sciences on January 19, 2024 (Approval No. 24/19/01). Results: The mean age of participants was 51.5±10.8 years, with 79.7% (n=118) being female and 20.3% (n=30) male. In the transverse acupuncture group, post-treatment results demonstrated a 53.8% increase in total sleep time, a 102.8% increase in deep sleep time, a 19.8% increase in light sleep time, a 36.1% increase in REM sleep time, and a 22.1% improvement in sleep normalization rate. The mean differences between pre- and post-treatment scores were statistically significant based on a one-sample t-test. In contrast, no statistically significant improvements were observed in the control group, except for sleep quality. Conclusion Both transverse acupuncture and conventional acupuncture significantly improved sleep quality indicators following treatment.