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Incidental Trifid Median Nerve Unveiled in a Lactating Mother

Siddiq MAB, Hossain Parash MT

Cureus, 2019 Sep 30;11(9):e5809.
PMID: 31728251 DOI: 10.7759/cureus.5809

Several anatomical variations concerning the median nerve have surfaced in the medical literature. Among them, bifid median nerve or median nerve bifurcation with or without persistent median artery has been widely reported. Sporadic case reports describe median nerve trifurcation (trifid median nerve) as well. In the present report, we describe carpal tunnel syndrome manifestations in association with trifid median nerve unveiled incidentally under high-frequency musculoskeletal ultrasonogram in a lactating mother-a first in the medical literature.
Fulltext Injury Incidence, Patterns, and Risk Factors in Functional Training Athletes in an Asian Population

Cheng TTJ, Mansor A, Lim YZ, Hossain Parash MT

Orthop J Sports Med, 2020 Oct;8(10):2325967120957412.
PMID: 33195710 DOI: 10.1177/2325967120957412

Background: Functional training, also known as CrossFit, is a unique sport that combines weightlifting, gymnastics, and metabolic conditioning into a single program. There are an estimated 50 functional training centers in Malaysia.
Purpose: To analyze the injury rates, patterns, and risk factors of functional training/CrossFit.
Study Design: Descriptive epidemiology study.
Methods: Electronic questionnaires were distributed to 244 participants from 15 centers in the country. Descriptive data regarding the athletes, injury occurrence within the past 6 months, injury details, and risk factors were collected.
Results: Of the 244 athletes, 112 (46%) developed at least 1 new injury over the previous 6 months. Injury rates were significantly higher in athletes from nonaffiliate training gyms compared with CrossFit-affiliated gyms, in athletes with previous injuries, and in those who perceived themselves as having more than average fitness.
Conclusion: Coaches and athletes need to be more aware of risk factors for injury to enable safer and better training strategies.
Fulltext Undiagnosed Term Abdominal Pregnancy in a District-Level Hospital of a Developing Country: A Miracle Baby

Than WW, Binti Pg Baharuddin DM, Hossain Parash MT, Mra A

Cureus, 2023 Feb;15(2):e35092.
PMID: 36945266 DOI: 10.7759/cureus.35092

Term abdominal pregnancy is a sporadic ectopic pregnancy associated with high maternal and perinatal morbidity and mortality. As symptoms are non-specific and resemble those of other ectopic pregnancies, early diagnosis is the major challenge in poor health setups. A 24-year-old primigravida at 38 weeks gestation was planned to undergo a cesarean section for the transverse lie. Abdominal pregnancy was accidentally discovered during the cesarean section, and a healthy, normal baby boy was delivered. The placenta was attached to the greater omentum, so its removal required omentectomy without compromising the blood supply to the bowels. Both patient and her baby boy were discharged on the seventh day without complications. No congenital anomalies were detected in the baby. In a term abdominal pregnancy, the most significant challenges are the control of bleeding and the decision on placenta removal, followed by prompt delivery of the fetus. Therefore, along with the gynecologist, the availability of trained personnel, such as anesthetists, pediatricians, and general surgeons, is necessary for a successful management outcome.
A Case-Control Study on Factors Associated With Secondary Amenorrhea Among the Medical Students of Universiti Malaysia Sabah

Than WW, Hossain Parash MT, Binti Abdul Majeed N, Nyein Yin K, Pg Baharuddin DMB, Fahmy EHAM, et al.

Cureus, 2023 Oct;15(10):e47625.
PMID: 38022313 DOI: 10.7759/cureus.47625

BACKGROUND AND AIM: This study aimed to evaluate the association between body mass index (BMI), anxiety, stress, depression, hormones, and secondary amenorrhea among female medical students at Universiti Malaysia Sabah (UMS).
METHODS: In this case-control study, UMS undergraduate female medical students aged 19-25 years who did not menstruate in the last three months (with a previous history of a regular menstrual cycle) or six months (with a history of irregular menstruation) were included as cases (40 students), and students with similar criteria but no menstrual irregularities were recruited in the study as controls (40 students). The study was conducted at Polyclinic UMS from January 1, 2021, until December 31, 2022. The chi-squared test and odd ratio examined the association of the above-mentioned factors with the secondary amenorrhea. A p-value less than 0.05 was considered significant, and an odds ratio if the confidence interval did not contain one was considered significant.
RESULT: Both the groups had a similar frequency of different BMI grades. The cases exhibited significantly higher levels of depression, anxiety, and stress than the controls. Again, the cases demonstrated higher estradiol (E2), testosterone, and thyroid-stimulating hormone (TSH) levels and lower levels of luteinizing hormone (LH) than those with regular menstruation. The research also revealed that a one-unit decrease in follicle-stimulating hormone (FSH) levels corresponds to a threefold increase in the risk of experiencing secondary amenorrhea, while the risk escalates to fourfold for LH. Moreover, E2, testosterone, and TSH levels exhibited protective effects on secondary amenorrhea.
CONCLUSION: Anxiety, serum LH, and FSH were significantly associated with secondary amenorrhea. Future studies should address the diurnal variation of the hormones and consider the participants' circumstances to get a proper effect of hormonal influence and stress.