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Fulltext Barriers affecting clubfoot treatment in Sarawak

Nur Alyana, B.A., Sahdi, H., Rasit, A.H., Zabidah, P.

JUMMEC, 2018;21(2):15-22.
MyJurnal

congenital deformity among paediatric patients. The outcome of starting clubfoot treatment early is very
promising. Patient retention throughout the treatment programme is challenging in Sarawak. In this study,
we explored the barriers that parents/caregivers face when seeking clubfoot treatment in Sarawak, Northwest
Borneo. A better understanding of the barriers will provide us with the information to formulate effective
programmes for clubfoot treatment in this region.
Methods: We conducted a questionnaire-based quantitative cross-sectional descriptive survey. We adapted
a set of closed-ended questionnaires originally designed by Kazibwe and Struthers in a study done in Uganda
in the year 2006.
Results: A total of 53 parents/caregivers of children with idiopathic clubfoot were recruited in this study, with
16 defaulter cases and 37 non-defaulter cases. We found 2 statistically significant barriers to clubfoot treatment
in Sarawak, with p-value < 0.05, namely the geographical factor (p = 0.019) and logistic factor (p = 0.017).
Conclusion: Barriers to clubfoot treatment that influence the compliance to treatment identified in this study
are long distance travel, logistics limitations, uncooperative patients during treatment, parents/caregivers
having other commitments, unsupportive family members, lack of understanding regarding clubfoot and its
treatment, inadequate specialists in clubfoot, traditional socio-cultural beliefs and practices and economic
constraints. Enhanced understanding in this matter will guide us in devising culturally admissible ways to
increase awareness in parents/caregivers regarding clubfoot and its treatment. A sustainable national clubfoot
program will be very beneficial in providing a holistic approach to tackle barriers to treatment in our country.
Fulltext Single-Bone Forearm Salvage Procedure for a Child with Acquired Radial Clubhand in a Resource Limited Centre: A Case Report

Sahdi H, Chan WH, Dollah NB, Entri A

Malays Orthop J, 2018 Nov;12(3):43-46.
PMID: 30555646 MyJurnal DOI: 10.5704/MOJ.1811.011

Acquired radial clubhand deformity can be a consequence of large bone gap left by premature extensive radius osteomyelitis sequestrectomy. Single-bone forearm reconstruction is a salvage procedure when other motion-preserving techniques are not feasible. Here we present a child who developed radial clubhand deformity after an untimely sequestrectomy of radius diaphysis. In view of limited microsurgical expertise in our centre, single-bone forearm procedure was done utilising simple Kirshner wires to achieve radio-ulnar fusion. The procedure resulted in pain-free stable wrist, restoration of hand function and improved cosmesis.
Modified French Osteotomy for Humeroradial Synostosis in a Child with Multiple Synostoses Syndrome: A Case Report

Sahdi H, Rasit AH, Khoo CS, Bojeng A, Nur-Alyana BA

Malays Orthop J, 2019 Jul;13(2):52-55.
PMID: 31467654 DOI: 10.5704/MOJ.1907.011

Congenital humeroradial synostosis can occur as an isolated clinical entity or as part of a syndrome. Bilateral elbow fixed flexion deformity is very incapacitating and challenging to treat. Here we present the case of a boy with fixed flexion deformity of both elbows due bilateral humeroradial synostosis. Other characteristic features of multiple synostoses syndrome were also present in this child, his elder brother and mother. We elected to improve the position of the right elbow by adapting the modified French osteotomy described by Bellemore et al.
A rare case of unilateral postaxial duplicated foot in a developmentally normal child

Sahdi H, Hoong CW, Rasit AH, Arianto F, Siong LK, Abdullah NA

J Orthop Surg (Hong Kong), 2017 01;25(1):2309499016684989.
PMID: 28166702 DOI: 10.1177/2309499016684989

Diplopodia, being a rare congenital disorder, is infrequently discussed in published texts. Most reported cases have accounted the involvement of duplicated preaxial digits with other associated organ system and physical deformities. Here, we present an unusual case of isolated diplopodia involving postaxial toes in a child with no other organ and physical abnormalities. Radiological studies revealed a set of 10-digit-duplicated foot over the lateral aspect of the native foot, complete with phalanges and its corresponding metatarsals as well as tarsals, supplied by an anomalous posterior branch of the popliteal artery. Definitive surgery was performed just before the child was learning to walk.
A nationwide, multihospital, cross-sectional, self-reported study: Knowledge, attitude and behaviour concerning the use of personal protective equipment among healthcare workers during the COVID-19 pandemic in Malaysia

Sahdi H, Zuraidi NF, Redzuan-Hafiz-Boon KI, Abang-Ahmad-Zaini DNA, Ramlee MS

Med J Malaysia, 2023 Mar;78(2):218-224.
PMID: 36988534

INTRODUCTION: Personal protective equipment (PPE) is crucial in reducing the risk of hospital-acquired COVID-19 as health care workers (HCW)s are highly exposed to the virus during the management of patients with COVID-19. This study assesses the knowledge, attitude and behaviour of the HCWs towards the use of PPE during the COVID-19 pandemic in Malaysia.
MATERIALS AND METHODS: This is a nationwide, online-based cross-sectional study utilising a self-administered questionnaire that was distributed to tertiary hospital HCWs in Malaysia, conducted between June and August 2020.
RESULTS: Forty-eight physicians, 66 nurses and 79 medical assistants participated in this study. 73.6% correctly recognised PPE components while 40.4% revealed correct hand hygiene practices and approximately 20% had misconceptions about the proper usage of PPE. Although 78.8% disclosed high compliance, 37.3% perceived that PPE protocol interferes with patient care. HCWs have suboptimal knowledge levels of hand hygiene. Age and poor behaviour were the independent predictors of good compliance with PPE.
CONCLUSION: This study highlights the necessity to analyse discrepancies in PPE practice among HCWs and its contributing elements. Recognised barriers should be addressed to narrow the gap between knowledge, attitude and behaviour to improve compliance. The study findings would assist in developing an improved disease transmission control and prevention training protocols for HCWs as a preparation for possible infectious outbreaks in the future.
Fulltext Development and validation of the Newborn Clubfoot Screening Checklist to improve the detection of postnatal congenital talipes equinovarus among newborns by non-orthopaedic-trained healthcare workers in Sarawak General Hospital: A cross-sectional prospective study

Sahdi H, Prabaharan R, Cheah WL, Rasit AH, Sultan Abdul Kader MABA, Bujang MA, et al.

Malays Fam Physician, 2024;19:68.
PMID: 39654868 DOI: 10.51866/oa.697

INTRODUCTION: Non-orthopaedic-trained healthcare professionals face challenges in identifying postnatal clubfoot deformities due to the lack of suitable assessment tools, resulting in misdiagnosis. Therefore, this study aimed to develop and validate the Neonatal Clubfoot Screening Checklist (NCSC) to assist non-orthopaedic-trained healthcare professionals in postnatal clubfoot assessment.
METHODS: The NCSC development involved five phases: conceptual understanding of deformity components, creation of pictorial representations, tool structure design, content and face validation, pilot study and field study. A cross-sectional prospective study was conducted in Sarawak General Hospital from January to June 2021. Non-orthopaedic-trained healthcare professionals were randomly assigned to two groups: one utilising the NCSC for newborn screening and another without it. Results were compared with assessments by the paediatric orthopaedic team. Kappa agreement tests and sensitivity and specificity analyses were performed to evaluate the tool's reliability and validity, respectively.
RESULTS: The content and face validity were satisfactory. Six hundred twelve feet were screened using the NCSC, and 596 feet were checked without the tool. The kappa agreement tests showed strong concordance (kappa coefficient=0.725-1.000, P<0.001) between the non-orthopaedic-trained personnel and paediatric orthopaedic team for all NCSC items. The NCSC exhibited 100% sensitivity, specificity and positive and negative predictive values.
CONCLUSION: The NCSC is a reliable tool for postnatal clubfoot screening, offering high sensitivity and specificity. It facilitates accurate differentiation of true-positive congenital talipes equinovarus from other foot conditions, reducing misdiagnoses and unnecessary referrals. The NCSC is valuable in resource-constrained settings and for healthcare professionals lacking specialised orthopaedic training.