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.

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.

Modified French Osteotomy for Humeroradial Synostosis in a Child with Multiple Synostoses Syndrome: A Case Report.

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.

Modified French Osteotomy for Humeroradial Synostosis in a Child with Multiple Synostoses Syndrome: A Case Report

@#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.

Single-Bone Forearm Salvage Procedure for a Child with Acquired Radial Clubhand in a Resource Limited Centre: A Case Report.

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.

BARRIERS AFFECTING CLUBFOOT TREATMENT IN SARAWAK

@#Congenital talipes equinovarus (CTEV), also known as clubfoot is the most common lower limb 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

Single-Bone Forearm Salvage Procedure for a Child with Acquired Radial Clubhand in a Resource Limited Centre: A Case Report

@#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 motionpreserving 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 painfree stable wrist, restoration of hand function and improved cosmesis.