Displaying publications 1 - 20 of 26 in total

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  1. Fulltext Breast self examination: to do or not to do?
    Leelavathi, M., Yasmin, S.A.K., Gomez, P.A., Aznida, F.A.A.
    Medicine & Health, 2006;1(1):1-4.
    MyJurnal
    This is a retrospective descriptive study done to look at common presentation and method of detection of breast cancer. A total of 366 case records of patients attending the Breast and Endocrine Clinic at Hospital Kuala Lumpur were reviewed. The peak age of breast cancer presentation was 40 to 49 years (39.6%). Most (81.4%) patients presented with a lump in the breast and the lump was mainly self-detected (97.3%). The mean tumour diameter on presentation was 4.7± 3 cm. Medical staff detected the disease in 1.6% cases and 1.1% of cases were detected by mammogram. Most women detected the lump themselves, suggesting that Breast Self Examination (BSE) can be used for detection of the disease in places where there is cost and availability constrains for mammogram. Early detection with BSE can possibly offer better treatment options and quality of life despite the evidence that it does not reduce the mortality due to breast cancer.
     
    Study site: Breast and Endocrine Clinic at Hospital Kuala Lumpur
  2. Fulltext Self reported hearing loss among elderly malaysians
    Rosdina AK, Leelavathi M, Zaitun A, Lee VKM, Noor Azimah M, Majmin SH, et al.
    Malays Fam Physician, 2010;5(2):91-4.
    PMID: 25606194 MyJurnal
    A cross-sectional study was conducted on patients attending a primary care facility to determine the prevalence of self reported hearing loss using a single question, "Do you have hearing loss?" Pure tone audiometry was performed to compare the accuracy of the self report. A total of 111 patients were recruited. The prevalence of self reported hearing loss using a single question and pure tone audiometry was 24.3% and 36.9% respectively. By using pure tone audiometry at a cut-off-level of 25 dBHL (decibels Hearing level), the single question yielded a sensitivity of 41.4% and specificity of 85.0%.The single question performed better at 40 dBHL pure tone audiometry with sensitivity of 55.0% and specificity of 82.0%. In conclusion, the prevalence of hearing loss in elderly was high and the single question self reported hearing loss performed satisfactorily with moderate hearing loss.
  3. Fulltext Contact dermatitis presenting as non-healing wound: case report
    Leelavathi M, Le Y, Tohid H, Hasliza A
    Asia Pac Fam Med, 2011 May 15;10(1):6.
    PMID: 21575147 DOI: 10.1186/1447-056X-10-6
    Topical antiseptics are commonly used in the management of minor wounds, burns, and infected skin. These agents are widely used by health professionals and are often self-prescribed by patients as they are easily available over-the-counter. This case illustrates a 73 year old man who presented with a non-healing wound on his right forearm for 4 weeks. The wound started from an insect bite and progressively enlarged with increasing pruritus and burning sensation. Clinically an ill-defined ulcer with surrounding erythema and erosion was noted. There was a yellow crust overlying the center of the ulcer and the periphery was scaly. Further inquiry revealed history of self treatment with a yellow solution to clean his wound for 3 weeks. Patient was provisionally diagnosed to have allergic contact dermatitis secondary to acriflavine. Topical acriflavine was stopped and the ulcer resolved after treatment with non-occlusive saline dressing. Skin patch test which is the gold standard for detection and confirmation of contact dermatitis showed a positive reaction (2+) to acriflavine. Acriflavine is widely used as a topical antiseptic agent in this part of the world. Hence, primary care physicians managing a large variety of poorly healing wounds should consider the possibility of contact allergy in recalcitrant cases, not responding to conventional treatment. Patient education is an important aspect of management as this would help curb the incidence of future contact allergies.
  4. Fulltext Brief report: nail sampling technique and its interpretation
    Leelavathi M, Tzar MN
    Malays Fam Physician, 2011;6(2-3):58-9.
    PMID: 25606224
    The clinical suspicion of onychomyosis based on appearance of the nails, requires culture for confirmation. This is because treatment requires prolonged use of systemic agents which may cause side effects. One of the common problems encountered is improper nail sampling technique which results in loss of essential information. The unfamiliar terminologies used in reporting culture results may intimidate physicians resulting in misinterpretation and hamper treatment decision. This article provides a simple guide on nail sampling technique and the interpretation of culture results.
  5. Fulltext Prevalance of smoking among secondary school students in Sarawak
    Juslina O, Leelavathi M, Khairani O, Tuti Iryani MD
    Malays Fam Physician, 2011;6(2):66-67.
    MyJurnal
    Adolescent smoking is an emerging health concern in the developing countries. A cross-sectional study is conducted to determine the prevalence and smoking behaviour of adolescents in Sarawak. The prevalence of smoking is 32.8% with mean age of initiation at 12.8±1.9 years. Most (67.2%) adolescents are experimental smokers and the majority (67.9%) did not smoke on a daily basis. Branded cigarettes are preferred (83.1%) and the cigarettes are obtained either from friends (49.1%) or self purchased (43.6%). Students prefer to smoke at their friend’s house (31.0%) or at school (25.3%). Smoking prevalence among adolescents in Sarawak is high and begins early. Early intervention on smoking prevention and risk awareness is perhaps more effective if initiated before the age of 12 years.
  6. Fulltext Homemade remedies causing contact dermatitis: case report on two patients with acne
    Leelavathi, M., Mazlin, M.B., Adawiyah, J.
    Medicine & Health, 2013;8(1):0-0.
    MyJurnal
    Natural products are often perceived as safe due to the absence of artificial or chemical materials in its content. However, many are unaware that some of these compounds, albeit natural in existence, can cause harm. Cinnamon and lemon are two commonly used home remedies for acne. Both these naturally existing ingredients are capable of producing dermatitis upon contact with the human skin. The aim of this article is to create awareness among physicians that natural remedies are not free from harm hence, should look out for any possible untoward reactions that these products may cause. Physicians need to explore the possible use of homemade remedies to treat common or minor ailments during history taking as this information may not be given voluntarily. Early identification of the offending agent, adequate management and future avoidance could help prevent further episodes of contact dermatitis and its complications.
  7. Fulltext Scales on the scalp
    Adawiyah J, Leelavathi M
    Malays Fam Physician, 2013;8(1):48-49.
    PMID: 25606270 MyJurnal
    A five-year-old boy presented with a six-week history of scales, flaking and crusting of the scalp. He had mild pruritus but no pain. He did not have a history of atopy and there were no pets at home. Examination of the scalp showed thick, yellowish dry crusts on the vertex and parietal areas and the hair was adhered to the scalp in clumps. There was non-scarring alopecia and mild erythema. There was no cervical or occipital lymphadenopathy. The patient’s nails and skin in other parts of the body were normal.
  8. Fulltext Onychomycosis nailed
    Leelavathi M, Noorlaily MN
    Malays Fam Physician, 2014;9(1):2-7.
    PMID: 25606290 MyJurnal
    Fungal infection of the nail is a common condition that causes much concern because of its disfiguring appearance. Although specific treatment is available for this condition, treatment outcome is variable and persistent nail dystrophy post-treatment may cause distress to both the patient and the physician. This article describes the current available treatment options for onychomycosis, management approach and the expected treatment outcome to enhance primary care physicians' confidence in managing this condition. Oral antifungal agents such as terbinafine and itraconazole are good treatment options for onychomycosis. Combination therapy using oral antifungal agents with topical lacquer preparations may provide added benefits. Evaluation of patient's expectations, providing information on treatment outcome, clinical cure and recurrence rates are essential in the management of onychomycosis. This article is intended to guide primary care physicians to achieve realistic treatment goals and for a satisfactory experience in the overall management of this challenging condition.
  9. Fulltext A tale of two boys: case report on nonconsanguineous siblings with cerebral palsy
    Leelavathi, M., Lim, J.L., Ahmad, S.
    Medicine & Health, 2014;9(1):74-79.
    MyJurnal
    Cerebral palsy is a common cause of childhood disability. It has a great impact on parents and caregivers, especially when it reoccurs in the same family. Although familial cerebral palsy is relatively uncommon, cases have been reported among children from consanguineous, non-consanguineous marriages and multiple pregnancies suggesting a possible complex genetic mode of inheritance. Physicians need to be aware of the possibility of familial cerebral palsy for early detection and counseling. We describe a rare case of two male siblings from a non-consanguineous marriage affected by cerebral palsy.
  10. Fulltext Acne disability, self management and help-seeking behaviour among medical students
    Leelavathi M, Tan HC, Puah JWD, Apipi M, Sohami AE, Mahat NF
    Medicine & Health, 2015;10(1):1-9.
    MyJurnal
    Acne can affect personal appearance and impair quality of life. A cross sectional study, over a period of 12 months was conducted among medical students at Universiti Kebangsaan Malaysia to evaluate the disability, self management and help-seeking behaviour of medical students for acne. A total of 361 students were selected using stratified cluster random sampling. Acne was graded using the Comprehensive Acne Severity Score (CASS) while acne disability was assessed using the Cardiff Acne Disability Index (CADI). Acne self management and helpseeking behaviour was assessed using the acne management questionnaire. Mean CADI score was 3.35 + 2.39, with mostly mild (83.8%, n=206) and moderate (14.6%, n=36) levels of impairment. Female students and those from the nonMalay ethnic group demonstrated higher disability (3.76 + 2.24, p=0.006 and 3.79 + 2.59, p=0.018, respectively). Although the majority of students (87.4%, n=215) knew that acne can be treated, they preferred to discuss their acne problems with friends (54.1%, n=133) rather than consulting a physician (9.3%, n=23). Most of them also practiced non-evidence based measures for their acne. The results of the present study shows that young adults tend to have mild grades of acne severity and disability. However, efforts are needed to enhance their knowledge on evidence based management of acne and modify their help seeking behavior. This would help reduce complications such as permanent scars and improve quality of life, as acne is a treatable dermatological disorder.
    Keywords: acne vulgaris, medical, disability, quality of life, students, severity, self care
  11. Fulltext Multiple concurrent primary extramammary Paget's disease
    Leelavathi M, Norazirah MN, Nur Amirah AP
    Malays Fam Physician, 2016;11(1):18-21.
    PMID: 28461844
    Extramammary Paget's disease (EMPD) is a rare malignant disorder of the skin, which was described in as early as the nineteenth century. EMPD usually occurs as a single lesion in the apocrine sweat gland-bearing skin with abundant hair follicles. Here, we present an elderly man who suffered from a non-resolving chronic genital pruritus for 8 months. Initially, he was managed for recurrent fungal infection and eczema. Later, a diagnosis of the rare condition multiple primary EMPD was made based on the histopathology findings and appropriate treatment was given.
  12. Fulltext Contact dermatitis following use of tropical traditional medicine
    Leelavathi, M., Teh, R.J., Chellathuray, S.
    Medicine & Health, 2016;11(1):96-100.
    MyJurnal
    Traditional or herbal medications are generally perceived as safe since it is derived
    from natural or plant sources. A rise in number of adverse reactions are being
    reported with the use of traditional medications including localized cutaneous
    reactions. The diagnosis of contact dermatitis is often quite straight forward
    based on its appearance, pattern, site and distribution of the lesion which usually
    corresponds to the area of contact. We report the case of a 65-year-old woman who
    presented with redness, burning sensation and swelling of her hand after applying
    topical Chinese traditional medication. This report aims to outline simple measures
    to identify and manage contact dermatitis secondary to topical medication. The
    present case creates awareness that topical traditional medications are not as harmless as previously thought to be. Precautions regarding adverse reactions are
    required, as those with conventional medications.
  13. Fulltext Multiple concurrent primary extramammary Paget’s disease
    Leelavathi, M., Norazirah, M.N., Nur Amirah, A.P.
    Malays Fam Physician, 2016;11(1):18-21.
    MyJurnal
    Extramammary Paget’s disease (EMPD) is a rare malignant disorder of the skin, which was described
    in as early as the nineteenth century. EMPD usually occurs as a single lesion in the apocrine sweat
    gland–bearing skin with abundant hair follicles. Here, we present an elderly man who suffered from
    a non-resolving chronic genital pruritus for 8 months. Initially, he was managed for recurrent fungal
    infection and eczema. Later, a diagnosis of the rare condition multiple primary EMPD was made
    based on the histopathology findings and appropriate treatment was given.
  14. Fulltext Self-perceived stigma and its effect on quality of life among Malaysians living with human immunodeficiency virus
    Nadia AB, Leelavathi M, Narul Aida. S, Diana M
    Medicine & Health, 2017;12(2):230-243.
    MyJurnal
    Human Immunodeficiency Virus (HIV) epidemic remains a significant burden in Malaysia. Stigma related to HIV and its effect on the quality of life (QOL) of persons living with HIV (PLHIV) remains under-reported. The aim of the present study was to assess self-perceived stigma amongst PLHIV attending an urban community clinic and its influence on their QOL. Data was collected using HIV Stigma Scale and WHO-QOL HIV BREF Scale. The overall stigma experienced by PLHIV in this community was higher than previous studies (mean ± SD; 103.37 ±18.14). Majority participants had fear disclosing their disease status, while personalized stigma or the experience of prejudice and rejection was the least experienced. The overall QOL was low and was significantly impaired in social relationship domain (mean ± SD; 12.72 ± 3.59). However, their ability to perform daily activities was not affected by the illness (mean ± SD; 14.48 ± 2.91). PLHIV with higher spiritual values demonstrate lower perception of negative self-image and inferiority (r= -0.54). This finding was unique to PLHIV in this study and suggested the importance of spirituality and personal beliefs on their self-esteem. In conclusion, stigma remains as a significant problem among PLHIV in this community. Primary care offers the best platform to promote a holistic management of PLHIV, where the integration between counselors, religious experts, family and non-governmental associations could come together. The management of PLHIV is unique in every community, hence individualized approach based on cultural norms and beliefs could assist in the overall management of PLHIV.
    Keywords: HIV, quality of life, social stigma
  15. Knowledge of obesity related pregnancy risks among expectant mothers and its associated factors
    Leelavathi M, Danasamy RS
    Med J Malaysia, 2018 08;73(4):239-243.
    PMID: 30121687 MyJurnal
    BACKGROUND: Obesity in pregnancy causes both maternal and foetal complications hence adequate knowledge of obesity related pregnancy risks would ensure better outcomes. This study aims to determine the knowledge of obesity related pregnancy risks among pregnant women.

    METHODS: A cross-sectional study was conducted among pregnant women from four antenatal clinics in Seremban, between February and May 2015. Knowledge on pregnancy risks was assessed using questionnaire. Women were defined as having broad knowledge on obesity related pregnancy risks if they correctly identified that women who are very obese, are at higher risk of obesity related pregnancy complications and weight loss prior to pregnancy is associated with lower risk of obesity related pregnancy complications. Descriptive statistics and regression tests were used in the analysis.

    RESULTS: A total of 315 women participated in this study. Their mean age is 29.3 (SD±4.8) years and majority were Malay (72.4%). More than half of them were overweight and obese (60.6%). About 63.2% participants had broad knowledge on obesity related pregnancy risk. Education is a significant predictor of broad knowledge as women with tertiary education had higher odds of having broad knowledge compared to those with only school education (OR 2.1; 95%CI: 1.28 to 3.59).

    CONCLUSIONS: This study found that more than half of the participants had knowledge of obesity related pregnancy risks and that education is a significant predictor for knowledge. Pre-pregnancy care education programmes can help identify barriers, introduce simple weight management strategies to overcome obesity, to ensure better maternal and foetal outcome.

  16. Fulltext Managing conception and pregnancy for HIV serodiscordant couple: a case report
    Sapiee, S., Leelavathi M.
    Medicine & Health, 2018;13(2):241-245.
    MyJurnal
    Worldwide, there is an increasing number of people living with HIV and AIDS especially in the reproductive age group. This has a huge impact when they wish to start a family. Managing reproductive issues among serodiscordant HIV couples is complex and often presents as a challenge especially in minimizing the risk of transmission. We report a case of a HIV positive man and his seronegative wife who successfully achieve conception and deliver a healthy baby without disease transmission of HIV to mother or child. Both partners were managed with treatment where the HIV positive male partner was treated with HAART while the unaffected female partner was on PrEP and conception was achieved through intrauterine insemination (IUI). Planning of conception, the use of medications and options for conception methods will be discussed in detail.
  17. Fulltext Online health information seeking among people with diabetes mellitus and its association with self-management
    Leelavathi M, Teh Rohaila J, Thenmolle A, Mohamad Salehuddin MS, Barathan M, Natasha PJ, et al.
    Medicine & Health, 2018;13(2):72-82.
    MyJurnal
    Diabetes requires dedicated self-management to be able to achieve good control and outcome as this is a lifelong condition. The internet offers an amazing wealth of health information which may influence diabetes self-management. The aim of this study was to determine the prevalence of online health information seeking among people with diabetes and its associated factors. About 380 participants answered the online health information seeking questionnaire developed from literature search and expert panel review. Diabetes Self-Management was assessed using the Diabetes Self-Management Questionnaire (DSMQ). The prevalence of online health information seeking among people with diabetes was 38.4%. Common information sought included diabetes treatment (82.9%) lifestyle modification (77.4%) and diabetes prevention (67.3%). A large majority (93.1%) felt that the online information on diabetes was useful. Doctors and printed reading materials were the most common sources of information for diabetes (94.2% & 65.3%). Lower median age (59 years, IQR = 11), having a family member with diabetes, (COR = 1.188) tertiary education (COR = 6.037) and those who are employed (COR = 3.880) have higher odds of seeking online diabetes related health information. However, there was no significant association between online health information seeking and diabetes self-management. Prevalence of online health information seeking among people with diabetes was at an acceptable level. However, it was not associated with optimal diabetic self-management. Doctors and printed information remain as popular sources of information and hence should be maintained.
    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

  18. Fulltext Menstrual care for individuals with disability: a case report
    Nadia, A.B., Leelavathi M., Noor Azimah, M.
    Medicine & Health, 2019;14(1):209-214.
    MyJurnal
    Individuals with disabilities have different needs and concerns at different stages of life. The arrival of puberty brings about new challenges especially for females with issues related to menstrual care involving both the patient and their caregivers. This case report is about a 13-year-old girl with Down syndrome who was cared for by her widowed father since the age of six. She was suffering from severe mental disability. Her father was concerned, because she was unable to maintain personal hygiene during menses such as changing sanitary napkins and managing stains, hence requested for menstrual manipulation. Options for menstrual manipulation for individuals with disabilities include both medical and surgical interventions. Hormonal therapy options include oral contraceptive pills, depo-provera, progestin implants and progesterone release intra-uterine contraceptive devices. Surgical options such as hysterectomy or endometrial ablation may be considered as a last resort as it is more invasive and irreversible, involving ethical and legal implications. Selection of the suitable therapy involves shared decision making between health care provider and caregiver taking into consideration the patient’s best interest. This case report also highlights the role of family physicians in managing and coordinating care on delicate issues related to menstrual care for people with disabilities. This case report may serve as a guide to physicians and families with special needs children, while approaching issues on menstrual care.
  19. Fulltext Characteristics and factors associated with adverse cutaneous drug reactions caused by traditional, complementary and conventional medicine in Malaysia
    Nor Hazlin, T., Leelavathi M., Zuhra, H., Adawiyah, J., Dawn, A.A.
    Medicine & Health, 2019;14(2):50-59.
    MyJurnal
    Traditional and Complimentary Medicines (TCMs) can potentially cause Adverse Cutaneous Drug Reactions (ACDRs). The aim of this study was to describe the characteristics of ACDRs due to TCMs and compare with those due to conventional medicine. This was a retrospective study with 134 cases being diagnosed with ACDR at the Dermatology Clinic of a tertiary hospital in Kuala Lumpur. Most (82.1%) ACDRs were caused by conventional drugs, while 17.9% were due to TCMs. Majority (70-75%) of the ACDRs were of mild to moderate severity. The most common ACDR to TCM was Exfoliative Dermatitis (ED) and Acute Generalized Exanthematous Pustulosis (AGEP) (both 16.7%) while maculopapular rash was the most common reaction for conventional medications (25.5%). The onset of adverse reaction to TCM was about 4 weeks (60.2%) while reactions due to conventional medication was earlier (1 to 6 days, 65.4%; p
  20. Fulltext E-cigarette use, its impact on tobacco smoking and the intention to quit
    Nurasyikin MS, Leelavathi M, Tohid H
    Medicine & Health, 2019;14(1):78-90.
    MyJurnal
    E-cigarettes have rapidly gained worldwide popularity. Since its use still poses a health risk to the users, it is important to assess their intention to quit this habit. This study aimed to determine the characteristics of e-cigarette use, its effect on cigarette smoking and users’ intention to quit vaping and smoking. A total of 377 e-cigarette users were recruited from three vape retail stores in Bandar Baru Bangi, Selangor. E-cigarette usage pattern, tobacco cigarette consumption and their intention to quit were assessed using a self-administered questionnaire. Most (70%) participants were e-cigarettes only users while 30% were dual users. The median duration of e-cigarette use was 2 (IQR 2) years. Almost all (98.4%) participants used third-generation devices and majority (63.7%) preferred liquid containing 6mg nicotine. About 92% participants, especially heavy smokers, smoked fewer tobacco cigarettes after initiating e-cigarette. Majority (79.6%) of dual users also had reduction in tobacco cigarette consumption with a median current consumption of 5 (IQR 5.0) cigarettes per day. Most (87%) e-cigarette users intend to quit the habit someday. However, many (63.1%) were in the pre-contemplation stage. E-cigarette users of less than 2 years duration tend to have the intention to quit compared to users of more than 2 years (p=0.005). In conclusion, there was more e-cigarette only users than the dual users. E-cigarette use could significantly reduce tobacco smoking, especially among heavy smokers. Most e-cigarette users had the intention to quit vaping but not in the near future and longer e-cigarette use may deter their intention to quit.
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