Lawrence Leung

Lawrence Leung
University of Ottawa · Department of Family Medicine

MBBChir (Cambridge) MFM(Clin) CCFP FRACGP FRCGP(UK)

About

61
Publications
207,084
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2,717
Citations
Citations since 2016
4 Research Items
2062 Citations
20162017201820192020202120220100200300400
20162017201820192020202120220100200300400
20162017201820192020202120220100200300400
20162017201820192020202120220100200300400
Additional affiliations
January 2009 - December 2012
Independent Researcher
Independent Researcher
July 2007 - present
Queen's University
Position
  • Professor (Associate)

Publications

Publications (61)
Article
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Diabetes mellitus is a chronic disease of major global health concern due to its increasing prevalence in both developing and developed counties, with a projection increase of 214% from the year 2000 to 2030. Among the Aboriginal population of Canada (which includes the First Nations, Inuit and Metis), diabetes mellitus contribute significantly to...
Article
Fibromyalgia syndrome (FM) is a debilitating chronic pain condition, which afflicts primarily females. Although the etiology of this illness is not completely understood, FM pain is thought to rely on enhanced pain sensitivity maintained by central mechanisms. One of these mechanisms is central pain amplification, which is characterized by altered...
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In its broadest term, economic evaluation (EE) is a comparative analysis of the input (costs) and the output (consequences, outcomes) of two or more alternatives to see if they are economically beneficial or feasible. The earliest form of economic evaluation took place in mid-19th century and since then; three main forms of EE have evolved which ar...
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Temporal summation of second pain (TSSP) occurs when painful stimuli are presented repetitively (≥0.33 Hz) and results from a C-fibre evoked enhancement (or “wind-up”) of the dorsal horn neurons. Based on electrophysiological studies in intact animals, windup is considered a purely central phenomenon. With advancements in functional MRI (fMRI), we...
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In general practice, qualitative research contributes as significantly as quantitative research, in particular regarding psycho-social aspects of patient-care, health services provision, policy setting, and health administrations. In contrast to quantitative research, qualitative research as a whole has been constantly critiqued, if not disparaged,...
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Nails are integral extensions of the skin and they together form the largest organ of the human body. Changes in nail appearance can be due to external insults or internal pathologies, and nail signs have to be interpreted in light of a good history. We present an interesting case of a man who developed dark-green discolouration of his nails over a...
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Objective There is insufficient evidence on which to base a recommendation for optimal antiplatelet therapy following a stroke while on aspirin. The objective was to compare clopidogrel initiation vs aspirin reinitiation for vascular risk reduction among patients with ischaemic stroke on aspirin at the time of their index stroke. Design Retrospecti...
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Premature ventricular complexes (PVCs) are common findings in asymptomatic participants during ECG recordings. While most PVCs are treated conservatively, some patients may develop adverse cardiac events needing further investigations and definitive ablation by radiofrequency. Spectral strain ultrasonography has demonstrated ventricular dysfunction...
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Review question/objective This review will be guided by the following main research question: Is the use of bitter melon an effective and safe alternative to traditional hypoglycemic agents for reducing fasting blood sugar in patients with type 2 diabetes mellitus? Additional questions that will be addressed, with data permitting, are: Does the eff...
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Nausea and vomiting in early pregnancy (NVEP) is commonly encountered in family medicine. Ginger (Zingiber officinale) is a popular nonpharmacological treatment but consensus of its use is lacking. We conducted a meta-analysis of clinical trials using ginger for NVEP as published in PubMed and EMBASE, CINAHL, Cochrane Library, and all EBM reviews....
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Background: Osteoporosis (OP) is reported to be far more prevalent in those with Chronic Obstructive Pulmonary Disease (COPD) than in healthy patients. While these two diseases share many common risk factors, studies suggest that COPD itself may be a contributing factor for poor bone health and thus could serve as a useful indicator to institute tr...
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Background: Generalized rash is amongst the most common conditions presented to practicing General Practitioners and common differentials include contact dermatitis, atopic eczema, sun-induced damage, drug eruption and general manifestations of systemic diseases or infections. Materials and Methods: We illustrate with differential diagnoses our cl...
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End-of-life (EOL) discussions remain difficult in non-terminal patients as death is often perceived as a taboo and uncertainty. However, the call for proper EOL discussions has recently received public attention and media coverage. Evidence also reveals that non-terminal patients are more satisfied with health-care encounters when EOL has been disc...
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Case study Mr L, an Asian man aged 48 years, presented to his family doctor with a 3 month history of pain and swelling of his left wrist. He described the pain as 'dull and gnawing', which escalated to a sharp and shooting sensation radiating to his third and fourth fingers. Pain was worsened by movement and only mildly relieved by rest. He rated...
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Verruca vulgaris is a common skin condition in general practice, which often resolves without treatment. For lesions needing treatment, they often persist despite repeated treatment and become recalcitrant warts. Hyfrecation is a form of electrosurgery which has been used in treating common and recalcitrant warts. This article describes the history...
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It would be no exaggeration to say that a clinician cannot spend a day without looking at numerical values for laboratory test results and deciding if any actions are needed. In fact, most, if not all, clinicians in daily practice simply rely on the reference values provided by the laboratory to make clinical decisions. However, how often do we que...
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Hydrocele is a common cause of scrotal swelling in general practice and is caused by a patent space in the tunica vaginalis. Treatment is often conservative unless the hydrocele grows to a critical size that leads to discomfort or difficulty in walking, in which case drainage is necessary. Depending on the communication of the tunica vaginalis with...
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Background: Constipation is a common complaint in the care of elderly in long term care facility. The Bristol Stool Chart (BSC) has been the gold standard for describing the form and consistency of bowel motions but is limited as a descriptive qualitative tool. Objective: To pilot the feasibility of a novel stool scoring system in quantitative anal...
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Background Benzodiazepines are commonly prescribed to elderly people for anxiety or insomnia despite adverse effectsThis metaanalysis focused on the risk of adverse effects of benzodiazepine use in elderly peopleStudy selectionTwo reviewers independently searched MEDLINE, EMBASE, and the Cochrane Database of Systemic Reviews for Englishlanguage pub...
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With the rapid advances in neurosciences in the last three decades, there has been an exponential increase in the use of neuroimaging both in basic sciences and clinical research involving human subjects. During routine neuroimaging, incidental findings that are not part of the protocol or scope of research agenda can occur and they often pose a ch...
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The quest to understand the functions of the human brain and central nervous system can be traced back to the earliest civilizations. In the last 50 years or so, advances in imaging techniques have significantly contributed to both basic and clinical neurosciences. Chronic pain remains a common and challenging condition to manage in clinical medici...
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Pain remains one of the top five reasons for consultations in general practice, presenting either alone or as comorbidity. The World Health Organization (WHO) analgesic ladder proposed in 1986 has been the cornerstone of pain management, but is often inadequate in daily practice, especially when dealing with the diverse nature and etiology of vario...
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Acupuncture is an ancient treatment modality that can trace its origins to as far back as 10,000 bc along the banks of the Yellow River in China. It involves the insertion of sharpened objects into specific areas of the body to achieve therapeutic effects. According to the theory of Traditional Chinese Medicine, acupuncture modulates the flow of Qi...
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In UK, GPs have been indoctrinated with the necessity to explore every patient's ideas, concern and expectations (the I.C.E. acronym) alongside their presenting complaints to ensure a whole person approach. As a UK-trained GP now practising in Canada, I have to adapt I.C.E. to F.I.F.E. : under-standing the F eelings and I deas of the patients regar...
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Critical limb ischaemia refers to an advanced form of peripheral vascular disease where severe arterial occlusion manifests as chronic ischaemic rest pain, nonhealing ulcers and gangrene. Depending on the severity of disease and level of occlusion, endovascular revascularisation and vascular surgical bypass are indicated to salvage the limb before...
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Pain catastrophizing has been described for more than half a century which adversely affects the pain coping behavior and overall prognosis in susceptible individuals when challenged by painful conditions. It is a distinct phenomenon which is characterized by feelings of helplessness, active rumination and excessive magnification of cognitions and...
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Spinal cord injury leads to immense disability and loss of quality of life in human with no satisfactory clinical cure. Cell-based or cell-related therapies have emerged as promising therapeutic potentials both in regeneration of spinal cord and mitigation of neuropathic pain due to spinal cord injury. This article reviews the various options and t...
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Tobacco smoking is still a worldwide health risk. Current pharmacotherapies have at best, a success rate of no more than 50%. Auricular (ear) acupressure has been purported to be beneficial in achieving smoking cessation in some studies, while in others has been deemed insignificant. We hereby describe the protocol for a three-arm randomised contro...
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Falls and fall-related fractures increase with age and affect skeletal and muscle health negatively. Insufficient vitamin D and calcium intake is a contributing factor to fall-related fractures in older people (aged ≥65 years). The use of vitamin D and calcium supplements by the general public has increased, especially among older people in nursing...
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A 56-year-old man presented with a painless cyst on the top of his head which has been increasing in size in the last 6 months. Due to his learning disability, he could not be dissuaded from his belief that the lump was a sign of brain prolapse which led to increasing agitation in the next 2 weeks. A provisional diagnosis of benign lipoma was made...
Data
PRISMA 2009 Checklist for the meta-analysis study. All items in the 2009 PRISMA checklist are considered and verified against the page of the original manuscript.
Data
Funnel plots showing bias of studies for adverse effects of (a)nausea, (b)constipation, (c)flatulence. File contains the funnel plots of various studies basing on the odds ratio, as categorised by the adverse effects of nausea, constipation and flatulence respectively.
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Tobacco smoking remains the leading modifiable health hazard and varenicline is amongst the most popular pharmacological options for smoking cessation. The purpose of this study is to critically evaluate the extent of gastrointestinal adverse effects of varenicline when used at maintenance dose (1 mg twice a day) for smoking cessation. We conducted...
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Odorous vaginal discharge is a common presentation to general practitioners, and a frequent presentation for bacterial infections and sexually transmissible diseases. Busy GPs may be tempted to make a diagnosis from the clinical history and symptoms, and prescribe antibiotics as a first line treatment. This case highlights an unusual cause of persi...
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Chronic constipation is a common condition seen in family practice among the elderly and women. There is no consensus regarding its exact definition, and it may be interpreted differently by physicians and patients. Physicians prescribe various treatments, and patients often adopt different over-the-counter remedies. Chronic constipation is either...
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Use of cannabis is often an under-reported activity in our society. Despite legal restriction, cannabis is often used to relieve chronic and neuropathic pain, and it carries psychotropic and physical adverse effects with a propensity for addiction. This article aims to update the current knowledge and evidence of using cannabis and its derivatives...
Article
The anti-inflammatory cytokines interleukin-10 (IL-10) and interleukin-13 (IL-13) were shown to reduce hyperalgesia in some models such as rats exposed to UV rays. In addition, IL-10 was also shown to reduce hyperalgesia in high dose of Leishmania major-induced inflammation in BALB/c mice accompanied by a significant decrease in the levels of inter...
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Mark, 54 years of age, has a nontender lump on his praecordium that has been present 'for a long time'. He vaguely recalls a smaller lump at the same site years ago, which he squeezed, with subsequent resolution. Mark denies any bleeding, however, he has noticed occasional yellowish-brown stains on his shirt.
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This is the third article of the series on Traditional Chinese Medicine (TCM) that explores the theory and practice of Chinese Herbal Medicine (CHM). Readers should refer to the first article for the meaning and explanation of various terminologies when in doubt., written in the Eastern Han Dynasty (AD 25 to AD 220), is said to be the earliest Chin...
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Well, it's a paradox. Patients have been referred to me with all sorts of chronic pain which fail conventional treatment. I put on a new pair of glasses and see these patients in a different perspective, grab some needles and insert them at specified points on the body, twist them around for half an hour and the patients get better. This is acupunc...
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Nongenital warts are a common presentation in general practice. Despite treatment according to evidence based guidelines, a significant proportion of common warts fail to resolve, becoming recalcitrant. This poses a problem in clinical management. The recommendations for treating recalcitrant warts are unclear and there is a wide range of second li...
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Nongenital warts are a common condition seen in general practice, affecting patients of all ages. There are many treatment options and patients often self medicate with remedies from folklore or tradition before presenting to their doctor. This article attempts to summarise the quality of different treatments and to provide recommendations and a qu...
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In the year 2000, I took a leap of faith to study Traditional Chinese Medicine (TCM). 'You aren't quitting medicine, are you?' my father said with a concerned look. 'Haven't you got better subjects to learn?' my clinical mentor said, staring at me intently. Ten years of general practice had revealed a long list of medical problems that Western medi...
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Should general practitioners care about genomics? Perhaps not right now, but definitely within the next decade.
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Tumor necrosis factor alpha (TNF-alpha) was discovered more than a century ago, and its known roles have extended from within the immune system to include a neuro-inflammatory domain in the nervous system. Neuropathic pain is a recognized type of pathological pain where nociceptive responses persist beyond the resolution of damage to the nerve or i...
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It has been estimated that up to one-third of patients with diabetes mellitus use some form of complementary and alternative medicine. Momordica charantia (bitter melon) is a popular fruit used for the treatment of diabetes and related conditions amongst the indigenous populations of Asia, South America, India and East Africa. Abundant pre-clinical...
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Let's face it. It's always there. It is never included in the medical school curriculum but patients often consult you about its use. You are not sure of its efficacy, so you cannot say it is useful. Some patients listen to you, some don't, and others use it without telling you. This scenario is happening every day in your consulting room. We are t...
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Novel drugs have to go through mandatory pre-clinical testing before they can be approved for use in clinical trials. In essence, it is a form of bench-to-bedside (N2B) translational medicine, but the wastage rate of target candidates is immensely high. Effects seen in vitro often do not translate to in vivo human settings. The search is on for bet...
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T ennis elbow (lateral elbow pain) has a prevalence of 1.3% with no gender predominance. The pathology is thought to be due to an overuse syndrome of the long extensor muscles of the forearm leading to a localized fas-ciitis or enthesopathy at lateral epicondyle where the ex-tensor tendons insert. Lateral elbow pain is brought on by resisted supina...

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