Journals of Universiti Kuala Lumpur
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Amlodipine-induced Generalised Exfoliative Dermatitis: Not to be Missed!
Full text linkAmlodipine a calcium channel blocker (CCB), is commonly used in treating hypertension, coronary artery disease, and chronic kidney disease. It is considered a first-line treatment for high blood pressure. Amlodipine acts by selectively inhibiting voltage-gated L-type calcium ion channels, which consequently decreases systemic vascular resistance, total vascular resistance, and muscle contractility. We report a case of amlodipine-induced exfoliative dermatitis, highlighting the importance of recognizing this rare but serious cutaneous reaction to amlodipine, a commonly used drug in primary care. Prompt discontinuation of the offending drug and appropriate management are crucial for improving patient outcomes. Clinicians should maintain a high index of suspicion for drug-induced exfoliative dermatitis in patients presenting with generalized erythema and scaling after initiating new medications
Healthy Gums Does It Matter?Amlodipine-Induced Gingival Overgrowth (AIGO): A Case Report
Full text linkIn Malaysia, more than half a million adults, representing 2.5% of the population, are living with four major non-communicable diseases (NCDs): diabetes, hypertension, hypercholesterolemia, and obesity. As for hypertension, 29.2% or 1 in 3 adults in Malaysia have hypertension, and 91% are on blood pressure medications. This includes dihydropyridine calcium channel blockers such as amlodipine, which is commonly used in primary care. We report a case from our primary care clinic involving a 70-year-old man with a known history of primary hypertension who developed painless gum swelling and discomfort while the patient was on T. amlodipine 10 mg. Oral examination showed diffuse gingival hypertrophy involving the upper and right lower gums. The condition resolved completely after discontinuation of the offending drug and substitution with an angiotensin-converting enzyme inhibitor. This case is notable because the gingival overgrowth developed only after 4 years of amlodipine 10 mg therapy. This paper aims to bring clinicians\u27 attention to these adverse effects of amlodipine, so that timely and effective management can be given to the patient, avoiding complications and unnecessary treatment
The Satisfaction-Success Paradox: Online Distance Learning Outcomes among Nursing Students during the COVID-19 Pandemic.
Full text linkIntroduction: The COVID-19 pandemic triggered an abrupt global transition to Online Distance Learning (ODL), posing significant challenges for nursing education, which depends heavily on hands-on clinical experiences. Although nursing students reported varying degrees of satisfaction with online learning, the extent to which these perceptions influenced academic success remained unclear. Methods: A cross-sectional study was conducted among 164 undergraduate nursing students at Universiti Kuala Lumpur Royal College of Medicine Perak (UniKL RCMP) between August 2023 and January 2024. Participants completed a sociodemographic questionnaire, a validated 20-item Learning Satisfaction Scale, and provided their cumulative Grade Point Average (GPA). Descriptive statistics were used to summarise participant characteristics and satisfaction levels, while Spearman’s rank-order correlation assessed the relationship between learning satisfaction and academic performance. Results: Most participants were female (82.3%) and aged between 18 and 25 years (93.3%). The majority reported average internet stability (62.2%) and financial burden (63.4%) during ODL. Overall, 70.7% of students demonstrated moderate learning satisfaction, while 29.3% expressed low satisfaction. The mean GPA was 3.37 ± 0.32, with 60.4% achieving satisfactory and 34.7% excellent performance. Correlation analysis revealed no significant association between total learning satisfaction and GPA (rs = 0.033, p = 0.672), indicating that satisfaction did not influence academic performance. Conclusion: Although nursing students maintained satisfactory academic results, their overall learning satisfaction remained moderate. Academic performance during ODL may have been shaped more by motivation, adaptability, and institutional support. Continuous improvement in instructional design, interaction, and learner support is vital to enhance satisfaction and academic outcomes in future blended or online nursing education
A Bibliometric Review of Holy Basil (Ocimum tenuiflorum) and Its Therapeutic Potential in Dermatological Applications
Full text linkOcimum tenuiflorum (O. tenuiflorum), commonly recognised as Holy Basil or Tulsi, has garnered growing interest within the scientific and industrial communities due to its extensive phytochemical profile and diverse therapeutic properties. This bibliometric review examines global research trends concerning O. tenuiflorum from 2000 to 2024, utilising data from Web of Science (WOS) alongside bibliometric tools including VOSviewer and Biblioshiny. The analysis indicates a consistent increase in publication output, with India leading research contributions and notable inputs from the USA, Thailand, and other nations. Research clusters delineate five principal thematic areas: traditional medicine, phytochemistry, pharmacology, nanotechnology applications, and dermatology. The plant’s bioactive compounds- such as eugenol, ursolic acid, rosmarinic acid, and luteolin- exhibit significant antioxidant, anti-inflammatory, adaptogenic, antidiabetic, and dermatological effects. Particularly in dermatology, O. tenuiflorum demonstrates promising roles in anti-ageing, skin barrier protection, acne management, and wound healing via mechanisms involving collagen synthesis, cytokine inhibition, and UV protection. This comprehensive bibliometric and phytochemical review underscores the versatile therapeutic potential of O. tenuiflorum, thereby supporting its development within cosmeceutical and pharmaceutical sectors, while also highlighting opportunities for further multidisciplinary research
Biometrics Iris Recognition And Two-Factor Authentication For Login System
Full text linkTraditional username and password authentication were easily compromised and had caused a breach of data. Research shows that two-factor authentication and biometrics applied to web systems is a more secure method compared to the traditional username and password when used appropriately. The project was to implement a secure login authentication mechanism for the inventory system in two different environments, the desktop environment, and the mobile browser environment. The stated mechanism is biometric iris detection and two-step authentication using one-time password (OTP)
Visualizing Energy: An AR Approach to Promoting Sustainable Consumption Habits
Full text linkEnergy consumption refers to the use of energy by household appliances, devices, and systems across residential, commercial, and industrial sectors. Beyond the total energy used, understanding consumption patterns is crucial in managing costs and promoting environmental sustainability. Many consumers lack awareness of how their daily energy usage impacts both expenses and the environment, leading to inefficient energy consumption, increased costs, and negative ecological consequences. This study explores the role of digital tools, particularly augmented reality (AR), in visualizing energy consumption and fostering sustainable habits. The research focuses on developing an AR-based Energy Consumption Awareness Application that provides users with interactive, real-time feedback on their energy usage. By leveraging a user-centered design approach and probability simple random sampling, this study evaluates how AR can enhance user engagement and encourage informed decision-making regarding energy efficiency. Results showed that 73.7% of participants were aware of appliance-level energy usage, 86.8% reported an increase in energy awareness after using the app, and 92.1% believed the app had the potential to influence their energy-efficient decisions. These findings support broader adoption of AR technology in energy management and present opportunities for collaboration with industry stakeholders such as Tenaga Nasional Berhad (TNB) or Suruhanjaya Tenaga
A Case of Non-Immune Hydrops Fetalis in an HIV-Positive Mother
Full text linkMother-to-child transmission (MTCT) remains the primary route of HIV infection in children, with an estimated 30–40% risk in untreated pregnancies. We report a case of a pregnant woman with a high HIV viral load who developed non-immune hydrops foetalis (NIHF), a rare and life-threatening foetal condition characterized by excessive fluid accumulation in at least two compartments. Ultrasound examinations revealed left ventriculomegaly, cardiomegaly with pericardial effusion, pleural effusion, and ascites with an enlarged spleen, confirming NIHF. Extensive investigations ruled out common infectious and non-infectious causes, raising the possibility of a link between maternal HIV and NIHF. This case highlights the need for further investigation into the potential relationship between maternal HIV, congenital HIV, and NIHF, as well as the importance of early detection and multidisciplinary management in high-risk pregnancies
Molecular Markers in Colorectal Carcinoma – Transforming Prognostication and Therapy in Malaysia.
Full text linkColorectal cancer (CRC) remains a formidable health challenge in Malaysia, contributing to 13.5% of all newly diagnosed cancers (2012-2026), ranking as the second most common malignancy. Alarmingly, survival outcomes remain poor, with a median survival of just 24 months and a 5-year survival rate of only 18.4% [1]. These sobering statistics underscore the urgent need for precision oncology strategies to improve patient outcomes. As a molecularly heterogeneous disease, CRC has distinct genetic and epigenetic alterations influencing tumour behaviour, treatment response, and prognosis. The advent of next-generation sequencing (NGS) and immunohistochemistry (IHC) has enabled the classification of CRC based on molecular subtypes, facilitating precision oncology. The evolution of molecular pathology classification systems from The Cancer Genome Atlas (TCGA, 2012), Consensus Molecular Subtypes (CMS, 2015), Colorectal Intrinsic Subtypes (CRIS, 2016), Single Cell Intrinsic CMS (iCMS, 2022) and to the latest Pathway Derived Subtypes (PDS, 2024) has revolutionised our understanding of CRC biology [2]. This editorial note discusses briefly a few molecular markers in CRC, their prognostic significance, and clinical implications for personalised therapy.
RAS/RAF Mutations (KRAS, NRAS, BRAF): KRAS and NRAS mutations are detected in 40-50% and 1.2-4.2% of CRC, respectively. Survival of KRAS and BRAF V600E mutation in the microsatellite stable (MSS) CRC, is better than in the microsatellite instability-high (MSI-H) CRC [3]. KRAS and NRAS mutations predict resistance to anti-epidermal growth factor receptor (anti-EGFR) therapy. Emerging data suggest that KRAS/BRAF wild-type MSS tumours may derive benefits from EGFR inhibition, reinforcing the need for routine molecular testing [4].
Microsatellite Instability-High (MSI-H)/Mismatch Repair Deficient (dMMR): MSI-H/dMMR tumours occur in ~15% of sporadic CRCs and exhibit a favourable prognosis in their early stages. MSI-H tumours display high tumour mutational burden, making them exquisitely sensitive to treatment with immune checkpoint inhibitors (pembrolizumab, nivolumab) [5]. Hence, MSI-H testing is important to identify patients for these immunotherapies, which will dramatically improve survival outcomes [4,5].
TP 53 and Adenomatous Polyposis Coli (APC) Mutations: TP53 is mutated in 60% of CRC, with most being missense substitutions at position R175 or R273. TP53 mutations correlate with aggressive tumour behaviour, metastasis, resistance to 5-fluorouracil, and dismal survival, underscoring their role as a poor prognostic marker [6]. APC mutations are seen in 70-80% of CRC, are early events in CRC, and drive the canonical (β-catenin-dependent) Wnt signaling pathway activation. Recent evidence suggests APC and TP53 mutations help to predict cetuximab sensitivity, offering new avenues for personalized therapy and better patient outcomes [6].
Human Epidermal Growth Factor Receptor 2 (HER2) Amplification: CRC with HER2 amplification is seen in 3-5%, are associated with aggressive behaviour, brain metastasis and worse outcomes. Dual HER2 blockade (trastuzumab and pertuzumab) has shown promise in metastatic HER2 CRC, mirroring advances in breast and gastric cancers [7].
While molecular diagnostics have transformed CRC management, several challenges persist in Malaysia, notably, limited access to NGS and biomarker testing in routine practice, and high costs of targeted therapies. To bridge these limitations, the molecular testing facilities in public hospitals should be expanded, and there should be integration of molecular biomarkers into the national CRC treatment protocols. Molecular stratification, guided by KRAS, BRAF, MSI, TP53, APC, and HER2 status, is essential for optimizing outcomes
The Role of Biochemical Parameters, Body Fat, and Comorbidities in Health-Related Quality of Life among Haemodialysis Patients.
Full text linkIntroduction: Health-related quality of life (HRQOL) is often compromised in patients with end-stage renal disease (ESRD), despite the life-saving benefits of haemodialysis (HD). Although poor nutritional status is prevalent among HD patients, the association between HRQOL and specific factors, such as biochemical parameters, body fat, and comorbidities, remains insufficiently explored. This study aimed to examine the correlations between these factors and HRQOL in HD patients. Methods: A cross-sectional study involving 97 ESRD patients from two HD centres in an urban area of Selangor was conducted to ascertain the correlation between HRQOL and nutritional status. Data on socio-demographic characteristics, anthropometric measurements, biochemical parameters, and medical history were collected. HRQOL was evaluated using the Kidney Disease Quality of Life Short Form (KDQOL-SFTM version 1.3). Results: The mean KDQOL-SF™ scores ranged from 30.41 ± 29.37 to 85.91 ± 16.38. The mean scores for physical composite summary (PCS) and mental composite summary (MCS) were 40.89 ± 9.77 and 47.17 ± 9.84, respectively. Significant differences in HRQOL were observed across socio-demographic characteristics with the exception of gender and money allowance. Positive correlations with HRQOL were found for serum phosphorus, sodium, creatinine, albumin, HDL-cholesterol, and duration of ESRD diagnosis. Meanwhile, serum chloride, total iron-binding capacity (TIBC), transferrin, body fat, and the number of comorbidities were inversely correlated with HRQOL. Conclusion: This study highlights the role of biochemical parameters, body fat, and comorbidities on HRQOL in haemodialysis patients, emphasizing the need for regular monitoring and targeted interventions to enhance HRQOL and overall patient outcomes
Remitting Seronegative Symmetrical Synovitis with Pitting Oedema (RS3PE) in a Young Patient Mimicking Syphilitic Arthritis: A Case Report.
Full text linkRemitting seronegative symmetrical synovitis with pitting oedema (RS3PE) is a rare disorder characterized by acute symmetrical synovitis involving both hands and feet, accompanied by pitting oedema. The aetiopathogenesis of RS3PE is still obscured. It commonly occurs in individuals over 50 years of age and has a good prognosis. RS3PE responds well to corticosteroid. We report a case of a young male being treated for sexually transmitted disease (STD) who presented with recurrent episodes of bilateral leg oedema and symmetrical joint pain involving the ankles and hands. He was successfully treated with corticosteroid. Reactive arthritis was excluded in view of the recurrent episodes with no evidence of all phases of syphilis, especially tertiary syphilis