Medical Journal of Malaysia最新文献

{"title":"Gender representation across surgical specialties in Malaysia.","authors":"J X Teh, S A Nah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Although female enrolment exceeds 50% in many undergraduate medical programmes worldwide, surgeons remain overwhelmingly male despite studies reporting better outcomes by female surgeons. We aimed to characterise gender representation across surgical specialties in Malaysia.</p><p><strong>Materials and methods: </strong>We performed a cross-sectional study, extracting data of all surgical specialties from the Malaysian Specialist Register up to 30th September 2023. Gender proportions were assessed using the UNESCO Gender Parity Index (GPI), GPI<1 indicating fewer females. Gender parity was considered present at GPI 0.97-1.03. Disparities were categorised as extreme (<0.5,>1.5), intermediate (0.5-0.89, 1.11-1.5), and close to parity (0.9- 0.96,1.04-1.1). Number of years post-specialisation for each surgeon were calculated.</p><p><strong>Results: </strong>5236 surgeons were included. Only one specialty (Obstetrics & Gynaecology, GPI=1.03) showed parity and two specialties (Breast & Endocrine, GPI 2.67 and Ophthalmology, GPI 1.27) had more female surgeons. The other thirteen specialties showed various degrees of male predominance. Most GPI values trended higher when younger surgeons were included in the calculation, indicating greater female representation in recent years.</p><p><strong>Conclusion: </strong>Most surgical specialties in Malaysia show extreme gender inequity. Further work is needed to identify root causes and improve trends. Future efforts should further examine gender disparities and strengthen measures such as mentorship, supportive policies, transparent processes, and inclusive cultures, to advance equity in surgery.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 3","pages":"394-398"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between neutrophil to lymphocyte ratio and the success of hydrostatic reduction in patients with intussusception.","authors":"S Y Agitya, M Akhmad, D Andi, Gunadi, K Gibran, P Eko","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Intussusception is a common emergency condition in children. Intussusception leads to inflammation, which is marked by an increase in acute inflammatory markers, including the Neutrophil-Lymphocyte Ratio (NLR). Reduction of sedation (SR) using air or fluid enema is considered safe and effective. We present examining the relationship between NLR and the success of hydrostatic reduction in patients with intussusception for 3 years.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted from July 2021 to July 2024 in Yogyakarta, Indonesia, involving 41 children with intussusception who underwent hydrostatic reduction under sedation. Demographic, clinical, and laboratory data were collected from medical records, and NLR values were calculated from neutrophil and lymphocyte counts. Receiver operating characteristic (ROC), bivariate, and multivariate analyses were performed to evaluate the association between NLR and successful reduction.</p><p><strong>Results: </strong>The average age of children who successfully underwent reduction was 25.5 months, compared to 9 months in those who failed. The proportion of children with bleeding stool in the successful reduction group was 28.6%, while it was 73.3% in the unsuccessful, with a p-value <0.05 (0.005). Bivariate analysis indicated that NLR is a significant predictor of successful reduction under sedation procedure with a p-value <0.05 (0.031). Children with NLR <1.73 had a success rate of 84.6%, with a p-value of <0.05 (0.036).</p><p><strong>Conclusion: </strong>The success rate of hydrostatic reduction is higher in children with a low NLR. This study provides new insights into how NLR can predict the success of SR in children with intussusception.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 3","pages":"362-365"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-specific orbital inflammation: Clinical and histopathological insights from a 6-year single-centre Malaysian cohort.","authors":"S J Sharifah Izzati, M J Farez Mukhriz, A R Adlina, M N Muzaliha, M Shahidatul Adha","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Non-specific orbital inflammation (NSOI), formerly known as idiopathic orbital inflammatory disease (IOID), is a rare, exclusion-based orbital disorder with diverse clinical manifestations. This study evaluates the demographic patterns, clinical features, histopathological profiles, and treatment outcomes of NSOI cases managed at a tertiary referral centre in Malaysia.</p><p><strong>Materials and methods: </strong>A six-year retrospective review was conducted at a tertiary referral centre in northern Malaysia, involving 36 patients diagnosed with NSOI between January 2018 and December 2023. Diagnosis was based on clinical features, exclusion of systemic and infectious causes through serology, and supportive imaging or biopsy findings. Only cases with histopathological confirmation and immunohistochemical staining negative for lymphoma, carcinoma, and other malignancies were included. Data included demographics, clinical presentation, imaging and histopathological findings, serologic evaluations, and treatment modalities. Outcomes were assessed based on symptom resolution, radiologic improvement, recurrence, and treatment response.</p><p><strong>Results: </strong>Most patients were male (61.1%), with a mean age of 43.6 years. Unilateral involvement predominated (77.8%). Common presentations included periorbital swelling (69.4%), ophthalmoplegia (22.2%), conjunctival mass (22.2%), and proptosis (19.4%). Imaging revealed frequent involvement of the lacrimal gland (45.8%), extraocular muscles (37.5%), and conjunctiva (37.5%). The main histopathological findings included reactive lymphoid hyperplasia (40%), granulomatous inflammation (20%), and chronic inflammation (23.3%). Of the 36 patients, 19 received medical treatment, with 84.2% given systemic corticosteroids, while the remaining 17 patients were managed conservatively without any medical treatment, and they remained clinically stable throughout follow-up with no evidence of disease progression. Among treated cases, recurrence occurred in 25%, predominantly in males.</p><p><strong>Conclusion: </strong>NSOI shows varied clinical and anatomical patterns. Corticosteroids remain the mainstay of treatment, but conservative management is appropriate in stable, nonprogressive cases when close monitoring and diagnostic exclusion are assured. These findings support individualised therapeutic strategies and long-term followup.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 3","pages":"389-393"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life of people living with HIV in a Malaysian state hospital during the COVID-19 pandemic.","authors":"W C Ang, N F S Jafferi, N S Bohari, A Roselan, A A Shafie","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Assessing health-related quality of life (HRQOL) promotes understanding well-being of people living with HIV (PLHIV). This study aims to determine factors influencing HRQOL.</p><p><strong>Materials and methods: </strong>The cross-sectional study used a self-administered questionnaire among PLHIV receiving treatment in HIV clinic of a state hospital in Perlis, Malaysia. Potential subjects were approached in the waiting areas during routine clinic visits. The Malay questionnaire consists of WHOQOL-HIV BREF, EQ-5D-5L and EQ-VAS. Multiple linear regressions (MLRs) were used to identify independent predictors of HRQOL, and Spearman's correlations assessed the relationships between instruments.</p><p><strong>Results: </strong>There were 88 participants in this study (mean age 43.5±13.1 years; 63.6% male). All were on antiretroviral therapy with undetectable viral loads. The mean overall WHOQOL score was 74.9±13.1 (on a 0-100 scale), EQ-5D index 0.90±0.13, and EQ-VAS 88.5±13.2. Each one-year increase in age was associated with a 3.3-point (β≈+3.3) higher WHOQOL score and middle-range household income of MYR3171-3970 (≈USD757-948 as of 1 USD=4.188 MYR) was linked to higher WHOQOL(β≈+8.7). In contrast, part-time employment corresponded to a lower WHOQOL(β≈-7.4). Having tertiary education and high income >MYR4850 (≈USD1158) were associated with lower EQ-VAS (β≈-10.3 and -16.0, respectively). An HIV transmission mode other than sex and intravenous drug use predicted significantly lower scores across all three HRQOL indicators. WHOQOL had a moderate positive correlation with EQ-5D (r=0.421) and a weaker correlation with EQ-VAS (r=0.265).</p><p><strong>Conclusion: </strong>PLHIV in Perlis, Malaysia reported generally good HRQOL despite the COVID-19 pandemic. Higher age and moderate income were associated with better WHOQOL, whereas higher education and income paradoxically lowered self-rated health (EQ-VAS). Multi-dimensional assessment (WHOQOL, EQ-5D, EQ-VAS) revealed consistent trends and underscores the importance of holistic care for PLHIV in pandemic conditions.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 3","pages":"332-336"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overview of paediatric cataract in Malaysia.","authors":"W Karimmah, I Shatriah","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Paediatric cataract is a leading cause of preventable childhood visual impairment in Malaysia. Despite a relatively strong healthcare system, delayed diagnosis and referral, particularly in rural areas, remain major challenges affecting visual outcomes. The condition may be congenital or acquired, with causes including genetic disorders, infections, metabolic diseases, and trauma. Surgical treatment, mainly lens aspiration with or without intraocular lens implantation, is effective, but visual prognosis depends on early intervention and adherence to amblyopia therapy. Malaysian studies show improved surgical outcomes, yet late presentation often leads to irreversible amblyopia. Strengthening screening programs and early referral systems is essential to reduce childhood blindness.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 3","pages":"329-331"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of computed tomography colonography following incomplete colonoscopy and its associated factors: A single-centre retrospective study.","authors":"M F Mohd Hayati, A A Abdul Wahid, M A T Shamsidi, A Hidrus, M S H Mohd Murad, L W Ong","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Incomplete colonoscopy presents an important clinical challenge, as segments of the colon that are not visualised may contain significant pathology. Computed tomography colonography (CTC) provides a minimally invasive alternative for comprehensive luminal evaluation, but local evidence regarding its diagnostic yield remains limited. This study aimed to evaluate the diagnostic yield of CTC following incomplete colonoscopy and to determine its associated factors with demography.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted among 93 adult patients who underwent CTC after incomplete colonoscopy between 2018 and 2023 at Hospital Tengku Ampuan Afzan, Kuantan. Patient demographics, prior surgical history, CTC findings and lesion characteristics were analysed using descriptive statistics, Chi-square and Fisher's exact tests.</p><p><strong>Results: </strong>CTC demonstrated a diagnostic yield of 21.5%. In this cohort, females accounted a 58.1% of the population. Polyps were the most frequent pathology, followed by diverticulosis, segmental wall thickening, and a single case of colorectal mass. Statistical analysis showed no significant association between abnormal findings and demographic factors such as age, gender, ethnicity, previous abdominal surgery, clinical indications, or most proximal colonoscopic intubation (p >0.05). Although statistical significance was not significant, abnormalities were more often detected in older patients and when colonoscopic intubation was confined to the rectosigmoid colon.</p><p><strong>Conclusion: </strong>CTC detected clinically important finding in more than one-fifth of patients, reconfirming its role as a valuable adjunct when colonoscopy is incomplete. These results showed polyps and diverticulosis as the main abnormalities with no clear predictors from patient factors. Larger prospective studies are needed to refine patient selection and optimise imaging quality in local setting.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 3","pages":"399-405"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologic drug survival in psoriasis: insights from a multi-center retrospective study in West Malaysia.","authors":"K V Chan, A A K Moonyza, A Mohd Affandi, M Mashor, J W Kwan, S Latha, H L Lee, S E Lee, E W Y Yap, A R Nazatul Shima, S B Wong, C S Lee, P Gunabalasingam","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Psoriasis is a chronic immune-mediated skin disorder with significant impact on patients' quality of life. Biologic therapies have revolutionized the treatment of moderate-to-severe psoriasis, but data on their long-term effectiveness, measured through drug survival rates, remains limited in Malaysia. This study aimed to analyze the drug survival of biologic therapies and identify factors influencing treatment discontinuation among psoriasis patients in Malaysia.</p><p><strong>Materials and methods: </strong>This retrospective cohort study analyzed 285 psoriasis patients receiving 437 biologic treatment courses in 10 tertiary hospitals in West Malaysia. Data on demographic characteristics, clinical profiles, and biologic treatments were collected and analyzed. Drug survival was evaluated using Kaplan-Meier analysis, and predictors of treatment discontinuation were identified using Cox proportional hazards modeling.</p><p><strong>Results: </strong>The study cohort had a mean psoriasis onset age of 28 (⊕ 13) years, with biologic initiation at 39 (⊕ 16) years. Secukinumab (53.7%) was the most commonly prescribed first-line biologic, followed by Ustekinumab (28.1%). Loss of efficacy was the leading cause of discontinuation, increasing from 49.6% in the first line to 100% by the fifth. Kaplan-Meier analysis showed Secukinumab had the longest mean survival (45.5 months), followed by Ustekinumab (41.4 months) and Rizankizumab (41.3 months). Cox regression revealed prior biologic use significantly increased discontinuation risk (HR = 1.415, p = 0.049), while diabetes mellitus approached significance increase discontinuation risk (HR = 1.575, p = 0.054).</p><p><strong>Conclusion: </strong>Biologic drug survival in Malaysian psoriasis patients reflects global trends, with Secukinumab demonstrating superior durability. Loss of efficacy and funding issues were key barriers to persistence. The findings emphasize the need for optimized treatment strategies with wider access to biological treatment.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"251-258"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming patient care: The QWIC system to optimise waiting times and efficiency in surgical outpatient clinics in Malaysia.","authors":"R Shariff, A A Harith, S C Tee, M S Jahit","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Waiting time at surgical outpatient clinics in Malaysian hospitals has become a critical concern, impacting patient satisfaction and overall healthcare efficiency. Many facilities face challenges leading to extended waiting periods for surgical consultations and procedures. These delays not only affect patient outcomes but also contribute to increased anxiety and frustration among patients. Implementing innovative solutions, such as advanced queue management systems, can play a significant role in operational workflows and reducing wait time. Thus, this study aims to determine the efficiency of waiting time using the Queue Won't Intimidate Customer (QWIC) system towards surgical outpatient clinics at the National Cancer Institute (NCI).</p><p><strong>Materials and methods: </strong>Data were collected retrospectively through a cross-sectional design over a six-month period, from April 1 to September 31, 2021, following the implementation of the QWIC system on 3 surgical clinics (bariatric clinic, general surgery (GS) clinic, and Upper gastrointestinal (UGI) clinic) under NCI. The Ministry of Health (MOH) established an acceptable waiting time benchmark of 60 minutes or less.</p><p><strong>Results: </strong>The most efficient clinic was GS (98.9%), followed by UGI (96.2%) and bariatric (83.4%). Based on logistic regression analysis, bariatric clinic (COR: 18.72, 95% CI: 6.51-51.28, p < 0.001; AOR: 15.33, 95% CI: 5.32-44.13, p <0.001) and new surgical cases (COR: 3.19, 95% CI: 1.96- 5.22, p < 0.001 and AOR: 2.56, 95% CI: 1.42-4.52, p = 0.001) are strongly associated with longer waits. UGI clinic also show increased waiting times (COR: 3.67, 95%CI: 1.23:10.94, p = 0.020; AOR: 3.34, 95% CI: 1.12-10.02, p = 0.031). Conversely, consultation durations over 60 minutes and attendance status did not significantly affect waiting times.</p><p><strong>Conclusion: </strong>The QWIC System represents a significant advancement in managing patient appointments and consultations within surgical clinics. Overall, types of surgical clinic and case status were key factors influencing waiting times in surgical clinics.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"313-320"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a new quality of life instrument for children with infantile esotropia before and after strabismus surgery.","authors":"H Waheeda-Azwa, N B Hassan, S Abdullah, J Che-Hamzah, I Shatriah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Infantile esotropia impacts the quality of life (QOL) of children and their families. In addition to surgical treatment, QOL assessment is an important tool for evaluating treatment success. Thus, this study aimed to assess QOL before and after strabismus surgery using the newly developed Infantile Esotropia Quality of Life Questionnaire (IEQ).</p><p><strong>Materials and methods: </strong>A prospective study was conducted from September 2018 to June 2019 at the Ophthalmology Clinic, Hospital Pakar Universiti Sains Malaysia. Children aged 5-17 years diagnosed with infantile esotropia were recruited. QOL and clinical examinations were measured pre- and post-strabismus surgery. The comparison of QOL scores before and after surgery was analysed using the paired t-test.</p><p><strong>Results: </strong>A total of 126 children participated in the study: 63 aged 5-8 years and 63 aged 9-17 years. Strabismus surgery significantly improved the QOL scores in both age groups. In the younger group, scores increased from 68.00 preoperatively to 89.36 postoperatively (P < 0.001), while in the older group, scores increased from 78.07 to 90.21 (P < 0.001). No significant association was found between QOL scores and gender, angle of deviation, or stereopsis (P > 0.05).</p><p><strong>Conclusion: </strong>Strabismus surgery significantly improved the quality of life in children with infantile esotropia in both age groups. The IEQ tool is a useful instrument for assessing functional and psychosocial outcomes in this population. Gender, ocular deviation, and stereopsis did not appear to influence QOL outcomes.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"273-279"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total corneal astigmatism magnitude and vector orientation in diabetic and non-diabetic Malay eyes.","authors":"A S Afira, M A Ahmad, M S Ibrahim, S Adzahar, M K Khairidzan, M Hudzaifah-Nordin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The influence of diabetes mellitus (DM) on total corneal astigmatism (TCA) remains incompletely understood. Using total keratometry (TK), this study characterised TCA magnitude and orientation in a Malay adult population and evaluated the influence of metabolic control and ocular parameters on TCA.</p><p><strong>Materials and methods: </strong>This cross-sectional study analysed 190 eyes (88 non-diabetic; 102 diabetic). TCA magnitude and axis were derived from TK obtained using swept-source optical coherence tomography (IOLMaster 700, Carl Zeiss Meditec, Germany) and decomposed into power-vector components; J0 (horizontal/vertical) and J45 (oblique). Corneal endothelial parameters were measured using specular microscopy (Topcon SP-1P, Japan). Group comparisons were performed using Welch's t-test. Within diabetic eyes, linear regression models identified independent predictors of TCA magnitude and orientation, adjusting for age, glycated haemoglobin (HbA1c), DM duration, cumulative metformin exposure, central corneal thickness, endothelial cell density, and white-to-white diameter.</p><p><strong>Results: </strong>TCA magnitude did not differ significantly between diabetic and non-diabetic eyes (p = 0.066). Vector analysis demonstrated no significant between-group difference in J0 or J45, with substantial vector centroid overlap. In diabetic eyes, higher HbA1c was independently associated with greater TCA magnitude, while increasing age was independently associated with a shift towards more negative J0 values. DM duration and metformin exposure were not independently associated with TCA magnitude or vector components.</p><p><strong>Conclusion: </strong>Diabetes status alone was not associated with systematic differences in TCA magnitude or orientation. Age and metabolic control were the strongest factors associated with TCA characteristics. Vector-based analysis provides a robust framework for astigmatism assessment in diabetic and non-diabetic eyes.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"297-303"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}