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All Journal Medicinus : Jurnal Kedokteran Narra J
Huang, Ian
Unknown Affiliation
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Association between triglyceride-glucose index and hypertension: A systematic review and meta-analysis Lukito, Antonia A.; Kamarullah, William; Huang, Ian; Pranata, Raymond
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.951

Abstract

The triglyceride-glucose (TyG) index is a simple and reliable indicator of insulin resistance, which is an important contributor to the development of hypertension. The aim of this meta-analysis was to determine the dose-response association between the TyG index and the incidence of hypertension. An extensive search was conducted through several databases, including PubMed, EMBASE, ScienceDirect, and Scopus until June 1, 2024. The TyG index was used as the exposure, and the incidence of hypertension was measured throughout the TyG index intervals. The effect estimates were presented as odds ratios (OR) in both the unadjusted and adjusted models. Adjusted OR were carried out from all included studies to eliminate the possibility of confounding factors being involved in the incidence of hypertension. A total of 108.936 participants (mean age: 48.2 years old, male sex: 47%, mean body mass index: 23.9 kg/m2) from 14 observational studies were included. The TyG index in the most eminent category was related to a higher risk of hypertension in both unadjusted (OR: 2.59, 95%CI: 2.03–3.31, p<0.001; I2: 97.1%, p<0.001) and adjusted model (OR: 1.74, 95%CI: 1.39–2.19, p<0.001; I2: 92.2%, p<0.001). Dose-response meta-analysis for the adjusted OR showed that the linear association analysis was not significant per 0.1 increase in the TyG index. The dose-response curve became increasingly steeper at the TyG index above 8.5. In conclusion, the TyG index was shown to be strongly linked with hypertension in a non-linear dose-response manner.
Addressing Uncontrolled Symptoms and Communication Gaps in a Patient with Metastatic Cholangiocarcinoma: Lessons from a Palliative Care Case Huang, Ian
Medicinus Vol. 14 No. 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i2.9553

Abstract

Background : Timely integration of palliative care is essential in managing advanced cancer patients, addressing both physical symptoms and psychosocial distress. Delayed communication of prognosis and inadequate symptom control can result in unnecessary suffering for patients and emotional distress for their families. Case Presentation : We report a 49-year-old male with metastatic cholangiocarcinoma, admitted with severe abdominal pain, nausea, and vomiting. He had undergone a Longmire procedure and gastrojejunostomy three weeks prior. Despite surgical intervention, his symptoms remained poorly controlled. Upon assessment, he expressed fear of death, while his wife struggled with the emotional burden of his prognosis, indicating a lack of prior communication regarding his terminal condition. Symptom management included oral morphine for pain and a combination of ondansetron, omeprazole, and haloperidol for nausea and vomiting, leading to improved symptom control. However, his condition deteriorated with pneumonia and respiratory failure, marking the transition to end-of-life care. He passed away peacefully 15 days after admission. Discussion : This case highlights the consequences of delayed prognosis disclosure and inadequate early symptom management. The absence of structured communication contributed to family distress, underscoring the importance of models like SPIKES in breaking bad news. The need for a multidisciplinary palliative care approach, including psychological support and optimized opioid management, was evident. Conclusions : Early palliative care involvement, proactive symptom control, and clear communication of prognosis are crucial in advanced cancer care. Establishing a dedicated palliative care team can improve quality of life, facilitate shared decision-making, and enhance end-of-life experiences for patients and families.
Tatalaksana Penurunan Kesadaran Pada Penderita Diabetes Mellitus Huang, Ian
Medicinus Vol. 6 No. 1 (2016): October 2016 - January 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i1.1139

Abstract

Hyperglycemic crisis (diabetic ketoacidosis or hyperosmolar hyperglycemic state), lactic acidosis, hypoglycemia, and uremic encephalopathy are life-threatening complications of diabetes mellitus (DM). Specific therapies of each condition are essential in reducing mortality rate of the complications.
Patofisiologi dan Diagnosis Penurunan Kesadaran pada Penderita Diabetes Mellitus Huang, Ian
Medicinus Vol. 5 No. 2 (2016): February 2016 - May 2016
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v5i2.1169

Abstract

Loss of consciousness (LOC) is a clinical presentation of patients with diabetes mellitus (DM) in emergency department which is caused by complications of the disease. Diabetic ketoacidosis, hyperosmolar hyperglycemic state, lactic acidosis, uremic encephalopathy, and hypoglycemia are the several main causes of LOC in patients with DM.  The comprehension of pathophysiology of LOC in patients with DM will be helpful in making accurate diagnosis. History taking, physical examination, and laboratory tests are essential in diagnosing that particular condition. Key Words: loss of consciousness, diabetes mellitus, hyperglycemic crisis, hypoglycemia
Co-Authors Kamarullah, William Lukito, Antonia A. Pranata, Raymond