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All Journal Indonesian Journal of Obstetrics & Gynecology Science Narra J COMSERVA: Jurnal Penelitian dan Pengabdian Masyarakat Society: Jurnal Pengabdian Masyarakat Jurnal Pendidikan dan Pengabdian Masyarakat
Munizar Munizar, Munizar
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Humanities Biochemistry, Genetics & Molecular Biology Computer Science & IT Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Languange, Linguistic, Communication & Media Medicine & Pharmacology Public Health Social Sciences Other

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Journal : Narra J

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Evaluating serum cyclooxygenase-2 and vascular endothelial growth factor as biomarkers for endometriosis severity in reproductive-age women Aslam, Aga; Rajuddin, Rajuddin; Munizar, Munizar; Rusnaidi, Rusnaidi; Hasanuddin, Hasanuddin
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.2984

Abstract

Endometriosis affects approximately 10–15% of reproductive-age women and up to 70% of those with chronic pelvic pain, with diagnosis typically relying on invasive laparoscopy with histopathological confirmation. Cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) are central mediators of the inflammatory and angiogenic pathways underpinning endometriosis pathogenesis, making them promising candidates for non-invasive biomarkers. This study aimed to analyze the correlation between serum COX-2 and VEGF concentrations and endometriosis severity to evaluate their potential utility as non-invasive biomarkers. A cross-sectional study was conducted among women with confirmed endometriosis at Dr. Zainoel Abidin General Hospital in Banda Aceh, Indonesia, in 2025. Peripheral blood samples were collected preoperatively, and serum COX-2 and VEGF concentrations were quantified using ELISA. Endometriosis severity was classified according to the American Society for Reproductive Medicine staging system. Correlation analyses were performed to assess associations between biomarker levels and disease stage, and diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis to determine the area under the curve (AUC) values, optimal cut-off points, sensitivity, and specificity. Twenty-eight patients were included, with the mean COX-2 and VEGF levels being 1.16±1.28 ng/mL and 266.50±72.91 pg/mL, respectively. VEGF demonstrated a strong and statistically significant correlation with endometriosis staging (r=0.744, p<0.001), while COX-2 showed a limited correlation that did not reach statistical significance (r=0.367, p=0.055). The ROC analysis further highlighted VEGF’s superior diagnostic performance, with an AUC of 0.975 (95%CI: 0.926–1.000, p<0.001) compared with COX-2 (AUC 0.734; 95%CI: 0.518–0.950, p=0.057). The optimal VEGF threshold of 221 pg/mL yielded 90% sensitivity and 100% specificity, whereas the COX-2 threshold of 0.675 ng/mL provided 80% sensitivity and 62.5% specificity. These findings indicate that VEGF is a highly promising non-invasive biomarker for assessing endometriosis severity and may support the development of improved diagnostic approaches for endometriosis management.
Relationship between serum CA125, prolactin and cortisol levels with disease stage and pain level in endometriosis patients Fasha, Teuku A.; Rajuddin, Rajuddin; Dewi, Tgk. Puspa; Rusnaidi, Rusnaidi; Munizar, Munizar
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.2988

Abstract

Endometriosis affects approximately 10% of women of reproductive age and is characterized by the presence of endometrial tissue outside the uterine cavity. Diagnostic delays are common due to nonspecific symptoms and the absence of reliable biomarkers. Serum CA125, prolactin, and cortisol have been implicated in the pathophysiology of endometriosis through inflammatory, neuroendocrine, and stress-response mechanisms. However, their role as biomarkers in endometriosis remains poorly studied. This study aimed to investigate the relationships between serum CA125, prolactin, and cortisol levels with endometriosis staging and pain severity in endometriosis patients. A cross-sectional study was conducted at Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia, involving women with laparoscopically confirmed endometriosis. Serum CA125, prolactin, and cortisol levels were measured using electrochemiluminescence immunoassay (ECLIA). Disease staging followed the American Society for Reproductive Medicine (ASRM) classification, and pain severity was assessed using the Numeric Rating Scale (NRS). Statistical analyses were performed using the Spearman correlation test. A total of 30 women with confirmed endometriosis were included in this study, with a mean age of 37.2 years. Endometriosis stages were distributed as stage II (20.0%), stage III (16.7%), and stage IV (63.3%), and the mean pain score was 5.60±1.48. Elevated serum biomarker levels were observed with CA125 of 72.65±55.39 U/mL, prolactin of 1456.77±1799.79 μIU/mL, and cortisol of 341.92±189.02 nmol/L. The serum CA125 level was positively correlated with endometriosis staging (r=0.580, p=0.001) but not with pain severity. Prolactin and cortisol had no significant correlations with disease stage or pain severity (all p>0.05). This study shows that serum CA125 levels are significantly correlated with endometriosis staging, supporting its potential as a biomarker of disease progression. Although prolactin and cortisol levels were elevated, their lack of association with clinical parameters suggests broader neuroendocrine dysregulation rather than direct markers of disease severity.
Comparison of interleukin-6 and serum creatinine levels in preeclampsia and normal pregnancy patients: A cross-sectional study in Indonesia Dewi, Syerli R.; Yeni, Cut M.; Munizar, Munizar; Dewi, Tgk. Puspa; Utami, Niken A.; Rusnaidi, Rusnaidi
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.3016

Abstract

Preeclampsia (PE) is a complication of pregnancy with high morbidity and mortality, characterized by endothelial dysfunction, systemic inflammation, and impaired renal function. Interleukin-6 (IL-6) and serum creatinine have potential as biomarkers for early detection of PE; however, data from Indonesia are limited. The aim of this study was to compare IL-6 and serum creatinine levels between pregnant women with PE and normotensive controls, as well as their diagnostic performance in identifying PE. A cross-sectional study involving pregnant women with PE and normotensive controls was conducted at Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia. Serum IL-6 and creatinine levels were measured using the ECLIA method. Levels were compared using the Mann–Whitney test; diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis, and multivariable logistic regression was used to evaluate combined diagnostic contribution. A total of 68 pregnant women were included, comprising 34 patients with PE and 34 normotensive controls. Median IL-6 levels were significantly higher in the PE group (16.05 pg/mL) than in the control group (3.71 pg/mL). Receiver operating characteristic analysis demonstrated excellent diagnostic performance of IL-6, with an are under the curve (AUC) of 0.831 (95%CI: 0.734–0.929). At an optimal cutoff value of 5.52 pg/mL, IL-6 achieved a sensitivity of 73.53%, specificity of 76.47%, and diagnostic accuracy of 86.76%. Median serum creatinine levels were also significantly elevated in the PE group (0.56 mg/dL) compared with controls (0.44 mg/dL; p<0.001). The AUC for serum creatinine was 0.806 (95%CI: 0.700–0.912), indicating good diagnostic performance. At a cutoff value of 0.475 mg/dL, serum creatinine demonstrated a sensitivity of 70.59%, specificity of 73.53%, and accuracy of 72.06%. Multivariable logistic regression confirmed that IL-6 (B=0.123; p=0.005) and serum creatinine (B=9.306; p=0.023) were independently associated with PE, explaining 57.5% of PE variability (Nagelkerke R²=0.575). These findings indicate that serum IL-6 and creatinine are significantly associated with PE, and their combined assessment shows potential as a predictive biomarker with good diagnostic performance.
Multi-stakeholder perspectives on cervical cancer screening implementation in Indonesia: A qualitative study of cervical screening barriers in Banda Aceh Yolanda, Febrina; Dewi, Tgk. Puspa; Nainggolan, Sarah I.; Munawar, Munawar; Munizar, Munizar; Bulqini, Rijal; Suhanda, Rachmad; Rusnaidi, Rusnaidi
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.3022

Abstract

Indonesia is committed to the WHO's cervical cancer elimination strategy through the National Action Plan (RAN) 2023–2030, targeting 75% screening coverage by 2030. However, current rates remain critically low at 7.02%. This study explores multi-stakeholder perspectives to identify implementation barriers and facilitators for policy enhancement. A qualitative descriptive case study was conducted in Banda Aceh (July-August 2025) involving 25 stakeholders: City Health Office Head, 11 puskesmas heads, 11 VIA coordinators and 2 community organization representatives. Thematic analysis using NVivo v.16 identified key implementation factors. Five major themes emerged: (1) Knowledge gaps—screening perceived necessary only when symptomatic despite available information; (2) Access paradox—excellent geographic access and flexibility undermined by limited examination rooms, insufficient midwives, and psychosocial barriers (shame, fear, lack of spousal support); (3) Financial sustainability—free services threatened by complex BPJS claims and low reimbursement affecting logistics; (4) Service quality variation—dependent on cross-sector collaboration and staff competency, with uneven training and limited cryotherapy (only 2 centers); and (5) Communication challenges—inconsistent digital media use necessitates face-to-face counseling and cadres, though reach remains limited. Implementation faces psychological barriers, capacity limitations, and uneven digital adoption despite strong infrastructure. Priority policy recommendations include: (1) HPV DNA self-sampling to overcome privacy barriers; (2) simplified BPJS claims with adequate reimbursement; (3) systematic competency-building and cryotherapy expansion; and (4) culturally-adapted education integrating local language and religious leaders. These evidence-based enhancements could accelerate Indonesia's RAN 2030 elimination targets.
Co-Authors Aslam, Aga Bulqini, Rijal Cut M. Yeni Dewi, Syerli R. Dewi, Tgk. Puspa Fasha, Teuku A. Febrina Yolanda Hasanuddin Hasanuddin Hendryan, Derevie Ika Amalia, Ika Mullah, Ikram Munawar Munawar Nainggolan, Sarah I. Nur Afni Safarina, Nur Afni Rachmad Suhanda Rahmayani, Fera Rahmia Dewi, Rahmia Rajuddin Rajuddin Rusnaidi Safuwan, Safuwan Salmiah Salmiah Utami, Niken A. Utami, Niken Asri Widi Astuti