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Narra J
Published by PT Narra Sains Indonesia
ISSN : -     EISSN : 28072618     DOI : https://doi.org/10.52225/narraj
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health
Narra J is a multidisciplinary journal and it is published three times (April, August, December) a year. The objective is to promote articles on infection, public health, global health, tropical infection, one health and diseases in tropics. Narra J publishes original research work across all disciplines of medicine and allied sciences, related to infection, public health, global health, tropical infection, one health and diseases in tropics. The journal publishes Original articles, Short Report, Review articles, and Letters to the Editor. All articles published in Narra J are peer-reviewed and published online for immediate access and citation. Narra J publishes the primary research papers, review articles, short communications and letters on topics but not limited to: Public health Global health Infection Tropical diseases One health Biomedical sciences Epidemiology and clinical epidemiology Molecular biology Environmental health Microbiology Pharmacological sciences Diseases in tropics
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 565 Documents
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Factors associated with the quality of life and persistent dyspnea severity in COVID-19 survivors: A cross-sectional study among healthcare workers Sinaga, Joshua P.; Sinaga, Bintang YM.; Siagian, Parluhutan; Eyanoer, Putri C.; Unata , Iduh M.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.419

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has a significant impact on global health. The alterations in quality of life (QoL) and the persistent symptom of dyspnea have been the healthcare workers’ challenges during and after the pandemic. The aim of this study was to assess factors associated with the QoL and persistent dyspnea experienced by COVID-19 survivors, particularly among healthcare workers. A cross-sectional study was conducted among healthcare workers at H. Adam Malik Hospital, Medan, Indonesia, using direct interviews to collect the data. The EuroQol 5-dimensional 5-level (EQ-5D-5L) and the self-assessment EuroQol-visual analog scale (EQ-VAS) were used to assess the QoL of the healthcare workers; and persistent dyspnea was evaluated using the modified Medical Research Council (mMRC) scale. Possible risk factors such as demographic characteristics, clinical characteristics (comorbidities, history of hospitalization, oxygen usage, history of COVID-19 vaccination, the severity of previous COVID-19, existence of post-COVID syndrome) and the symptoms of the post-COVID syndrome were collected. Chi-squared test or Fisher’s exact test were used to identify the risk factors associated with the QoL and persistent dyspnea. A total of 100 healthcare workers were included in the study and 2% of healthcare workers experienced pain/discomfortand 4% experienced anxiety/depression. The average healthcare worker’s EQ-VAS score was 87.6±8.1. There was no significant association between studied demographics and clinical characteristics with QoL dimensions. However, post-COVID symptoms of activity limitation (p=0.004), sore throat (p=0.026), headache (p=0.012), myalgia (p=0.006), and arthralgia (p=0.001) were associated with pain/discomfort dimension of QoL. In addition, there was a significant association between activity limitation (p=0.012), headache (p=0.020), myalgia (p=0.015) and arthralgia (p=0.032) with anxiety/depression dimension of QoL. Our data suggested that the presence of post-COVID syndrome (p=0.006) and the presence of post-COVID syndrome symptoms of cough (p=0.021) and fatigue (p=0.015) were associated with the persistent dyspnea. In conclusion, this study suggests that the presence of post-COVID syndrome and its symptoms are associated with low quality of health-related QoL and persistent dyspnea. Therefore, cautions are needed for such patients to prevent low QoL in the future.
Effectiveness of adequate chicken egg white consumption on dyspnea degree and exacerbation incidence in stable COPD patients practicing strength and endurance exercises Monica, Nanda S.; Tarigan, Amira P.; Pradana, Andika; Mutiara, Erna; Pandia, Pandiaman; Sinaga, Bintang YM.; Sihombing, Benny; Rhinsilva, Ella; Zulkarnain, Zulkarnain; Listyoko, Aditya S.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.420

Abstract

Lack of physical exercise and inadequate nutritional intake in chronic obstructive pulmonary disease (COPD) patients could lead to low muscle mass and function, which causes reduced respiratory function, increased incidence of exacerbations, exercise intolerance, increased visits to health facilities, and low health status. Therefore, physical exercise and good nutritional intake are the main foundations of a comprehensive pulmonary rehabilitation program for COPD patients. The aim of the study was to determine the effect of chicken egg white supplementation on dyspnea degree and the incidence of exacerbations in stable COPD patients who perform physical exercise independently at home. A quasi-experimental study was conducted in 38 stable COPD patients based on the Global Initiative for Chronic Lung Disease (GOLD) 2021 classification criteria. The patients were divided into two groups: the control group who did smartphone application-assisted physical exercises and the intervention group who did the same physical exercises plus chicken egg white supplementation for 12 weeks. Performed physical exercises included both strength and endurance training. The degree of dyspnea was assessed with modified Medical Research Council (mMRC) dyspnea scale and the incidence of exacerbations was assessed by direct interviews at the beginning and at the end of the intervention. A Fisher’s exact test was used to assess the association between the intervention with dyspnea degree and exacerbation incidence. In the intervention group, chicken egg white supplementation for 12 weeks lowered the dyspnea degree by 3.16 times than the control (relative risk 3.16 with p=0.001). Furthermore, the incidence of exacerbations was also reduced by 1.8 times compared to the control group (relative risk 1.8, p=0.001). This study highlights a significant improvement in dyspnea degree and exacerbation incidence in COPD patients with the combination of protein supplementation and physical exercise. Therefore, adding chicken egg white intake could be beneficial for stable COPD patients practicing physical exercises.
Characterization of red algae (Gracilaria verrucosa) on potential application for topical treatment of oral mucosa wounds in Rattus norvegicus Hakim, Rachmi F.; Idroes, Rinaldi; Hanafiah, Olivia A.; Ginting, Binawati; Kemala, Pati; Fakhrurrazi, Fakhrurrazi; Putra, Noviandi I.; Shafira, Ghina A.; Romadhoni, Yenni; Destiana, Khaerunisa; Muslem, Muslem
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.422

Abstract

Wound healing in the mouth has its challenges due to masticatory movements and the presence of bacteria that can inhibit its process. The aim of this study was to analyze the contents of red algae (Gracilaria verrucosa) from Indonesia, and its potential as a wound-healing agent for oral wounds using animal model. Red algae content was determined by phytochemical tests and gas chromatography-mass spectroscopy (GC-MS). The wound was made by making an incision on the gingival mucosa of Rattus norvegicus and the parameters assessed were bleeding time, number of fibroblast cells, and time of wound closure. Three doses of G. verrucosa gel were used (2.5%, 5%, and 10%) and the gels were applied twice a day, at 6:00 and 18:00. Application was carried out topically by applying 0.1 ml of gel to the incision wound using a 1 mL syringe. Our phytochemical test indicated that the G. verrucosa contained alkaloids, steroids, flavonoids, and phenols. The dominant contains of the G. verrucosa were glycerol (36.81%), hexadecenoic acid (20.74%), and cholesterol (7.4%). The hemostasis test showed that the 2.5% G. verrucosa extract gel had the shortest bleeding time, 33.98±5.33 seconds. On the seventh day of the initial proliferation phase, the number of fibroblasts was not significantly different among groups. On day 14, the number of fibroblasts was only significantly different between 10% G. verrucosa and untreated group (p=0.007). On day 28, however, both 5% and 10% G. verrucosa were significantly higher compared to untreated group, both had p=0.010. Daily clinical examination showed that animals that were given 2.5% and 5% of G. verrucosa extract gel experienced wound closure on day 10. Animals treated with 10% of extract gel, all wounds healed on day 9. This study suggested that G. verrucosa extract could accelerate wound closure and wound healing.
A pediatric case and literature review of mucormycosis: Diagnostic and treatment challenges in a resource poor setting Lubis, Inke ND.; Farah, Sara; Pasaribu, Ayodhia P.; Evalina, Rita; Daulay, Rini S.; Wijaya, Hendri
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.426

Abstract

Mucormycosis is an emerging disease that primarily affects immunocompromised patients; however, it has also been reported in immunocompetent individuals. Studies in the pediatric population are limited and reported mostly in case studies or series. The aim of this case report is to present a pediatric mucormycosis originated from Sumatra Island, Indonesia. A 13-year-old boy was referred to a tertiary hospital with facial necrosis involving the nasal, oral, and left maxillary areas, as well as left periorbital edema. No known underlying conditions were documented. The diagnosis was confirmed by histopathological findings of broad, pauci-septate, ribbon-like hyphae branching at 90°. The patient was managed by a multidisciplinary team consisting of the ear, nose, and throat, infectious diseases, dermatology, surgery, microbiology, and pathology departments. Management of the patient included debridement of the necrotic lesion and antibiotics and anti-fungal (fluconazole). Due to unavailability, the patient was not treated with amphotericin B. The patient died after 30 days of admission. This case highlights the importance of maintaining a high suspicion of invasive mucormycosis, even in immunocompetent children, when symptoms and signs are present, especially in resource-limited settings.
Treatment-seeking behavior for malaria among communities in Indonesia: A systematic review Philothra, Biodya D.; Alona, Ivana; Situmorang, Elizabeth; Limbardon, Patrick; Salsalina, Viktris G.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.428

Abstract

Indonesia stands as one of the nine malaria-endemic countries in Southeast Asia with a total of 443,530 cases in 2022. Eastern Indonesia is listed as an area with high malaria endemicity and the Indonesian government has set a target of eliminating malaria by 2030. From 2010 to 2014, the number of malaria cases decreased but stagnated until 2020 and have continued to increase. Stagnation may occur as a result of many non-medical treatment-seeking behaviors. The aim of this systematic review was to provide a summary and overview of malaria treatment-seeking behavior among communities in several regions in Indonesia. The searches were conducted through four databases (Cochrane, PubMed, Google Scholar, and ScienceDirect) using medical subject headings (MeSH) "treatment-seeking behavior" OR "health-seeking behavior" AND "malaria" AND "Indonesia". This systematic review was limited to studies conducted in Indonesia that were published between 2013 and 2023 using either a quantitative or qualitative approach. Out of 2831 studies, a total of thirteen studies were included. The pattern of seeking malaria treatment varied between doing nothing or no action, self-treatment (purchasing drugs at pharmacies and consuming leftover medicines), traditional medicine, and medical treatment (public health facilities or malaria control clinics). Those behaviors are attributed to education level, socioeconomic level, occupation, distance from home to health facilities, geographical conditions, and people's perceptions of malaria and antimalarial medicines. There is still a range of malaria treatment-seeking behavior outside of recommended medical treatment in communities in several regions in Indonesia. The phenomenon of medical pluralism and syncretism requires approaches from various sectors in order to achieve a malaria-free Indonesia by 2030.
Antifungal activity of Durio zibethinus Murray peel extract against Candida albicans: A preliminary study Siregar, Syifa S.; Adella, Cut A.; Enitan, Seyi S.
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.429

Abstract

The incidence of antifungal resistance to Candida albicans infections has been growing over the past years; therefore, innovations are required to develop medicinal plants with antifungal properties such as durian fruit peels (Durio zibethinus Murray) that contain significant of bioactive compounds with antifungal properties. The aim of this study was to determine the antifungal activity of D. zibethinus fruit peel extract against C. albicans by analyzing the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). A post-test only control group experiment was conducted from July to October 2020. D. zibethinus peel was collected from Simalungun Regency, Medan, Indonesia, and extracted by maceration technique using 70% ethanol to obtain D. zibethinus peel ethanol extract (DPEE). Samples of C. albicans were obtained from the Laboratory of Microbiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. The diffusion method was used to determine the antifungal activity. Six groups with different concentrations of DPEE (6.25%, 12.5%, 25%, and 50%), ketoconazole (positive control) and dimethyl sulfoxide (negative control) were exposed to C. albicans in six replicates. Six lower concentrations (12.5%, 6.25%, 3.12%, 3%, 1.56%, and 0.78%) were divided to perform the liquid dilution method to obtain the MIC and affirmation test for MBC. The diameter of the inhibition zone was analyzed using one-way ANOVA and the Tukey post-hoc test for differences between concentrations. Our data indicated that the DPEE 6.25% had the largest inhibition zone (17.26±5.64 mm) and the inhibition zones were significant different among concentrations of DPEE (p<0.05). Furthermore, the DPEE had a MIC of 0.78% and MBC of 3.125% against C. albicans. This study highlights that the ethanol extract of D. zibethinus has potential antifungal activity against C. albicans. However, a further study is needed to determine its antifungal activities in more precise manner.
Vitamin D3 induces stem cell activation via Lgr5-Bmi1 expression and improving mouse colitis histology index Wibowo, Satrio; Pramadhani, Almira; Subandiyah, Krisni; Handono, Kusworini; Poeranto, Sri
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.430

Abstract

Conventional therapy for inflammatory bowel disease using long-term anti-inflammatory drugs does not seem to provide optimal results. Adjuvant therapy using vitamin D3 is believed to have an essential role in repairing the colonic mucosa through the activation of colonic stem cells. The aim of this study was to demonstrate the effect of vitamin D3 in mucosal repair through stem cell activation, marked by leucin-rich repeat-containing G protein-coupled receptor 5 (Lgr5) and B lymphoma Mo-MLV insertion region 1 (Bmi1) expression and decrease the mouse colitis histology index (MCHI) score. In this study, 50 Mus musculus strain BALB/c were divided into five groups: negative control group, colitis group, and colitis groups with vitamin D3 administration of 0.2 mcg, 0.4 mcg, and 0.6 mcg per 25 g body weight for seven days. Dextran sulfate sodium (DSS) 5% was used to induce colitis. Lgr5-Bmi1 expression was measured using immunodoublestain fluorescent labeling method. Our data suggested that administration of vitamin D3 significantly increased expression of Lgr5-Bmi1 in the colonic mucosa. The colitis group treated with the highest dose of vitamin D3 (0.6 mcg/25 gram) showed the lowest MCHI score (3.60±0.64) while the lowest dose of vitamin D3 had the highest MCHI score (12.60±1.47). In conclusion, stimulating stem cells, vitamin D3 administration stimulates mucosal regeneration, as demonstrated by upregulated expression of Lgr5-Bmi-1.
Characteristics and susceptibility pattern of catheter-associated urinary tract infections (CAUTI) bacteria in Indonesia: A study in a national reference hospital of Sumatra region 2020–2021 Perdana, Muhammad A.; Wahyuni, Dian D.; Yunita, Rina
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.436

Abstract

Catheter-associated urinary tract infection (CAUTI) is defined as a urinary tract infection associated with catheter placement for more than two consecutive days. Hence, antibiotic resistance in the context of CAUTIs represents a substantial challenge. The aim of this study was to present the characteristics of patients with CAUTI and the susceptibility pattern of CAUTI bacteria in the national reference hospital of the Sumatra region of Indonesia. A cross-sectional study was conducted at H. Adam Malik General Hospital, Medan, Indonesia, from 2020 to 2021, using a total sampling. All CAUTI patients included were on catheterization and diagnosed based on the Centers for Disease Control and Prevention (CDC) guidelines. The patient’s urine culture and antibiotic susceptibility test were carried out on the patient’s admitted urine sample for further assessment. Identification of bacteria, antibiotic susceptibility test, and the extended-spectrum beta-lactamase (ESBL) test for Escherichia coli and Klebsiella pneumoniae were conducted using the VITEK-2 Compact. A total of 74 CAUTI patients were included in the study, 59.5% were female, 54.1% were 46–65 years old, and a third had cardiovascular disease comorbidities (33.8%). A total of 83 CAUTI-associated bacteria were isolated. The majority were Gram-negative bacteria (74.7%), and the most bacteria isolated was E. coli (31.3%), followed by K. pneumoniae, Enterococcus faecalis, Acinetobacter baumannii, and Enterococcus faecium. The ESBL test was positive mostly in K. pneumoniae (100%) and E. coli (76.9%). CAUTI-associated E. coli was susceptible to tigecycline, meropenem, ertapenem, nitrofurantoin, and gentamicin. The isolated K. pneumoniae was susceptible to tigecycline, meropenem, ertapenem, and amikacin. While E. faecalis showed susceptibility to tigecycline, nitrofurantoin, vancomycin, imipenem, linezolid, ampicillin, piperacillin/tazobactam, amoxicillin/clavulanic acid, ampicillin/sulbactam, and piperacillin.
Factors associated with small airway obstruction in COVID-19 survivors: A cross-sectional study among health-care providers Aritonang, Minarni ES.; Pandia, Pandiaman; Pradana, Andika; Ashar, Taufik
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.437

Abstract

Coronavirus disease 2019 (COVID-19) has been identified for more than two years, yet studies assessing post-infection lung function are limited. Reports on lung function in COVID-19 patients indicate that patients have restrictive defects and small airway dysfunction that can persist and are not necessarily related to the severity of the disease. The aim of this study was to assess the incidence of small airway obstruction and its incidence-associated factors among COVID-19 survivors to better describe the long-term effects of COVID-19. A cross-sectional study was conducted among COVID-19 survivors who less than 50 years at Medan Adventist Hospital between 2020–2022. The data were collected through interview, direct assessment and respiratory examination. A total of 89 COVID-19 survivors were recruited of which the majority of them were female with a mean age of 32.6-year-old with the largest group was 19–30 years. The comorbidities found among the survivors were heart and thyroid disorders, with the most common symptom of post-COVID-19 was fatigue. Most of them had mild COVID-19. The mean forced mid-expiratory flow (FEF25–75%) was 96.3±20.22, with an incidence rate of small airway obstruction was 19.1%. Univariate and multivariate analyses indicated no significant association between age, gender, comorbidities, history of oxygenation during COVID-19 treatment, COVID-19 severity and the type of post COVID-19 syndrome symptoms with the incidence of small airway obstruction. In conclusion, among COVID-19 survivors who were less than 50 years old, those studied variables seems have less association with the incidence of small airway obstruction. Nevertheless, a further study with a bigger sample size is important to be conducted.
Correlation between serum vitamin D levels and bone mass density evaluated by radiofrequency echographic multi-spectrometry technology (REMS) in menopausal women Siregar, M. Fidel G.; Jabbar, Feisal; Effendi, Iman H.; Alhair, Tanzil; Prabudi, Muhammad O.; Faradina, Dwi
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.452

Abstract

Osteoporosis is a common condition associated with an increased risk of bone fractures due to fragility. Bone mineral density (BMD) is lower in menopausal women due to estrogen deficiency, age-related decline in osteoblast function, decreased calcium absorption, and reduced synthesis of vitamin D, which lead to osteoporosis. The aim of this study was to determine the correlation between serum vitamin D levels and BMD assessed using radiofrequency echographic multi-spectrometry technology (REMS) in menopausal women. A cross-sectional study was conducted at Prof. Dr. Chairuddin P. Lubis Hospital of Universitas Sumatera Utara, Medan, Indonesia, from May 2023 to August 2023. Consecutive sampling method was employed to sample menopausal women with no history of hysterectomy or oophorectomy (unilateral or bilateral), and no history of hormone replacement therapy or vitamin D supplementation. Interviews and physical examinations were conducted to obtain the characteristics of the subjects (age, duration of menopause, and body mass index). The 25(OH)D level was measured using immunoassay and REMS examination was conducted to assess BMD. The Spearman correlation test was used to assess the correlation between serum vitamin D levels and BMD. A total of 32 menopausal women were included in this study with the average vitamin D level was 18.05±5.81 ng/mL, and the mean BMD level was -2.13±1.23. The data showed a significant positive correlation between serum vitamin D levels and BMD in menopausal women (r=0.710; p=0.020). This study highlights that REMS could be useful as an alternative to dual-energy x-ray absorptiometry (DXA) to assess DMD in postmenopausal women.

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