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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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Long non-coding RNAs as prognostic biomarkers in non-muscle invasive bladder cancer: A systematic review Hendri, Ahmad Z.; Suryawati, Sri; Heriyanto, Didik S.; Hardianti, Mardiah S.; Pikatan, Narpati W.; Shaleh, Sabillal; Robert, Robert; Febriyanto, Toni; Liliana, Belinda; Pratama, Angga DM.
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1233

Abstract

Traditional prognostic tools for non-muscle invasive bladder cancer (NMIBC) often overestimate progression and recurrence risks, underscoring the need for more precise biomarkers. While long non-coding ribonucleic acids (lncRNAs) have been reviewed in bladder cancer, no review has focused on NMIBC. The aim of this study was to address this gap by investigating the role of lncRNAs in predicting NMIBC survival and progression. A systematic review was conducted using PubMed, Scopus, and Cochrane databases as of July 31, 2024. Prognostic studies investigating the association between lncRNA expression and survival outcomes, such as cancer-specific survival, disease-free survival, recurrence-free survival, or overall survival, using Kaplan-Meier curves or hazard ratios, were included. A total of three studies were analyzed, involving 279 NMIBC patients and focusing on three lncRNAs: urothelial cancer associated 1 (UCA1), growth arrest-specific 5 (GAS5), and up-regulated in non-muscle invasive bladder cancer (UNMIBC). Increased UCA1 expression was strongly associated with poor disease-free survival (hazard ratio (HR): 1.974; 95%CI: 1.061–3.673; p=0.032) and progression-free survival (HR: 3.476; 95%CI: 1.187–10.18; p=0.023). Reduced GAS5 expression was significantly associated with poor disease-free survival (HR: 2.659; 95%CI: 1.348–5.576; p=0.005) and progression-free survival (HR: 6.628; 95%CI: 1.494–29.40; p=0.013). Higher level of UNMIBC was strongly associated with poor recurrence-free survival (HR: 2.362; 95%CI: 1.504–4.837; p=0.007). In conclusion, lncRNAs have potential as prognostic biomarkers in NMIBC, with UCA1 and UNMIBC overexpression and GAS5 underexpression being significant in predicting disease recurrence and progression, highlighting the clinical relevance of monitoring these lncRNAs to improve prognosis and guide treatment decisions.
Association between tumor necrosis factor-α gene polymorphism and interleukin-6 level with mortality of neonatal sepsis Darnifayanti, Darnifayanti; Akmal, Muslim; Nur, Syahrun; Yusuf, Sulaiman
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1234

Abstract

Sepsis is a systemic infection that significantly causes morbidity and mortality among neonates, which is associated with immature immune response. Variations in the tumor necrosis factor-alpha gene (TNF-α) -308G/A may be linked to neonatal sepsis mortality by modulating interleukins (ILs) involved in the immune response cascade, such as IL-6. The aim of this study was to investigate the association between TNF-α -308G/A gene variation and IL-6 level with mortality of neonatal sepsis. A cohort of 30 neonates diagnosed with clinical sepsis was recruited. Blood culture was performed for all patients and serum IL-6 levels were examined 24 hours after suspected sepsis. Genetic analysis of TNF-α single nucleotide polymorphisms (SNP) -308G/A was conducted using polymerase chain reaction and DNA sequencing. The association was assessed based on bivariate logistic regression. We found that 12 (40%) of 30 patients had blood culture-proven sepsis. Genotype of TNF-α -308G/A stratified of the patients was 56.7% for GA and 43.3% for GG. There were no AA variations found in this study. There was no significant association between the TNF-α -308 G/A genotype and mortality in neonatal sepsis (p=0.211). Similarly, the allelic model of TNF-α -308 gene had no association with mortality (p=0.325). Additionally, there was no association between serum IL-6 level and mortality in neonatal sepsis (p=0.253). In conclusion, SNP of TNF-α -308 gene and IL-6 level are not associated with mortality in neonatal sepsis.
Risk factors for viral hepatitis in pulmonary tuberculosis patients undergoing treatment: A systematic review and meta-analysis Ilham, Ahmad F.; Andini, Salsabila R.; Afladhia, Hanna L.; Rakasiwi, Muhammad ID.; Burhan, Erlina
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1242

Abstract

Liver injury in tuberculosis patients, associated with noncompliance with treatment, is further exacerbated by viral hepatitis, which not only directly harms the liver but also increases susceptibility to drug-induced liver injury. The aim of this study was to analyze the associated risk factors for viral hepatitis in tuberculosis patients. This systematic review and meta-analysis adhere to the PRISMA 2020 statement, and the protocol has been registered with PROSPERO (CRD42023477241). Screening and selection of articles were carried out according to predetermined inclusion and exclusion criteria, utilizing four databases: Embase, Medline, Scopus, and ProQuest. Baseline characteristics and patient-related risk factors from each included study were extracted, followed by a meta-analysis of factors that potentially had significance, with the heterogeneities also being analyzed. Of the 21 included studies out of 6,415 identified records, 12 potential risk factors for hepatitis B and 15 for hepatitis C were subjected to meta-analysis. Some key risk factors included for hepatitis B and C were HIV infection (OR: 3.42; 95%CI: 2.19–5.34 and OR: 6.99; 95%CI: 5.09–9.61, respectively), smoking (OR: 1.55; 95%CI: 1.19–2.02 and OR: 3.06; 95%CI: 1.63–5.75, respectively) and alcohol consumption (OR: 2.38; 95%CI: 1.06–5.37 and OR: 4.32; 95%CI: 2.76–6.78, respectively). Furthermore, meta-analysis indicated that other significant risk factors for hepatitis B and/or C include injecting and non-injecting drug use, multiple sexual partners, tattooing, ear-nose piercing, blood transfusion, dental interventions, homelessness, incarceration, living with prisoners, sexually transmitted diseases, and diabetes mellitus. In conclusion, patients with tuberculosis who have risk factors such as smoking, HIV, or alcohol consumption should be screened for hepatitis B and C to prevent liver injury.
Efficacy of angiotensin receptor neprilysin inhibitor in hypertension management: A systematic review and meta-analysis of clinical trials Ramadhan, Roy N.; Rampengan, Derren DCH.; Puling, Imke MDR.; Willyanto, Sebastian E.; Tjandra, Kevin C.; Thaha, Mochammad; Multazam, Chaq ECZ.; Suryantoro, Satriyo
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1247

Abstract

Dysregulation of renin-angiotensin-aldosterone system (RAAS) often leads to hypertension and severe cardiorenal complications. Although RAAS-targeted therapies have proven effective, it remains yet optimal in reducing cardiovascular events. The aim of this study was to evaluate the efficacy and safety of angiotensin receptor neprilysin inhibitor (ARNI) compared to control in patients with hypertension. The primary outcomes were systolic and diastolic blood pressure (BP) control, along with the incidence of adverse events. A systematic review and meta-analysis was conducted according following PRISMA guidelines. A comprehensive literature search was performed across five databases: PubMed, ScienceDirect, EBSCO, Cochrane, and ProQuest, with studies identified up until 3 October 2024. The study included nine clinical trials that met the predefined eligibility criteria: (1) randomized clinical trials; (2) adult patients diagnosed with hypertension; and (3) comparison of ARNI versus control, reporting either BP control or adverse events. Quality appraisal using RoB 2.0 revealed that eight studies had a low risk of bias, and one had a high risk of bias. The pooled analysis demonstrated that ARNI is significantly more efficacious in achieving targeted systolic BP as compared to the control group (OR: 1.80; 95%CI: 1.41-2.30; p<0.001; I²=0%), and there was no statistical difference for the efficacy on diastolic BP compared to control (OR: 0.92; 95%CI: 0.75–1.13; p=0.45; I²=75%). The incidence of adverse events was not associated with ARNI (OR: 1.07; 95%CI: 0.90–1.27; p=0.46; I²=72%). In conclusion, ARNI demonstrated a favorable outcome only in systolic BP, but in diastolic BP which could be associated with inadequate duration of observation. Further studies are warranted to assess BP-lowering effect and safety profile of ARNI in a longer observation time.
Common intestinal parasitic infections in an improved water access, sanitation, and hygiene profile setting in North Jakarta, Indonesia Narayani, Dewa AJ.; Ali, Soegianto; Surja, Sem S.; Kristin, Helen; Hangestu, Anastasia; Widowati, Tria A.; Wijaya, Meiliyana; Kaisar, Maria MM.
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1264

Abstract

Intestinal parasitic infections (IPIs), caused by helminths and/or protozoa, continue to be a significant public health concern in Indonesia. Water access, sanitation, and hygiene practices (WASH) are influential factors for IPIs, especially among children. The aim of this study was to investigate the association between WASH and IPIs among school-aged children. A cross-sectional study involving 338 school-age children in an urban slum area in North Jakarta, Indonesia, was conducted using stool specimens subjected to microscopic and real-time polymerase chain reaction (rt-PCR) examination. The children underwent a finger-prick blood test and anthropometric measurements to determine anemia and nutritional status. Parents whose children participated in stool and blood examinations were interviewed using a modified WASH questionnaire. Helminth infections were not found in this study, whereas the overall prevalence of intestinal protozoa parasitic infection (IPPI) was 18.3% and 52.4% by microscopy and rt-PCR, respectively. Blastocystis spp. was found to have the highest prevalence (microscopy: 12%; rt-PCR: 48.6%), followed by Giardia intestinalis (microscopy: 0.6%; rt-PCR: 6.7%), Cryptosporidium spp. (microscopy: 5.1%; rt-PCR: 1.6%), and Entamoeba histolytica/dispar (microscopy: 0.6%; rt-PCR: 3.2%). Additionally, Dientamoeba fragilis was detected by rt-PCR at 4.1%. Furthermore, the discrepancies between microscopy and rt-PCR were observed in 8.9% (n=28) of the examined specimens. The majority of the respondents had a low-risk category of WASH profile. School children aged 5–10 years old (OR=2.06; 95%CI=1.27–3.33) and those who drank unprocessed cooking water (OR=1.95; 95%CI=1.07–3.57) were significantly associated with IPPI. The present study demonstrated that rt-PCR provides a better understanding of IPI epidemiology and has potential as a monitoring strategy for managing IPIs. Even though this population exhibits an adequate WASH profile and is not directly associated with IPIs, conducting a more in-depth observation of WASH facilities and practices is recommended to ensure a comprehensive assessment of the WASH profile. Additionally, engaging stakeholders in health promotion programs to ensure the sustainability of a good WASH profile and awareness of parasitic infections will be advantageous in achieving optimal urban health.
Non-dominant handgrip strength is associated with higher cardiorespiratory endurance and elevated NT-proBNP concentrations in ambulatory male adult outpatients with stable HFrEF Triangto, Kevin; Radi, Basuni; Siswanto, Bambang B.; Tambunan, Tresia FU.; Heriansyah, Teuku; Harahap, Alida R.; Kekalih, Aria; Katsukawa, Hajime; Santoso, Anwar
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1278

Abstract

Understanding the significance of handgrip strength is essential for identifying frailty in heart failure patients. The aim of this study was to identify the association between handgrip strength and cardiorespiratory endurance while highlighting the importance of the musculoskeletal system in cardiac rehabilitation for patients with heart failure. An observational cross-sectional study was conducted at Harapan Kita Hospital, Jakarta, Indonesia, from April 2022 to April 2023, among patients with heart failure with reduced ejection fraction (HFrEF) attributed to cardiomyopathy or coronary artery disease. Patients were classified by a 6-minute walk test (6MWT) distance into <400 meters (low endurance) or ≥400 meters (high endurance). The short physical performance battery (SPPB), handgrip strength, ultrasonographic forearm muscle thickness, left ventricle ejection fraction, tricuspid annular plane systolic excursion, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured. Results indicated significant differences in non-dominant handgrip strength, gait speed, and sit-to-stand SPPB scores between patients achieving a 6MWT distance of ≥400 meters and those below this threshold, with values of 31.11±6.88 kg vs 27.66±6.66 kg (p=0.049), 0.52±0.08 m/s vs 0.61±0.13 m/s (p=0.001), and 10.71±2.47 seconds vs 12.85±4.11 seconds (p=0.014), respectively. Stronger non-dominant handgrip strength (>30 kg) was associated with higher endurance (odds ratio (OR): 3.80; 95%CI: 1.35–10.67; p=0.010) and thicker forearm muscles (>1.9 cm) as measured by ultrasonography (AUC: 0.713; 95%CI: 0.585–0.840, p=0.001). In conclusion, a cut-off of ≤30 kg for non-dominant handgrip strength could effectively stratify the male patients into a lower endurance group (6MWT ≤400 meters), which is associated with elevated NT-proBNP levels and reduced forearm muscle thickness.
In silico analysis of Arbacia lixula-derived peptides and plasmid construction for recombinant anti-aging therapies Yenny, Satya W.; Jamsari, Jamsari; Hazmi, Auliya A.; Cuandra, Kevin N.; Hanifah, Wafiq; Yahono, Angela S.; Wahyudi, Dhyani P.; Buana, Gherriandi R.; Rahman, Awalil RK.; Maharani, Annisa D.; Firjatullah, Muhammad F.; Maulana, Rafi; Prayogi, Norbertus M.; Tristan, Christopher D.
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1283

Abstract

Skin aging is one of the degenerative processes influenced by tyrosinase, elastase, collagenase, hyaluronidase, and matrix metalloproteinase-9 (MMP9) activity. One promising avenue for discovering antiaging therapeutics is the peptides from the Arbacia lixula spine. The aim of this study was to explore the potential of peptides from A. lixula spine as a multitarget inhibitor for recombinant antiaging therapies through in silico approaches. The crystal structure of peptides previously identified in A. lixula spine was visualized using the UCSF Chimera. The protein data bank (PDB) database was used to obtain the crystal structures of protein targets. The webservers Innovagen, AllerTop, and ToxinPred were utilized to predict the peptide's water solubility, toxicity, and allergenicity. MOE application was used to prepare all ligands and proteins, molecular docking, and visualization. Molecular dynamics simulations were carried out on the protein-ligand complexes on Yasara Dynamics application. The Benchling website was used to perform virtual electrophoresis and reconstruct the recombinant plasmid (Psb1c3). Based on the molecular docking results, peptide REGSPDLLE has the potential as a multitarget inhibitor of tyrosinase (-9.07 kcal/mol), hyaluronidase (-10.57 kcal/mol), elastase (-9.32 kcal/mol), collagenase (-10.57 kcal/mol), and MMP9 (-10.43 kcal/mol). Peptide REGSPDLLE was selected due to its strong binding affinity on the active site of each target protein and exhibits non-toxic, non-allergenic, and good water-soluble as indicated by Support Vector Machine score <0. Molecular dynamics simulations confirmed stable interactions with receptor proteins. Peptide REGSPDLLE was successfully inserted into the recombinant pSB1C3 plasmid, confirmed by virtual electrophoresis with bands at ~2000 bp and ~150 bp. Further in vitro and in vivo studies are necessary to verify the anti-aging efficacy of peptide REGSPDLLE.
Health promotion model in the utilization of health services for Indonesian social security agency for health participants Mustikawati, Irma F.; Sulaeman, Endang S.; Subiyanto , Achmad A.; Suminah, Suminah
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1300

Abstract

Health promotion models are essential for enhancing community health and facilitating access to quality health services. Understanding the effects of these models on the utilization of health services among participants of the Indonesian Social Security Agency for Health (Badan Penyelenggara Jaminan Sosial Kesehatan/BPJS) provides valuable insights for developing effective health promotion strategies. The aim of this study was to assess the impact of health promotion on the utilization of health services among BPJS health participants, focusing on the mediating roles of perception, self-efficacy, expected results, and social support, using structural equation modeling (SEM). A descriptive, quantitative research design was employed, involving 160 BPJS health participants at Prof. Dr. Margono Soekarjo Hospital, Purwokerto, Indonesia. Data was collected using structured questionnaires, with participants selected through purposive sampling. SEM analysis, performed using AMOS software, was utilized to examine the relationships among health promotion, perception, self-efficacy, social support, expected outcomes, and health service utilization behavior. The SEM analysis revealed that health promotion significantly influenced health service utilization behavior directly (critical ratio (CR)=2.741; p=0.011). Furthermore, health promotion had a significant effect on perception through self-efficacy (CR=2.500; p=0.012).  Perception also significantly influenced behavior through self-efficacy (CR=3.789, p<0.001), while its indirect effect on behavior through outcome expectations was not significant (CR=0.908; p=0.958). Social support directly affected behavior (CR=2.267; p=0.023) and exerted both direct and indirect effects on behavior through self-efficacy (CR=3.789; p<0.001) and outcome expectations via self-efficacy (CR=6.267; p<0.001). However, self-efficacy did not significantly influence the behavior of utilizing BPJS health services through outcome expectations (CR=0.237; p=0.185). The findings indicate that health promotion significantly enhances the utilization of health services among BPJS health participants by improving perceptions and self-efficacy. Social support emerges as a critical factor in influencing health service utilization behavior and shaping outcome expectations through perception. In conclusion, future health promotion strategies should prioritize strengthening perceptions, enhancing self-efficacy, and leveraging social support to improve health service outcomes effectively.
KOMPAK: Translation, cross-cultural adaptation, and validation of an instrument for assessing interprofessional collaboration between pharmacists and physicians in Indonesia Amin, Irnawati H.; Massi, Muhammad N.; Wahyudin, Elly; Bahar, Muhammad A.; Hadju, Veni; Niamuzisilawati, Eva; Munawwaroh, Makiyatul; Utami, Ikrimah N.; Ardiansyah, Akhmad; Alkaff, Sylmina D.; Arifin, Bustanul
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1309

Abstract

Interprofessional collaboration is crucial for addressing the complexity of health problems, requiring contributions from various professions to enhance healthcare quality, improve patient satisfaction, and achieve better clinical outcomes. The aim of this study was to develop and validate the physicians and pharmacists collaborative practice instrument, known as KOMPAK (Kolaborasi Medis Persepsi Apoteker dan Dokter/Medical Collaboration: Perceptions of Pharmacists and Physicians) for use in Indonesia. A cross-sectional study was conducted across the western, central, and eastern rigors of Indonesia, targeting physicians and pharmacists. The study included translation (forward and backward), cross-cultural adaptation (with 30 participants), and validation using confirmatory factor analysis (CFA) among 315 physicians and 315 pharmacists. The present study found no significant changes emerged during the translation and adaptation phases. In the validation phase, the CFA results for the physician instrument indicated a Comparative Fit Index (CFI) of 0.94 (>0.92), Tucker-Lewis Index (TLI) of 0.93 (>0.92), Root Mean Squared Error of Approximation (RMSEA) of 0.055 (<0.07), Standardized Root Mean Residual (SRMR) of 0.07 (<0.08), and Cronbach’s Alpha reliability of 0.88. The pharmacist instrument yielded similar results with a CFI of 0.94 (>0.92), TLI of 0.93 (>0.92), RMSEA of 0.06 (<0.07), SRMR of 0.05 (<0.08), and Cronbach’s Alpha reliability of 0.83. The final instrument consists of 24 items. In conclusion, the KOMPAK instrument demonstrated validity and reliability, supporting its use for measuring interprofessional collaboration between physicians and pharmacists in Indonesia.
In silico studies on quercetin, myricetin, and kaempferol in inhibiting TGF-β1 and galectin-3 for cardiac fibrosis management Suryono, Suryono; Amien, Muhammad I.; Tohari, Achmad I.; Saputra, Antonius D.; Hidayat, Muhammad RF.; Ramadhan, Hazbina F.
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1310

Abstract

Cardiac fibrosis remains as the leading cause of death worldwide and is often associated with elevated levels of transforming growth factor-β 1 (TGF-β1) and galectin-3, making them potential therapeutic targets. Recent studies revealed that quercetin, myricetin, and kaempferol have the biological effect for several cardiovascular diseases. However, the investigation into this topic through molecular models and analysis remain unexplored. The aim of this study was to evaluate the potential effect of quercetin, myricetin, and kaempferol which targeted TGF-β1 and galectin-3. In this study, quercetin, myricetin, and kaempferol roled as the tested ligands. Subsequently, colchicine and native ligand acted as control ligands that were screened through molecular docking against TGF-β1 and galectin-3 using AutoDock tools to identify the potential inhibitor. The stability of ligand-receptor complexes was assessed through molecular dynamic (MD) simulations using NMAD. Absorption, Distribution, Metabolism, Excretion and toxicity (ADMET) prediction were also performed using ADMETlab 2.0. Molecular docking analysis revealed that quercetin, myricetin, and kaempferol exhibited strong binding affinity which are -8.9 kcal/mol, -8.5 kcal/mol, -7.6 kcal/mol respectively with TGF-β1, and -7.5 kcal/mol, -7.0 kcal/mol, -5.7 kcal/mol respectively with galetcin-3; low inhibition constant (Ki); and stable interaction with the active sites of TGF-β1 and galectin-3. MD simulations confirmed the stability and compactness of the ligand-receptor complexes. ADMET analysis also showed high Plasma Protein Binding (PPB) values (quercetin: 95%, myricetin: 92%, and kaempferol: 97%) and moderate clearance values (quercetin: 8.284%, myricetin, and 7.716%, kaempferol: 6.868%) for the tested compounds. In conclusion, the in silico analyses suggested that quercetin, myricetin, and kaempferol are promising for cardiac fibrosis therapies by inhibiting TGF-β1 and galectin-3.

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