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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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Effect of Nigella sativa seed extract on estradiol, FSH levels, and vaginal maturity index in menopausal women: A randomized controlled trial Sukatendel, Khairani; Hasibuan, Reni H.; Siregar, Muhammad FG.; Faradina, Dwi; Edianto, Deri; Lintang, Letta S.; Rusda, Muhammad; Inriani, Vega
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.v5i1.1399

Abstract

Nigella sativa seed extract has been shown to have a significant effect on endometrial thickness and vaginal cytology in ovariectomized animal models, suggesting potential benefits for managing menopausal symptoms. However, to the best of the author’s knowledge, no human studies have been done to support these conclusions. The aim of this study was to investigate the effects of N. sativa seed extract on estradiol, follicle-stimulating hormone (FSH), and the vaginal maturity index (VMI) in postmenopausal women. A single-blinded, randomized placebo-controlled experiment was carried out at Haji Adam Malik Hospital, Medan, Indonesia, with 50 eligible postmenopausal women patients randomized into three groups. Group 1 received a placebo, while groups 2 and 3 were given N. sativa seed extract at 910 mg/day and 1,365 mg/day, respectively. All participants were blinded to the treatment they received. The study used Shad Nigella Plus, an Indonesian herbal medicine containing 455 mg of N. sativa seed extract per capsule. Before the treatments, estradiol levels, FSH levels, and VMI were measured at baseline and remeasured after eight weeks of treatment. Two participants in the intervention group withdrew due to nausea, a reported side effect of N. sativa seed extract consumption. Both treatment groups showed significant increases in estradiol levels (p=0.01 and p=0.001) and VMI (p=0.004 and p=0.001) after eight weeks of daily N. sativa seed extract administration compared to the placebo group. However, no significant differences were found between the two doses in estradiol levels and VMI (p=0.12 and p=0.673, respectively). Moreover, FSH levels showed no significant difference throughout both interventions (p=0.53 and p=0.96, respectively). In conclusion, twice-daily N. sativa seed extract at 910 mg/day or 1,365 mg/day for eight weeks significantly increased estradiol levels and VMI in menopausal women but had no significant effect on FSH levels. These findings support the potential role of N. sativa seed extract as a natural treatment for menopausal symptoms.
Improving Indonesian nurse performance on nursing care documentation: A mixed-methods study of a culturally tailored hybrid roleplay intervention Mahfud, Mahfud; Hartono, Hartono; Subiyanto, Achmad A.; Anantanyu, Sapja
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.v5i1.1488

Abstract

Nursing documentation is critical for ensuring quality patient care and effective communication among healthcare professionals. However, in low- and middle-income countries (LMICs), documentation practices often fall short due to resource limitations and cultural barriers. This mixed-methods study evaluated a culturally adapted roleplay-based intervention to improve nursing documentation quality among Indonesian nurses. Guided by Kolb's Experiential Learning Theory, this intervention focused on experiential, reflective, and technology-enhanced components to enhance nursing documentation practices. Using a quasi-experimental design, 132 nurses from three public hospitals in Jakarta were assigned to either the treatment or control group. The intervention integrated conventional roleplay, digital simulation, and reflective practice. Quantitative data were collected at baseline, post-intervention, and at a 12-week follow-up, measuring documentation quality, self-efficacy, and cognitive load. Additionally, qualitative data were gathered through semi-structured interviews with 15 experimental group participants. Results showed significant improvements in documentation quality (Cohen’s d=1.28 at T1; d=1.14 at T2), self-efficacy (d=0.99 at T1; d=0.85 at T2), and reductions in cognitive load (d=-0.84 at T1; d=-0.72 at T2), indicating significant and sustained improvements at the 12-week follow-up. Qualitative findings highlighted increased confidence, realism of the scenarios, integration of digital skills, and cultural considerations in documentation practices. Participants' hierarchical structure orientation moderated the effectiveness of the intervention. In conclusion, this study provides evidence that hybrid roleplay interventions can enhance nursing documentation practices in low- and middle-income countries, with a focus on culturally tailored healthcare education.
Exploring the role of polysaccharides in mitigating organ damage caused by pesticide-induced toxicity: A systematic review and meta-analysis of in vivo studies Sakinah, Elly N.; Diniyah, Nurud; Subagio, Achmad; Marchianti, Ancah CN.; Firdaus, Jauhar; Fambudi, Stela S.; Amini, Stefia A.; Putri, Dhiani E.
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.v5i1.1553

Abstract

Although polysaccharides have demonstrated potential in alleviating dysbiosis, the overall impact of polysaccharides on minimizing oxidative stress and organ damage in vivo has not been thoroughly investigated. The aim of this study was to investigate the comprehensive effects of polysaccharides in mitigating pesticide toxicity in animal studies, focusing on biomarkers related to oxidative stress, antioxidant activity, kidney injury, lipid profiles, liver function, and the preservation of liver and kidney weights. A systematic search was conducted across nine indexed databases, including PubMed, Cochrane CENTRAL, Taylor & Francis, Scopus, Sage, EBSCO, ProQuest, ScienceDirect, and Google Scholar. Rayyan.ai was used to screen in vivo studies that met the predefined inclusion and exclusion criteria. The quality of the selected in vivo studies was evaluated using SYRCLE’s Risk of Bias tool, specifically designed for animal studies. Thirteen randomized animal studies, comprising 330 mice and rats, were included in the analysis. The findings revealed that polysaccharides significantly increased antioxidant levels, including catalase (CAT) (p<0.00001), superoxide dismutase (SOD) (p<0.00001), glutathione peroxidase (GPx) (p<0.00001), and reduced glutathione (GSH) (p<0.00001). Polysaccharides also significantly reduced oxidative stress markers, such as malondialdehyde (MDA) (p<0.00001) and nitric oxide (NO) (p<0.0001), as well as kidney injury biomarkers, including serum creatinine (p<0.00001) and urea (p<0.00001). Additionally, improvements in lipid profiles were observed, with significant reductions in triglycerides (TG) (p=0.04) and total cholesterol (TC) (p<0.00001). However, there were no significant differences in high-density lipoprotein (HDL) (p=0.28) and low-density lipoprotein (LDL) (p=0.32) levels. Polysaccharides significantly alleviate liver biomarkers, including aspartate transaminase (AST) (p<0.0001), alanine transaminase (ALT) (p<0.005), and alkaline phosphatase (ALP) (p<0.0001). Polysaccharides also contributed to the maintenance of liver weight (p=0.009), although no significant differences were observed in kidney weights (p=0.81). The study highlights that polysaccharides exert significant effects in enhancing antioxidant levels, reducing oxidative stress and organ damage biomarkers, and preserving liver weights.
Identifying the attributes of adherence to tuberculosis treatment in Indonesia: A Delphi study Prasetyo, Yunus A.; Thanasilp, Sureeporn; Preechawong, Sunida
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.v5i1.1590

Abstract

Adherence to tuberculosis (TB) treatment is essential for achieving successful health outcomes. Establishing a consensus among healthcare professionals regarding the definition and key attributes of adherence to TB treatment is essential. The aim of this study was to explore the perspectives of experts and patients on the attributes of adherence to TB treatment. A total of 20 TB specialists and 10 pulmonary TB patients from various regions in Indonesia participated in a three-round Delphi study designed to categorize and validate these attributes. In the first round, participants were interviewed to gather qualitative insights. In the second and third rounds, experts assessed the level of agreement on identified attributes using a five-point Likert scale. The strength of consensus was measured using the interquartile range (IQR), following the best practices outlined in the Conducting and REporting DElphi Studies (CREDES) guidelines. The experts achieved a substantial consensus, with over 85% agreement on the identified attributes. The findings indicated that adherence to TB treatment encompasses the ability of pulmonary TB patients to follow agreed-upon recommendations, including both medication adherence and lifestyle modifications. These lifestyle changes include improved nutritional care, smoking cessation, abstaining from alcohol, stress management, improved physical activity, better sleep, and rest quality, and preventive behaviors related to TB. In conclusion, the findings enhanced the understanding of adherence to TB treatment by highlighting its multifaceted nature. The consensus emphasized that adherence extends beyond medication-taking behaviors to include essential lifestyle changes, underscoring the comprehensive approach needed to support TB patients effectively.
RAGE gene polymorphism (rs1800625) and type 1 diabetes mellitus: A potential new model for early diagnosis and risk prediction Mohamed, Amal A.; Al-Obeidat, Feras; Abdallah, Gamil M.; Ibrahim, Ibrahim T.; Ali, Nada S.; Hussein, Mona A.; Hafez, Wael; Girgiss, Mina W.; Shalby, Hassan; EL-Bohy, Doaa; Elgamal, Rasha; Farghly, Maysa I.; Shaheen, Mahmoud M.; Elmahdy, Reem; Nagaty, Raghda A.; Hassan, Noheir AIF.; Hamdi, Amel; Mahmoud , Mohamed O.
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.v5i1.1603

Abstract

Studies have associated advanced glycation end-products (AGEs) and the polymorphism of the AGEs receptor (RAGE) gene with clinical disorders, such as diabetes, in certain ethnic groups. However, its association with type 1 diabetes mellitus (T1DM) in Egyptians has not yet been explored. The aim of this study was to investigate the association between the RAGE gene polymorphism rs1800625 and T1DM susceptibility in Egyptians. A case-control study was conducted with 177 T1DM patients and 177 age- and sex-matched healthy controls. Variables included glycemic markers (fasting blood glucose (FBG), postprandial blood glucose (PBG), hemoglobin A1c (HbA1c)), anthropometric measurements (waist circumference, body mass index (BMI)), lipid profile (total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL)), renal function (albumin-to-creatinine ratio (A/C ratio), serum creatinine), and history of hypertension and smoking. Genotype distribution and allele frequency of the RAGE rs1800625 polymorphism (TT, TC, CC genotypes; T and C alleles) were assessed. This study identified the RAGE rs1800625 polymorphism as a significant genetic factor associated with T1DM susceptibility. The CC genotype was significantly more prevalent in patients compared to controls (29.9% vs 11.9%; OR: 3.62; 95%CI: 1.87–6.97; p<0.001). Similarly, the C allele was more common in patients (54.5% vs 41.0%, OR: 1.73; 95%CI: 1.28–2.33; p<0.001). Multivariate analysis revealed that HbA1c (adjusted OR (aOR): 12.97; 95%CI: 4.00–42.05; p<0.001), FBG (aOR: 8.96; 95%CI: 1.59–50.47; p=0.010), and the rs1800625 polymorphism (aOR: 1.82; 95%CI: 1.146–2.876, p=0.010) were significant predictors of T1DM. In conclusion, a genetic association was found between the RAGE gene polymorphism rs1800625 and T1DM susceptibility, with the CC genotype and C allele being more common in T1DM patients. FBG, HbA1c, and rs1800625 were identified as key predictors for T1DM, with HbA1c being the strongest. These findings highlight the importance of integrating genetic and metabolic factors in managing T1DM.
Cardiomyopathy as the forgotten symptom of systemic lupus erythematosus in children: A case report Yudhianto, Eric; Malisie, Ririe F.; Abdillah, Hafaz Z.; Rusli, Rita E.
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.v5i1.1621

Abstract

Cardiomyopathy is a rare clinical manifestation in pediatric systemic lupus erythematosus (SLE), with only a single case reported in the literature. Its identification in pediatric SLE is challenging due to its typically subclinical presentation and low incidence, which frequently result in delayed diagnosis and management. The aim of this study was to present a unique case of dilated cardiomyopathy, a rare cardiac complication of SLE, which can be life-threatening if not promptly recognized and treated. An 11-year-old boy was admitted to the emergency department of Murni Teguh Memorial Hospital, diagnosed with SLE based on the 2019 European Alliance of Associations for Rheumatology (EULAR) criteria, with a total score of 30 and a Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score of 16, indicating high disease activity. Clinical findings included oral ulcers, a non-pruritic hyperpigmented discoid macule, anemia, lymphopenia, positive both the direct and indirect Coombs tests, elevated D-dimer level, and pulmonary congestion. Initial treatment stabilized the patient condition, allowing transfer to the general ward by day five. Five days after admission, the patient developed palpitations and tachycardia, with a heart rate of 140 beats per minute. Electrocardiography showed sinus tachycardia, while echocardiography revealed all cardiac chambers dilation, left ventricular ejection fraction (LVEF) of 43%, moderate mitral regurgitation, and mild pulmonary regurgitation, subsequently diagnosed as dilated cardiomyopathy. Heart failure therapy was initiated with intravenous furosemide, oral ramipril, and digoxin. Palpitations and tachycardia resolved within two days. Following two weeks of treatment, the patient was discharged with stable vital signs. A one-month follow-up thoracic echocardiography demonstrated improved cardiomyopathy, with an LVEF of 53%. Cardiomyopathy in pediatric SLE is rare but can cause significant morbidity and mortality if undiagnosed. Its nonspecific presentation and immune-mediated pathogenesis make early detection challenging. Due to its rarity, it may be overlooked, highlighting the importance of comprehensive cardiac evaluation, including echocardiography, in children with suspected cardiac involvement.
Effectiveness and safety of thoracic segmental spinal anesthesia for breast surgery: A systematic review and meta-analysis Hamdi, Tasrif; Mastari, Ekawaty S.; Lubis, Andriamuri P.; Ghozali, Imam; Kemalasari, Nadia; Harahap, Awi TM.
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.v5i1.1630

Abstract

General anesthesia is the standard approach for thoracic and abdominal procedures; however, it has notable limitations, particularly in high-risk patients. Regional anesthesia techniques, such as thoracic segmental spinal anesthesia, have gained popularity due to their potential to reduce these associated risks. The aim of this study was to assess the effectiveness and safety of thoracic segmental spinal anesthesia in breast cancer surgery using systematic review and meta-analysis. This study adhered to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines, conducting a comprehensive literature search across ScienceDirect, Cochrane Library, and PubMed databases up to July 4, 2024. The inclusion criteria focused on studies that provided specific information on the effectiveness (postoperative pain reduction) and safety (incidence of adverse events and complications) of thoracic segmental spinal anesthesia, as well as satisfaction among patients and surgeons. Out of 4,060 articles, six studies were included for qualitative assessment, with four further analyzed quantitatively. Meta-analysis findings indicated that thoracic segmental spinal anesthesia provided significantly better pain control at 12 hours postoperatively (SMD: -1.25; 95%CI: -1.54 to -0.96; p<0.0001), although no significant difference was noted at 0 hours (SMD: -1.07; 95%CI: -2.33 to 0.18; p=0.09). Thoracic segmental spinal anesthesia was associated with a lower incidence of postoperative vomiting (RR: 0.46; 95%CI: 0.22–0.95; p=0.04), but it presented a higher risk of hypotension (RR: 2.57; 95%CI: 1.41–4.71; p=0.002). Importantly, no anesthesia-related mortalities were reported. The technique resulted in higher satisfaction levels among both patients (SMD: 0.63; 95%CI: 0.33–0.92; p<0.0001) and surgeons (SMD: 0.81; 95%CI: 0.51–1.11; p<0.0001) compared to general anesthesia. The study highlights that thoracic segmental spinal anesthesia is a safe and effective alternative to general anesthesia for breast cancer surgery, offering superior postoperative pain control, enhanced patient and surgeon satisfaction, and a reduced incidence of postoperative vomiting.
Hypocapnia and its relationship with in-hospital mortality in acute heart failure patients: Insights from the Indonesian multicenter ICCU registry Prasetya, Indra; Afifah, Yuri; Anjarwani, Setyasih; Juzar, Dafsah A.; Bagaswoto, Hendry P.; Muzakkir, Akhtar F.; Habib, Faisal; Astiawati, Tri; Wirawan, Hendy; Ilhami, Yose R.; Djafar, Dewi U.; Sungkar, Safir; Danny, Siska S.; Rohman, Mohammad S.
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.v5i1.1638

Abstract

Acute heart failure (AHF) presents serious risks for hospitalized patients. The aim of this study was to explore the relationship between arterial partial pressure of carbon dioxide (PaCO2) levels and outcomes in AHF patients admitted to the intensive cardiovascular care unit (ICCU), utilizing data from the IndONEsia ICCU Registry (One ICCU Registry). A multicenter retrospective observational study was performed covering data between August 2021-2023. Participants were categorized by PaCO2 levels: hypocapnia (<35 mmHg), normocapnia (35–45 mmHg), and hypercapnia (>45 mmHg). The primary outcomes included ICCU mortality, in-hospital mortality, and 30-day mortality, whereas the length of the stays in the ICCU or hospital and ventilation requirement were set as the secondary outcomes. Mortality risks were assessed using Cox proportional hazards models. Of the 1,870 patients, 1,102 (58.96%) had hypocapnia, 645 (34.5%) had normocapnia, and 123 (6.5%) had hypercapnia. Hypocapnia patients had significantly higher ICCU, in-hospital, and at 30-day mortality rates compared to normocapnic patients (all p<0.001), along with longer lengths of stay in ICCU and in hospital (p<0.001). Hypocapnia significantly increased noninvasive and mechanical ventilation requirement compared to normocapnia patients. Multivariate analysis identified factors impacting patients’ survival, including age, treatment with angiotensin-converting enzyme inhibitors (ACEi)/angiotensin II receptor blockers (ARBs) drugs, and severity scores such as the quick sequential organ failure assessment (qSOFA) and simplified acute physiology score II (SAPS II). In conclusion, hypocapnia in AHF patients could increase in-hospital, ICU and 30-days mortality rates and length of hospital stays, as well as noninvasive and mechanical ventilation requirements.
Effective probiotic regimens for bacterial vaginosis treatment and recurrence prevention: A systematic review Udjianto, Udjianto; Sirat, Noorhamdani A.; Rahardjo, Bambang; Zuhriyah, Lilik
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.v5i1.1671

Abstract

Probiotics represent a promising alternative therapy for bacterial vaginosis; however, consensus on the most effective species, strains, and doses remains lacking, and long-term safety data are limited. The aim of this study was to evaluate the effectiveness of probiotics in managing bacterial vaginosis, considering species, strain, clinical outcomes, optimal dosage, duration, and side effects. This study included randomized-controlled trials (RCTs) published in English (2014–2024) on probiotic treatment for bacterial vaginosis, assessing species, strain, dose, duration, and efficacy. A systematic search was conducted on December 20, 2024, in Scopus, Web of Science, and PubMed using the keywords "vaginosis," "bacterial vaginosis," and "probiotic." Data were extracted and synthesized, and study quality was assessed using the Risk of Bias 2 tool, while NVivo 14 software facilitated thematic analysis. The systematic search yielded 1,560 initial records, of which 16 RCTs were included. The findings revealed that Lactobacillus rhamnosus TOM 22.8 (10×10⁹ CFU/day for 10 days) was the most effective strain and dose, significantly improving Nugent scores, vaginal pH, and microbiota composition and reducing bacterial vaginosis recurrence rate. Alternative strains, including L. crispatus, L. plantarum, and L. acidophilus, showed therapeutic potential at doses of 1×10⁸ to 5.4×10⁹ CFU/day for treatment durations ranging from 6 days to 4 months. The reported side effects were mild and self-limiting. This study supports the use of probiotics as an adjunctive or alternative bacterial vaginosis treatment, emphasizing the need for a personalized approach based on patient characteristics. However, limitations such as small sample sizes and heterogeneous outcome measures necessitate further research. Larger, well-designed trials with standardized methodologies are required to refine probiotic recommendations.
Effect of clove flower extract (Syzygium aromaticum) administration timing on skeletal muscle damage induced by eccentric exercise: An in vivo study Ningrum, Tyas Sari Ratna; Doewes, Muchsin; Indarto, Dono; Cilmiaty, Risya; Kristiyanto, Agus; Widyaningsih, Vitri
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.v5i1.1680

Abstract

Eccentric exercise often leads to oxidative stress, inflammation, and muscle damage that impair athletic performance. To counter these adverse effects, clove flower extract (Syzygium aromaticum) offers promising potential as a natural remedy to promote muscle repair with its potent antioxidant and anti-inflammatory properties. The aim of this study was to assess the effects of clove flower extract administration timing on oxidative stress and inflammatory responses in skeletal muscle damage induced by acute eccentric exercise in mice. This study used a post-test-only control group design, involving 35 male mice (Mus musculus, Balb/c) randomly divided into five groups: a healthy control group (HC) with no exercise and no treatment, a negative control group (NC) with exercise but no treatment, and three treatment groups: T1, T2, and T3 (clove flower extract 24 hours before exercise, immediately after exercise, and 24 hours after exercise, respectively). The treatment groups received a single dose of clove flower extract (500 mg/kg body weight). The skeletal muscle damage of mice was collected for the NADPH oxidase (NOX) and superoxide dismutase (SOD) activities using spectrophotometry, and toll-like receptor 4 (TLR4) and interleukin-8 (IL-8) measurements using enzyme-linked immunosorbent assay (ELISA). Moreover, the skeletal muscle damage was analyzed through the histopathological method. Data were analyzed using one-way analysis of variance (ANOVA) followed by Fisher's least significant difference (LSD) tests as a post hoc test. The result showed that clove flower extract significantly reduced NOX activity (p=0.049) and IL-8 levels (p=0.032), and increased SOD activity (p=0.001) while not significantly affecting the TLR4 levels (p=0.532). Moreover, the results showed a significant reduction in muscle damage (p=0.001). The study highlights that the administration of clove flower extract (500mg/kg bw) can be given 24 hours before, immediately after exercise, or 24 hours after exercise to prevent muscle damage.

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