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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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Chemical fingerprinting and antioxidant properties of Glochidion philippicum Khairuddin, Khairuddin; Manggau, Marianti A.; Rante, Herlina; Hardiyanti, Widya; Latada, Nadila P.; Umar, Abdul H.; Nur, Syamsu; Wahyudin, Elly; Rahman, Latifah; Yulianty, Risfah; Nainu, Firzan
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.v5i1.1886

Abstract

Glochidion philippicum has been suggested to exhibit considerable pharmacological potential, yet its chemical composition and bioactivity remain inadequately explored. The aim of this study was to investigate the chemical fingerprint and antioxidant properties of G. philippicum leaf extracts using Fourier-transform infrared spectroscopy (FTIR) with chemometric analyses, and in vitro and in vivo evaluations. Four extraction methods (maceration, reflux, ultrasound-assisted extraction (UAE), and microwave-assisted extraction (MAE)) were optimized with water, 70% ethanol, ethyl acetate, and n-hexane as solvents. FTIR profiles were analyzed with principal component analysis (PCA), hierarchical cluster analysis, and orthogonal partial least squares discriminant analysis. An in vitro study assessing the free radical scavenging capacity was conducted using the 2,2'-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), 2,2-diphenyl-1-picrylhydrazyl (DPPH), and ferric-reducing antioxidant power (FRAP) methods, while in vivo evaluations were conducted using Drosophila melanogaster to measure antioxidant enzyme activity and expression of endogenous antioxidant-related genes. FTIR profiles identified functional groups contributing to antioxidant activity. In vitro assays using ABTS and FRAP methods revealed that extracts obtained with 70% ethanol and water exhibited the highest antioxidant activity, attributed to key functional groups such as C=C (aromatic), O−H (acidic), N=O (nitro), and C−O (ester). In vivo studies showed that ethanol-based MAE extracts (MAEEO) significantly improved the survival of autoinflammatory PGRP-LBΔ mutant larvae exposed to heat-killed Escherichia coli. Real-time quantitative PCR analysis indicated this effect was dependent on endogenous antioxidant gene activation. The study highlights that G. philippicum leaf extracts as a natural source of bioactive compounds with exogenous antioxidant properties, offering potential for therapeutic applications.
Comparative predictive value of APACHE-II, SAPS-II and GRACE scores for mortality in acute coronary syndrome (ACS) patients: Evidence from Indonesia intensive cardiovascular care unit registry Prasetya, Indra; Hakim, Dennis I.; Anjarwani, Setyasih; Bagaswoto, Hendry P.; Muzakkir, Akhtar F.; Habib, Faisal; Astiawati, Tri; Wirawan, Hendy; Ilhami, Yose R.; Djafar, Dewi U.; Sungkar, Safir; Danny, Siska S.; Juzar, Dafsah A.
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.v5i1.1911

Abstract

The Global Registry of Acute Coronary Events (GRACE) score is acknowledged for its ability to predict in-hospital mortality among patients with acute coronary syndrome (ACS). However, intensive care physicians often employ general prognostic scores such as Acute Physiologic and Chronic Health Evaluation II (APACHE-II) and Simplified Acute Physiology Score II (SAPS-II) to predict the mortality of ACS patients. However, their predictive values are not well-determined in predicting mortality in ACS treated in the cardiovascular care unit (CVCU). The aim of this study was to evaluate the performance of APACHE-II and SAPS-II scores in comparison with GRACE scores in predicting the CVCU mortality and in-hospital mortality of ACS patients admitted to CVCU. A multicenter retrospective cohort study was conducted using data from a registry of patients admitted to 10 hospitals in Indonesia between August 2021 and July 2023. This study evaluated the APACHE-II, SAPS-II, and GRACE scores for patients with ACS upon admission to CVCU. The area under the curve (AUC) of the receiver operating characteristic (ROC) was utilized to assess the discriminative ability for predicting mortality. Among the 12,950 admitted patients, 9,040 were diagnosed with ACS, and 6,490 patients were included in the final analysis. All three scoring systems had relatively good discriminative ability to predict CVCU mortality with APACHE-II having better results (AUC: 0.771; sensitivity: 63.9%; specificity: 78.7%) compared to GRACE (AUC: 0.726; sensitivity: 61.7%; specificity: 73.2%) and SAPS-II (AUC: 0.655; sensitivity: 38.9%; specificity: 85.2%). To predict in-hospital mortality, APACHE-II had better results (AUC: 0.815; sensitivity: 68.7%; specificity: 80.4%) compared to GRACE (AUC: 0.769; sensitivity: 64.6%; specificity: 77.5%) and SAPS-II (AUC: 0.683; sensitivity: 41.8%; specificity: 86.2%). APACHE-II had the best single risk factor for CVCU mortality (odds ratio (OR): 1.198; 95% confidence interval (CI): 1.181–1.214) and in-hospital mortality (OR: 1.259; 95%CI: 1.240–1.279). In conclusion, APACHE-II, SAPS-II, and GRACE scores moderately predict CVCU and in-hospital mortalities, with the APACHE-II score exhibiting the highest predictive capability in ACS patients admitted to CVCU.
Examining the interplay between endometriosis and later-life cerebro-cardiovascular diseases: A systematic review, meta-analysis, and trial sequential analysis Winata, I GS.; Immanuel, Surya S.; Leonardo, Leonardo; Rinaldi, Fransiskus X.; Tandecxi , Gabriel; Wijaya, Richard
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.v5i1.1935

Abstract

Beyond gynecological issues, women with endometriosis have a significant risk of cardiac outcomes. Despite this evidence, the extent and mechanisms of the association remain unclear. The aim of this study was to evaluate the association between endometriosis and the incidence of cerebro-cardiovascular disorders. Using preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines, seven databases were searched as of October 14, 2024, for observational studies assessing the association between endometriosis and cerebro-cardiovascular disorders. The main outcome was major adverse cardiovascular and cerebrovascular event (MACCE) while the secondary outcomes included all-cause mortality, cerebrovascular accident (CVA), ischemic heart disease (IHD), myocardial infarction (MI), arrhythmia, and heart failure (HF). Bias was assessed with the risk of bias in non-randomized studies of exposures (ROBINS-E) tool. Odds ratios with 95% confidence interval (CI) were calculated using random-effects meta-analysis. Evidence certainty was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Robustness was assessed via sensitivity analyses and trial sequential analysis (TSA). Out of 3,141 studies, nine cohort studies encompassing 1,670,589 women (follow-up 7–28 years) were included. Endometriosis was associated with 24% higher odds of MACCE incidence (95%CI: 1.18–1.31, moderate certainty). In addition, having endometriosis increased the odds of CVA by 49% (95%CI: 1.20–1.85, high certainty), IHD by 64% (95%CI: 1.31–2.05, low certainty), MI by 53% (95%CI: 1.18–1.98, high certainty), arrhythmias by 24% (95%CI: 1.12–1.37, high certainty), and HF by 13% (95%CI: 1.03–1.25, high certainty). Endometriosis did not significantly associate with all-cause mortality. Sensitivity analyses and TSA reinforced all of these findings. In conclusion, endometriosis was significantly associated with increased odds of cerebro-cardiovascular disorders. Future research should clarify the underlying mechanisms and develop targeted prevention strategies.
Synergistic mechanism of Phyllanthus emblica extract and tetracycline against multidrug-resistant Acinetobacter baumannii Nasution, Haris M.; Yulyana, Ana; Utama, Rezza F.; Bangar, Roy I.; Kaban, Vera E.; Daulay, Wardiyah; Astyka, Ririn; Lubis, Muhammad 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.v5i1.1939

Abstract

The rising incidence of multidrug-resistant (MDR) Acinetobacter baumannii infections underscores the urgent need for novel antimicrobial strategies. The aim of this study was to investigate the synergistic effects between a polyphenol-rich extract from Phyllanthus emblica fruit and tetracycline against MDR A. baumannii strains. The extraction process was optimized using the Box-Behnken design approach to maximize the total phenolic content (TPC) of the P. emblica extract. Key variables, including ethanol concentration, extraction time, and solid-to-liquid ratio (w/v), were determined through single-factor experiments. The antimicrobial activity of the extract, both alone and in combination with tetracycline, was evaluated against A. baumannii. Mechanistic studies focusing on bacterial lysis and efflux pump inhibition were conducted to assess the extract's effects and its combined potential with tetracycline. The Box-Behnken design successfully optimized the extraction conditions, yielding the highest TPC at 68.92% ethanol concentration, 1.85 days of extraction time, and a 1:9.58 w/v ratio. The predicted and experimentally verified TPC values of the extract were 129.19 and 130.76±2.46 mg GAE/g samples, respectively, with no significant difference (p>0.05). The extract contained several phenolic compounds identified using liquid chromatography–high-resolution mass spectrometry (LC-HRMS). It exhibited antimicrobial activity against MDR Acinetobacter baumannii, either alone or in combination with tetracycline. The combination demonstrated a synergistic effect against MDR A. baumannii, with a fractional inhibitory concentration index (FICI) of 0.37. Moreover, the combination showed superior bacteriolytic effects against MDR A. baumannii cells, as evidenced by increased release of nucleic acid components and membrane destabilization, compared to the extract or tetracycline alone (p<0.0001 for all comparisons). Additionally, the combination significantly enhanced the efflux pump inhibition effect compared to the extract or tetracycline alone (p<0.05 for both). These findings support the potential use of polyphenol-rich P. emblica extracts as adjuncts to conventional antibiotics in treating drug-resistant bacterial infections.
Factors associated with mental health disorders in undergraduate students: A meta-analysis Kartikasari, Dhian; Andarini, Sri; Wardhani, Viera; Windarwati, Heni D.
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.v5i1.1962

Abstract

Mental health disorders are a significant issue, yet there is currently no consistent data regarding the factors that may contribute to their occurrence. The aim of this study was to identify the factors that may influence the occurrence of mental health disorders in the undergraduate student population. This meta-analysis, registered in PROSPERO, was conducted as of September 5, 2024. The systematic searches were conducted on three databases (Scopus, Embase, and PubMed). Data on factors related to the occurrence of mental health disorders in undergraduate students were collected to calculate pooled point estimates using the Mantel-Haenszel test. Out of 6,837 articles, 16 articles were included in the analysis. Our findings revealed that female students had a higher chance of experiencing mental health disorders compared to male students (OR: 1.43; 95%CI: 1.14–1.80; p-Egger of 0.1041; p-Heterogeneity of <0.0001; p=0.0020). The chance of having mental health disorders was also higher among single students compared to those in relationships (OR: 1.20; 95%CI: 1.02–1.43; p-Egger of 0.0535; p-Heterogeneity of 0.1130; p=0.0180). This study did not find any associations between age group, family income, smoking, living arrangements, years of study, or regularity of physical activity with the occurrence of mental health disorders. These findings could serve as a basis for improving policies aimed at reducing the rates of mental health disorders in undergraduate students.
Dual effects of Camellia sinensis and Andrographis paniculata on hyperglycemia and infection in Drosophila Nainu, Firzan; Sartini, Sartini; Subehan, Subehan; Sari, Dwi K.; Bahar, Muhammad A.; Mudjahid, Mukarram; Latada, Nadila P.; Asbah, Asbah; Hardiyanti, Widya; Pratama, Muhammad R.; Suhenro, Suhenro
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.v5i1.1972

Abstract

The coexistence of hyperglycemia and infectious diseases represents a critical global health challenge, particularly in resource-limited settings where it amplifies disease severity and complicates treatment approaches. Medicinal plants such as Camellia sinensis and Andrographis paniculata have gained recognition for their antioxidant, anti-inflammatory, and antimicrobial properties, making them promising candidates for addressing this double health burden. The aim of this study was to establish a preclinical model of hyperglycemia and infection (HI model) using Drosophila melanogaster and to investigate the therapeutic potential of C. sinensis and A. paniculata extracts in alleviating the burden associated with the HI condition. In this study, the HI model was established by simultaneously exposing D. melanogaster larvae to a high-concentration sucrose solution and Staphylococcus aureus for 24 hours. The larvae were then transferred to a high-sucrose diet supplemented with C. sinensis or A. paniculata extracts. Survival assays and molecular analyses were subsequently performed to evaluate the outcomes. Our findings revealed that the combination of hyperglycemia and infection significantly reduced survival rates in the Drosophila model. However, treatment with 1.25% C. sinensis and A. paniculata extracts notably improved survival, attributed to their antibacterial activity and regulation of key molecular pathways involved in immune responses, metabolic balance, and endogenous antioxidant defenses. These findings validate the utility of D. melanogaster as a model organism for investigating the double burden of HI. Furthermore, the study offers compelling evidence of the dual therapeutic potential of C. sinensis and A. paniculata in mitigating the detrimental effects of this condition. Overall, this research underscores the significant promise of plant-derived compounds in managing HI and paves the way for future studies to explore their underlying mechanisms and potential clinical applications.
Effects of porang glucomannan combined with a high-protein diet on oxidative stress, inflammation, and aging markers in D-galactose-induced rats Safitri, Azizah H.; Sayyida, Rahmata A.; Setyawan, Sigit; Tyagita, Nurina
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.v5i1.1995

Abstract

Aging is a predominant risk factor for several diseases associated with reduced life expectancy. To address this risk factor, several studies have proposed the combined use of porang glucomannan and a high-protein diet to improve various aging markers. The aim of this study was to determine the effects of porang glucomannan and high-protein combination diet as an anti-aging agent. An experimental study using a post-test-only control group design was conducted using Sprague Dawley white rats. The animals were randomly divided into four groups with different treatments as follows: normal control, D-galactose, high-protein diet, and a combination of porang glucomannan and high-protein combination diet. Blood samples were then collected from the ophthalmic vein on day 58 for biomarker measurement using the enzyme-linked immunosorbent assay (ELISA) method. The parameters measured were superoxide dismutase (SOD), malondialdehyde (MDA), interleukin (IL)-6, tumor necrosis factor-alpha (TNF-α), insulin growth factor-1 (IGF-1), NOD-like receptor family pyrin domain-containing protein 3 (NLRP3), growth differentiation factor-11 (GDF11), and α-Klotho levels. The results showed that the combination of porang glucomannan and high-protein diet could improve oxidative stress, inflammation, and aging markers. The analysis of variance (ANOVA) test followed by post-hoc least significant difference (LSD) showed significant differences between the combination diet and high protein group (p<0.0001). In addition, the average levels of oxidative stress markers (SOD and MDA) in porang glucomannan and high-protein combination group were improved significantly. Similar results were also obtained for inflammatory markers (IL-6 and TNF-α) and aging markers (NLRP3, IGF-1, GDF-11, and α-Klotho). The mean NRLP-3 levels in glucomannan and high-protein combination group were not significantly different compared to control. The study highlights that the combination of porang glucomannan and a high-protein diet effectively improved various aging markers.
Improving pelvic floor muscle strength in women with postpartum stress urinary incontinence using electromagnetic stimulation therapy: A randomized controlled trial Roziana, Roziana; Chan, Muhammad SN.; Santoso, Budi I.; Sjusad, Suskhan; Priyatini, Tyas; Hakim, Surahman; Moegni, Fernandi; Mutia, Alfa P.; Kurniawan, Andrew P.; Armita, Nurdarlila
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.v5i1.2015

Abstract

Electromagnetic stimulation (EMS) has emerged as a potential alternative for managing urinary incontinence in women. However, research directly comparing EMS to Kegel exercises in cases of postpartum stress urinary incontinence (SUI) is limited. The aim of this study was to assess the effectiveness of EMS (improvement of the symptoms, incontinence severity and pelvic floor muscle strength) and patient compliance with the therapy in postpartum women with SUI. A single-blind randomized clinical trial was conducted involving postpartum women diagnosed with SUI at least three months after delivery. The EMS group received the therapy three times a week for five weeks, while the Kegel group was instructed to perform daily exercises for eight weeks. Improvement of the symptoms and incontinence severity were evaluated using the Urogenital Distress Inventory-6 (UDI-6) and a 1-hour pad test, respectively, while pelvic floor muscle strength was measured with a perineometer. Both groups showed significant improvements in UDI-6 scores, 1-hour pad test results and pelvic floor muscle strength compared to before treatment. However, the EMS group had significantly greater muscle strength than the Kegel group (16.5 vs 8.0 cmH2O, p=0.006). The UDI-6 scores, 1-hour pad test results and patients’ compliance were not significantly different between EMS and Kegel groups. EMS demonstrated a greater ability to enhance pelvic floor muscle strength than Kegel exercises. These findings suggest that EMS may be a more effective option for enhancing pelvic floor muscle strength in postpartum women.
Network analysis of the relationship between self-management, self-efficacy, and quality of life among diabetes mellitus patients Le, Minh H.; Dao, Tran NP.; Le, Ngoc D.; Tran, Van D.
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.v5i1.2029

Abstract

Diabetes mellitus (DM) requires constant self-management and self-efficiency, which affects the quality of life among patients. It is important to understand the complex interplay between these factors to improve the results of treatment. The aim of this study was to explore the relationship between self-management, self-efficacy, and quality of life among diabetes mellitus patients. A cross-sectional study of 363 diabetes patients from three public hospitals in Cao Lanh City, Vietnam, was conducted. Self-management, self-efficacy, and quality of life were assessed using the 35-item Diabetes Self-Management Instrument (DSMI), the 6-item Self-Efficacy for Managing Chronic Disease Scale (SECD6), and the 5-item European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L), respectively. Network analysis was performed to visually describe the relationship between self-management (which includes five domains of self-integration, self-regulation, interaction with health professionals and other significant people, self-monitoring, and medication adherence), self-efficacy, and quality of life. The network analysis showed that self-monitoring had the highest centrality. Two subscales of self-management, adherence and self-integration, were directly and positively correlated with quality of life, while the interaction was directly and negatively correlated with quality of life. Self-efficacy was positively correlated with self-regulation and self-monitoring, while it was negatively correlated with adherence. A direct positive correlation was also found between self-efficacy and quality of life. In conclusion, these findings highlight the pivotal role of self-management and self-efficacy in enhancing quality of life. Future studies should focus on patient education interventions to enhance adherence and self-efficacy, ultimately improving the quality of life in people with diabetes.
Evaluating socio-demographic, behavioral, and maternal factors in the dual burden of malnutrition among school-aged children in Batam, Indonesia Erda, Roza; Hamidi, Dachriyanus; Desmawati, Desmawati; Rasyid, Rosfita; Sarfika, Rika
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.v5i1.2049

Abstract

Malnutrition among school-aged children in urban-industrial settings presents a dual burden of undernutrition and overnutrition. The aim of this study was to examine factors influencing the nutritional status of elementary school children in Batam, Indonesia. A case-control study was conducted in Batam, focusing on children aged 6–12 years, with malnourished cases (undernutrition and overnutrition) and well-nourished controls, along with their mothers. Respondents were selected through stratified random sampling from public elementary schools. Inclusion criteria encompassed children enrolled in these schools, while exclusion criteria involved children with chronic health conditions. Data were collected via structured interviews utilizing validated questionnaires, anthropometric assessments (weight-for-age and height-for-age), and parent-reported socioeconomic, behavioral and family characteristics. Statistical analysis involved binary logistic regression to identify significant risk factors associated with malnutrition. A total of 188 children, including 94 malnourished cases (40 undernutrition and 54 overnutrition) and 94 well-nourished controls. The findings revealed significant differences between cases and controls in socioeconomic factors (pocket money (p=0.027), family income (p=0.042)), behavioral factors (sedentary activity (p=0.019), dietary habits (p=0.037)) and family factors (maternal BMI, p=0.011; maternal nutritional knowledge, p=0.004; parenting style, p=0.035). Dominant risk factors for malnutrition (undernutrition or overnutrition) included poor dietary habits (adjusted odds ratio (aOR): 0.451; 95%CI: 0.225–0.901; p=0.024), maternal obesity class II (aOR: 0.126; 95%CI: 0.030–0.535; p=0.005), and low maternal nutritional knowledge (aOR: 0.294; 95%CI: 0.124–0.696; p=0.005). Targeted family-centered interventions focusing on dietary practices and maternal education are therefore recommended to address this issue.

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