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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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A novel diastolic dysfunction score: A proposed diagnostic predictor for left ventricular dysfunction in obese population Kamelia, Telly; Rumende, Cleopas M.; Makmun, Lukman H.; Timan, Ina S.; Djauzi, Samsuridjal; Prihartono, Joedo; Fardizza, Fauziah; Tabri, Nur 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.v5i1.1564

Abstract

Obesity-related diastolic dysfunction is an emerging contributor to heart failure and cardiovascular mortality. However, effective and accessible diagnostic tools are still limited. Current methods for assessing diastolic dysfunction are often invasive or technologically demanding, making them impractical for routine clinical use and community settings. The aim of this study was to develop a novel, non-invasive scoring system designed to predict diastolic dysfunction in obese adults, addressing this diagnostic gap. This community-based, prospective cross-sectional study was conducted in Jakarta, Indonesia, from March to November 2021, and included 82 participants aged 18 to 60 years, all with a body mass index (BMI) ≥25 kg/m². Patients with acute or critical illnesses, valvular heart diseases, or acute confusional states were excluded. Each participant underwent blood tests, polysomnography, and echocardiography. Of the study population, 80.5% were diagnosed with obstructive sleep apnea (OSA), and 12.2% exhibited diastolic dysfunction, all within the OSA group. The novel scoring system integrates four predictors: oxygen desaturation index (ODI) ≥39 (score 1; prevalence ratio: 4.31 (95% confidence interval (CI): 1.58–11.75)), HbA1C ≥5.95% (score 2; prevalence ratio: 6.32 (95%CI: 2.84–14.06)), pulmonary artery wedge pressure (PAWP) ≥10 mmHg (score 1; prevalence ratio: 5.95 (95%CI: 2.30–15.39)), and global longitudinal strain (GLS) ≥-16.95% (score 1; prevalence ratio: 4.32 (95%CI: 1.87–9.99)). A score of ≥2 predicted diastolic dysfunction with 90% sensitivity, with positive predictive value and negative predictive value of 40.91% and 98.33%, respectively. In conclusion, the diastolic dysfunction score is a simple and practical tool for the early detection of diastolic dysfunction in obese individuals without cardiovascular symptoms.
Resistance status of Aedes mosquitoes as dengue vectors and the potential of plant larvicides from Indonesia for biological control: A narrative review Kasman, Kasman; Ishak, Hasanuddin; Alam, Gemini; Amiruddin, Ridwan; Hastutiek, Poedji; Arsin, Andi A.; Nasir, Sudirman; Ridha, Muhammad R.; Wahid, Isra
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.v5i1.1819

Abstract

Dengue fever remains a major public health threat in Indonesia, exacerbated by rising insecticide resistance in Aedes aegypti. Strategies relying on chemical insecticides, while initially effective, have led to widespread resistance in mosquito populations. This resistance is particularly pronounced in areas such as Java, where the extensive use of insecticides, including organophosphates and pyrethroids, has been documented. To address this challenge, one promising alternative is the utilization of biolarvicides derived from local Indonesian plant materials. Biolarvicides are environmentally friendly, safe, and have the potential to mitigate the adverse impacts associated with chemical insecticides. Numerous studies have explored the larvicidal properties of indigenous plants native to Indonesia, demonstrating their efficacy against A. aegypti. The aim of this study was to examine insecticide resistance in Aedes mosquitoes across Indonesia, highlighting geographical variations and underexplored regions, and exploring plant-based biolarvicides as sustainable alternatives.  Biolarvicides derived from native Indonesian plants could be eco-friendly alternative for dengue vector management. Their integration into existing control strategies could significantly enhance efforts to control dengue while reducing the environmental and health risks posed by chemical insecticides.
Factors associated with newly diagnosed ischemic stroke among people with type 2 diabetes mellitus in Thailand: A population-based case-control study Phasom, Junjira; Ungcharoen, Ratchadaporn; Pusuwan, Pakorn; Phoosuwan, Nitikorn
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.v5i1.2205

Abstract

Stroke is a leading cause of mortality and disability-adjusted life years. Its incidence is rising across Asia, with ischemic stroke accounting for approximately 80% of total stroke cases in Thailand. Stroke often leads to long-term disabilities, including impairments in speech, communication, and cognitive function. The aim of this study was to investigate risk factors associated with newly diagnosed ischemic stroke. A matched case-control study was conducted, including 154 newly diagnosed ischemic stroke cases and 183 non-stroke controls, all with type 2 diabetes mellitus (T2DM). Data were collected between February and September 2022 (post-COVID-19 period) using a structured questionnaire covering socio-demographics, lifestyle factors, perceived social support, and self-care management (SCM). Multivariable logistic regression models were used to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI). The majority of participants were female (60.8%), Buddhist (92.9%), and agriculturists (66.5%), with a mean age of 58.9 (±9.9) years. Factors associated with ischemic stroke included male (aOR: 3.53; 95%CI: 1.73–7.21), Buddhism (aOR: 3.53, 95%CI: 1.11–11.25), sedentary occupation (aOR: 5.78; 95%CI: 2.61–12.81), and T2DM duration >10 years (aOR: 6.19, 95%CI: 3.55–10.80). Protective factors included age ≥60 years (aOR=0.55, 95%CI: 0.31–0.98) and moderate SCM levels (aOR=0.45, 95%CI: 0.26–0.80). This study highlighted that prolonged T2DM and sedentary occupations significantly contributed to ischemic stroke risk. Targeted prevention strategies, including lifestyle modifications and enhanced diabetes self-care management, may help reduce the burden of ischemic stroke.
Effectiveness of digital health in improving pregnancy quality among preconception women: A systematic review Nurleli, Nurleli; Hadju, Veni; Indriasari, Rahayu; Areni, Intan S.; Masni, Masni; Riskyani, Shanti
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.993

Abstract

Improving nutrition in women prior to conception represents an alternative approach to enhancing the quality of pregnancy. Increased knowledge and self-efficacy among preconception women positively impact changes in health behavior. The rapid development of technology provides an opportunity to implement innovative interventions, including digital health. The aim of this study was to systematically review the efficacy of digital health interventions in modifying the behavior of preconception women. The data were obtained by searching relevant articles published from 2015 to 2023 in electronic databases, including Google Scholar, Science Direct, Web of Science (WoS), Biomed Central, and PubMed. The following keywords were used: "digital health" OR "mobile health" OR "e-health" AND "preconception women" OR "pre-marriage women." Of the 266 studies identified in the search phase, only those that met the inclusion criteria were included in the review. These criteria included 10 articles that assessed the effectiveness of digital health interventions on the behavior change of preconception women. The articles included in this study originated from diverse countries and addressed various digital health interventions. The findings of the review indicated that ten articles reported an increase in pregnant women's knowledge, nine articles demonstrated an enhancement in self-efficacy, and nine articles documented behavioral changes. The behavioral changes observed included the initiation of folic acid consumption before pregnancy, an increase in vegetable and fruit consumption, and a reduction in unhealthy dietary behaviors, such as maintaining a normal weight, smoking cessation, and reduced alcohol consumption. In conclusion, digital health literacy interventions, delivered via web-based platforms or mobile applications, demonstrate effectiveness in promoting positive preconception health behaviors among women, ultimately contributing to improved pregnancy outcomes.
Peptide-based drug as atherosclerosis multitarget therapy from Lytechinus variegatus spine: An in silico study Arisanty, Dessy; Khairani, Salsabila P.; Nathaniel, Kevin; Wahyudi, Dhyani P.; Kamila, Isna C.; Maharani, Malya CS.; Theodora, Eillen; Budianto, Raymond E.; Shofiy, Alifya R.; Nugraha, Ikwandi C.; Aaliyya, Zaki S.; Rahman, Awalil RK.; Ariouso, Al H.
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.1152

Abstract

Atherosclerosis is a leading cardiovascular disease characterized by the buildup of plaques within arterial walls. The aim of this study was to investigate the potential of peptides derived from Lytechinus variegatus spines as novel therapeutic agents for atherosclerosis using an in silico approach. Key proteins involved in atherosclerosis were selected as target proteins: vascular endothelial growth factor receptor (VEGFR), protein kinase B (AKT1), epidermal growth factor receptor (EGFR), mitogen-activated protein kinase 8 (MAPK8), and endothelin-1 (ET-1). Comprehensive analysis involving ligand and protein preparation, toxicity, and allergenicity assessments, absorption, distribution, metabolism and excretion (ADME) predictions, and molecular docking were conducted to evaluate the safety, pharmacokinetic properties, binding affinity (kcal/mol), root mean square deviation (RMSD) (Å), as well as a 2D and 3D visualization. Toxicity predictions revealed that peptide 9 was non-toxic and non-allergenic, with a lethal dose 50 (LD50) of 3,000 mg/kg, indicating its safety. Peptide 9 demonstrated the most promising results, effectively inhibiting VEGFR2 (-10,90 kcal/mol), AKT1 (-10,56 kcal/mol), EGFR (-9,82 kcal/mol), MAPK8 (-9,64 kcal/mol), and ET-1 (-11,41 kcal/mol) with strong binding affinities and specificity. These interactions suggested that peptide 9 from Lytechinus variegatus spines may serve as a competitive multitarget inhibitor, offering potential multitarget therapeutic activity against atherosclerosis. Peptide 9 also had high water solubility and did not affect the concentration or excretion of other drugs or compounds, minimizing the risk of drug-drug interactions.
Assessing health-related quality of life in schizophrenia patients using EQ-5D-5L index: Insights from patients and caregivers A. Prasetiyo, Nugraha; Wahyudin, Elly; Setiawan, Iman; Sanusi, Mayamariska; Purba, Fredrick D.; Arifin, Bustanul; Alkaff, Sylmina D.
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.1314

Abstract

Schizophrenia is a prevalent mental health disorder often marked by relapses, significantly affecting the health-related quality of life (HRQoL) of both patients and their families. The aim of this study was to compare the EuroQol 5-Dimension 5-level (EQ-5D-5L) responses of schizophrenia patients and their caregivers. Using an observational cross-sectional design, HRQoL was assessed among schizophrenia patients and their family caregivers recruited from a provincial referral hospital. Sociodemographic (age, sex, education, marital status, income) and clinical variables (diagnosis, treatment duration, comorbidities) were analyzed alongside HRQoL using structured interviews, medical record reviews, and the EQ-5D-5L instrument (self-report by patients and proxy-reported by family caregivers). Statistical analyses included chi-square tests for associations, Wilcoxon tests for patient-family caregiver comparisons, and multivariate modeling of HRQoL determinants. A total of 526 participants (263 patients and 263 accompanying family caregivers) were included. Significant differences were observed between patients and family caregivers in two domains: pain/discomfort and anxiety/depression. Also, the agreement between patients' and family caregivers’ reports showed good results. A substantial agreement was observed between patient-reported and family caregiver-assessed HRQoL, as indicated by a Cohen’s Kappa value of 0.8. This result suggests a strong level of consistency between the two assessments, supporting the potential use of family caregivers as reliable proxies for evaluating patient HRQoL when self-reports are unavailable or unreliable. In the self-care domain, mobility, and daily activities, patient and caregiver assessments show high agreement. In conclusion, the closeness between patients and caregivers significantly influences patients' HRQoL, providing critical insights for evaluating treatment effectiveness in schizophrenia cases. While discrepancies exist between patient and caregiver assessments, these interactions are particularly impactful in subjective domains like pain/discomfort and anxiety/depression, but not for other domains that are visible.
Stigma and health-related quality of life (HRQoL) among people with multidrug-resistant tuberculosis (MDR-TB): A cross-sectional study in Indonesia Arifin, Bustanul; Sarwadan, Muhamad G.; Wahyudin, Elly; Sarifah, Latifah M.; Fuady, Ahmad; Purba, Fredrick D.; Alkaff, Sylmina D.; Ardiansyah, Akhmad; Madolangan, Jamaluddin
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.1317

Abstract

Stigma often accompanies people with multidrug-resistant tuberculosis (MDR-TB) and potentially affects their health-related quality of life (HRQoL). The aim of this study was to investigate the stigma faced by patients with MDR-TB, both from the patients' and community's perspective, and its relationship with HRQoL. Data was gathered at the provincial hospital in Makassar, South Sulawesi, Indonesia. The instrument employed in this research was the Indonesian version of the tuberculosis (TB) stigma instrument to assess MDR-TB stigma from the patient and community perspectives. The patient perspective represents how individuals with TB perceive and experience stigma, including the fear of disclosure, isolation, and guilt (feeling responsible for the burden on their family or their own risky behaviors). Meanwhile, the community perspective reflects how individuals with TB perceive societal attitudes towards them, such as social distancing, avoidance, and reluctance to interact. HRQoL was measured using the European quality of life-5 dimensions-5 level version (EQ-5D-5L) instrument. Notably, the evaluation of anxiety and depression is centered on the fifth dimension of the EQ-5D-5L instrument. A total of 210 patients with MDR-TB were included in the study, all of whom reported experiencing stigma. Most participants perceived stigma at a moderate level, with 76% from the patient perspective and 71% from the community perspective. The average EQ-5D-5L index score was 0.72 (95% confidence interval (95%CI): 0.68–0.76). Measurements from both perspectives show similar scores. There is a substantial negative association between the level of stigma and HRQoL, both from the patient's perspective (R2=-0.33; F=102.52; p<0.001) and the community's (R2=-0.32; F=96.76; p<0.001). The study highlights that the stigma of MDR-TB significantly affects the HRQoL from the patient and community perspective.
Lichen substances from Teloschistes flavicans (Sw.) Norman: Isolation, crystal structure, and evaluation of their antibacterial activities Ismed, Friardi; Arifa, Nurwahidatul; Nissa, Mentari Q.; Putra, Deddi P.; Orue, Analia IC.; Clegg, Jack K.; Rouaud, Isabelle; Dévéhat, Françoise L.
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.1463

Abstract

Teloschistes flavicans (Sw.) Norman is a lichen known as the golden-haired lichen. This lichen has been recognized and used in herbal medicine mixtures as an antimicrobial and bioindicator of air pollution that plays a role in ecological systems. The aim of this study was to explore the potential of its secondary metabolites as antibacterial and anticancer agents, particularly against bacterial pneumonia. Two main compounds (vicacinin and parietin) were isolated with chromatography and identified by spectrometry and single-crystal X-ray diffraction. The crystallographic data of vicanicin are reported for the first time. Chromatography and recrystallization methods were used to obtain both compounds with orange (parietin) and white (vicanicin) crystals. Furthermore, these compounds were evaluated for cytotoxicity on keratinocytes (HaCaT) cells and antibacterial activity against pneumonia pathogens (Klebsiella pneumoniae ATCC 1706, Streptococcus pneumoniae ATCC 49619, Moraxella catarhalis ATCC 25240, and Staphylococcus pyogenes ATCC 19615). The cytotoxic activity of these compounds was moderate at the concentration of 50-100 µM. The antibacterial pneumonia activity was relatively weak compared to chloramphenicol. Between the two compounds, vicanicin showed stronger activity than parietin against all strains. Vicanicin was more active against Klebsiella pneumoniae and Staphylococcus pyogenes with minimum inhibitory concentrations of 156±0.77 µM and 156±0.91 µM, respectively. In this study, comprehensive molecular structures of parietin and vicanicin have been successfully elucidated, and their antibacterial and cytotoxic activities have been provided.
Probiotic Lactobacillus sp. as a strategy for modulation of non-comorbid obesity: A systematic meta-analysis and GRADE assessment of randomized controlled trials Lele, Juan AJMN.; Sihaloho, Karlos B.; Vighneswara, Dewa; Rampengan , Derren DCH.; Rizqiansyah, Chrisandi Y.; Permatasari, Happy K.; Mayulu, Nelly; Tallei, Trina E.; Taslim, Nurpudji A.; Kim, Bonglee; Kezia, Immanuelle; Nurkolis, Fahrul; Syahputra, Rony A.
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.1562

Abstract

Given the high prevalence of obesity worldwide, effective therapeutic strategies are crucial to prevent and manage obesity-related health conditions. Existing studies indicate that Lactobacillus sp. showed beneficial effects on body weight and adiposity by modifying the gut microbiota; however, no meta-analysis has been conducted assessing the efficacy of Lactobacillus sp-based probiotics on anthropometric parameters, leptin and adiponectin levels, and gut microbiota composition. The aim of this study was to evaluate the efficacy and safety of probiotic supplementation with Lactobacillus sp. in obese individuals without comorbidities. A systematic search was conducted on November 28, 2024, using five databases: PubMed, Wiley, ScienceDirect, Epistemonikos, and Cochrane. Primary outcomes included changes in body mass index (BMI), body weight, waist and hip circumferences, visceral and subcutaneous fat areas, and total body fat content. Secondary outcomes included alterations in leptin and adiponectin levels, gut microbiota composition, and the incidence of adverse events. A total of 1,058 individuals were included across 12 clinical trials. Significant reductions were observed in BMI (mean difference (MD): -0.40 kg/m²; 95%CI: -0.48–(-0.32), p<0.00001), body weight (MD: -1.16 kg; 95%CI: -1.79–(-0.53), p=0.0003), waist circumference (MD: -1.41 cm; 95%CI: -1.75–(-1.08), p<0.00001), and hip circumference (MD: -0.85 cm; 95%CI: -1.09–(-0.61), p<0.00001) compared to controls. Additionally, compared to control group, significant reductions were observed in visceral and subcutaneous fat mass (MD: -7.35; 95%CI: -9.95–(-4.75); p<0.00001) and overall body fat (MD: -1.11; 95%CI: -1.31–(-0.91); p<0.00001). Leptin levels significantly decreased (MD: -2.11 μg/mL; 95%CI: -3.59–(-0.64), p=0.005) compared to before Lactobacillus sp. supplementation, while adiponectin levels increased (MD: 0.71 μg/mL; 95%CI: 0.22–1.20, p=0.004) following Lactobacillus sp. supplementation compared to placebo group. No significant adverse events were reported in either the intervention or control groups. In conclusion, Lactobacillus sp. probiotic supplementation may serve as an adjuvant therapy to enhance obesity management in non-comorbid obese individuals.
Beetroot (Beta vulgaris) potential in preventing colorectal cancer using in-silico analysis Dwijayanti, Adisti; Azizah, Norma N.; Erlina, Linda; Kusmardi, Kusmardi; Ningsih, Sri S.; Fadilah, Fadilah; Hashim, Najihah M.
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.1578

Abstract

Colorectal cancer (CRC) is one of the leading causes of cancer-related mortality worldwide, necessitating the need for an effective therapeutic strategy. Beta vulgaris (beetroot) possesses active compounds that exert anti-cancer properties. The aim of this study was to evaluate the potential of beetroot as a preventative agent against the progression of CRC using differentially expressed gene (DEG) analysis and network pharmacology approaches. The protein-protein interaction network and molecular docking analyses were employed to assess the key interactions of beetroot active compounds with CRC-related target protein. Cytotoxicity of beetroot extract was experimentally evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium bromide (MTT) assay on the HT29 cell line. The result of this study showed that protein in the cell cycle was significantly enriched in CRC, with cyclin-dependent kinase 4 (CDK4) gene as one of the specific genes. Quercetin, galangin, hesperidin, farrerol, and betanin were the most typical compounds of beetroot based on the Comparative Toxicogenomics Database (CTD). Molecular docking studies revealed the strong binding affinity between quercetin (-7.04 kcal/mol) and bentanin (-8.11 kcal/mol) with CDK4. Beetroot demonstrated anticancer properties against the HT29 cell line with IC50 value of 39.03±1.4 µg/mL. In conclusion, the beetroot extract has inhibitory activity against HT29 cell line proliferation, highlighting its potential in preventing the development of CRC through the substantial suppression of gene expression within the cell cycle pathway.

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