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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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Exploring the potential effects of Lactococcus lactis D4 on the proliferation, apoptosis, and inflammatory responses in colorectal cancer cells Rivai, Muhammad I.; Lusikooy, Ronald E.; Putra, Andani E.; Elliyanti, Aisyah; Sukma, Ade
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.v5i2.1596

Abstract

Lactococcus lactis D4 is a probiotic produced through the fermentation of buffalo milk in bamboo, namely "dadih", a traditional food from West Sumatera, Indonesia. To the best of our knowledge, no specific research has investigated the effects of L. lactis D4, derived from dadih extraction, on colorectal cancer or its potential clinical applications. Therefore, the aim of this study was to evaluate the potential of L. lactis D4 from dadih to inhibit colorectal cancer growth in rat models, with a focus on its effects on cell proliferation, apoptosis, and inflammatory responses. An in vivo study was conducted using 37 male Sprague-Dawley rats, allocated into five groups: (1) control (no treatment), (2) dysplasia (induced with 1,2-dimethylhydrazine until dysplasia developed), (3) dysplasia + L. lactis D4 (induced with 1,2-dimethylhydrazine, then treated with L. lactis D4 after dysplasia confirmation), (4) cancer (induced with 1,2-dimethylhydrazine until cancer was confirmed), and (5) cancer + L. lactis D4 (induced with 1,2-dimethylhydrazine until cancer was confirmed, then treated with L. lactis D4 for 15 days). The effects of L. lactis D4 on cancer progression were assessed through immunohistochemical analysis of cell proliferation (cyclin D1, Bcl-2), apoptosis (p53, caspase-3), and inflammation (nuclear factor-κB (NF-κB) and cyclooxygenase-2 (COX-2)). This study found that L. lactis D4 treatment reduced adenocarcinoma and dysplasia severity in colorectal cancer models through significant reduction in cyclin D1, Bcl-2, NF-κB, and COX-2 expression observed across all groups (p<0.01), although changes in dysplasia and cancer subgroups were not statistically significant (p>0.05). No statistically significant change was noted in p53 expression (p=0.518), whereas caspase-3 expression varied significantly across groups (p=0.010). In conclusion, L. lactis D4 reduces the expression of cyclin D1, Bcl-2, NF-κB, and COX-2 proteins, offering insights into its potential to modulating proliferation and inflammation in colorectal cancer growth.
Designing the CORI score for COVID-19 diagnosis in parallel with deep learning-based imaging models Kamelia, Telly; Zulkarnaien, Benny; Septiyanti, Wita; Afifi, Rahmi; Krisnadhi, Adila; Rumende, Cleopas M.; Wibisono, Ari; Guarddin, Gladhi; Chahyati, Dina; Yunus, Reyhan E.; Pratama, Dhita P.; Rahmawati, Irda N.; Nareswari, Dewi; Falerisya, Maharani; Salsabila, Raissa; Baruna, Bagus DI.; Iriani, Anggraini; Nandipinto, Finny; Wicaksono, Ceva; Sini, Ivan R.
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.v5i2.1606

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has triggered a global health crisis and placed unprecedented strain on healthcare systems, particularly in resource-limited settings where access to RT-PCR testing is often restricted. Alternative diagnostic strategies are therefore critical. Chest X-rays, when integrated with artificial intelligence (AI), offers a promising approach for COVID-19 detection. The aim of this study was to develop an AI-assisted diagnostic model that combines chest X-ray images and clinical data to generate a COVID-19 Risk Index (CORI) Score and to implement a deep learning model based on ResNet architecture. Between April 2020 and July 2021, a multicenter cohort study was conducted across three hospitals in Jakarta, Indonesia, involving 367 participants categorized into three groups: 100 COVID-19 positive, 100 with non-COVID-19 pneumonia, and 100 healthy individuals. Clinical parameters (e.g., fever, cough, oxygen saturation) and laboratory findings (e.g., D-dimer and C-reactive protein levels) were collected alongside chest X-ray images. Both the CORI Score and the ResNet model were trained using this integrated dataset. During internal validation, the ResNet model achieved 91% accuracy, 94% sensitivity, and 92% specificity. In external validation, it correctly identified 82 of 100 COVID-19 cases. The combined use of imaging, clinical, and laboratory data yielded an area under the ROC curve of 0.98 and a sensitivity exceeding 95%. The CORI Score demonstrated strong diagnostic performance, with 96.6% accuracy, 98% sensitivity, 95.4% specificity, a 99.5% negative predictive value, and a 91.1% positive predictive value. Despite limitations—including retrospective data collection, inter-hospital variability, and limited external validation—the ResNet-based AI model and the CORI Score show substantial promise as diagnostic tools for COVID-19, with performance comparable to that of experienced thoracic radiologists in Indonesia.
Hybrid function of light fraction patchouli oil in hair care formulations for effective hair and anti-dandruff treatment Isnaini, Nadia; Muhammad, Syaifullah; Prajaputra, Vicky; Indra, Indra; Sufriadi, Elly; Ernawati, Ernawati; Riski, Cantika 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.v5i2.1622

Abstract

Hair issues, such as hair loss and dandruff, pose significant challenges in hair care. Patchouli oil, rich in bioactive components, has emerged as a promising candidate for addressing these concerns. The aim of this study was to investigate the hybrid functionality of fractionated patchouli oil in hair care formulations designed to promote hair growth and control dandruff caused by Malassezia globosa. Crude patchouli oil (CPO) was fractionated to enhance its efficacy, producing light fraction patchouli oil (LFPO), which was then characterized using gas chromatography-mass spectrometry (GC-MS) analysis. Hair tonic formulations containing three different LFPO concentrations (0.5%, 1.0%, and 1.5%) were developed and evaluated for stability, pH, viscosity, and antifungal activity against M. globosa. The results showed that LFPO contained 2.51% acid number, 0.70% ester number, 0.71 mg/kg iron content, and 25.88% patchoulol. The formulations exhibited stable physicochemical properties, with pH levels of 5.36–5.51 and viscosity ranging from 3.94 to 4.08 centipoise (cP), suitable for hair tonic applications. Formulation of 1.5% LFPO demonstrated the strongest antifungal activity, producing a 31.18±1.37 mm inhibition zone against M. globosa, surpassing ketoconazole (21.72±0.28 mm), suggesting potential as a natural antifungal agent. Histological analysis in rabbits revealed that 1.5% LFPO formulation reduced epidermal cell shedding, increased hair length by 41.6±0.35 mm after six weeks, and promoted dense hair follicle growth. This research provides a foundation for developing natural, effective, and stable hair care formulations. Despite these promising results, the efficacy and safety of LFPO formulations in humans remain unexplored. Therefore, a clinical human trial is necessary to assess skin tolerance, irritation risks, and long-term effects under real-world conditions.
Challenges in maritime evacuation during pre-hospital emergency anesthesia on a remote island in Indonesia: A case report Mutiar, Airi; Arifi Abbas, Kun
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/narraj.v5i2.1643

Abstract

Preeclampsia and eclampsia remain significant contributors to maternal and perinatal mortality. Managing these conditions is particularly challenging in remote areas in many islands of Indonesia, where access to medical care is severely limited. The aim of this study was to analyze the pre-hospital anesthetic management of an eclampsia patient during maritime evacuation to a higher-level facility, highlighting the complexities of medical transport in resource-limited settings. A 38-year-old multiparous woman from a remote village on Pagerungan Island, Indonesia, at 37 weeks of gestation, presented with tonic-clonic seizures consistent with eclampsia. The absence of antenatal care necessitated urgent intervention. Upon presentation, the patient had a Glasgow Coma Scale (GCS) score of 5, tachycardia, and irregular breathing, requiring rapid-sequence intubation and magnesium sulfate administration. Given the geographic constraints, the patient was evacuated by sea under challenging conditions. Despite significant waves, a multidisciplinary team successfully performed an emergency cesarean section onboard, delivering a male infant who required neonatal resuscitation. Postoperatively, both mother and neonate were transferred to a higher-level facility. However, engine failure extended the journey to 18 hours, leading to depletion of oxygen and essential medications, necessitating critical decision-making. This case underscores the significant challenges of emergency eclampsia management in remote settings, particularly during maritime evacuation. Effective stabilization, anesthesia, monitoring, and timely transport are crucial. This case highlights the need for optimized evacuation protocols and increased healthcare resource allocation to enhance maternal and neonatal outcomes in maritime and other resource-limited settings.
Cryotherapy on exfoliative cytological changes for oral mucositis in cancer patients undergoing chemotherapy: A randomized control trial Erika, Kadek A.; Mulhaeriah, Mulhaeriah; Miskad, Upik A.; Zuraida, Eli; Sangkala, Moh S.; Magfirah, Ika; Achmad, Harun
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.v5i2.1644

Abstract

Oral mucositis is a common complication of chemotherapy that significantly impacts quality of life and may reduce treatment efficacy. While oral cryotherapy has been widely studied as a preventive intervention due to its cost-effectiveness, safety, and ease of use, most research focused on clinical outcomes without incorporating objective cytological assessments of mucosal changes. The aim of this study was to evaluate the effectiveness of oral cryotherapy in managing chemotherapy-induced mucositis using exfoliative cytology to monitor oral mucosal changes. A single-blinded, randomized controlled trial was conducted involving 50 cancer patients undergoing chemotherapy, who were randomly assigned to either the intervention or control group. The control group (n=25) received standard oral hygiene care, while the intervention group (n=25) received oral cryotherapy in addition to routine oral hygiene. A 20-minute oral cryotherapy was administered twice daily after breakfast (09:00 A.M.) and lunch (01:00 P.M.) for 14 days. This study found a significant reduction in mucositis scores was observed in both groups (p<0.05). However, post-hoc analysis indicated that mucositis severity declined earlier in the cryotherapy group, whereas improvement in the control group was noted only after 14 days. Serial oral mucosal smears analyzed via exfoliative cytology revealed a reduction in inflammatory cells and the absence of coccus microorganisms by days 7 and 14 in the intervention group. In conclusion, this study demonstrated that oral cryotherapy effectively reduces the severity and duration of mucositis and accelerates recovery in cancer patients undergoing chemotherapy. Oral cryotherapy can be applied as a viable alternative to mitigate the severity of oral mucositis in this patient population.
Metabolomic profiling and antimicrobial investigation of Aspergillus fumigatus LBKURCC269 and Bacillus paramycoides LBKURCC218 co-culture Octarya, Zona; Nugroho, Titania T.; Nurulita, Yuana; Suraya, Nabella; Saryono, Saryono
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.v5i2.1647

Abstract

The increasing resistance of pathogenic microbes to antibiotics is a major public health concern, necessitating the discovery of effective antimicrobial compounds. The aim of this study was to assess the bioactive metabolites produced by Aspergillus fumigatus LBKURCC269 and Bacillus paramycoides LBKURCC218 under three fermentation conditions: monoculture of each microorganism and their co-culture. Metabolite analyses initiated with gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-high-resolution mass spectrometry (LC-HRMS) followed with molecular networking–Global Natural Products Social Molecular Networking (GNPS) and molecular docking. Antimicrobial activity of the extracts was then conducted. Metabolite analysis using GC-MS identified key antimicrobial compounds, including 2,6-bis(1,1-dimethylethyl)-4-methylphenol, pentadecanoic acid, cyclopropane pentanoic acid, and 3-piperidinol. LC-HRMS, combined with multivariate analysis and GNPS molecular networking, revealed additional antimicrobial compounds, including novel pyrazine derivatives induced in co-culture fermentation. Molecular docking analysis of 3-(propan-2-yl)-octahydropyrrolo[1,2-a]pyrazine-1,4-dione demonstrated its potential as an antimicrobial agent by inhibiting topoisomerase IV and cytochrome monooxygenase with binding affinity of -5.34 kcal/mol and -5.6 kcal/mol, respectively. The antimicrobial assays showed that the co-culture fermentation extract had the strongest activity, with inhibition zones of 20.33±0.59 mm (Escherichia coli), 14.33±0.59 mm (Staphylococcus aureus), and 25.67±0.59 mm (Candida albicans). This study highlights the advantages of co-culture fermentation in enhancing the discovery of antimicrobial compounds. The findings underscore the potential of this approach to simplify chemical isolation and accelerate the identification of novel antimicrobial agents for pharmaceutical development.
Mortality and associated factors among community-acquired pneumonia patients: A cross-sectional study in a provincial referral hospital in Indonesia Rosdiana, Dani; Siregar, Fajri M.; Ediwi, Nabila C.; Putri, Rahmi T.; Nurrahma, Zuyyina ER.; Elisabet, Adinda; Sarassari, Rosantia; Safari, Dodi; Ilmiawati, Cimi; Elliyanti, Aisyah
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.v5i2.1649

Abstract

Community-acquired pneumonia (CAP) poses a significant impact on the healthcare system due to rehospitalization and mortality. About one-third of hospitalized CAP patients died within one year. In addition to advanced age, vulnerable groups with comorbidities such as cancer, diabetes, and cerebrovascular disease (CVD) are more likely to suffer from severe CAP. The aim of this study was to investigate the factors linked to mortality in adult hospitalized CAP patients. The study extracted the medical records of patients aged ≥18 years, admitted to a referral hospital in Riau Province, who were diagnosed with CAP between January and December 2023. Multiple logistic regression step-wise analysis was employed to determine the factors associated with mortality in CAP patients. The study involved 334 patients with a median age of 58 years. Based on the confusion, urea, respiratory rate, blood pressure, and age ≥65 years (CURB-65) score, 11.9% of patients had severe CAP (CURB-65 scores 3 and 4). Age was a significant predictor of severe CAP (p≤0.001). The most prevalent comorbidities were malignancy (33.2%), CVD (30.2%), and diabetes (28.4%). Mortality incidence during hospitalization reached 35.9%. Significant factors associated with mortality in hospitalized CAP patients included renal dysfunction/elevated serum urea levels (p=0.031), CURB-65 score (p=0.023), vasopressor use (p≤0.001), mechanical ventilator use (p≤0.01) and steroid use (p=0.029). However, CVD was associated with a decreased risk of mortality (p=0.019). Gram-negative bacteria predominated, accounting for 50.6% of all positive isolates.  Several significant factors were associated with mortality in adult patients hospitalized with CAP at referral Hospital in Riau, including renal dysfunction, CURB-65 score, vasopressor use, mechanical ventilator use, and steroid use. This finding underscored the importance of early identification factors in CAP patients.
Genetic variations of the L2 gene in human papillomavirus (HPV) type 16 from cervical cancer patients in Sumatra region, Indonesia Savira, Maya; Farniga, Arnaldi; Ilmiah, Zidny; Rachmadina, Rachmadina; Rini, Ika A.; Kemal, Rahmat A.; Mahargyarani, Azza E.; Admiral, Muhammad Z.; Sofian, Amru; Razali, Renardy R.; Suhaimi, Donel; Putra, Andani E.
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.v5i2.1653

Abstract

The L2 protein, a minor capsid component of human papillomavirus (HPV), plays a critical role in the HPV life cycle by packaging the viral genome with the L1 protein and facilitating DNA transport to the nucleus. Identifying genetic variations in the L2 gene is essential for improving vaccine development, diagnostic accuracy, and understanding viral evolution, potentially contributing to more effective HPV vaccines. The aim of this study was to investigate the genetic variation of the L2 gene in cervical cancer specimens collected from patients in Riau Province, Indonesia. A single-center, cross-sectional study was conducted at Arifin Achmad General Hospital, Riau Province, involving cervical cancer patients with confirmed HPV16 infection between January 2018 and August 2020. Demographic, clinical, and risk factor data were collected through structured interviews and direct assessments. Cervical biopsy specimens were collected, and viral DNA was extracted for L2 gene amplification using polymerase chain reaction (PCR). Sequencing was conducted on PCR products, followed by single-nucleotide polymorphism (SNP) identification through alignment with the HPV16 reference genome. The amplification and sequencing of the HPV16 L2 gene from 22 cervical cancer specimens revealed 36 SNPs, including 31 nonsynonymous and five synonymous mutations. High-frequency mutations were observed at nucleotide positions 4,074 and 4,177, each detected in 95.45% of the samples. Notable insertions were found at positions 3,668–3,669 and 4,275–4,276, indicating substantial sequence variation. Phylogenetic analysis grouped the sequences into three clusters, with most belonging to sub-lineage A2 (European), while others aligned with A4 (Asian) and East Asian lineages. The observed genetic diversity in the HPV16 L2 gene may reflect regional viral evolution and has potential implications for future vaccine development.
Determinants of safety performance in healthcare settings: A meta-analysis Prihatiningsih, Septyani; Martiana, Tri; Widajati, Noeroel; Fajar, Jonny K.
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.v5i2.1654

Abstract

Safety performance among healthcare workers is an important issue, and currently, the factors related to it remain unclear. The aim of this study was to identify the factors related to safety performance among the healthcare worker population. This meta-analysis study was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) standards. Data on the factors affecting safety performance in the healthcare population were collected from each article to determine pooled point estimates. Data heterogeneity was evaluated using the Q statistic. Numerical data were analyzed using the inverse variance test, and the Mantel-Haenszel test was used for categorical data analysis. Pooled point estimates were presented as mean difference (MD) or odds ratio (OR) along with a 95% confidence interval (95%CI). Fifty articles were included in this study. Our results showed that nurses had lower safety performance compared to other professions (OR: 0.66; 95%CI: 0.56–0.79; p-Egger: 0.3739; p-Heterogeneity <0.0001; p<0.0001). On the other hand, it was also identified that housekeepers were associated with better safety performance compared to other professions (OR: 1.90; 95%CI: 1.08–3.35; p-Egger: 0.1577; p-Heterogeneity: 0.0950; p=0.0220). Furthermore, our findings revealed that healthcare workers who had undergone work safety training had better safety performance compared to those who had not (OR: 1.40; 95%CI: 1.01–1.95; p-Egger: 0.6124; p-Heterogeneity <0.0001; p=0.0430). In conclusion, this study has identified the factors contributing to safety performance in the healthcare population. These findings can inform policymakers in developing regulatory improvements regarding safety performance in healthcare workers.
Adherence to iron supplementation and associated factors among pregnant women in Cambodia: Insights from the 2021–2022 Demographic and Health Survey Buanasita, Annas; Sumarmi, Sri; Mahmudiono, Trias; Melaniani, Soenarnatalina; Salim, Lutfi A.; Sokvy, Ma; Sari, Nur MW.
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.v5i2.1659

Abstract

Iron deficiency is the leading cause of anemia during pregnancy, a major public health concern in many developing countries. To mitigate anemia, iron supplementation for at least 90 days is recommended for pregnant women. The aim of this study was to evaluate adherence to iron supplementation during pregnancy and to identify its key determinants in Cambodia. A cross-sectional study was conducted using secondary data from the 2021–2022 Cambodia National Demographic and Health Survey. Key variables assessed included maternal age, education level, ethnicity, wealth index, number of pregnancies, age at first pregnancy, prenatal care provider, timing of the first antenatal care (ANC) visit, and frequency of ANC visits. Multivariate logistic regression was employed to evaluate associations between adherence and independent variables. A total of 4,475 women aged 15–49 years who had been pregnant in the past five years were included in the analysis, with 91.2% adhering to iron supplementation for at least 90 days. Multivariate logistic regression showed that those with primary and higher education had greater odds of adherence (odds ratio (OR)=1.38; 95%CI: 1.00–1.90; OR=3.07; 95%CI: 1.39–6.79, respectively) compared to women with no education. There was a positive relationship between education level and adherence. Women who attended four or more ANC visits were more likely to adhere (OR=2.93; 95%CI: 2.27–3.77), and those who initiated ANC in the first trimester had higher adherence compared to those who started later (OR=1.78; 95%CI: 1.35–2.36). This study highlights that education level, frequency, and timing of ANC visits significantly influenced adherence to iron supplementation. Strengthening maternal education and promoting early and regular ANC follow-up should be prioritized to improve adherence and prevent anemia during pregnancy.

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