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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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Helicobacter pylori sabA, hopQ and hom genotypes as potential genetic biomarkers for gastric mucosal inflammation Hunowu, Ramdan; Fauzia, Kartika A.; Alfaray, Ricky I.; Dewi, Selva R.; Juniastuti, Juniastuti; Yamaoka, Yoshio; Miftahussurur, Muhammad
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.v5i2.1917

Abstract

Helicobacter pylori infection drives heterogeneous gastric pathologies, yet genotype-phenotype correlations in diverse populations remain underexplored. The aim of this cross-sectional study was to investigate the associations between H. pylori virulence genotypes (sabA, hopQ, hom family) and histopathological severity in gastric mucosa among 113 Indonesian dyspepsia patients (mean age: 49.6 years; male predominance: 64.6%). Whole-genome sequencing characterized virulence genotypes, while histopathological grading system using the Updated Sydney System assessed inflammation, atrophy, and bacterial density in the antral and corporal gastric regions. Phylogenetic analysis elucidated strain relatedness. Key genotype frequencies included sabA "on" (40.6%, 43/106), hopQ type I (53.7%, 43/80), and homCL (82.4%, 75/91). Statistical analysis revealed sabA "on" status significantly associated with elevated antral bacterial density (odds ratio (OR) 2.70 and 95% confidence interval (95%CI) 1.10–6.60, p=0.027). The homC variants (homCL/homCS) demonstrated robust associations with chronic inflammation severity (OR: 3.04; 95%CI: 0.99–9.36, p=0.046) and atrophy progression (OR: 4.78; 95%CI: 1.00–22.86, p=0.035), in contrast to the hopQ genotype, which showed no histopathological association. These findings indicated that sabA and homC as critical determinants of gastric microenvironment modulation, potentially through sabA-mediated colonization efficiency and homCL-babA synergistic interactions. While histological profiles predominantly indicated mild atrophy, widespread severe chronic inflammation signals latent progression risks.
Biomarkers for predicting COVID-19 mortality: A study at Sulianti Saroso Infectious Disease Hospital, Indonesia Maemun, Siti; Widiantari, Aninda D.; Murtiani, Farida; Herlina, Herlina; Tanjungsari, Dian W.; Wijiarti, Kunti; Pratiwi, Tiara Z.; Matondang, Faisal; Rusli, Adria; Rivaldiansyah, Rivaldiansyah; Tampubolon, Maria L.; Mariana, Nina; Setiawaty, Vivi; Purnama, Tri B.
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.v5i2.1936

Abstract

The high transmissibility and mortality rates of the COVID-19 pandemic pose significant challenges. Patients can deteriorate rapidly, making it crucial to identify laboratory biomarkers for high-risk individuals. The aim of this study was to evaluate the predictive value of various laboratory parameters, including C-reactive protein (CRP), D-dimer, ferritin, neutrophil-to-lymphocyte ratio (NLR), prothrombin time (PT), and procalcitonin (PCT), in predicting COVID-19 mortality. A retrospective cohort study was conducted at Sulianti Saroso Infectious Disease Hospital, where COVID-19 patients were categorized into survivors and non-survivors. The Mann-Whitney test was used to assess group differences, while receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of each biomarker, with Youden's index (J) determining optimal cut-off values. Kaplan-Meier analysis was used to compare median survival times, and Cox regression assessed hazard rates and the relationship between biomarkers and mortality. A total of 1,598 patients were analyzed, the majority of whom were admitted with oxygen saturation levels >95% and classified as having mild to moderate disease severity. Among them, 216 patients died, resulting in a mortality rate of 13.52%. Significant variations in mortality rates were observed along the survival functions for NLR, ferritin, D-dimer, CRP, and PCT (p<0.001). The survival curves for these biomarkers demonstrated distinct trends across tertiles over time. Among hematological markers, NLR was significantly associated with mortality (p<0.001), with a 1.5–2.2% increased risk per unit increase. Biochemical markers (complete blood count) proved to be more effective than hematological parameters (NLR, ferritin, PT, D-dimer, CRP, PCT) when evaluating individual prognostic performance. Bivariate analysis of CRP, D-dimer, ferritin, NLR, PT, and PCT between survivors and non-survivors showed significant differences. Notably, NLR and PCT were highly relevant for predicting disease prognosis and mortality, with sensitivity and specificity values exceeding 80%.
Prevalence and risk factors of adult attention deficit hyperactivity disorder in university students: A study from the United Arab Emirates Salama, Rasha A.; Tadross, Talaat M.; Ammar, Ali R.; Manasrah, Haya T.; Razack, Rishana A.; Koya, Shameena M.; Wadid, Nihal A.; Patni, Mohamed AF.; Khan, Shehla S.
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.v5i2.1950

Abstract

Attention deficit hyperactivity disorder (ADHD), once considered primarily a childhood condition, is now increasingly recognized as a disorder that persists into adulthood and significantly impacts academic and professional success. The aim of this study was to investigate the prevalence of ADHD and identify associated risk factors among university students. A cross-sectional study was conducted over a period of six months at Ras Al Khaimah Medical and Health Sciences University, United Arab Emirates. Data were collected through a self-report questionnaire addressing sociodemographic, lifestyle, and family environment factors. ADHD symptoms were assessed using the World Health Organization Adult ADHD Self-Report Scale version 1.1, based on the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition criteria. The study sample included 472 students, with a mean age of 19.9±1.85 years. The overall prevalence of ADHD was 13.6% (n=64). Logistic regression analysis revealed significant associations between the mother's smoking status (odds ratio (OR): 2.35; 95% confidence interval (95%CI): 1.949–5.862, p=0.050) and living in shared housing (OR: 3.35; 95%CI: 1.674–6.723, p=0.001) with increased odds of ADHD. Conversely, being male (OR: 0.4; 95%CI: 0.216–0.891, p=0.02) and being born full-term (OR: 0.331; 95%CI: 0.138–0.794, p=0.013) were associated with decreased odds of ADHD. Other factors, such as college affiliation, smoking status, exercise habits, maternal employment, mode of delivery, and pregnancy complications, were not significant risk factors. These findings highlight the need for targeted interventions in university settings, including early screening, tailored support services, and increased staff awareness, to support students with ADHD and enhance their academic success and well-being.
CTLA-4 +6230G>A polymorphism and its impact on CTLA-4 level and risk of hepatocellular carcinoma: A case-control study in Batak patients with chronic hepatitis B Darmadi, Darmadi; Rey, Imelda; Lubis, Masrul; Lindarto, Dharma; Muzasti, Riri 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.v5i2.1959

Abstract

Genetic polymorphisms in cytotoxic T-lymphocyte-associated protein 4 gene (CTLA-4) vary by ethnic background, necessitating population-specific studies. The aim of this study was to assess the association between the CTLA-4 +6230G>A polymorphism, serum CTLA-4 level, and hepatocellular carcinoma (HCC) in Batak patients with chronic hepatitis B, a group with high hepatitis B virus (HBV) endemicity. A case-control study was conducted among cases (Batak patients with chronic hepatitis B and HCC) and controls (chronic hepatitis B without HCC). Genotyping of the CTLA-4 +6230G>A polymorphism was performed using the TaqMan SNP Genotyping Assay. Serum CTLA-4 level was quantified using enzyme-linked immunosorbent assay (ELISA). Patient’s demographic, clinical and laboratory data were recorded and assessed including age, sex, body mass index (BMI), smoking history, cirrhosis status, HBV DNA level, liver function markers (aspartate aminotransferase (AST) and alanine aminotransferase (ALT)), hepatitis B e-antigen (HBeAg) status, smoking history, and alcohol consumption. This study found that G allele was significantly associated with an increased risk of HCC (OR: 2.69; 95%CI: 1.21–6.00; p=0.013). Individuals with GG/AG genotypes had a 2.89-fold higher risk of developing HCC compared to those with the AA genotype (p=0.032). Serum CTLA-4 level was significantly elevated in G allele carriers (GG: 159.9±57.1 pg/mL vs AA: 83.7±44.7 pg/mL; p<0.001). Multivariate analysis identified cirrhosis as the strongest predictor of HCC (OR: 7.60; p<0.001), followed by elevated ALT (OR: 3.42; p=0.018) and high HBV DNA levels (OR: 2.31; p=0.024). In conclusion, the CTLA-4 +6230G>A GG/AG genotype and elevated serum CTLA-4 level were significantly associated with an increased risk of HCC in Batak individuals with chronic HBV infection. Further research is needed to explore additional CTLA-4 polymorphisms and immune regulatory mechanisms in HBV-related HCC to improve risk stratification and therapeutic strategies.
Striving for smoke-free families: Wives’ role in Gayo Lues, Aceh-Indonesia Saffutra, Hasrizal; Yahya, Mustanir; Rosemary, Rizanna; Indah, Rosaria; Syahrizal, Dedy
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.v5i2.1960

Abstract

Smoking remains a prevalent habit in many households, particularly in regions where cultural norms strongly accept tobacco use. The aim of this study was to examine the influential role of wives in Gayo Lues, Aceh, Indonesia, in promoting smoking cessation within their families. Amidst cultural norms that widely accept smoking, these wives employed both persuasive and, occasionally, coercive methods to encourage healthier behaviors among family members. Utilizing a qualitative approach with Participatory Action Research (PAR), data were collected through in-depth interviews with seven wives who have firsthand experience with smoking behaviors in their families. The findings revealed that wives in Gayo Lues act as both health monitors and guardians, balancing emotional support with firm boundaries to foster a smoke-free home environment. Their roles extended beyond traditional caregiving, as they actively shape family health outcomes. In conclusion, this study underscored the importance of empowering wives as health advocates in public health efforts, particularly in culturally conservative settings. Future research could further explore the broader socio-cultural dynamics influencing wives’ health advocacy roles and assess the sustainability of these behaviors over time.
Effects of doxazosin as adjuvant to abiraterone on viability and apoptosis of metastatic castration-resistant prostate cells cancer (mCRPC) PC3 Pratama, Putu KD.; Rahman, Zakaria A.; Hidayatullah, Furqan; Laksita, Tetuka B.; Hakim, Lukman
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.v5i2.1961

Abstract

Prostate cancer is a leading cause of death among men worldwide, with limited therapeutic options for castration-resistant metastatic prostate cancer (mCRPC). The aim of this study was to investigate the potential role of doxazosin, an α1-blocker, as an adjunctive therapy for mCRPC in combination with abiraterone. Using mCRPC PC3 cells, the effects of doxazosin on cell viability and apoptosis were assessed. The experimental design was an in vitro study with post-test-only control design. Experimental groups were divided into four groups: control group, doxazosin group, abiraterone group, and combination group (doxazosin and abiraterone). Cell viability was analyzed using the cell counting kit-8 (CCK-8) assay, while apoptosis was analyzed using Fluorescence-activated cell sorting (FACS). This study found that the IC50 value for doxazosin was 25.42±1.42 µM (mean ± standard error). The results indicated that doxazosin significantly reduced cell viability, with effects varying based on the dose administered, and doxazosin was able to induce apoptosis in mCRPC PC3 cells. The combined treatment of doxazosin and abiraterone in mCRPC PC3 cells demonstrated a significantly higher mean apoptosis percentage compared to the control group (16.27%; 95% confidence interval (CI): 11.89–20.65; p=0.001). Furthermore, the combined treatment showed a significantly higher mean apoptosis percentage compared to abiraterone alone (4.79%; 95%CI: 0.41–9.18; p=0.029), and doxazosin alone (10.99%; 95%CI: 6.61–15.38; p=0.001). These findings suggest that doxazosin, traditionally used as an α1-blocker for lower urinary tract symptoms (LUTS), could offer a novel therapeutic approach for mCRPC patients.
Ivermectin and dexamethasone combination induces apoptosis in SUP-B15 cell line Siregar, Olga R.; Wahyuni, Arlinda S.; Pasaribu, Ayodhia P.; Edianto, Deri; Ugrasena, I DG.; Amelia, Rina; Lubis, Inke ND.; Rusda, Muhammad
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.v5i2.1975

Abstract

The development of glucocorticoid resistance has complicated the management of acute lymphoblastic leukemia (ALL), leading to increased mortality rates. Ivermectin, a low-cost and well-established anthelmintic, exhibits anticancer potential and may enhance glucocorticoid toxicity in ALL, offering a possible strategy to overcome resistance. The aim of this study was to evaluate the apoptotic effect of combining ivermectin with dexamethasone in ALL. ALL SUP-B15 cells were cultured under standard conditions before treatment with dexamethasone (200 nM) alone or combined with ivermectin (5, 10, and 20 µM), with an untreated group serving as the control.  Cytotoxicity was assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay by measuring cell viability and inhibition. Apoptosis was evaluated through BAX, BCL-2, and CASP3 gene expression analysis using reverse transcription-polymerase chain reaction (RT-PCR). The findings revealed that the combination of ivermectin and dexamethasone was superior in the repression of ALL cell viability compared to control (p<0.001). The combination of dexamethasone 200 nM + ivermectin 20 μM demonstrated the most significant cell inhibition of 38.16±0.04% (p<0.001) and produced the lowest cell viability of 61.84±0.05% (p<0.001). Moreover, the combination of dexamethasone 200 nM + ivermectin 20 μM demonstrated superior upregulations of BAX (p<0.001) and CASP3 (p<0.001). In conclusion, the addition of ivermectin (5 µM) to dexamethasone regimen (200 nM) increases its cytotoxic and apoptotic activities against SUP-B15 cell line as observed by the CASP3 and BAX upregulation. Studies to confirm the enhanced anticancer activity by this combination by observing the protein levels and animal studies are warranted.
Tackling the ST elevation in leptospirosis: A double-edged sword between bleeding and thrombosis – A case report Dewi, Ivana P.; Damayanti, Kadex RS.; Anggitama, Andreas M.; Bagaskara, Arya T.; Dewi, Kristin P.; Yusrizal, Teuku
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.v5i2.1978

Abstract

Although leptospirosis is a well-recognized zoonotic disease, the occurrence of ST-segment-elevation myocardial infarction (STEMI)-mimicking leptospiral myocarditis, accompanied by subsequent bleeding and thrombocytopenia is an exceptionally rare finding. The dual risks of bleeding and thrombosis further complicate the management of anticoagulation and thrombolytic therapy amidst competing risks. The aim of this study was to present leptospirosis complicated by myocarditis, which mimicked STEMI, followed by bleeding and thrombocytopenia. A 61-year-old male patient was referred from a community health center to the hospital with primary complaints of chest discomfort and diaphoresis, which had started 11 hours prior to admission. These symptoms were associated with a 12-day history of intermittent fever, nausea, and vomiting. Upon physical examination, the patient appeared lethargic, with a blood pressure of 86/63 mmHg, heart rate of 107 bpm, respiratory rate of 22 breaths per minute, and temperature of 39.8°C. Electrocardiography revealed widespread ST-segment elevation. Echocardiography showed global hypokinesia with a reduced ejection fraction of 48%. Laboratory tests confirmed the presence of IgM and IgG anti-Leptospira antibodies, along with elevated high-sensitivity cardiac troponin levels. The patient was diagnosed with Weil's disease (Faine's score 32), with leptospiral myocarditis and STEMI considered as differential diagnoses. Initial management involved a loading dose of dual antiplatelet therapy (aspirin 320 mg and clopidogrel 300 mg) due to the suspected diagnosis of STEMI. However, it was later discontinued on the second day of admission due to the development of severe thrombocytopenia and minor bleeding manifestations. Following the administration of ceftriaxone 2 g every 12 hours and doxycycline 100 mg every 12 hours, the patient's condition improved. This case highlights the importance of recognizing leptospirosis as a potential cause of myocarditis and thrombocytopenia, especially when clinical signs resemble those of STEMI. Early diagnosis and careful management, including the suspension of dual antiplatelet therapy and initiation of targeted antibiotic therapy, were pivotal in preventing further complications and improving the patient's outcomes.
Comparative assessment of smartphone‐based digital planimetry for wound area measurement Sharun, Khan; Banu, Shajahan A.; Mamachan, Merlin; Vinodhkumar, Obli R.; Manjusha, Kallemuchikal M.; Kumar, Rohit; Pawde, Abhijit M.; Dhama, Kuldeep; Pal, Amar
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.v5i2.1987

Abstract

Accurate wound area measurement is essential for effective wound care as it helps determine the progression of healing in patients. The aim of this study was to compare two wound area measurement techniques wound tracing (manual planimetry) and imitoMeasure (smartphone-based digital planimetry) with standard ImageJ-based digital image analysis in a rabbit wound healing study. The study involved 291 wounds categorized into small, intermediate, and large wounds. ImageJ was used as the reference method for comparisons. The intraclass correlation coefficient (ICC) was computed to assess the agreement and reliability between different wound measurement techniques. A mountain plot was used to assess the agreement between measurement methods, and a Bland-Altman plot was used to evaluate the agreement and concordance between measurement methods. The time required for analysis (processing time) was also compared. The study revealed that the imitoMeasure consistently demonstrated a greater level of agreement with ImageJ, especially in small and intermediate wounds. The ICC values indicated substantial agreement between ImageJ and imitoMeasure, with an exceptionally high ICC value for small wounds. Mountain plots revealed that the imitoMeasure had better agreement with ImageJ across all wound sizes. Bland-Altman plots further supported these findings, with wound tracing exhibiting wider limits of agreement and greater variability than imitoMeasure. ImitoMeasure consistently proved to be the quickest method across all wound sizes, whereas wound tracing required the longest processing time. These findings indicate that the imitoMeasure is a more reliable and consistent method for measuring the wound area, in particular for small and intermediate wounds.
Fecal ingestion rate based on worker activity patterns during stool handling in a ruminant farm Paramitadevi, Yudith V.; Priadi, Cindy R.; Rahmatika, Iftita; Rukmana, Andriansjah
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.v5i2.1989

Abstract

Farm workers who handle livestock stools face an increased risk of infection by pathogenic bacteria, such as Escherichia coli O157 and Salmonella spp., leading to millions of severe health issues and thousands of fatalities annually. The aim of this study was to assess the impact of these pathogens by measuring their concentrations, determining rates of unintentional fecal consumption, and conducting a quantitative assessment of microbial risk. An integrated farm in Sukabumi City, Indonesia, was examined for E. coli O157 and Salmonella spp. in livestock stools. Additionally, the study monitored the rate of incidental fecal ingestion among farm workers. Stool samples were collected (n= 40) from ruminants and analyzed following ISO 16649-1:2018, ISO 9308-1:2014, and ISO 6579-1:2017/Amd.1:2020. The study tracked worker’s behavior daily to determine the contact time. The fecal ingestion rate was calculated by multiplying the estimated stool weight ingested by the contact time workers spent cleaning livestock stools in the barn each day. Microbial analysis revealed that the highest concentration of E. coli O157 in beef cattle stools was 2.49 log10 CFU/g. The study determined mean fecal ingestion rates during the dry season (8.64 mg/day) and rainy season (6.84 mg/day). Results from the quantitative microbial risk assessment showed that stool from beef cattle posed a higher risk of E. coli O157 infection compared to other ruminants, with an estimated disease burden of 9.8 × 10-3 pppy. This study represents the first comprehensive quantitative evaluation of fecal ingestion by farm workers during animal husbandry. The findings underscore the need for improved worker safety measures, such as enhanced sanitation practices and protective equipment, to mitigate the risks of handling livestock stools.

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