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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 607 Documents
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Impact of anthropometric adiposity and excessive daytime sleepiness on endothelial function in healthcare workers: A cross-sectional analysis Damay, Vito; Ivan, Ignatius; Islami, Nadhira A.; Rubismo, Kenza Y.
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.v5i2.2003

Abstract

Obesity and excessive daytime sleepiness (EDS) are known contributors to cardiovascular risk through their impact on endothelial function. Healthcare workers, frequently exposed to shift work, are particularly vulnerable to these risk factors. The aim of this study was to assess the relationship between anthropometric adiposity measures and EDS with endothelial function, measured via flow-mediated dilation (FMD), in healthcare workers. This cross-sectional study included 82 healthcare workers aged 20–50 years without pre-existing cardiovascular conditions. Anthropometric measures such as body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) were collected to assess adiposity. EDS was evaluated using the Epworth sleepiness scale (ESS), with a score ≥10 indicating EDS. Endothelial function was measured via FMD, with values <7.1% indicating dysfunction. Multivariate logistic regression was used to identify predictors of endothelial dysfunction, adjusting for confounders such as age and sex. Collinearity diagnostics, including the Belsley–Kuh–Welsch method, were applied to confirm multicollinearity and refine the regression model. Overweight and obesity, high-risk WC, and increased risk WHtR were associated with endothelial dysfunction (p<0.001), with WHtR showing an independent association (adjusted odds ratio (AOR): 8.48; 95%CI: 2.58–27.86; p<0.001). EDS also showed a significant independent association with impaired FMD outcomes (AOR: 3.73; 95%CI: 1.23–11.26; p=0.020). Pearson correlation analysis revealed significant negative correlations between BMI (r=-0.483, p<0.001), WC (r=-0.473, p<0.001), and WHtR (r=-0.432, p<0.001) with FMD, indicating that higher adiposity levels were linked to poorer endothelial function. Obesity and poor sleep quality, even in the absence of cardiovascular disease, are associated with an increased risk of endothelial dysfunction in healthcare workers. Early intervention focusing on weight management and improving sleep quality could mitigate future cardiovascular risks in this population.
Role of LBX1 rs11190870 polymorphism in adolescent idiopathic scoliosis in the Acehnese population: A preliminary study Aulia, Teuku N.; Gatam, Luthfi; Yaman, Aman; Djufri, Djufri
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.v5i2.2038

Abstract

Genome-wide association studies (GWAS) have identified the single nucleotide polymorphism (SNP) rs11190870 near the ladybird homeobox 1 (LBX1) gene as being associated with the susceptibility and severity of adolescent idiopathic scoliosis (AIS). However, no such genetic studies have been conducted in the Indonesian population. The aim of this study was to investigate the genetic profile of AIS patients in the Acehnese population, with a focus on LBX1 rs11190870, and to assess its association with disease severity. A total of 30 female AIS patients were included. Genetic analysis was performed to determine the rs11190870 genotype in each subject. The association between rs11190870 and curve progression, measured by Cobb angle, was analyzed using the Mann–Whitney U test. The T allele was found to be more prevalent (73.3%), with the TC genotype being the most common (53.3%). A significant association was observed between LBX1 rs11190870 and curve progression, where patients with the TT genotype exhibited a larger Cobb angle compared to those with TC or CC genotypes (p=0.01). This is the first study to characterize the genetic profile of AIS and its association with curve severity in the Acehnese population. These findings suggest that LBX1 rs11190870 may act as a disease modifier in AIS. Further studies with larger sample sizes are warranted to confirm the role of LBX1 rs11190870 in AIS susceptibility and severity in the Indonesian population.
Cytoarchitectural changes in the developing cerebellar cortex of the laggard mutant mouse Yunus, Junaedy; Setsu, Tomiyoshi; Kikkawa, Satoshi; Terashima, Toshio
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.v5i2.2075

Abstract

The laggard (lag) mutant mouse, which arises from a mutation in the Kif14 gene, begins to exhibit ataxia and impaired growth after the first postnatal week and subsequently dies prematurely around two weeks of age. In this mutant mouse, the layered architecture of the cerebellar cortex, cerebral cortex, dentate gyrus, and olfactory bulb is disrupted at the cellular level. The aim of this study was to identify the effect of Kif14 mutation on the development of the cerebellar cortex. Abnormalities in the cytoarchitectonics of the developing cerebellar cortex were assessed using hematoxylin-eosin (HE) staining and immunohistochemistry. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and bromodeoxyuridine (BrdU) assays were performed to identify apoptotic and proliferating cells. Macroscopic observation of the lag mutant cerebellum reveals a marked reduction in size compared to wild-type mice. HE staining displays a normal foliation and lamination pattern in the lag mutant cerebellum, but detailed analysis has shown morphological disorganization in the cytoarchitectonics of the cerebellar cortex. The mutant internal granular layer is poorly defined and contains significantly fewer granule cells. Meanwhile, Purkinje cells form multilayer arrangements instead of a monolayer arrangement, as observed in wild-type mice, with their dendritic arborization being severely underdeveloped. Some Purkinje cells exhibit multiple nuclei, suggesting that the Kif14 mutation disrupts normal cell division. These phenotypes are already recognized during early postnatal days, although no difference is determined before birth. TUNEL-positive cells are significantly more numerous in the mutant external granular layer, indicating that increased apoptotic cell death contributes to the diminished granule cell population in the lag mutant mouse. In conclusion, the lag mutant cerebellar cortex shows distinct structural abnormalities, suggesting that the Kif14-encoded protein exerts multifaceted roles in the development of the brain laminated structures as well as in myelin formation.
Key contents of health education and their impact on improving medication adherence among hypertensive patients: A systematic review and meta-analysis Mustara, Mustara; Hartono, Hartono; Pamungkasari, Eti P.
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.v5i2.2080

Abstract

Hypertension is a global health issue with significant effects on morbidity and mortality, and medication adherence is crucial for effective management. Despite its importance, adherence remains low among hypertensive patients. Health education has been shown to improve medication adherence, though its effectiveness varies across studies. The aim of this study was to systematically synthesize evidence on the impact of health education in enhancing medication adherence among hypertensive patients. This study followed preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and employed the population, intervention, control, and outcome (PICO) approach to develop keywords for a search across five databases: Emerald, ProQuest, PubMed, ScienceDirect, and Scopus. All randomized control trials published between 2019 and 2024 in English, evaluating health education's impact on medication adherence in hypertensive patients aged ≥18 years were included. The protocol was registered on PROSPERO (CRD42024532890), and study quality was assessed using the CEBMa scale. Twelve high-quality articles (CEBMa score of ≥7) involving 1,827 participants were included, identifying four key themes in health education for hypertension: an overview of hypertension and complications, medication and side-effect management, healthy lifestyle modification, and medication adherence strategies. Health education significantly improved medication adherence by 33% (risk ratio (RR): 1.33; 95%CI: 1.08–1.64; p=0.008), with a medium-large effect on improving medication adherence (d=0.70; 95%CI: 0.34–1.05; p<0.0001) and a small-medium effect on reducing non-adherence (d=-0.45; 95%CI: -0.66–(-0.24); p<0.0001). Health education delivered 1 to 3 months and with individualized approaches showed better adherence outcomes compared to more than three months and group-based methods. Face-to-face education was more effective than the digital method. In conclusion, health education improves medication adherence in hypertensive patients when delivered comprehensively over 1–3 months through individualized face-to-face sessions. These findings support its integration as a key strategy in hypertension management to enhance adherence.
Zero-fluoroscopy versus fluoroscopy-guided catheter ablation in ventricular arrhythmia: A systematic review and meta-analysis Irnizarifka, Irnizarifka; Tristan, Christopher D.; Wijayanto, Matthew A.; Myrtha, Risalina; Modesty, Kyra; Rahma, Annisa A.; Budiono, Enrico A.; Rahman, Awalil R. K.; Hamka, Muhammad Farid; Ilyas, Muhana F.
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.v5i2.2094

Abstract

Catheter ablation has been the go-to treatment for ventricular arrhythmia, with traditional fluoroscopy-guided and non-zero fluoroscopy (NZF) catheter ablation posing high radiation risk for operators and patients. Zero-fluoroscopy technique offers elimination of radiation risk; however, its efficacy and safety in ventricular arrhythmia patients are not well explored. The aim of this study was to systematically evaluate the effectiveness, safety, and feasibility of zero-fluoroscopy ablation on ventricular arrhythmia patients. This study only included relevant studies comparing zero-fluoroscopy and NZF in ventricular arrhythmia ablation that were identified from Scopus, PubMed, and ScienceDirect (up to June 20, 2024). The quality of the study was assessed using the ROBINS-I tool, and the meta-analysis was conducted using a random-effect model. Out of 383 studies found, nine cohort studies were included with 1.408 patients. There was no significant difference in the acute procedural success rate of the zero-fluoroscopy and NZF (relative risk: 1.01; 95%CI: 0.95–1.07; p=0.69), with a similar recurrence rate (p=0.88; for four studies; n=374), and comparable procedural time (mean difference: -19.22 minutes; 95%CI: -41.16–2.72; p=0.09). Adverse events such as pericardial effusion, pseudoaneurysm, and hematoma were similar between zero-fluoroscopy and NZF. Overall, zero-fluoroscopy catheter ablation has demonstrated non-inferiority as a treatment option for ventricular arrhythmia ablation. As zero-fluoroscopy eliminates radiation risk without compromising procedural efficacy, zero-fluoroscopy has the potential to become a widely adopted approach for catheter ablation in ventricular arrhythmia.
Outcomes of first-generation versus second-generation drug-eluting stents in calcified coronary lesions: A meta-analysis Rohman, Mohammad S.; Fajar, Jonny K.; Widyaningsih, Melly C.; Aziizah, Yusnia N.; Khasanah, Uswatun A.; Nendro, Farid EB.; Beting, Euphrasiane G.; Tanaem, Vini S.; Jannati, Desi; Putri, Wanda M.; Tamara, Fredo
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.v5i2.2100

Abstract

The choice between first-generation drug-eluting stents (DES) and second-generation DES in managing calcified coronary lesions remains a topic of debate. The aim of this study was to compare outcomes between first-generation DES and second-generation DES in patients with calcified coronary lesions. This meta-analysis study was conducted from October to November 2024. The databases used were Embase, Scopus, and PubMed. Relevant articles were collated, and data regarding outcomes in patients with calcified coronary lesions treated with first-generation and second-generation DES were included to calculate the pooled effect size. The statistical analysis was performed using the Mantel-Haenszel method. Six articles were included in the study. The results indicated that calcified coronary lesions treated with first-generation DES were associated with increased risks of all-cause mortality (Odd ratios (OR): 1.23; 95% confidence interval (95%CI): 1.05–1.45; p-Egger= 0.9346; p-Heterogeneity: 0.9720; p=0.0120), myocardial infarction (OR: 1.48; 95%CI: 1.22–1.80; p-Egger: 0.6472; p-Heterogeneity: 0.5890; p<0.0001); and target lesion revascularization (TLR) (OR: 1.47; 95%CI: 1.24–1.74; p-Egger: 0.9982; p-Heterogeneity: 0.5950; p<0.0001), in comparison with second-generation DES. In contrast, when comparing first- and second-generation DES in terms of cardiac death and major adverse cardiovascular events, a similar risk was depicted. This study compared the outcomes of first-generation and second-generation DES in the management of patients with calcified coronary lesions, which may serve as a reference for selecting DES in the patient population.
Impact of walking exercise intensity on cartilage IL-1, TNF-α, IL-4, MMP-13 and pain threshold in osteoarthritis rat models Handono, Kusworini; Prasetyo, Dwi A.; Kurnianingsih, Nia; Wahono, Cesarius S.; Albaar, Thoha 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.v5i2.2109

Abstract

Pro-inflammatory cytokines produced by chondrocytes play a crucial role in activating matrix metalloproteinase-13 (MMP-13), leading to an imbalance between the synthesis and degradation of the extracellular matrix (ECM) in osteoarthritis (OA). Although regular walking exercise has been shown to reduce inflammatory cytokine levels in OA animal models, the optimal exercise intensity remains underexplored. Therefore, the aim of this study was to investigate the effects of different intensities of regular walking exercise on the levels of pro-inflammatory cytokines (interleukin-1 (IL-1), tumor necrosis factor-alpha (TNF-α)), anti-inflammatory cytokine (interleukin-4 (IL-4)), as well as MMP-13 expression in cartilage and pain thresholds in an OA animal model. A total of 30 adult male Rattus norvegicus (6–8 weeks old) were divided into five groups: (1) healthy control; (2) monosodium iodoacetate (MIA)-induce OA model; (3) OA with light-intensity walking (OA1); (4) OA with moderate-intensity walking (OA2); (5) and OA with high-intensity walking (OA3). The exercise intervention began one week after MIA injection and continued for six weeks. Pain threshold, inflammatory cytokine (IL-1, TNF-α, IL-4) levels, and MMP-13 expression were measured using an analgesymeter, enzyme-linked immunosorbent assay (ELISA), and immunohistochemistry (IHC), respectively. The results demonstrated a significant reduction in IL-1 and TNF-α levels, along with decreased MMP-13 expression and increased IL-4 levels, in all exercise groups (OA1, OA2, OA3) compared to the untreated OA group. Additionally, pain thresholds improved following exercise. However, no significant differences were observed among the three exercise intensities in terms of cytokine levels, MMP-13 expression, or pain threshold. This study highlights that the light-intensity regular walking exercise effectively reduces inflammation, MMP-13 expression, and pain in OA. Further research is needed to elucidate the underlying mechanisms of exercise in OA management.
Network pharmacology, molecular docking, and molecular dynamics analyses to explore the molecular mechanism of paclitaxel in atherosclerosis therapy Oktomalioputri, Biomechy; Afriwardi, Afriwardi; Darwin, Eryati; Rita, Rauza 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.v5i2.2140

Abstract

Atherosclerosis is a chronic arterial disease and the leading cause of vascular death. Paclitaxel has long been recognized as an anticancer agent, but recent studies have shown that paclitaxel can also potentially reduce the progression of atherosclerosis. The aim of this study was to explore the molecular mechanism of paclitaxel as an atherosclerosis therapy using in silico study. Pharmacokinetic and pharmacodynamic analyses of paclitaxel were conducted using SwissADME, ProTox v3.0, and SCFbio websites. Cytoscape software was used to construct a network of protein-protein interactions, and the key proteins involved in paclitaxel-related atherosclerosis were identified, including AKT serine/threonine kinase 1 (AKT1), Jun N-terminal kinase (JNK), and Endothelin 1 (ET1). These key proteins were then subjected to molecular docking and molecular dynamic simulation using MOE and Yasara applications. Pharmacokinetic and pharmacodynamic analyses revealed that paclitaxel has good distribution, metabolism, and excretion properties. However, paclitaxel has shortcomings in absorption, toxicity, and water solubility. According to the results of molecular docking, paclitaxel showed consistent results as the most potential inhibitor of AKT1 (-9.59 kcal/mol), ET1 (-9.16 kcal/mol), JNK (-8.72 kcal/mol) when compared to the control ligands. Molecular dynamics simulations also confirmed the interaction stability between paclitaxel with AKT1, ET1, and JNK, with paclitaxel-AKT1 demonstrating the highest conformational stability (Carbon-α Root Mean Square Deviation <3.0 Å). Even though our in-silico results are promising, more experimental studies are required to confirm the efficacy of paclitaxel as an atherosclerosis therapy.
Healing the healers: Unlocking psychological well-being through meaningful work and quality of work life Aprilia, Eka D.; Adam, Muhammad; Zulkarnain, Zulkarnain; Mawarpury, Marty
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.v5i2.2152

Abstract

Healthcare workers in developing countries, such as Indonesia, experience significant psychological stress due to heavy workloads, limited resources, and systemic inefficiencies, all of which negatively impact their psychological well-being (PWB). The aim of this study was to investigate the direct and indirect effects of quality of work life (QWL) on PWB, with meaningful work (MW) as a mediating variable. A cross-sectional survey was conducted with 285 healthcare professionals from various healthcare facilities, including specialists, general practitioners, and nurses. Data were collected using validated scales to assess QWL, MW, and PWB. Pearson correlation analysis was employed to examine relationships among variables, while mediation analysis tested direct and indirect effects. The results indicate that QWL positively influences PWB both directly (β=0.22, p<0.001) and indirectly through MW (β=0.13, p<0.001). Furthermore, MW was found to be a strong mediator (β=0.61, p<0.001), underscoring its critical role in enhancing purpose and resilience. Specialists reported the highest QWL and PWB, whereas nurses exhibited the lowest levels, highlighting occupational disparities. These findings suggest that enhancing the QWL and fostering MW can significantly improve healthcare professionals' PWB. Accordingly, organizations should prioritize strategies that promote MW and improve work-life conditions to support mental well-being and job satisfaction.
Customized feeding plate for nutritional and respiratory support in an infant with Pierre Robin sequence and cleft palate complicated by severe respiratory infections: A case report Jayanti, Claudia NR.; Anugerah, Evelyn; Soewondo, Willyanti; Pasha, Asep K.; Puratmaja, Galuhafiar
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.v5i2.2175

Abstract

Pierre Robin sequence (PRS) is a congenital condition characterized by micrognathia, glossoptosis, and airway obstruction, often accompanied by cleft palate. Feeding difficulties and respiratory compromise pose significant challenges in early management. While feeding plates are commonly used to improve feeding and airway stability, their application in infants with severe respiratory infections remains underreported. The aim of this study was to describe the challenges of impression-taking and feeding plate fabrication in an infant with PRS complicated by multiple congenital anomalies and severe respiratory complications, including bilateral pneumonia. A 23-day-old male infant was referred to the pediatric dentistry department of Pandega General Hospital, Pangandaran, Indonesia, with the chief complaints of feeding difficulties, recurrent choking episodes, and respiratory distress. The patient was diagnosed with PRS with a cleft palate, complicated by congenital tuberculosis and bilateral pneumonia, exacerbating respiratory compromise. Given the patient's fragile condition, impression-taking was performed with strict airway precautions, including lateral positioning, continuous oxygen monitoring, and suction readiness. High-viscosity alginate and a perforated stock tray were used to minimize aspiration risk. Two clinicians ensured airway security throughout the procedure. A customized acrylic feeding plate was fabricated with a palatal extension to prevent nasal regurgitation and a contoured surface to aid tongue positioning. The plate was polished for comfort, adjusted for retention, and fitted to accommodate maxillary growth, ensuring safe and effective feeding support. Within one month, the infant’s weight increased from 2,200 g to 3,100 g, choking episodes significantly decreased, and a transition from orogastric tube to bottle feeding was achieved. In conclusion, this case highlights the feasibility and benefits of feeding plate adaptation in PRS management, even in the presence of severe respiratory infections. A non-invasive approach using a feeding plate can serve as an initial intervention before surgical correction, particularly in fragile neonates.

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