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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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Developing a maturity-level model for interprofessional collaboration in elective surgery preparation Agustina, Else; Dradjat, Respati S.; Wardhani, Viera; Putra, Kuswantoro 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.v5i2.2213

Abstract

Interprofessional collaboration plays a crucial role in the preparation for elective surgeries to enhance the quality, safety, and efficiency of patient care. However, its implementation continues to encounter substantial obstacles, which require the creation of a customized maturity model to effectively resolve these concerns. The aim of this study was to develop an interprofessional collaboration maturity model that is specifically designed for the context of elective surgery preparation. This qualitative study employed a case study approach, conducted in 2024. This maturity model was developed through four stages: (1) a literature study to identify key interprofessional collaboration indicators in surgery; (2) in-depth interviews with ten healthcare professionals at Universitas Muhammadiyah Malang Hospital, Malang, Indonesia; (3) adaptation of existing maturity models (Fleming, Hudson, collaboration maturity model, and quality management system) as a framework for synthesizing data from the findings of stage 2 (in-depth interviews); and (4) expert panel review to evaluate the maturity model. We successfully developed an interprofessional collaboration maturity model specifically applied to elective surgery preparation, Preoperative Interprofessional Collaboration Maturity Model (P-ICMM), consisting of five maturity levels: emerging, developing, coordinated, integrated, and optimized. Each level’s assessment criteria are based on indicators of interprofessional collaboration. This maturity model has been evaluated by the experts in elective surgery preparation to ensure its validity and applicability. This maturity model is expected to help hospitals identify the level of interprofessional collaboration, design strategies to enhance collaboration, and ultimately improve the quality of healthcare services and patient safety in the preparation for elective surgeries.
Colchicine attenuates chemical hypoxia-induced pyroptosis through downregulation of nuclear factor kappa B and caspase-1 in cardiomyocytes Satrijo, Budi; Rohman, Mohammad S.; Aulanni'am, Aulanni'am; Sujuti, Hidayat; Lestari, Bayu
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.v5i2.2245

Abstract

Myocardial infarction (MI) is the leading cause of mortality worldwide. During MI, cardiomyocyte necrosis and inflammation are crucial in the post-MI cardiac remodeling process, including pyroptosis. Although colchicine is a well-known anti-inflammatory drug that has been clinically studied in the context of MI, its role in cardiac pyroptosis remains unclear. The aim of this study was to investigate the role of colchicine in pyroptosis in vitro, using CoCl2-induced H9c2 cells. Prior to the primary experiment, the hypoxic model in H9c2 cells was optimized by evaluating hypoxia-inducible factor-1 alpha (HIF-1α) expression and viability in cells exposed to various concentrations of CoCl2 at different time intervals. Subsequently, an in vitro hypoxia model was established by treating H9c2 cells with CoCl2 (600 µM), with or without colchicine (1 µM), for 3 hours. Flow cytometry was used to measure the expression of nuclear factor-kappa beta (NF-κB), interleukin 18 (IL-18), caspase-1, and HIF-1α in pyroptotic cells. Immunofluorescence was used to assess caspase-1 localization and its colocalization with propidium iodide during late-stage pyroptosis. Our data indicated that CoCl2-induced hypoxia significantly upregulated NF-κB, caspase-1, and IL-18 expression, and increased pyroptotic cell death in H9c2 cells. Colchicine treatment attenuated these effects, leading to a marked reduction in NF-κB, caspase-1, and IL-18 expression in hypoxic cells. Colchicine treatment significantly decreased the number of late pyroptotic cells. The protective effect of colchicine was more pronounced in late hypoxia (24-hour) setting compared to early hypoxia (3-hour). These findings suggest that colchicine attenuates cardiac pyroptosis in hypoxic H9c2 cells, as evidenced by the significant downregulation of key proteins involved in this pathway, including NF-κB, caspase-1, and IL-18. This protective effect appeared to be more effective in late hypoxia.
Associations between plasma beta amyloid and cognitive decline: A systematic review and meta-analysis Cynthia, Cynthia; Nugraha, Jusak; Hamdan, Muhammad; Dharma, Rahajuningsih; Lumempouw, Silvia 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/narra.v5i2.2268

Abstract

Alzheimer’s disease is a leading neurodegenerative disorder characterized by progressive cognitive decline. Early prediction is crucial for enabling timely interventions. Plasma amyloid β-peptides (Aβ), particularly the Aβ-42/Aβ-40 ratio, have been proposed as potential non-invasive biomarkers for cognitive decline and Alzheimer’s disease risk. However, conflicting findings and methodological variability have hindered consensus regarding their clinical utility. The aim of this study was to evaluate whether the plasma Aβ levels predict dementia, Alzheimer’s disease, and cognitive decline. Studies were eligible for inclusion if they measured at least one plasma Aβ species (Aβ-40, Aβ-42, or the Aβ-42/Aβ-40 ratio) and reported outcomes related to dementia, Alzheimer’s disease, or cognitive change. Only human studies published in peer-reviewed journals were included. A comprehensive search of six databases (PubMed, PMC, SSRN, Scopus, BioRxiv, and MedRxiv) was conducted up to December 1, 2024. Risk of bias was assessed using the ROBINS-E tool, and pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random-effects meta-analysis. A total of 25 studies were included in the systematic review, with four contributing to the meta-analysis. Lower plasma Aβ-42/Aβ-40 ratio was not significantly associated with Alzheimer’s disease risk (pooled HR=0.8; 95%CI: 0.62–1.04), and substantial heterogeneity was observed (I²=70%, p=0.02). Individual studies varied in their findings: while some reported that lower Aβ-42/Aβ-40 ratio predicted increased Alzheimer’s disease risk, others found no association or even opposing trends. Methodological heterogeneity—including differences in sample handling, measurement techniques, and study designs—likely contributed to these inconsistencies. Overall, this review suggests that plasma Aβ-42/Aβ-40 ratio is not reliable predictors for the onset of Alzheimer’s disease or dementia. However, the substantial heterogeneity observed underscores the need for further research to clarify the potential of plasma Aβ as a preclinical biomarker.
Therapeutic potential of hUC-MSC secretome preconditioned with IFN-γ and/or TNF-α: An in vitro study on Alzheimer’s neuronal cell models Widaja, Edhijanto; Pawitan, Jeanne A.; Ramli, Yetty
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.v5i2.2281

Abstract

Alzheimer's disease is a progressive neurodegenerative disease that is characterized by toxic Amyloid-β (Aβ) plaques and neurofibrillary tangles (NFTs). Treatment options include the use of human umbilical cord mesenchymal stem cell (hUC-MSC)-based therapy. Its secretome contains healing substances such as neprilysin (CD10), which breaks down Aβ42; anti-inflammatory cytokines, which lower inflammation; and growth factors, which promote neuronal regeneration. The aim of this study was to produce hUC-MSC secretomes preconditioned with tumor necrosis factor-alpha (TNF-α) and/or interferon-gamma (IFN-γ) to enhance the secretion of these healing substances. hUC-MSCs were sub-cultured in T-25 flasks at a seeding density of 5×10³ cells/cm² in 10 mL xeno-free medium. hUC-MSCs were preconditioned with TNF-α only, IFN-γ only, and a combination of TNF-α and IFN-γ. This study used 10 ng/mL TNF-α and 20 ng/mL IFN-γ. The secretome was harvested after 48 hours of preconditioning and then filtered through a 0.22 µm filter. In vitro tests were conducted to assess the effects of the secretome on neuronal survival using the neuroblastoma SH-SY5Y cell line. These cells were differentiated with retinoic acid (RA) and then exposed to Aβ42 to mimic Alzheimer's disease neurons. Secretome therapy was applied at concentrations of 5%, 10%, and 20% to evaluate neuroprotective effects. Four types of secretome were tested: unpreconditioned, TNF-α preconditioned, IFN-γ preconditioned, and a combination of TNF-α and IFN-γ. High levels of CD10 (neprilysin) expression were observed in hUC-MSCs treated with IFN-γ and TNF-α, although they did not release sufficient soluble neprilysin (sNEP). Viability results indicated that secretomes preconditioned with IFN-γ at 10% and 20% concentrations provided the highest increase in cell viability after 72 hours post-therapy. The combination of TNF-α and IFN-γ preconditioned secretome exhibited synergistic effects, particularly at 5% and 10% doses at 24- and 72-hours post-therapy. In conclusion, preconditioned hUC-MSC secretome represents a promising therapeutic approach for Alzheimer's disease, as it enhances neuronal cell viability and promotes neuronal regeneration. However, further studies are required to optimize sNEP release and maximize therapeutic efficacy in in vivo models.
Exploring the hypoglycemic potential of fresh, semangit, and bosok tempe: A comparative metabolite profile Astawan, Made; Adurrasyid, Zaid; Novita, Rias R.; Damayanti, Aprilia F.; Saraswati, Saraswati; Wresdiyati, Tutik; Saithong, Pramuan; Chitisankul, Wanida T.; Putri, Sastia 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.v5i2.2327

Abstract

Tempe, a traditional Indonesian fermented soybean product made with Rhizopus spp., is classified based on fermentation duration into fresh (two days), semangit (five days), and bosok (seven days) varieties, fermented at room temperature (28–30°C). Longer fermentation is believed to enhance its antidiabetic properties. The aim of this study was to compare the metabolite profiles and hypoglycemic activities of fresh, semangit, and bosok tempe made from germinated and non-germinated soybeans. Diabetic rat models were used to assess the effects of these tempe types on body weight, blood glucose levels, serum insulin, pancreatic β-cell count, and glycogen content in liver and muscle tissues. Metabolomic profiling was conducted using gas chromatography-mass spectrometry (GC-MS), followed by principal component analysis (PCA) to assess the influence of fermentation stage and germination. Fresh tempe, especially from germinated soybeans, had the highest moisture content. Fermentation duration significantly influenced color, texture, and pH, with bosok tempe showing the most notable changes. Tempe and gliclazide significantly reduced blood glucose in diabetic rats in vivo, with semangit and bosok tempe restoring levels close to normal. However, weight loss was not reversed. Bosok non-germinated tempe induced the highest insulin levels among tempe treatments and improved β-cell count and density to levels comparable with gliclazide. Glycogen stores in the liver and muscle were significantly restored by tempe, with bosok non-germinated tempe showing the greatest effect. GC-MS profiling identified 154 metabolites, of which 63 were annotated. Fermentation and germination shifted the metabolite profile, with bosok non-germinated tempe showing the highest diversity, including amino acids, sugars, and amines. PCA separated samples by fermentation stage, highlighting metabolite accumulation with prolonged fermentation. The findings revealed that bosok tempe from non-germinated soybeans had the highest abundance of bioactive metabolites, including isoflavones, which likely contributed to its superior antioxidant and hypoglycemic potential compared to other tempe types.
Thymoquinone and madecassoside improve motor function in a rotenone-induced mouse model of early Parkinson’s disease: Role of dopamine, alpha-synuclein and mBDNF Kusumawati, Shinta; Endharti, Agustina T.; Balafif, Farhad; Kurniawan, Shahdevi N.; Rosidah, Aris; Anaqah, Rabjhany; Barqillah, Izzunazel A.; Khotimah, Husnul
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.v5i2.2439

Abstract

Parkinson’s disease is a progressive, incurable neurodegenerative disorder characterized by the degeneration of dopaminergic neurons and pathological aggregation of α-synuclein in the midbrain, leading to motor dysfunction. Thymoquinone (TQ), an active compound from Nigella sativa, has demonstrated antioxidant properties that may reduce dopamine degradation, while madecassoside (MA), a triterpenoid component of Centella asiatica, exhibits neuroprotective effects. To date, no study has investigated the combined effects of TQ and MA in a Parkinson’s disease model. The aim of this study was to evaluate the synergistic neuroprotective potential of TQ and MA on motor function, dopamine levels, α-synuclein accumulation, and mature brain-derived neurotrophic factor (mBDNF) expression in a rotenone (ROT)-induced mouse model of early Parkinson’s disease. Rotenone (2.5 mg/kg BW) was administered subcutaneously for two weeks to induce Parkinson’s disease, while TQ alone, MA alone and combination of TQ and MA at various doses, as well as a reference drug (pramipexole) were given every 48 hours concurrently with rotenone. Motor symptoms were assessed through behavioral tests, including the open field test (OFT), beam walking test, and hanging wire test; midbrain dopamine levels were quantified via enzyme-linked immunosorbent assay (ELISA), α-synuclein expression was assessed using Western blotting, and immunohistochemistry was used to detect mBDNF-positive cells in the cerebral cortex. The combination of TQ and MA significantly increased midbrain dopamine levels and improved locomotor activity, as shown by increased total distance traveled and mean velocity in ROT-induced mice. Biochemically, this combined treatment reduced α-synuclein expression, suggesting attenuation of early pathological aggregation typically observed in Parkinson’s disease. Although the increase in mBDNF expression in the cerebral cortex was not statistically significant, it was higher in the TQ-MA treatment group compared to controls and other groups. Collectively, these results highlight the therapeutic potential of TQ and MA in combination to counteract both motor deficits and early neurochemical disruptions in a ROT-induced model of Parkinson’s disease.
Coenzyme Q10 as adjuvant therapy could reduce oxidative stress and enhance sperm quality in cryptorchidism animal models Nurhadi, Pradana; Daryanto, Besut; Dhani, Fauzan K.; Purnomo, Athaya F.; Kusworini, Kusworini; Alfandy, Tommy N.
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.v5i2.2474

Abstract

The role of coenzyme Q10 (CoQ10) as an antioxidant in the context of cryptorchidism is increasingly recognized due to its potential protective effects against oxidative stress, a key contributor to testicular dysfunction in this condition. The aim of this study was to evaluate the antioxidant activity of CoQ10 and its impact on sperm parameters as an adjuvant therapy in a cryptorchidism mouse model. A total of 36 male Sprague Dawley mice were divided into six groups: control (negative control), cryptorchidism (positive control), orchidopexy only, and orchidopexy treated with CoQ10 at 5, 10 and 20 mg/kg body weight (BW). After seven days of induction into the cryptorchidism model, the mice underwent orchidopexy, and CoQ10 was administered orally from day 1 to day 7 post-orchidopexy. At the end of the treatment period, all mice were euthanized, and the left testes were collected for immunohistochemical analysis of malondialdehyde (MDA) and superoxide dismutase (SOD), as well as histological examination and sperm parameter assessment. Testicular tissue damage was assessed using the Cosentino grade, while spermatogenesis was evaluated using the Johnsen scoring system. Additionally, sperm parameters were analyzed from the left testis. MDA expression in the cryptorchidism group was significantly lower than in all CoQ10-treated groups (p<0.001). In contrast, SOD expression was significantly higher in the cryptorchidism group compared to the 10 mg/kg BW and 20 mg/kg BW CoQ10 groups (both had p<0.001). Cosentino grade and Johnsen score showed no significant differences between the control group and the group treated with 20 mg/kg BW CoQ10 (p=0.891 and p=0.123, respectively). Furthermore, the 20 mg/kg BW CoQ10 group had significantly greater sperm concentration and motility compared to the cryptorchidism group (p<0.001 for both). These findings demonstrated that CoQ10 had significant antioxidant activity as an adjuvant therapy in a cryptorchidism mouse model. CoQ10 supplementation could reduce oxidative stress markers, enhance antioxidant enzyme expression, and improve sperm parameters, supporting its potential to mitigate testicular damage associated with cryptorchidism.
Medical cost inflation and its drivers in Indonesian employer-sponsored health insurance for retiree families Prastyo, Cahya E.; Gani, Ascobat
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.v5i2.2528

Abstract

Rising life expectancy and changes in disease patterns have led to an increase in retiree medical costs. Understanding these trends is essential for ensuring the financial sustainability of retiree healthcare programs. The aim of this study was to analyze medical cost inflation and its drivers in Indonesia's employer-sponsored retiree health insurance program from 2020 to 2023. A retrospective cohort study using total sampling included 29,695 retirees, analyzing medical records and insurance claims to examine demographic transition, cost analysis and relative risk of cost drivers. The study found that the retiree population is aging, characterized by longer life expectancy and a growing proportion of individuals aged above 71 years. Medical cost inflation among retirees is higher compared to the general population, driven by aging, high-cost diseases, increased healthcare utilization, and rising treatment costs. Cardiovascular diseases, diabetes, and chronic kidney disease are major drivers of high medical costs. Inpatient care is the most significant cost component, with a cost risk 14.39 times higher than clinic visits. Medicine and medical treatment are leading cost contributors in the retired population. The rising cost of retiree healthcare necessitates sustainable financing strategies. The study highlights that medical cost inflation in retirees was higher than in the general population, driven by aging, high-cost diseases, increased utilization, and rising treatment costs. Strengthening preventive care, optimizing primary care, and diversifying funding sources are recommended to ensure long-term financial stability.
Development of decellularized mouse auricular scaffolds using sodium dodecyl sulfate immersion-agitation for microtia tissue engineering Jaya, Putu KD.; Dewi, Anak AAAP.; Lestarini, Asri; Witari, Ni PD.; Evayanti, Luh G.
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.1610

Abstract

Effective treatment strategies for microtia remain limited due to the side effects and shortcomings associated with current therapeutic approaches. Tissue engineering, particularly the development of biological scaffolds, has emerged as a promising alternative. However, research on auricular scaffold fabrication in murine models using sodium dodecyl sulfate (SDS) and the immersion–agitation decellularization technique remains scarce. The aim of this study was to evaluate the effects of varying SDS concentrations on the decellularization efficiency and extracellular matrix (ECM) preservation of murine auricular tissue for scaffold development. Auricular tissues from mice (n=4) were immersed in Erlenmeyer flasks containing 0.1%, 0.5%, or 1% SDS and subjected to continuous agitation until the tissues became macroscopically translucent. Qualitative assessments included macroscopic appearance and microscopic evaluation using hematoxylin–eosin and Masson's trichrome staining. Quantitative analysis involved counting residual nuclei, while semiquantitative analysis of ECM area fractions was performed using ImageJ software. Statistical comparisons were conducted using one-way analysis of variance (ANOVA), with significance defined as p<0.05. The results demonstrated that the decellularized scaffolds exhibited macroscopic translucency, significantly reduced nuclear content (p=0.001), and preserved ECM integrity (p=0.012). Among the tested concentrations, 0.5% SDS provided the optimal balance between effective decellularization and ECM preservation. These findings support the potential application of murine auricular scaffolds decellularized with 0.5% SDS via the immersion–agitation method for future microtia tissue engineering.
Development of an inactivated viral transport medium for diagnostic testing in low-resource countries Rahmani, Silmi; Meitha, Karlia; Septiani, Popi; Priharto, Neil; Kamarisima, Kamarisima; Ningrum, Ratih A.; Angelina, Marissa; Agustiyanti, Dian F.; Wisnuwardhani, Popi H.; Nugroho, Herjuno A.; Tan, Marselina I.
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2068

Abstract

Viral transport medium (VTM) is crucial for retaining clinical specimens, such as the virus or its genetic material from the mucus of respiratory tract of coronavirus disease 2019 (COVID-19) suspected patients. However, the locally produced VTM in Indonesia lacks the ability to inactivate the virus, risking the safety of diagnostic personnel. The aim of this study was to formulate inactive VTM (iVTM) incorporating chaotropic agents like guanidine salt, along with anionic detergents, chelators, buffers, and surfactants, to inactivate the virus while maintaining RNA integrity. Viral RNA stability in iVTM (pH 4 and pH 6) was evaluated for 30 days at 4°C and 25–28°C. In vitro inactivation test was performed on SARS-CoV-2 isolate (variant B1). The stability test revealed that storing the clinical specimens in iVTM at pH 6 maintained severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) detectability by qPCR for up to 30 days at cold and room temperatures. Stability assessments conducted over a 4-month period (at 25–28°C) on iVTM with a pH of 6 revealed clear appearance, consistent pH stability, no alteration in the solution color, and no indications of bacterial or fungal contamination. Results from an in vitro inactivation assay demonstrated that iVTM pH 6 eliminated SARS-CoV-2 infectivity within just five minutes of contact. These findings suggest that iVTM pH 6 offers a safer and cost-effective alternative for handling and transportation of clinical specimens.

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