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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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Human strongyloidiasis in rural villages of South Kalimantan, Indonesia: A case series Kristi, Priska PP.; Kusumasari, Peni; Puspawati, Puspawati; Tanzil, Yurniah; Nurmansyah, Dian; Syairaji, Muhammad; Kusumasari, Rizqiani A.; Sholikhah, Eti N.; Buehler, Nina; Sy, Issa; Schneitler, Sophie; Becker, Sören L.; Murhandarwati, Elsa H.
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.v5i3.2515

Abstract

Strongyloidiasis, caused by the nematode Strongyloides stercoralis, can lead to severe complications, including hyperinfection syndrome and disseminated disease, particularly in immunocompromised individuals. However, data on its epidemiology and clinical significance in Indonesia remain scarce and outdated. The aim of this study was to investigate the presence of S. stercoralis, identify potential sources of infection, and explore associated risk factors. A case series of strongyloidiasis was identified during a soil-transmitted helminth survey conducted in two villages in Banjar District, South Kalimantan, Indonesia, between May and July 2024. S. stercoralis larvae were detected in four individuals out of 224 fecal samples (1.8%) using the Baermann funnel method, with confirmation via quantitative polymerase chain reaction (qPCR). All infected individuals were female farmers who reported nonspecific clinical symptoms. Subsequent environmental sampling revealed viable S. stercoralis larvae in soil from one of the villages. The detection of asymptomatic, infected individuals suggests that humans serve as reservoirs for ongoing transmission. In the context of open defecation practices, sustained transmission is likely unless targeted interventions are implemented. Urgent actions are needed, including community education and the provision of basic sanitation infrastructure such as latrines and access to clean water. These interventions are especially critical given that ivermectin—the first-line treatment for strongyloidiasis—is not currently available in Indonesia.
Navigating the intersection of COVID-19 and lower extremity acute limb ischemia: A retrospective cohort study of clinical characteristics and outcomes at Dr. Cipto Mangunkusumo Hospital Muradi, Akhmadu; Fachriza, Ihza; Pratama, Dedy; Suhartono, Raden; Harunarashid, Hanafiah
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.v5i3.2557

Abstract

Acute limb ischemia (ALI), a critical condition threatening limb viability and patient survival, has demonstrated an increased incidence during the COVID-19 pandemic, primarily due to virus-associated thrombotic complications. The pandemic has also led to delays in the diagnosis and treatment of non-COVID conditions, including ALI. The aim of this study was to evaluate the clinical characteristics and outcomes of ALI patients treated at Dr. Cipto Mangunkusumo Hospital between 2018 and 2022, comparing outcomes before and during the COVID-19 pandemic. Patients were categorized into two cohorts: pre-pandemic (n=28) and pandemic (n=53), with March 2020 marking the onset of the pandemic period. Treatment outcomes—revascularization success, re-intervention, and mortality—were assessed using multivariate logistic regression. Among the 81 patients, 34.6% were treated before the pandemic and 65.4% during the pandemic. Revascularization success was significantly higher during the pandemic (relative risk (RR): 2.46; 95% confidence interval (CI): 1.16–5.24; p=0.013), whereas no significant differences were observed in re-intervention or mortality rates (both with p>0.05). A prior history of COVID-19 was not significantly associated with revascularization outcome (p=0.933). The use of fluoroscopic guidance was significantly associated with improved revascularization success (RR: 36.58; 95%CI: 6.54–204.6; p=0.001). Rutherford classification was a significant predictor of re-intervention success (p=0.022), while the presence of dyslipidemia and cardiovascular disease were independently associated with mortality (RR: 0.08–0.76, p=0.0o5, and RR: 2.24–25.18, p=0.001, respectively). In conclusion, fluoroscopy appears to enhance revascularization outcomes in the treatment of ALI. Comorbidities such cardiovascular disease, and COVID-19 history should be taken into account when managing patients with ALI.
Biopsychosocial determinants of anxiety and depression among working mothers in China: A public mental health perspective Jiao, Jia; Jenraumjit, Rewadee; Worland , Shirley; Bunyachatakul , Saifon; He, Bijing; Wongpakaran, Tinakon
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.v5i3.2754

Abstract

Working mothers often face dual demands from work and parenting, increasing their risk for anxiety and depression. However, the prevalence and contributing factors among Chinese working mothers remain underexplored. The aim of this study was to examine the prevalence and biopsychosocial determinants of anxiety and depression in this population. A cross-sectional survey was conducted between October 17 and November 21, 2024 through WeChat online among 330 working mothers aged 30–45 years old using validated instruments, including the Outcome Inventory-21 (OI-21), Parental Stress Scale (PSS), Experiences in Close Relationships-revised (ECR-R-10), Inner Strength-based Inventory (I-SBI), and the Multidimensional Scale of Perceived Social Support (MSPSS). Sociodemographic, socioeconomic and biological factors, including age, marital status, annual income, and physical disease, were also collected through a self-administered general information questionnaire. Data were analyzed using t-test, analysis of variance, Pearson’s correlation, and hierarchical linear regression. This study found the prevalence was 26.1% for anxiety symptoms and 38.2% for depression symptoms in this group based on the screening tools. Anxiety was significantly associated with both biological (e.g., hormonal changes, family psychiatric history) and psychological factors (e.g., attachment anxiety, parental stress). At the same time, depressive symptoms were primarily predicted by psychological and lifestyle-related factors (e.g., smoking, alcohol use). Notably, inner strength was a protective factor across both conditions. The findings highlight the importance of early detection and integrative care strategies for addressing mental health concerns in working mothers. Incorporating psychological screening, lifestyle assessment, and resilience-building interventions into workplace and community-based healthcare services may improve work-family balance outcomes in this population.
Cerebral artery stenosis and neurological outcomes after anticoagulant and antiplatelet therapy in acute ischemic stroke: A digital subtraction angiography-based study in Indonesia Musadir, Nasrul; Syahrul, Syahrul; Imran, Imran; Fiqri, Aidil; Danial, Dini R.
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.v5i3.2919

Abstract

Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality, with cerebral artery stenosis serving as an important prognostic factor. While revascularization therapies benefit selected patients, most rely on pharmacological strategies. However, evidence regarding the effect of sequential anticoagulant–antiplatelet therapy on vascular stenosis and neurological outcomes remains limited. The aim of this study was to evaluate changes in cerebral artery stenosis, assessed using digital subtraction angiography (DSA), and neurological deficits, assessed by the National Institutes of Health Stroke Scale (NIHSS), in patients with first-onset AIS treated with anticoagulant and antiplatelet therapy. A prospective cohort study was conducted involving 35 patients who received low-molecular-weight heparin or warfarin for seven days, followed by 90 days of oral antiplatelet therapy (aspirin or clopidogrel). Sixteen patients consented to repeat DSA at 90 days. Among these, the median stenosis decreased from 44.5% (30–90%) to 44.0% (20–90%) (p=0.003). In the full cohort (n=35), the median NIHSS improved from 10 (5–17) at baseline to 9 (2–14) at 90 days (p<0.001). Correlation analysis demonstrated a positive but non-significant association between stenosis reduction and NIHSS improvement (r=0.474, p=0.064). These findings suggest that sequential anticoagulant–antiplatelet therapy in first-onset AIS was associated with a modest but statistically significant reduction in arterial stenosis and meaningful improvement in neurological function. Although vascular and clinical outcomes were not significantly correlated, the observed trend highlights the importance of structured pharmacological therapy and the potential role of serial vascular imaging in follow-up care.
Phytochemical profiling and enzyme inhibitory activity of Sterculia populifolia DC stem bark extract and fractions against elastase and tyrosinase Khairi, Nur; Nursamsiar, Nursamsiar; Utami, Novi F.; Marwati, Marwati; Nur, Syamsu; Indrisari, Maulita; Kursia, Sukriani
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.v5i3.1778

Abstract

The demand for natural ingredients in cosmetic and medical applications is steadily increasing, particularly for anti-aging and skin-lightening products. Sterculia populifolia DC, a member of the Sterculia genus, is known to contain diverse bioactive compounds such as flavonoids, phenolics, and terpenoids, which may offer pharmacological benefits. The aim of this study was to evaluate the anti-aging potential of S. populifolia stem bark extract and its solvent-partitioned fractions through enzyme inhibition assays coupled with phytochemical profiling. The stem bark was extracted using 96% ethanol via maceration, followed by sequential liquid-liquid partitioning with n-hexane, ethyl acetate, n-butanol, and water. Phytochemical constituents were characterized using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The inhibitory activities of the extract and fractions against tyrosinase and elastase enzymes were evaluated using spectrophotometric assays, with kojic acid and quercetin as positive controls, respectively. IC₅₀ values were calculated to quantify enzyme inhibition potency. LC-MS/MS analysis revealed key bioactive compounds, including 4-[(E)-(3,5-diamino-1H-pyrazol-4-yl)diazenyl]phenol, isofraxidin, and (22E)-ergosta-4,6,8(14),22-tetraen-3-one. Among the tested samples, the ethanol extract exhibited the most potent activity, with an IC₅₀ of 93.35 µg/mL for elastase inhibition and 133.15 µg/mL for tyrosinase inhibition—classified as strong and moderate activity, respectively. Collectively, these findings demonstrate that S. populifolia stem bark extract possesses promising anti-aging and depigmenting properties, supporting its potential development as a natural bioactive ingredient in cosmetic and skincare formulations.
Enhancing the quality of tuberculosis care in a high-prevalence area of West Java, Indonesia: A comparative study between public and private hospitals Dewi, Inaz K.; Hairi, Farizah M.; Andriani, Helen
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.v5i3.2108

Abstract

Despite the World Health Organization’s (WHO) ambitious goal of eradicating tuberculosis (TB) by 2035, the three key indicators of the End TB Strategy remain unmet. Improving the quality of care is essential to achieving better health outcomes in Indonesia, where both public and private hospitals play a pivotal role in strengthening TB services. The aim of this study was to evaluate the quality of TB care in public and private hospitals in Karawang Regency, a district with the fifth highest TB prevalence in West Java, Indonesia. A mixed-methods approach was employed, using an evaluation framework that integrated the High-Quality Health System (HQHS) model and the Quality of Tuberculosis Service Assessment (QTSA) tool. Quantitative data were collected using a modified QTSA questionnaire administered to patients, while qualitative primary data were obtained through in-depth interviews with stakeholders and healthcare providers. Secondary qualitative data were sourced from patient visit records and TB control reports. The findings indicated that low treatment success rates were associated with increased patient loss to follow-up, inadequate evaluation, patient mortality, and dissatisfaction, which were largely driven by deficiencies in foundational elements and suboptimal treatment processes, including budgeting, policy dissemination, and the functioning of internal and external networks. Positive patient experiences and access to follow-up care significantly influenced patient satisfaction. Strengthening the foundational components of the TB health system and adopting a sustainable, integrated treatment approach are critical to improving treatment success rates, clinical outcomes, and patient satisfaction.
Chronic exercise reduces astrocytic c-Fos and CCL2 via conditioned serum and cerebrospinal fluid Allahyari, Victoria; Behroozi, Zahra; Akhavan, Maziar M.; Shahrezaei, Aidin; Nasirinezhad, Farinaz
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.v5i3.2726

Abstract

Inflammation, a critical immune response to infection and tissue damage, is mediated by pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), which upregulate the expression of cellular proto-oncogene Fos (c-Fos) and chemokine ligand 2 (CCL2). Chronic exercise has been shown to exert systemic anti-inflammatory effects, yet its impact on astrocytic inflammatory signaling remains unclear. The aim of this study was to investigate whether chronic exercise modulates astrocytic expression of c-Fos and CCL2 through factors present in conditioned serum and cerebrospinal fluid (CSF). Male wistar rats were assigned to an exercise group (progressively increased swimming, five times per week for four weeks) or a sedentary control group. Conditioned serum and CSF were collected and applied to astrocyte cultures with or without TNF-α induction. After 120 minutes, c-Fos and CCL2 expression were quantified using western blot analysis. Conditioned serum and CSF from exercise rats significantly reduced TNF-α induced c-Fos and CCL2 expression compared with controls. These findings suggest that chronic exercise may attenuate neuroinflammatory responses by modulating astrocytic expression of c-Fos and CCL2. The parallel reductions observed in both serum and CSF indicate that exercise-induced circulating factors may possess anti-inflammatory properties within neural environments. This study provides preliminary in vitro evidence for mechanistic link between chronic exercise and reduced neuroinflammation, underscoring the need for in vivo validation and translational research to assess therapeutic potential.
Death contemplation and mental well-being in elderly Thai Buddhist meditation practitioners Glushich, Alla; DeMaranville, Justin; Wongpakaran, Tinakon; Wedding, Danny; Wongpakaran, Nahathai
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.v5i3.2753

Abstract

Depression is prevalent among older adults in Southeast Asia, with fear of death as a key contributing factor. In Thailand, Buddhist death contemplation practices promote acceptance of mortality and may support mental well-being. However, their impact on mental health among elderly Thai Buddhist meditation practitioners remains underexplored. The aim of this study was to examine the interrelationships among death contemplation practice, positive death attitudes, and key psychological outcomes: well-being, depression, and gratitude among elderly Thai Buddhist meditation practitioners. A cross-sectional study design was employed, and data were collected from elderly Thai Buddhist meditation practitioners in Northern Thailand. Participants completed validated instruments assessing death attitudes (Morana Questionnaire; MoQ), death contemplation practice (Modified Meditation Evaluation Questionnaire; MMEQ), well-being (WHO-5-T), depression (Outcome Inventory-21), and gratitude (Gratitude Inventory-6). Descriptive statistics, Pearson correlations, and analysis of covariance (ANCOVA) were used to examine associations among variables and differences across levels of death contemplation practice. A total of 332 elderly participants (mean age=68.12 years; 66% female) were included. Death contemplation practice showed a significant negative association with depression (p=0.011) but not with well-being (p=0.116) or gratitude (p=0.226) after controlling for covariates. Positive death attitudes were independently associated with lower levels of depression (p<0.001), as well as higher levels of well-being (p<0.001) and gratitude (p<0.001), remaining a significant predictor across all outcomes. The association between contemplation and depression weakened when positive attitudes were included in the model, suggesting a mediating effect. These findings underscore the central role of positive death attitudes, cultivated through contemplative practice, in supporting mental health among elderly Thai Buddhist meditation practitioners. Integrating such practices into interventions may offer culturally appropriate strategies for enhancing well-being in aging Buddhist populations.
Emergency management of recurrent ovarian ectopic pregnancy in a hemodynamically unstable patient: A case report Singgih, Rendy; Larose, Skmarina H.; Kwary, Meilyana MI.; Helmina, Helmina
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.v5i3.2811

Abstract

Recurrent ectopic pregnancy is defined as the occurrence of more than one extrauterine implantation of a fertilized ovum. Ectopic pregnancy arises when a fertilized egg fails to implant within the endometrial cavity and instead attaches to an alternative site such as the fallopian tube, ovary, or peritoneal cavity. In this report, a rare case of recurrent ovarian ectopic pregnancy in a 31-year-old patient at six weeks’ gestation is presented. The aim of this study was to highlight the clinical presentation, diagnostic challenges, and management considerations associated with recurrent ovarian ectopic pregnancy. The patient was admitted to the emergency maternal unit with severe abdominal pain. A previous history of ectopic pregnancy raised the suspicion of recurrence. The diagnosis of ectopic pregnancy was established, and the patient underwent emergency exploratory laparotomy. During the procedure, the gestational sac was identified on the surface of the right ovary. Postoperatively, the patient required blood transfusion and supportive management, and was discharged in stable condition after several days of hospitalization. Ovarian ectopic pregnancy is an uncommon but serious condition. Early diagnosis, ideally with high-resolution ultrasonography, is essential to prevent life-threatening complications such as rupture, massive intra-abdominal hemorrhage, hemorrhagic shock, and maternal mortality. This case highlights the importance for clinicians of recognizing the possibility of recurrence in patients with a prior history of ectopic pregnancy and ensuring vigilant follow-up and timely intervention.
Exploring the potential of Holothuria atra extract in modulating fasting triglyceride index and obesity: In silico, in vitro and in vivo studies Al’asyi, Assyu’ara; Ujianti, Irena; Nadika, Rara; Zahirah, Zahirah; Faizin, Bimo J.; Afifah, Devana A.; Farhan, Randhiva; Rahmadina, Salsabila P.; Lubis, Raisya ZN.; Ghaisani, Sakinah; Arkananta, Kiflan; Lakshmi, Bety S.; Pangestu, Mulyoto
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.v5i3.2839

Abstract

Obesity remains a major global health challenge and is strongly associated with metabolic disorders, particularly cardiovascular disease. This has fueled growing interest in natural interventions that regulate lipid metabolism as potential strategies to mitigate associated risks. Among these, Holothuria atra has emerged as a candidate due to its diverse bioactive compounds, though its mechanisms of action and therapeutic efficacy remain inadequately characterized. The aim of this study was to evaluate the combined effects of H. atra extract (HAE) and exercise on metabolic regulation, with the goal of determining whether their synergistic use enhances obesity management by targeting multiple metabolic pathways. Specimens of H. atra were collected from Tablolong Beach, Indonesia, and ethanol extracts were prepared. An in-silico analysis was performed to assess drug-likeness, quantitative structure-activity relationship (QSAR) properties, and network pharmacology. In vitro test using human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) underwent adipogenic differentiation with or without HAE treatment. This study used male Sprague-Dawley rats that were fed either a control or high-fat diet and further subdivided into groups receiving extract supplementation, swimming exercise, or a combination of both for six weeks. Liquid chromatography-mass spectrometry (LC-MS) analysis identified 6-gingerol and sarcostin as principal bioactive compounds, both of which fulfilled drug-likeness criteria. In silico analyses implicated peroxisome proliferator-activated receptor gamma (PPAR-γ) signaling as a major molecular target. In vitro tests found that HAE attenuated adipogenic differentiation of hUC-MSCs. Both HAE and exercise significantly reduced triglycerides, glucose, and the triglyceride–glucose index in rats fed a high-fat diet. The combination of HAE and exercise produced the greatest improvements, with significant reductions in glucose (p<0.01) , triglycerides (p<0.001), and the triglyceride–glucose index (p<0.001) compared to the high-fat diet control group. Collectively, these findings suggest that HAE, particularly when combined with regular exercise, improves lipid metabolism and may serve as a promising complementary strategy for obesity management.

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