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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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The role of mediator suppressor of cytokine signaling (SOCS), toll-like receptor 3 (TLR-3) and nuclear factor kappa B (NFκB) on cytokine production during dengue virus infection Sri Masyeni; Kuntaman Kuntaman; Aryati Aryati; Muchlis AU. Sofro; Usman Hadi; Gondo Mastutik; Windu Purnomo; Agus Santosa; Muhammad Iqhrammullah; Benediktus Yohan; Erni J. Nelwan; R. Tedjo Sasmono
Narra J Vol. 3 No. 2 (2023): August 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i2.167

Abstract

Inability to understand the pathogenesis of severe dengue, in particular the control mechanism of immune responses, has led to high mortality rate for patients with dengue shock syndrome (DSS). The aim of this study was to determine the control mechanism of cytokine production by mediator suppressor of cytokine signaling (SOCS), toll-like receptor 3 (TLR-3) and nuclear factor kappa B (NFκB) during DENV infection. Peripheral blood mononuclear blood cells (PBMC), isolated from healthy individuals, were infected with dengue virus (DENV)-2 strain SJN-006 Cosmopolitan genotype (isolated from Bali, Indonesia). The relative gene expression of SOCS-3, TLR-3, NFκB, and the cytokine genes (interleukin (IL)-6, IL-8, interferon inducible protein 10 (IP-10), and macrophage inflammatory protein-1 beta (MIP-1β)) were measured using qRT-PCR at 6, 12 and 24 hours post infection (hpi). Student t-test and Mann-Whitney test were used to compare the gene expressions while causal correlations were analyzed using regression test and path analyses. DENV-2 infection increased the gene expression of SOCS-3, TLR-3, and NFκB after 12 and 24 hpi. The expression of IL-6, IL-8, IP-10, and MIP-1β genes was increased and peaked at different times post-infection. NFκB and SOCS-3 genes likely have role in the upregulation of IL-8 and IL-6 gene expression, respectively. MIP-1β gene expression was significantly induced by both NFκB and SOCS-3. In conclusion, our study suggested that SOCS-3, TLR-3, and NFκB are important in regulating the production of IL-6, IL-8, IP-10, MIP-1β during early phase of DENV-2 infection. This enriches our understanding on pathogenesis pathway of DENV-associated cytokine storm.
Phytocompounds of Nigella sativa seeds extract and their neuroprotective potential via EGR1 receptor inhibition: A molecular docking study Kulsum Kulsum; Syahrul Syahrul; Kartini Hasbalah; Ummu Balqis
Narra J Vol. 3 No. 2 (2023): August 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i2.173

Abstract

Bioactivity of Nigella sativa seed extract has the potential as a neuro-protector, offering its promising utility in the clinical setting for brain injury management. This study aimed to identify the phytocompounds contained in the extract of N. sativa seeds and further screen their respective neuronal anti-inflammatory activities in silico. The extract of N. sativa seeds was prepared through successive maceration using non-polar to polar solvents (n-hexane and ethanol, respectively). The phytocompounds in the ethanolic extract were initially identified through qualitative analysis and further analyzed with gas chromatography-mass spectrometry (GC-MS). The spectral data were compared with the compound library for identification. The identified phytocompounds were then simulated computationally for their binding affinities toward the active pocket of early growth response-1 (EGR1) receptor (PDB: 14r2a). We found that the ethanolic extract of N. sativa seeds were predominantly constituted of hexadecanoic acid, ethyl ester (17.15%); linoleic acid ethyl ester (15.0%); octadecanoic acid (13.26%); and ethyl oleate (10.38%). The binding affinity of the phytocompounds ranged from -7.49 kcal/mol (methyl palmitoleate) to -14.31 kcal/mol (9-hexadecanoic acid, methyl ester), with 12 compounds having binding affinity < -10 kcal/mol. In conclusion, ethanolic extract of N. sativa seeds are rich with fatty acids that have active as anti-inflammatory and may exert neuronal protection by inhibiting EGR1 receptor. Studies using animal models to confirm the activity are warranted.
Antibacterial and anti-inflammatory activities of Nothopanax scutellarium, Moringa oleifera and Piper betle extracts on staphylococcal mastitis animal model Cut Sriyanti; Tongku N. Siregar; Mudatsir Mudatsir; Azhari Gani; Denny I. Hasan; Amalia Sutriana
Narra J Vol. 3 No. 2 (2023): August 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i2.176

Abstract

Inappropriate and prolonged administration of antibiotics in mastitis could cause antibiotic resistance and herbal treatment might could be one alternative treatment. Nothopanax scutellarium, Moringa oleifera, and Piper betle are medicinal plants that contain various active compounds, including antibacterial and anti-inflammatory agents, but their potentials in treating mastitis are not well understood. The aim of this study was to assess the effectiveness of those plants against mastitis in rabbit model induced by Staphylococcus aureus. A total of 25 lactating rabbits (Oryctolagus cuniculus) weighing 3.0±0.4 kg were grouped into five groups: healthy control; mastitis control, and three treatment groups (Nothopanax scutellarium, Moringa oleifera, and Piper betle). Except the healthy control group, all animals were inoculated with 0.15 mL of Staphylococcus aureus containing 1.5x107colony forming unit (CFU)/mL on eight days after giving birth. The extract was administered orally after four hours Staphylococcus aureus inoculation at a dose of 50 mg/kg body weight, twice a day for five consecutive days. The number of bacteria in the milk and the level of serum interleukin 6 (IL-6) were measured and histopathological examination of mammary gland tissues were analyzed. The log number of total plate count of Staphylococcus aureus indicated that all extract groups had significant lower of bacterial logs compared to mastitis control (all comparisons had p<0.05) with the lowest was found in Piper betle group, followed by Nothopanax scutellarium and Moringa oleifera. The enzyme-linked immunosorbent assay (ELISA) results showed that all ethanolic extract groups had significantly lower levels of IL-6 compared to the mastitis control (all comparisons had p<0.05). The histopathologyassessment suggested that extract groups had lower infiltration of inflammatory cells such as lymphocytes and macrophages in alveoli compared to the mastitis control group. In conclusion, all three extracts contained antibacterial and anti-inflammatory activities and Piper betle had the most effective in reducing bacterial growth and IL-6 level compared to others.
Hemostatic and liver function parameters as COVID-19 severity markers Qanita Iqbal; Mudatsir Mudatsir; Harapan Harapan; Nurjannah Nurjannah; Teuku Maulana
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.178

Abstract

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a disease newly discovered in December 2019 which affects coagulation cascade and liver functions. The aim of this study was to investigate the potential of hemostatic and liver function parameters as severity markers in COVID-19 patients. This study was an observational analytic with cohort retrospective design using total sampling method. Data were retrieved from medical record of COVID-19 patients admitted to provincial hospital in Banda Aceh, Indonesia from March 2020 to March 2022. There were 1208 data eligible for the study after applying certain criteria. Mann–Whitney, logistic regression, and receiving operating characteristic (ROC) analyses were used to analysis the data. Thrombocyte count (p<0.001), prothrombin time (p<0.001), activated partial thromboplastin time (p<0.001), D-dimer (p<0.001), fibrinogen (p<0.001), aspartate aminotransferase (p<0.001), and alanine transaminase (p<0.001) significantly increased in severe compared to mild COVID-19 patients. After being adjusted, age (odds ratio (OR); 1.026 (95% confidence interval (CI): 1.016–1.037) was the most significant factor in predicting COVID-19 severity. Fibrinogen (cut-off 526.5 mg/L) was the best parameter associated with COVID-19 severity with 70% sensitivity and 66.4% specificity. Meanwhile, D-dimer (cut-off 805 ng/mL) had a sensitivity of 72.3% and specificity of 66.4%. Combining the parameters resulted in improved sensitivity to 82.0% with a slight decline of specificity to 65.5%. In conclusion, fibrinogen and D-dimer level on admission could be used as biomarkers in predicting COVID-19 prognosis. Routine monitoring and evaluation of laboratory testing especially D-dimer and fibrinogen could be implemented in order to reduce morbidity and mortality rate of COVID-19.
Co-incidence of COVID-19 and hepatocellular carcinoma during pregnancy: Double punches to disease severity and mortality? Azzaki Abubakar; Fauzi Yusuf; Sarah Firdausa; Desi Maghfirah; Andrie Gunawan; Fitrah Sari
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.264

Abstract

Hepatocellular carcinoma (HCC), a considerable leading cause of cancer-related deaths worldwide, is the most common primary liver cancer with poor prognosis and outcome. Many advances in prevention, screening, and new technologies in diagnostics and therapy have been achieved, but its incidence and mortality remain increasing. Co-infection of another viral disease in HCC patients with pregnancy might exacerbate the condition and double the mortality rate. The aim of this case report was to describe the co-infection of coronavirus disease 2019 (COVID-19) in an HCC patient during pregnancy. A 26-year-old woman with 16–17weeks of gestation was admitted to Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia with shortness of breath. The patient also reported that the abdomen expanded rapidly in the last three weeks, followed by severe pain and collateral vein appearance. Laboratory findings revealed anemia, leukocytosis, HBsAg reactive, hypoalbuminemia, hyperbilirubinemia, elevated liver enzymes, increased alpha-fetoprotein (AFP), and cancer antigen 125 (CA-125). Ultrasonography indicated gestation with a single fetus, an enlarged liver with a 9.9 x 9.4 cm nodule, and massive ascites. The patient was also RT-PCR-confirmed COVID-19. On day 8 of hospitalization, the patient suddenly reported severe abdominal pain. Ultrasonography revealed fetal distress immediately followed by fetal death. Adequate management of cancer pain, continuous evacuation of ascites, and other supportive care could not save the patient who died on the day 17 of hospitalization. In this case, we found no proof that the patient experienced cirrhosis prior to HCC. Pregnancy through hormonal alteration is thought to be the aggravating factor that accelerates the progression of pre-existing liver disease into carcinoma and infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) worsened the outcome in this patient.
Salt intake- related knowledge, attitudes, and practices among Jordanian adults Zeina A. Majeed; Rawhieh Barham; Ayoub Al-Jawaldeh; Nada Ahmad; Yousef Khader
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.v5i3.1021

Abstract

High salt consumption is a worldwide public health problem, and its magnitude varies considerably among different communities. This study aimed to assess Jordanian adults’ knowledge, attitudes, and practices related to salt intake and to examine how these domains differed between genders. A quantitative cross-sectional survey was conducted using a multi-stage sampling technique to select a representative sample from the population of Amman, Jordan. Data were collected through a structured, validated questionnaire administered by trained interviewers between November and December 2021. The findings indicate that the majority of participants (70.8%) did not know the maximum recommended daily salt intake and reported not reading food labels when purchasing food. Almost half of the participants (48.2%) reported always adding salt while cooking, and 14.6% reported always adding table salt after cooking. The most commonly reported practices to reduce salt intake included using spices other than salt while cooking (67.2%) and avoiding or reducing the consumption of salt-rich foods. Significant gender differences were observed in knowledge, attitudes, and practices (KAP) toward salt intake. Females demonstrated greater awareness of recommended salt intake and associated health risks, and were more likely to engage in practices aimed at reducing salt consumption, such as avoiding high-salt foods and using alternatives in cooking. In contrast, males were more likely to report misconceptions, limited use of food labels, and higher engagement in unhealthy practices such as daily smoking and lower awareness of low-salt alternatives. In conclusion, this study showed that Jordanian adults have relatively limited knowledge about salt intake, and their practices regarding salt consumption are inappropriate. Therefore, there is a need to adopt long-term strategies to reduce salt intake among the Jordanian population and mitigate its negative impacts on community health.
Unraveling the power of peptides from Cucumaria frondosa coelomic fluid as multitarget therapy of diabetic kidney disease: An in-silico study Rauza S. Rita; Kevin N. Cuandra; Syahidatul A. Nasri; Mutiara A. Carmenita; Nathania A. Kristaningtyas; Daffa Z. Rasendriya; Rafi Maulana; Muhammad N. Hibatullah; Angela S. Yahono; Fitrah Afdhal; Filzatuz Z. Ibrahim; Balqist K. Nayu; Muhammad Teguh
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1180

Abstract

Diabetic kidney disease is a condition characterized by persistent albuminuria, diabetic glomerular lesions, and a reduced glomerular filtration rate in people with diabetes. Peptides in Cucumaria frondosa coelomic fluid have been proven to provide antidiabetic and anti-inflammatory activity that can be used as one of the innovations in developing a multitarget therapy, especially in diabetic kidney disease. Therefore, the aim of this study was to unravel the power of peptide-based metabolites from C. frondosa coelomic fluid as multitarget therapy for diabetic kidney disease using an in-silico study. UCSF Chimera software was utilized to construct the three-dimensional structure of coelomic fluid peptides from C. frondosa. The toxicity and allergenicity of peptides were examined using the ToxinPred and AllerTop websites, respectively. From the PDBJ database, the 3D structures of protein kinase B, alpha isoform (AKT1); vascular endothelial growth factor receptor 2 (VEGFR2); epidermal growth factor receptor (EGFR); α-glucosidase; and glucokinase were obtained. Molecular docking was carried out using MOE Software. In this in-silico study, peptide 9 (-10.32 kcal/mol), peptide 1 (-9.41 kcal/mol), and peptide 3 (-9.55 kcal/mol) were shown to act as specific adenosine triphosphate-competitive inhibitors of EGFR, AKT1, and VEGFR2, respectively. Peptide 8 (-11.06 kcal/mol) can specifically inhibit α-glucosidase by binding to its active site. Peptide 1 (-9.80 kcal/mol) is predicted to specifically inhibit glucokinase activity by blocking its active side. Molecular dynamics simulations confirmed stable interactions with receptor proteins. In conclusion, C. frondosa coelomic fluid peptides have been shown not only to alleviate diabetic kidney disease but also to stabilize blood glucose levels and prevent hyperglycemia based on in-silico analysis.
Assessing health-related quality of life in schizophrenia patients using EQ-5D-5L index: Insights from patients and caregivers Nugraha A. Prasetiyo; Elly Wahyudin; Iman Setiawan; Mayamariska Sanusi; Fredrick D. Purba; Bustanul Arifin; Sylmina D. Alkaff
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.v5i2.1314

Abstract

Schizophrenia is a prevalent mental health disorder often marked by relapses, significantly affecting the health-related quality of life (HRQoL) of both patients and their families. The aim of this study was to compare the EuroQol 5-Dimension 5-level (EQ-5D-5L) responses of schizophrenia patients and their caregivers. Using an observational cross-sectional design, HRQoL was assessed among schizophrenia patients and their family caregivers recruited from a provincial referral hospital. Sociodemographic (age, sex, education, marital status, income) and clinical variables (diagnosis, treatment duration, comorbidities) were analyzed alongside HRQoL using structured interviews, medical record reviews, and the EQ-5D-5L instrument (self-report by patients and proxy-reported by family caregivers). Statistical analyses included chi-square tests for associations, Wilcoxon tests for patient-family caregiver comparisons, and multivariate modeling of HRQoL determinants. A total of 526 participants (263 patients and 263 accompanying family caregivers) were included. Significant differences were observed between patients and family caregivers in two domains: pain/discomfort and anxiety/depression. Also, the agreement between patients' and family caregivers’ reports showed good results. A substantial agreement was observed between patient-reported and family caregiver-assessed HRQoL, as indicated by a Cohen’s Kappa value of 0.8. This result suggests a strong level of consistency between the two assessments, supporting the potential use of family caregivers as reliable proxies for evaluating patient HRQoL when self-reports are unavailable or unreliable. In the self-care domain, mobility, and daily activities, patient and caregiver assessments show high agreement. In conclusion, the closeness between patients and caregivers significantly influences patients' HRQoL, providing critical insights for evaluating treatment effectiveness in schizophrenia cases. While discrepancies exist between patient and caregiver assessments, these interactions are particularly impactful in subjective domains like pain/discomfort and anxiety/depression, but not for other domains that are visible.
Projecting the impact of a national strategy to accelerate stunting prevention in East Nusa Tenggara, Indonesia, using the Lives Saved Tool Helen Andriani; Miftahul Arsyi; Alphyyanto E. Sutrisno; Alexander Waits; Nurul D. Rahmawati
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1462

Abstract

Stunting remains a critical public health issue in East Nusa Tenggara (ENT), Indonesia, with prevalence rates among the highest in the country, despite national efforts to reduce its occurrence. The aim of this study was to project the impact of the 2018–2024 National Strategy to Accelerate Stunting Prevention on children under five years old in ENT, using the Lives Saved Tool. A cross-sectional approach was employed, integrating data from various sources, including the 2020 Census of Indonesia, the Global Data Lab-Area Database, the Central Bureau of Statistics Republic Indonesia, the National Socioeconomic Survey, the 2017 Indonesia Demographic and Health Survey, the 2018 Basic Health Research, and the 2021 Indonesia Nutrition Status Survey. The analysis considered three scenarios: (1) a baseline scenario reflecting ENT’s 2017 coverage, maintained through 2028; (2) a scenario assuming Indonesia achieves the Health Plan Action Stunting targets; and (3) a projection of stunting rates based on ENT-specific coverage. Under scenarios 1 and 2, the prevalence of stunting was projected to decrease from 40.04% in 2018 to 39.82% and 39.78%, respectively, by 2028, with scenario 3 reflecting a similar trend.  The findings revealed a sharp increase in the number of stunting cases averted among children under five years old between 2017 and 2021, followed by a more gradual decline, culminating in the 2028 projections: 2,249 children (scenario 2), 2,130 children (scenario 3), and 1,966 children (scenario 1). Breastfeeding promotion emerged as the most impactful intervention, accounting for over half of the total stunting cases averted under both Indonesia-wide and ENT-specific coverage scenarios. This was followed by interventions such as multiple micronutrient supplementation and vitamin A supplementation. The study highlights that reducing the prevalence of stunting among children requires a comprehensive prioritization of intervention strategies. The implementation of breastfeeding promotion, combined with appropriate complementary feeding practices, is expected to contribute significantly to achieving the sustainable development goal targets.
Challenges in maritime evacuation during pre-hospital emergency anesthesia on a remote island in Indonesia: A case report Airi Mutiar; Kun Arifi Abbas
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narraj.v5i2.1643

Abstract

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

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