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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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Cryotherapy on exfoliative cytological changes for oral mucositis in cancer patients undergoing chemotherapy: A randomized control trial Kadek A. Erika; Mulhaeriah Mulhaeriah; Upik A. Miskad; Eli Zuraida; Moh S. Sangkala; Ika Magfirah; Harun Achmad
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.v5i2.1644

Abstract

Oral mucositis is a common complication of chemotherapy that significantly impacts quality of life and may reduce treatment efficacy. While oral cryotherapy has been widely studied as a preventive intervention due to its cost-effectiveness, safety, and ease of use, most research focused on clinical outcomes without incorporating objective cytological assessments of mucosal changes. The aim of this study was to evaluate the effectiveness of oral cryotherapy in managing chemotherapy-induced mucositis using exfoliative cytology to monitor oral mucosal changes. A single-blinded, randomized controlled trial was conducted involving 50 cancer patients undergoing chemotherapy, who were randomly assigned to either the intervention or control group. The control group (n=25) received standard oral hygiene care, while the intervention group (n=25) received oral cryotherapy in addition to routine oral hygiene. A 20-minute oral cryotherapy was administered twice daily after breakfast (09:00 A.M.) and lunch (01:00 P.M.) for 14 days. This study found a significant reduction in mucositis scores was observed in both groups (p<0.05). However, post-hoc analysis indicated that mucositis severity declined earlier in the cryotherapy group, whereas improvement in the control group was noted only after 14 days. Serial oral mucosal smears analyzed via exfoliative cytology revealed a reduction in inflammatory cells and the absence of coccus microorganisms by days 7 and 14 in the intervention group. In conclusion, this study demonstrated that oral cryotherapy effectively reduces the severity and duration of mucositis and accelerates recovery in cancer patients undergoing chemotherapy. Oral cryotherapy can be applied as a viable alternative to mitigate the severity of oral mucositis in this patient population.
Metabolomic profiling and antimicrobial investigation of Aspergillus fumigatus LBKURCC269 and Bacillus paramycoides LBKURCC218 co-culture Zona Octarya; Titania T. Nugroho; Yuana Nurulita; Nabella Suraya; Saryono Saryono
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.v5i2.1647

Abstract

The increasing resistance of pathogenic microbes to antibiotics is a major public health concern, necessitating the discovery of effective antimicrobial compounds. The aim of this study was to assess the bioactive metabolites produced by Aspergillus fumigatus LBKURCC269 and Bacillus paramycoides LBKURCC218 under three fermentation conditions: monoculture of each microorganism and their co-culture. Metabolite analyses initiated with gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-high-resolution mass spectrometry (LC-HRMS) followed with molecular networking–Global Natural Products Social Molecular Networking (GNPS) and molecular docking. Antimicrobial activity of the extracts was then conducted. Metabolite analysis using GC-MS identified key antimicrobial compounds, including 2,6-bis(1,1-dimethylethyl)-4-methylphenol, pentadecanoic acid, cyclopropane pentanoic acid, and 3-piperidinol. LC-HRMS, combined with multivariate analysis and GNPS molecular networking, revealed additional antimicrobial compounds, including novel pyrazine derivatives induced in co-culture fermentation. Molecular docking analysis of 3-(propan-2-yl)-octahydropyrrolo[1,2-a]pyrazine-1,4-dione demonstrated its potential as an antimicrobial agent by inhibiting topoisomerase IV and cytochrome monooxygenase with binding affinity of -5.34 kcal/mol and -5.6 kcal/mol, respectively. The antimicrobial assays showed that the co-culture fermentation extract had the strongest activity, with inhibition zones of 20.33±0.59 mm (Escherichia coli), 14.33±0.59 mm (Staphylococcus aureus), and 25.67±0.59 mm (Candida albicans). This study highlights the advantages of co-culture fermentation in enhancing the discovery of antimicrobial compounds. The findings underscore the potential of this approach to simplify chemical isolation and accelerate the identification of novel antimicrobial agents for pharmaceutical development.
Effect of hemp seed oil on accelerating wound healing: Evaluation of wound size reduction, epithelialization, granulation tissue formation, and vascularization in murine models Safrizal Rahman; Mohammad A. Rivai; Dasrul Dasrul; Onarisa Ayu
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/narraj.v5i1.1878

Abstract

Essential oils have gained interest in wound management, with prior studies exploring combinations of hemp seed oil (Cannabis sativa) and other oils. However, single-oil strategies may offer simpler formulation, reducing the risk of interactions while preserving therapeutic benefits. The aim of this study was to explore the effect of hemp seed oil on accelerating wound healing, focusing on wound size reduction, epithelialization, granulation tissue formation, and vascularization in murine models. An in vivo with a post-test-only control group was conducted using 36 male Mus musculus mice (3−4 months, 150–250 grams) which were divided into three groups: negative control (NC), positive control (PC, treated with chloramphenicol ointment twice daily), and treatment group (TG, treated with hemp seed oil 400,000 mg/mL twice daily). Mice were euthanized on day 3, 7, 14, and 21 for wound healing assessment, including macroscopic evaluation (visual observation, wound size, and wound healing rate) and microscopic evaluation (epithelialization, granulation tissue formation, and vascularization). The present study found that the TG group demonstrated smaller wound sizes on day 14 (p<0.001) and day 21 (p<0.001). This group also enhanced wound healing rates observed on day 14 (p<0.001) and day 21 (p=0.001) compared to PC and NC groups. Epithelialization was significantly higher in the TG group compared to PC and NC groups on day 14 (p=0.007), while granulation tissue formation showed significant improvement on day 3 (p=0.045), day 14 (p=0.028), and day 21 (p=0.003). Additionally, TG group showed significantly greater new blood vessel formation on day 21 (p=0.001) compared to the PC and NC groups. In conclusion, hemp seed oil demonstrated significant potential in accelerating wound healing processes suggesting a superior effect compared to chloramphenicol ointment. Therefore, hemp seed oil may serve as a promising natural and cost-effective adjunct for wound management.
Comparative assessment of smartphone‐based digital planimetry for wound area measurement Khan Sharun; Shajahan A. Banu; Merlin Mamachan; Obli R. Vinodhkumar; Kallemuchikal M. Manjusha; Rohit Kumar; Abhijit M. Pawde; Kuldeep Dhama; Amar Pal
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.1987

Abstract

Accurate wound area measurement is essential for effective wound care as it helps determine the progression of healing in patients. The aim of this study was to compare two wound area measurement techniques wound tracing (manual planimetry) and imitoMeasure (smartphone-based digital planimetry) with standard ImageJ-based digital image analysis in a rabbit wound healing study. The study involved 291 wounds categorized into small, intermediate, and large wounds. ImageJ was used as the reference method for comparisons. The intraclass correlation coefficient (ICC) was computed to assess the agreement and reliability between different wound measurement techniques. A mountain plot was used to assess the agreement between measurement methods, and a Bland-Altman plot was used to evaluate the agreement and concordance between measurement methods. The time required for analysis (processing time) was also compared. The study revealed that the imitoMeasure consistently demonstrated a greater level of agreement with ImageJ, especially in small and intermediate wounds. The ICC values indicated substantial agreement between ImageJ and imitoMeasure, with an exceptionally high ICC value for small wounds. Mountain plots revealed that the imitoMeasure had better agreement with ImageJ across all wound sizes. Bland-Altman plots further supported these findings, with wound tracing exhibiting wider limits of agreement and greater variability than imitoMeasure. ImitoMeasure consistently proved to be the quickest method across all wound sizes, whereas wound tracing required the longest processing time. These findings indicate that the imitoMeasure is a more reliable and consistent method for measuring the wound area, in particular for small and intermediate wounds.
Fecal ingestion rate based on worker activity patterns during stool handling in a ruminant farm Yudith V. Paramitadevi; Cindy R. Priadi; Iftita Rahmatika; Andriansjah Rukmana
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.1989

Abstract

Farm workers who handle livestock stools face an increased risk of infection by pathogenic bacteria, such as Escherichia coli O157 and Salmonella spp., leading to millions of severe health issues and thousands of fatalities annually. The aim of this study was to assess the impact of these pathogens by measuring their concentrations, determining rates of unintentional fecal consumption, and conducting a quantitative assessment of microbial risk. An integrated farm in Sukabumi City, Indonesia, was examined for E. coli O157 and Salmonella spp. in livestock stools. Additionally, the study monitored the rate of incidental fecal ingestion among farm workers. Stool samples were collected (n= 40) from ruminants and analyzed following ISO 16649-1:2018, ISO 9308-1:2014, and ISO 6579-1:2017/Amd.1:2020. The study tracked worker’s behavior daily to determine the contact time. The fecal ingestion rate was calculated by multiplying the estimated stool weight ingested by the contact time workers spent cleaning livestock stools in the barn each day. Microbial analysis revealed that the highest concentration of E. coli O157 in beef cattle stools was 2.49 log10 CFU/g. The study determined mean fecal ingestion rates during the dry season (8.64 mg/day) and rainy season (6.84 mg/day). Results from the quantitative microbial risk assessment showed that stool from beef cattle posed a higher risk of E. coli O157 infection compared to other ruminants, with an estimated disease burden of 9.8 × 10-3 pppy. This study represents the first comprehensive quantitative evaluation of fecal ingestion by farm workers during animal husbandry. The findings underscore the need for improved worker safety measures, such as enhanced sanitation practices and protective equipment, to mitigate the risks of handling livestock stools.
Impact of anthropometric adiposity and excessive daytime sleepiness on endothelial function in healthcare workers: A cross-sectional analysis Vito Damay; Ignatius Ivan; Nadhira A. Islami; Kenza Y. Rubismo
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 Teuku N. Aulia; Luthfi Gatam; Aman Yaman; 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 Junaedy Yunus; Tomiyoshi Setsu; Satoshi Kikkawa; Toshio Terashima
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.
Zero-fluoroscopy versus fluoroscopy-guided catheter ablation in ventricular arrhythmia: A systematic review and meta-analysis Irnizarifka Irnizarifka; Christopher D. Tristan; Matthew A. Wijayanto; Risalina Myrtha; Kyra Modesty; Annisa A. Rahma; Enrico A. Budiono; Awalil R. K. Rahman; Muhammad Farid Hamka; Muhana F. Ilyas
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.
Enhancing the quality of tuberculosis care in a high-prevalence area of West Java, Indonesia: A comparative study between public and private hospitals Inaz K. Dewi; Farizah M. Hairi; Helen Andriani
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.

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