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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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Factors associated with newly diagnosed ischemic stroke among people with type 2 diabetes mellitus in Thailand: A population-based case-control study Junjira Phasom; Ratchadaporn Ungcharoen; Pakorn Pusuwan; Nitikorn Phoosuwan
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.v5i1.2205

Abstract

Stroke is a leading cause of mortality and disability-adjusted life years. Its incidence is rising across Asia, with ischemic stroke accounting for approximately 80% of total stroke cases in Thailand. Stroke often leads to long-term disabilities, including impairments in speech, communication, and cognitive function. The aim of this study was to investigate risk factors associated with newly diagnosed ischemic stroke. A matched case-control study was conducted, including 154 newly diagnosed ischemic stroke cases and 183 non-stroke controls, all with type 2 diabetes mellitus (T2DM). Data were collected between February and September 2022 (post-COVID-19 period) using a structured questionnaire covering socio-demographics, lifestyle factors, perceived social support, and self-care management (SCM). Multivariable logistic regression models were used to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI). The majority of participants were female (60.8%), Buddhist (92.9%), and agriculturists (66.5%), with a mean age of 58.9 (±9.9) years. Factors associated with ischemic stroke included male (aOR: 3.53; 95%CI: 1.73–7.21), Buddhism (aOR: 3.53, 95%CI: 1.11–11.25), sedentary occupation (aOR: 5.78; 95%CI: 2.61–12.81), and T2DM duration >10 years (aOR: 6.19, 95%CI: 3.55–10.80). Protective factors included age ≥60 years (aOR=0.55, 95%CI: 0.31–0.98) and moderate SCM levels (aOR=0.45, 95%CI: 0.26–0.80). This study highlighted that prolonged T2DM and sedentary occupations significantly contributed to ischemic stroke risk. Targeted prevention strategies, including lifestyle modifications and enhanced diabetes self-care management, may help reduce the burden of ischemic stroke.
Thymoquinone and madecassoside improve motor function in a rotenone-induced mouse model of early Parkinson’s disease: Role of dopamine, alpha-synuclein and mBDNF Shinta Kusumawati; Agustina T. Endharti; Farhad Balafif; Shahdevi N. Kurniawan; Aris Rosidah; Rabjhany Anaqah; Izzunazel A. Barqillah; Husnul Khotimah
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.
Human strongyloidiasis in rural villages of South Kalimantan, Indonesia: A case series Priska PP. Kristi; Peni Kusumasari; Puspawati Puspawati; Yurniah Tanzil; Dian Nurmansyah; Muhammad Syairaji; Rizqiani A. Kusumasari; Eti N. Sholikhah; Nina Buehler; Issa Sy; Sophie Schneitler; Sören L. Becker; Elsa H. Murhandarwati
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.
Biopsychosocial determinants of anxiety and depression among working mothers in China: A public mental health perspective Jia Jiao; Rewadee Jenraumjit; Shirley Worland; Saifon Bunyachatakul; Bijing He; Tinakon Wongpakaran
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.
Emergency management of recurrent ovarian ectopic pregnancy in a hemodynamically unstable patient: A case report Rendy Singgih; Skmarina H. Larose; Meilyana MI. Kwary; 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 Assyu’ara Al’asyi; Irena Ujianti; Rara Nadika; Zahirah Zahirah; Bimo J. Faizin; Devana A. Afifah; Randhiva Farhan; Salsabila P. Rahmadina; Raisya ZN. Lubis; Sakinah Ghaisani; Kiflan Arkananta; Bety S. Lakshmi; Mulyoto Pangestu
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.
Association between the CYP24A1 rs2762939 polymorphism and vascular calcification in Indonesian patients with chronic kidney disease on hemodialysis Wendy Wendy; Riri A. Muzasti; Radar R. Tarigan
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.v5i3.2874

Abstract

Vitamin D plays a key role in mineral metabolism, and its dysregulation contributes to vascular calcification, a major complication of chronic kidney disease–mineral and bone disorder (CKD–MBD) in patients undergoing hemodialysis with CKD. The CYP24A1 gene encodes 24-hydroxylase, the enzyme responsible for degrading active vitamin D metabolites and its polymorphisms, particularly rs2762939, have been linked to variability in vitamin D status and coronary artery calcification. The aim of this study was to assess the association between the rs2762939 polymorphism of CYP24A1 and vascular calcification in Indonesian patients with CKD undergoing maintenance hemodialysis. A case–control study was conducted in 92 hemodialysis patients, including 46 with vascular calcification and 46 without. Genotyping of the rs2762939 polymorphism was carried out using PCR–RFLP, and the amplified products were separated by electrophoresis on 4% agarose gel. The frequency of vascular calcification was found to be significantly higher in patients with diabetes mellitus than in the control group (19 (82.6%) vs 4 (17.4%)), whereas in non-diabetic patients the frequency of vascular calcification was lower compared with controls (27 (39.1%) vs 42 (60.9%)). A statistically significant association between CKD etiology and vascular calcification was observed (p=0.001). The prevalence of vascular calcification was lower among carriers of the mutant C allele (45%) compared with the G allele (51.4%), although this difference was not statistically significant (OR=0.77; 95%CI: 0.38–1.56; p=0.592). The rs2762939 polymorphism of the CYP24A1 gene was not significantly associated with vascular calcification in Indonesian patients with CKD undergoing maintenance hemodialysis. Further studies with larger, ethnically diverse cohorts and integration of vitamin D status are needed to clarify the genetic contribution of CYP24A1 and related pathways to vascular calcification.
Biomolecules derived from salivary exosomes encapsulated in chitosan for bone regeneration in alveolar osteitis: A systematic review Silvia Sulistiani; Endang W. Bachtiar; Boy M. Bachtiar
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.v5i3.2877

Abstract

Alveolar osteitis (dry socket) is a common complication after tooth extraction that delays bone healing and causes significant pain. Conventional treatments are largely palliative and do not actively promote regeneration. Salivary exosomes, rich in bioactive molecules, and chitosan, a biocompatible and biodegradable polymer, might offer a promising combined approach for targeted bone regeneration. The aim of this systematic review was to systematically evaluate the regenerative potential of salivary exosomes encapsulated in chitosan for the treatment of alveolar osteitis. The systematic review was conducted following PRISMA guidelines and the PICO framework. Comprehensive searches were performed across PubMed, ScienceDirect, ProQuest, Cochrane Library, and Google Scholar for English-language articles published between 2021 and 2025. Eligible studies included in vitro, in vivo, and preclinical research assessing chitosan-encapsulated salivary exosomes for bone regeneration. Data were extracted on study design, interventions, outcome measures, and therapeutic effects. From 524 retrieved records, 10 full-text articles were assessed, and two met the eligibility criteria. Both studies demonstrated that chitosan encapsulation improved the stability and delivery efficiency of salivary exosomes. Outcomes included increased osteogenic gene expression (ALP, BMP-2, osteocalcin, RUNX2), enhanced angiogenesis, reduced inflammation, and histological evidence of accelerated bone regeneration compared with conventional treatment. In conclusion, current evidence suggests that salivary exosomes encapsulated in chitosan have strong therapeutic potential for alveolar osteitis by promoting osteogenesis, reducing inflammation, and enhancing bone healing. However, further preclinical validation and controlled human trials are required before clinical translation.
Comparison of anti-SARS-CoV-2 IgG seropositivity among vaccinated, unvaccinated, and COVID-19 survivor individuals: A cross-sectional study in Palembang, Indonesia Ekowati Retnaningsih; Nuryanto Nuryanto; Reni Oktarina; Oom Komalasari; Sri Maryani; Veny Larasti; Soilia Fertilita
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.v5i3.2890

Abstract

Measurement of anti–severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) antibody levels provides evidence of prior infection or vaccination. Persistent vaccine hesitancy underscores the importance of robust, evidence-based data to inform policy decisions. The aim of this study was to compare anti-SARS-CoV-2 IgG seropositivity among vaccinated individuals, unvaccinated individuals, and coronavirus disease 2019 (COVID-19) survivors in the community during the pandemic. In this cross-sectional study, 517 participants were enrolled, including 167 vaccinated individuals, 97 COVID-19 survivors, and 253 unvaccinated individuals, selected through multistage cluster sampling of 40 clusters. Anti-SARS-CoV-2 IgG seropositivity was defined as ≥50 AU/mL. Multivariable logistic regression was performed to evaluate associations between group type and seropositivity, adjusting for demographic factors, COVID-19 symptoms, hypertension, and body mass index (BMI). Vaccinated individuals demonstrated significantly higher odds of seropositivity compared with unvaccinated participants (odds ratio (OR)=5.60; 95% confidence interval (CI): 2.36–13.27). Covariates independently associated with seropositivity (p<0.05) included the presence of COVID-19 symptoms, hypertension, and BMI. Vaccination was strongly associated with increased anti-SARS-CoV-2 IgG seropositivity in the community, independent of clinical and demographic factors. These findings support ongoing vaccination campaigns and highlight the relevance of comorbidities and symptomatic history in shaping humoral immune responses.
Predicting early in-hospital mortality in acute hemorrhagic stroke: Implications for improving stroke care and health outcomes in low-income settings Shefina P. Harnold; Syahrul Syahrul; Imran Imran; Nasrul Musadir; Muhammad Yani
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.2977

Abstract

Stroke is a leading cause of death and disability worldwide, and mortality in acute intracerebral hemorrhagic (ICH) stroke is influenced by many factors, and early identification of high-risk patients is crucial for guiding clinical management. This study aimed to evaluate the role of blood pressure, blood glucose level, and Glasgow coma scale (GCS) on admission as predictors of 10-day in-hospital mortality and to develop a predictive scoring system in patients with acute ICH stroke. A cross-sectional study was conducted at Dr. Zainoel Abidin Hospital, a provincial referral hospital in Banda Aceh, Indonesia, in 2025. Patients with acute ICH were consecutively recruited. Clinical parameters on admission, including systolic and diastolic blood pressure, random blood glucose level, and GCS, were recorded. Associations with 10-day mortality were assessed with a Chi-squared test, and a predictive scoring system was developed based on independent predictors. A total of 62 patients were included in this study. Higher systolic blood pressure (≥140 mmHg), diastolic blood pressure (≥90 mmHg) and GCS <9 on admission were significantly associated with 10-day mortality (p=0.031, p=0.023 and p<0.001, respectively). Multivariate analysis identified that GCS <9 was the only independent predictor. A predictive scoring system assigned 8 points for GCS <9, 5 points for systolic ≥140 mmHg, 4 points for diastolic ≥90 mmHg, and 1 point for random blood glucose ≥200 mg/dL, estimating patient-specific mortality risk, highest when all risk factors were present. This study indicates that GCS <9 and elevated blood pressure on hospital admission are key predictors of 10-day mortality in acute ICH. The developed scoring system may assist in early risk stratification and management, and further exploration of predictive models is warranted to optimize clinical outcomes.

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