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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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Evaluating serum cyclooxygenase-2 and vascular endothelial growth factor as biomarkers for endometriosis severity in reproductive-age women Aga Aslam; Rajuddin Rajuddin; Munizar Munizar; Rusnaidi Rusnaidi; Hasanuddin Hasanuddin
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.v6i1.2984

Abstract

Endometriosis affects approximately 10–15% of reproductive-age women and up to 70% of those with chronic pelvic pain, with diagnosis typically relying on invasive laparoscopy with histopathological confirmation. Cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) are central mediators of the inflammatory and angiogenic pathways underpinning endometriosis pathogenesis, making them promising candidates for non-invasive biomarkers. This study aimed to analyze the correlation between serum COX-2 and VEGF concentrations and endometriosis severity to evaluate their potential utility as non-invasive biomarkers. A cross-sectional study was conducted among women with confirmed endometriosis at Dr. Zainoel Abidin General Hospital in Banda Aceh, Indonesia, in 2025. Peripheral blood samples were collected preoperatively, and serum COX-2 and VEGF concentrations were quantified using ELISA. Endometriosis severity was classified according to the American Society for Reproductive Medicine staging system. Correlation analyses were performed to assess associations between biomarker levels and disease stage, and diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis to determine the area under the curve (AUC) values, optimal cut-off points, sensitivity, and specificity. Twenty-eight patients were included, with the mean COX-2 and VEGF levels being 1.16±1.28 ng/mL and 266.50±72.91 pg/mL, respectively. VEGF demonstrated a strong and statistically significant correlation with endometriosis staging (r=0.744, p<0.001), while COX-2 showed a limited correlation that did not reach statistical significance (r=0.367, p=0.055). The ROC analysis further highlighted VEGF’s superior diagnostic performance, with an AUC of 0.975 (95%CI: 0.926–1.000, p<0.001) compared with COX-2 (AUC 0.734; 95%CI: 0.518–0.950, p=0.057). The optimal VEGF threshold of 221 pg/mL yielded 90% sensitivity and 100% specificity, whereas the COX-2 threshold of 0.675 ng/mL provided 80% sensitivity and 62.5% specificity. These findings indicate that VEGF is a highly promising non-invasive biomarker for assessing endometriosis severity and may support the development of improved diagnostic approaches for endometriosis management.
Cortisol and pregnancy-related anxiety in relation to preeclampsia among third-trimester pregnant women: A case–control study from Aceh, Indonesia Teuku M. Hezron; Tgk. Puspa Dewi; Yusra Septivera; Rajuddin Rajuddin; Niken A. Utami
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.v5i3.2985

Abstract

Despite extensive research, the interplay between hormonal stress markers and pregnancy-specific anxiety in the pathogenesis of preeclampsia remains insufficiently understood. This study aimed to analyze the simultaneous relationships between serum cortisol levels, pregnancy-related anxiety, and the occurrence of preeclampsia among third-trimester pregnant women. A case–control study was conducted at three hospitals in Banda Aceh, Indonesia, involving third-trimester pregnant women. Serum cortisol concentrations were measured using an immunoassay, and anxiety levels were assessed with the validated Pregnancy Related Anxiety Questionnaire (PRAQ). Preeclampsia diagnosis followed standard clinical and laboratory criteria. Associations between cortisol levels (categorized into high and normal) and PRAQ scores (classified as high and low–moderate) with preeclampsia were evaluated using the Chi-squared test, and crude odds ratios (OR) with 95% confidence intervals (95%CI). The Spearman’s correlation was used to determine the correlation between cortisol levels and PRAG scores. A total of 66 pregnant women were included in the final analysis (33 with preeclampsia and 33 with normal pregnancy). Women with high serum cortisol levels had a markedly greater likelihood of developing preeclampsia compared with those with normal cortisol levels (odds ratio (OR)=34.00; 95% confidence interval (95%CI): 4.93–234.46). Similarly, women with high pregnancy-related anxiety exhibited a significantly elevated risk of preeclampsia (OR=16.71; 95%CI: 4.95–56.39). No significant correlation was observed between cortisol levels and PRAQ scores in both groups (preeclampsia: r=-0.041, p=0.821; normal pregnancy: r=0.278, p=0.117). In conclusion, elevated serum cortisol and high pregnancy-related anxiety are independently associated with preeclampsia, although not directly correlated with each other. These findings highlight the potential of dual screening for cortisol and pregnancy-specific anxiety as an innovative approach for early identification of women at high risk of preeclampsia.
Development and diagnostic performance of a novel scoring system for predicting COVID-19 severity in a national referral hospital Rikarni Rikarni; Najirman Najirman; Dwi Yulia; Ricvan D. Nindrea; Muhammad AP. Yudha; Amalina Amalina
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.v6i1.2987

Abstract

Coronavirus disease 2019 (COVID-19) shows a wide spectrum of clinical manifestations, ranging from mild illness to severe and critical disease. Early identification of patients at risk of deterioration remains important for timely clinical decision-making. The aim of this study was to develop a novel scoring system for predicting COVID-19 severity in a national referral hospital. This prospective cohort study included patients with confirmed COVID-19 admitted to Dr. M. Djamil Hospital, Padang, Indonesia, from May to December 2021. Demographic, clinical, and laboratory data were collected, and disease severity was classified according to the World Health Organization criteria. Univariate analysis was performed to identify candidate variables, followed by multivariable logistic regression analysis to determine independent predictors of severity. A scoring system was then constructed based on the retained predictors, and its diagnostic performance was evaluated using receiver operating characteristic analysis and the Youden index. Five variables were independently associated with COVID-19 severity: white blood cell count (WBC) ≥10,000/mm3, absolute lymphocyte count (ALC) <1,500/mm3, platelet large cell ratio (PLCR) ≥30%, interleukin-6 (IL-6) ≥7 pg/mL, and D-dimer ≥500 ng/mL. These variables were incorporated into a scoring system with a maximum total score of 6. Using a cut-off score of 3.5, the model showed a sensitivity of 96.15% and a specificity of 79.03% for differentiating severe from non-severe COVID-19. This study highlights that a novel scoring system based on WBC, ALC, PLCR, IL-6, and D-dimer performed well in predicting COVID-19 severity and may support early risk stratification in hospitalized patients.
Delayed percentage attenuation ratio (DPAR) on multiphase CT as a quantitative predictor of early response in hepatocellular carcinoma Yana Supriatna; Rifki Bachtiar; Muhammad Y. Makkaraeng; Arif Budiman
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.v6i1.2996

Abstract

Hepatocellular carcinoma (HCC) remains a major cause of cancer-related mortality, and transarterial chemoembolization (TACE) is the standard therapy for intermediate-stage disease. However, response to TACE is variable, and reliable quantitative imaging biomarkers are needed to support early treatment decision-making. This study aimed to evaluate the predictive value of the delayed percentage attenuation ratio (DPAR) measured from pre-TACE multiphasic computed tomography (CT) in forecasting early therapeutic response. A retrospective cross-sectional study was conducted involving patients with a definitive diagnosis of HCC who underwent their first TACE session and had complete multiphasic CT imaging before and after treatment. Quantitative washout parameters, delayed percentage attenuation ratio (DPAR), absolute washout (WOAbs), and relative washout (WORel) were measured using standardized region of interest (ROI) placement by three radiologists. Treatment response was assessed four to six weeks post-TACE based on modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria and classified into responders and non-responders. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis, and interobserver reliability was assessed using intraclass correlation coefficient (ICC) and Cohen’s κ. A total of 49 HCC patients were included and analyzed. Responders demonstrated significantly higher DPAR values compared with non-responders (median 134.5 vs 113.0; p<0.001). DPAR showed the strongest discriminative performance with an area under the curve (AUC) of 0.898, outperforming WOAbs (AUC 0.689) and WORel (AUC 0.704). The optimal DPAR threshold of ≥120.5 provided 84.4% sensitivity and 88.2% specificity to predict early post-TACE treatment response. Interobserver reliability was excellent for all washout parameters (ICC 0.98–0.99), and agreement for mRECIST classification was also excellent (κ=0.867). In conclusion, pre-TACE DPAR is a robust and reproducible quantitative imaging biomarker that accurately predicts early response to TACE in HCC. A threshold value of ≥120.5 may assist in treatment planning and patient selection in routine clinical practice.
Development and evaluation of a synthetic Cu-Zn-reinforced biphasic calcium phosphate scaffold for periodontal bone repair Devina Novelia; Theophani O. Cahyadi; Natasya MP. Sidharta; Mora Octavia; Evi UM. Situmorang; Daniel Edbert
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.v6i1.3001

Abstract

Periodontal bone defects require bone grafting materials that provide structural stability, biocompatibility, and reliable biological performance. Synthetic alloplastic scaffolds composed of biphasic calcium phosphate, integrating hydroxyapatite (HAp) and β-tricalcium phosphate (β-TCP), offer a promising alternative to other graft materials. Polycaprolactone provides flexibility and support for pore formation, while copper (Cu) and zinc (Zn) ions contribute to their antimicrobial and osteogenic benefits. This study aimed to investigate the physicochemical, morphological, mechanical, and biological properties of a synthetic HAp40/β-TCP60 alloplastic scaffold reinforced with polycaprolactone and to compare them with those of a commercial xenograft. The scaffold was fabricated using a freeze-drying method with dimethylformamide, and characterization included Fourier-transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) for chemical and crystalline confirmation, Archimedes principle for porosity, light microscopy, and scanning electron microscopy (SEM) for morphological assessment, compressive testing, blood adhesion, as well as water and blood absorption analysis. FTIR and XRD verified the successful incorporation of polycaprolactone and the formation of a well-ordered biphasic calcium phosphate structure. Light microscopy showed that the synthetic scaffold had smaller macropore dimensions (324±49 µm) than the control (1410±541 µm), while SEM demonstrated markedly higher microporosity (8.184±2.581 µm) compared to the control (0.287±0.091 µm). Water absorption was lower in the synthetic scaffold (174.7%) than in the control (1172.5%), whereas blood absorption was comparable (300% vs 316.6%). The synthesized scaffold also exhibited superior blood adhesion, as evidenced by the absence of turbidity after agitation. Mechanical testing revealed that the control had superior compressive and yield strengths (0.980 MPa and 0.537 MPa, respectively) compared to the synthesized scaffold (0.287 MPa and 0.126 MPa, respectively). In conclusion, the synthetic HAp40/β-TCP60 scaffold exhibited properties within optimal ranges, highlighting its potential as a promising synthetic alloplastic material for clinical bone regeneration.
Biomarkers for diagnosis, disease progression, and therapeutic response in psoriasis vulgaris: A mini-review Sarah Q. Edwar; Yudo Irawan; Windy K. Budianti; Endi Novianto; Eyleny M. Fitri
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.v6i1.3017

Abstract

Psoriasis vulgaris is a chronic immune-mediated inflammatory disease with substantial clinical, psychosocial, and public health impact. Despite advances in therapeutic options, disease management continues to rely predominantly on clinical assessment, which remains limited in its ability to detect early disease, quantify subclinical inflammation, monitor disease progression, and anticipate long-term outcomes. These limitations are further compounded by marked interindividual heterogeneity in disease course, systemic inflammatory burden, comorbidity risk, and treatment response. Although a growing body of research has identified numerous candidate biomarkers related to genetic susceptibility, epidermal pathology, immune activation, and systemic inflammation, their clinical relevance and integration into routine practice remain unclear. A comprehensive synthesis that bridges molecular biomarkers with clinically meaningful applications is therefore needed. This review critically examines the current landscape of biomarkers in psoriasis vulgaris and explores their potential roles in diagnosis, assessment of disease progression, and prediction of therapeutic response. This review discusses genetic biomarkers associated with disease susceptibility and immune pathway regulation, tissue-associated biomarkers reflecting epidermal dysfunction and local inflammatory activity, and soluble biomarkers indicative of systemic inflammation and metabolic dysregulation. By organizing existing evidence across these biomarker domains, this review seeks to highlight conceptual frameworks, unresolved challenges, and future directions for biomarker-informed psoriasis management.
Multi-stakeholder perspectives on cervical cancer screening implementation in Indonesia: A qualitative study of cervical screening barriers in Banda Aceh Febrina Yolanda; Tgk. Puspa Dewi; Sarah I. Nainggolan; Munawar Munawar; Munizar Munizar; Rijal Bulqini; Rachmad Suhanda; Rusnaidi Rusnaidi
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.v6i1.3022

Abstract

Indonesia is committed to the WHO's cervical cancer elimination strategy through the National Action Plan (RAN) 2023–2030, targeting 75% screening coverage by 2030. However, current rates remain critically low at 7.02%. This study explores multi-stakeholder perspectives to identify implementation barriers and facilitators for policy enhancement. A qualitative descriptive case study was conducted in Banda Aceh (July-August 2025) involving 25 stakeholders: City Health Office Head, 11 puskesmas heads, 11 VIA coordinators and 2 community organization representatives. Thematic analysis using NVivo v.16 identified key implementation factors. Five major themes emerged: (1) Knowledge gaps—screening perceived necessary only when symptomatic despite available information; (2) Access paradox—excellent geographic access and flexibility undermined by limited examination rooms, insufficient midwives, and psychosocial barriers (shame, fear, lack of spousal support); (3) Financial sustainability—free services threatened by complex BPJS claims and low reimbursement affecting logistics; (4) Service quality variation—dependent on cross-sector collaboration and staff competency, with uneven training and limited cryotherapy (only 2 centers); and (5) Communication challenges—inconsistent digital media use necessitates face-to-face counseling and cadres, though reach remains limited. Implementation faces psychological barriers, capacity limitations, and uneven digital adoption despite strong infrastructure. Priority policy recommendations include: (1) HPV DNA self-sampling to overcome privacy barriers; (2) simplified BPJS claims with adequate reimbursement; (3) systematic competency-building and cryotherapy expansion; and (4) culturally-adapted education integrating local language and religious leaders. These evidence-based enhancements could accelerate Indonesia's RAN 2030 elimination targets.

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