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harapan@unsyiah.ac.id
Phone
+62895600103060052
Journal Mail Official
harapan@unsyiah.ac.id
Editorial Address
School of Medicine Universitas Syiah Kuala Darussalam, Banda Aceh, 23111 Indonesia
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Kota banda aceh,
Aceh
INDONESIA
Narra J
ISSN : -     EISSN : 28072618     DOI : https://doi.org/10.52225/narraj
Core Subject : Health, Science,
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
Articles 565 Documents
Oral rehydration solution (ORS) for fasting doping: Examining the Twitter data in Indonesia Kusuma, Ikhwan Y.; Bahar, Muhammad A.
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.v3i3.196

Abstract

Oral rehydration solution (ORS) or oralit is a sugar and salt-based solution that restores electrolyte balance, counters dehydration and mitigates metabolic acidosis. In Indonesia, particularly during the month of Ramadan, the use of ORS as a form of fasting doping has become increasingly prevalent. This study aimed to analyze the patterns of communication, key influencers, and sentiment within the Twitter network in Indonesia regarding the use of ORS as fasting doping. From March 15 to March 26, 2023, Twitter data was collected using NodeXL software. The dataset was then analyzed using NodeXL and Gephi software to identify key influencers and patterns within the network. To assess attitudes towards the use of ORS as fasting doping expressed in tweets, sentiment analysis was conducted using Azure Machine. The dataset consisted of 13,746 tweets, from which the analysis revealed that Twitter discourse concerning the use of ORS as fasting doping demonstrated a diverse range of individuals. The top five users with the highest betweenness centrality scores were medical doctors, mention and confess (menfess) accounts, and personal accounts. The sentiment analysis of the collected tweets unveiled a relatively high negative sentiment toward the use of ORS for fasting purposes. Notably, the proportion of positive and neutral sentiments were comparable. Our data indicate that ORS use as fasting doping is controversial in Indonesia. Most tweets express concerns about misuse and negative consequences, indicating a need for guidance and regulation from public health authorities. Further research and guidelines are necessary to ensure the safe and appropriate use.
A choledochal cyst type IVa in a child treated with Roux-en-Y hepaticojejunostomy Yusuf, Sulaiman; Nuriyanto, Alivia R.; Nadia, Nurul; Muntadhar, Muntadhar; Muzakkir, Yumna; Susanti, Nurhayani D.; Al-shather, Zain; Harrika, Fenny
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.v3i2.201

Abstract

A choledochal cyst is a bile duct anomaly that disrupts the transportation of bile from the liver to the gallbladder and small intestine. Choledochal cysts are rare, occurring in approximately one out of every 100,000 to 150,000 children in Western countries, with a girls-to-boys ratio of 4:1. Immediate surgery to excise the cyst and construct a biliary-enteric continuity is necessary to treat this condition. This case-report aimed to present a child with choledochal cyst type IVa who underwent a Roux-en-Y hepaticojejunostomy. A 3-year-11-month-old girl with an abdominal mass experienced jaundice, nausea, and vomiting over the past two years, which worsened in the last month. Abdominal ultrasonography indicated intrahepatic biliary dilatation. Abdominal computed tomography (CT) scan results confirmed a choledochal cyst type IVa, characterized by fusiform cyst dilatation at the bilateral intrahepatic bile duct, common hepatic duct, cystic duct, and common bile duct. The cyst exerted pressure on the pancreas and small intestine. Before the surgery, the patient was treated with ceftriaxone 100 mg/kg/day and gentamicin 5 mg/kg/day. Roux-en-Y hepaticojejunostomy was performed, involving the complete excision of the extrahepatic bile duct to reconstruct the biliary system. During the surgery, a retroperitoneal cyst measuring 20 cm x 10 cm with a volume of 200 cc was discovered. Following the surgery, the patient showed clinical improvement. Patient follow-ups indicated that no complications such as wound infection, acute pancreatitis, and the formation of pancreatic or biliary fistula occurred. This case highlights that Roux-en-Y hepaticojejunostomy proves to be an effective surgical approach for managing choledochal cyst type IVa in children, helping to prevent further complications.
Quality of life and its predictors among people living with HIV in Muslim majority region: A cross-sectional study in Aceh Hasan, Maryatun; Jamil, Kurnia F.; Darmawi, Darmawi; Syukri, Maimun; Liansyah, Tita M.; Beočanin, Anđelija; Erianza, Dava
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.v3i2.202

Abstract

Human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) remain significant global health challenges addressed by countries worldwide. The advent of antiretroviral therapy (ARV) has significantly reduced morbidity and mortality of people living with HIV (PLHIV), transforming HIV/AIDS from a fatal disease to a manageable chronic disease. However, the increasing number of elderly individuals with HIV who experience early frailty syndrome presents new challenges and potential for diminished quality of life. The aim of this study was to assess the quality of life and to identify its significant predictors in PLHIV patients who have received ARV therapy in Banda Aceh, a Muslim-majority region in Indonesia. A cross-sectional study was conducted on all PLHIV who received ARV therapy at the voluntary counseling and testing (VCT) polyclinic at Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia between January and February 2023. The WHOQOL-HIV BREF instrument, a multi-dimensional tool developed by the World Health Organization (WHO), was used to assess the quality of life of the PLHIV, and potential predictors were assessed. The Chi-squared test was used to determine the predictors associated with the quality of patient’s lives. Our data indicated that the majority of PLHIV were male (88%), 26–35 years old (78%), employed (92%), and unmarried (54%). Poor quality of life was dominant for the physical health (100%) and social relationships (76%) domains. In contrast, good quality of life was observed in aspects of independence, psychology, and spirituality, all reporting 100% results. Significant associations were found between married status (p=0.004) and medication adherence (p<0.001) with higher quality of life among PLHIV. In conclusion, married PLHIVs that received support from their partners regarding adherence to therapy exhibited a better quality of life. These results underscore the significance of sustained support systems and adherence strategies to enhance PLHIV's quality of life.
Safety evaluation and effects of cascara pulp Gayo Arabica coffee cream as anti-photoaging in animal model Lestari, Wahyu; Hajar, Sitti
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.v3i2.204

Abstract

Prolonged sunlight and ultraviolet (UV) exposure causes premature skin aging called photoaging and coffee-derived topical antioxidants may help to reduce this process. Since a significant amount of antioxidant-rich cascara pulp are wasted in coffee processing, this study aimed to evaluate the safety of cascara extract cream of Gayo Arabica coffee pulp (CECGACP) as anti-photoaging in male Wistar rats (Rattus norvegicus) by assessing the skin primary irritation index (PII), skin macroscopic changes and the level of tumor necrosis factor-alpha (TNF-α). Twenty-five rats were randomly divided into five different groups: negative control (base cream only), positive control containing L-ascorbic acid 3%, and three treatment groups treated with cream containing 5%, 7.5% and 10% of CECGACP. The CECGACP was extracted, formulated into cream as a topical treatment and applied on the backs of the rats two times a day, once before the UV exposure and four hours after the exposure. After four weeks, the skins were macroscopically examined, and the TNF-α levels were measured. The PII was assessed after applying the cream 24 hours before UX exposure. Our data suggested that CECGACP was considered safe because there were no erythema and edema formation on the skin of the rats with PII score of 0 (classified as no irritation or negligible). After UV exposure, all rats had visible wrinkles and erythema on the skin in particular in the first week. After administration of CECGACP, both wrinkles and erythema were decreased. The levels of TNF-α varied from 0.15±0.02 ng/mL in the negative control and CECGACP 7.5% rat groups to 0.19±0.03 in the positive control group; however, there was no significant difference among all the groups. Our study suggests that CECGACP is safe to use in Wistar rats and able to reduce the erythema and edema due to UV exposure. However, the application of CECGACP does not provide a significant reduction of TNF-α levels.
Normal intellectual ability and hyperprolactinemia as unique clinical manifestations of congenital hypothyroidism: A case report and review of hypotheses Zulfa, Putri O.; Debbyousha, Maulina; Sucipto, Krishna W.; Ekadamayanti, Agustia S.; Firdausa, Sarah; Zufry, Hendra
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.v3i3.205

Abstract

Congenital hypothyroidism is the deficiency of thyroid hormone in infants and hyperprolactinemia is frequently observed. Previously reported cases typically involve intellectual disability, highlighting this particular unique case report to the first reported patient demonstrating normal intellectual ability despite experiencing growth and gonad dysfunction. This study aims to present a case and review medical hypotheses related to the patient's condition. A 19-year-old female presented with a chief complaint of irregular menstruation for up to 40 days or not occurring at all. The patient experienced the first menstruation at the age of 16 years old. The patient's height was 133 cm, body weight 40 kg, and body mass index 22.61 kg/m2; other family members were normal. Physical examination showed no abnormalities, and laboratory examination showed suppressed serum free T4 (FT4) level (6.41 pmol/L), elevated thyroid stimulating hormone (TSH) level (333.700 µIU/mL), and elevated prolactin hormone level (32.03 ng/mL). Ultrasound of the thyroid gland found hypoplasia of the left and right thyroid glands. The patient was a college student enrolled in a public national university and had never complained about academic performance throughout the patient's education. The patient was diagnosed with congenital hypothyroidism and hyperprolactinemia. The patient was administered up to 100 μg daily of oral levothyroxine, which improved the patient’s menstrual cycles. The patient's delayed diagnosis may be attributed to central congenital hypothyroidism being underdiagnosed. We hypothesized that thyroid-releasing hormone receptor (TRHR) gene mutation might contribute to the underlying cause of hyperprolactinemia and normal intellectual ability of the patient. Further study on the significance of TRHR gene mutations in congenital hypothyroidism is required to improve diagnosis and treatment.
Comparative analysis of accuracy between fine-needle aspiration biopsy and postoperative histopathology for detecting large thyroid nodules: A retrospective observational study Zufry, Hendra; Nazaruddin, Nazaruddin; Zulfa, Putri O.; Sucipto, Krishna W.; Kamarlis, Reno K.; Ekadamayanti, Agustia S.; Beočanin, Anđelija; Firdausa, Sarah
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.v3i2.206

Abstract

To avoid unnecessary surgeries, ultrasound-guided fine-needle aspiration biopsy (FNAB) is an effective and reliable procedure for the preoperative evaluation of thyroid nodules. However, there have been only a limited number of studies exploring the ability of preoperative FNAB to distinguish malignancy compared to postoperative histopathology in thyroid nodules larger than 4 cm. The aim of this study was to investigate the diagnostic accuracy of FNAB compared to postoperative histopathology in distinguishing malignancy in thyroid nodules larger than 4 cm. A single-center retrospective observational study was conducted at Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia, between January 2014 and December 2018. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated. A total of 83 patients were included in the study. The results showed that preoperative FNAB may have the ability to distinguish malignancy compared to postoperative histopathology. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 42.85%, 98.38%, 90.00%, 83.56%, and 84.33%, respectively. These data suggested that ultrasound-guided preoperative FNAB is a reliable diagnostic tool in the preoperative evaluation of thyroid nodules larger than 4 cm, but it has limited capability in distinguishing malignancies. In conclusion, although FNAB may be useful in reducing unnecessary surgeries, histopathology remains the preferred method for confirming malignancy in thyroid nodules.
Feeding artery characteristics and enhancement patterns of hepatoblastoma patients treated with transarterial chemoembolization (TACE): Digital subtraction angiography evaluation Yus, Teuku M.; Sarastika, Hartono Y.; Soeprijanto, Bambang
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.v3i3.209

Abstract

Hepatoblastoma is one of the most common primary malignant liver tumors in children. The incidence of hepatoblastoma has been increasing, reaching 1.2 per million children now. The transarterial chemoembolization (TACE) procedure is one of the most practical and effective treatment options besides surgery. Digital subtraction angiography (DSA) is performed as the first step of the TACE procedure. The aim of this study was to provide information about the feeding arteries and enhancement pattern of the hepatoblastoma that was assessed by DSA before the TACE procedure. A retrospective study was conducted among hepatoblastoma cases that had undergone DSA on the TACE procedure to obtain information on the vascularity of the tumor. A total of 26 hepatoblastoma cases who had DSA examination as a part of their first TACE procedure were included, consisting of 15 boys and 11 girls, aged between 1–15 years. All cases were stage III and IV according to the Pre-Treatment Extent of Tumor (PRETEXT) staging classification. All hepatoblastoma cases had multiple feeding arteries, most of which were branches of the right hepatic artery. The largest diameter of the feeding artery was 1.82 mm, and the smallest was 0.63 mm. Most cases (84.62%) had strong contrast absorption, and spread evenly, either at the edges or in the center of the tumor. DSA is believed to be an accurate procedure to provide a detailed description of the feeding artery; enhancement patterns of hepatoblastoma were influenced by an adequate TACE.
Assessing hospital disaster preparedness: A scoping review of available tools Husaini, Brury A.; Sugiarto, Sugiarto; Rahman, Safrizal; Oktari, Rina S.
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.v3i2.210

Abstract

One of the problems faced after a disaster is health service for victims and hospitals play a critical role in handling disaster victims. Therefore, hospitals must enhance their preparedness and establish a disaster-safe environment to effectively fulfill their role as a provider of health services during a crisis. The aim of this scoping review was to identify hospital disaster preparedness tools used around the globe and to identify the critical aspects that need to be included in hospital disaster preparedness. This study used the five stages of Arksey and O'Malley's scoping review framework to determine what disaster preparedness tools can be used in a hospital setting. The electronic literature searches of English articles published between 2018 and 2023 were conducted using PubMed, Elsevier, ProQuest, ISI Web Science, and Google Scholar databases. The searched keywords were combined into several search terms such as sub-discipline, subtitle, year, language, and content type. The keywords of sub-title searching were “preparedness”, “hospital” and “disaster”. After applying some inclusion criteria, ten articles out of 1,221 identified records were included in the final analysis. The World Health Organization (WHO) Hospital Safety Index, WHO Hospital Emergency Checklist or their modified versions, and modified Public Health Emergency Preparedness were tools used in assessing hospital disaster preparedness. These tools evaluate some aspects such as structural safety, non-structural safety, and functional capacity. The studies indicated that each tool used to measure hospital disaster preparedness has strengths and weaknesses in each assessed aspect. Although some tools have been recommended to assess hospital disaster preparedness, assessing each tool validity and reliability are critical and needs to be conducted.
Psychotherapies for chronic kidney disease patients with hemodialysis: A systematic review of randomized control trials and quasi-experiments Zahra, Zulfa; Effendy, Elmeida; Mawarpury, Marty; Marthoenis, Marthoenis; Jaya, Indra
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.v3i3.215

Abstract

Chronic kidney disease (CKD) patients, especially those with hemodialysis, frequently struggle with mental health issues like anxiety and depression. Psychotherapy has been known to treat psychological problems, but its effectiveness in managing CKD patients is still rarely scientifically proven. The aim of this study was to analyze the role of psychological treatments in improving the mental health of CKD patients with hemodialysis. We comprehensively reviewed the related studies published in PubMed, Google Scholar, ScienceDirect, and Clinical Key over the last ten years, up to June 7, 2023. A keyword combination was used in the search engine strategies, and all articles about CKD patients receiving hemodialysis and psychotherapy were included. Based on the eligibility criteria, 716 patients were included in 13 out of 18,830 studies in the final analysis. Psychological problem was complained by 399 CKD patients. The psychotherapy included cognitive behavioral therapy (reported in four studies, n=4), diaphragmatic breathing relaxation (n=1), meditation (n=1), hypnotherapy (n=1), Kidney Optimal Health Program (KOHP) (n=1), psychological intervention (n=1), murottal Al-Qur'an therapy (n=3), and spiritual therapy (n=1). These interventions were performed once to four times a week, for ten minutes to five hours during hemodialysis for two to ten weeks. Meditation and KOHP showed no significant improvement in anxiety and depression. The remaining psychotherapies significantly improved the quality of life by reducing anxiety and depression in hemodialysis patients and enhancing sleep quality, self-esteem, hopefulness, medication adherence, and physical condition. In conclusion, psychotherapy should be considered in an interdisciplinary team to treat CKD patients comprehensively. Further studies are still necessary to determine the efficacy of each psychological intervention in CKD patients with psychiatric problems. 
Systemic manifestation of necrotic erythema nodosum leprosum: A case report of a fatal leprosy Maulida, Mimi; Vella, Vella; Budini, Sulamsih S.; Kamarlis, Reno K.; Junaidi, Fachrul; Pradistha, Aldilla; Bulqiah, Mikyal
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.v3i2.216

Abstract

Necrotic erythema nodosum leprosum (ENL) is an uncommon manifestation of type 2 lepra reaction, encountered in lepromatous and borderline lepromatous cases of leprosy. Necrotic ENL is associated with the involvement of multiple organs, therefore delayed diagnosis and treatment will lead to complications and poor prognosis. The aim of this case report was to report a challenging case of necrotic ENL misdiagnosed with multiple cellulitis since there were no signs of prior leprosy nor had any antimycobacterial treatment. A 45-year-old man was presented to the surgery department of Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia, with complaints of fever, joint pain, and painful tender skin lesions with ulceration over the trunk, extremities, and ears for one month. The patient was diagnosed clinically with multiple cellulitis and underwent a debridement procedure. Clinical improvement was absent, the patient was then consulted to the dermatology department. Physical examination showed normal vital signs, madarosis, inguinal lymphadenopathy, thickening of nerves, and sensation of numbness in both hands and feet. Laboratory examinations on admission showed leucocytosis, anemia, thrombocytopenia, hypoalbuminemia, hypocalcemia, and elevated creatinine and ureum level. A slit skin smears examination yielded positive acid-fast bacilli (AFB) with a bacteriological index (BI) value of 3+ and morphological index (MI) of 72%. The patient was diagnosed with lepromatous leprosywith necrotic ENL reaction. Intravenous methylprednisolone and cefoperazone-sulbactam were given. Multidrug therapy mulitbacillary (MDT-MB) without dapsone, and ofloxacin 400 mg was initiated. On day 17, the patient had septic shock. The patient became unconscious and experienced death. This case highlights that medical professionals should be aware of the various manifestations of necrotic ENL to correctly diagnose and provide treatment as soon as possible to prevent mortality, especially in leprosy-endemic country, Indonesia.

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