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Narra X
Published by PT Narra Sains Indonesia
ISSN : -     EISSN : 29882990     DOI : DOI: https://doi.org/10.52225/narrax
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Chemistry Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Physics Public Health
Narra X is a multidisciplinary journal, published three times in a year (April, August, and December). The journal aims to act as a platform for rapid scientific communication while upholding the highest integrity. Articles are published in a form of Original articles, Short Report, Case Reports, Methods articles, Review articles, and Letters to the Editor. All submitted articles are subjected to peer-review prior to their publication. As a multidisciplinary journal, Narra X welcomes articles from any subject field, depending on the editorial capacity. At the moment, Narra X is handled by section editors in the following fields: Health and medicine Chemistry Biology Mathematics Physics Narra X is online only journal and all articles do not have page numbers; instead, they are given a unique article number.
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Articles 90 Documents
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Factors associated with feeding problems in children with cerebral palsy: A cross-sectional study from Indonesia Maulidia, Dwi S.; Sembiring, Tiangsa; Dimyati, Yazid; Tanjung, Ika CD.; Wahyuni, Arlinda S.; Pratita, Winra; Nasution, Halida R.; Alharbi, Olayan; Pasaribu, Ayodhia P.
Narra X Vol. 2 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i3.163

Abstract

Children with cerebral palsy are at high risk for feeding difficulties and malnutrition due to motor impairments and associated conditions. The aim of this study was to evaluate the prevalence and types of feeding problems and their association with malnutrition in children with cerebral palsy. A cross-sectional study was conducted involving 54 children under five years old with cerebral palsy. Participants were classified into spastic cerebral palsy subtypes such as quadriplegic, hemiplegic, diplegic, or triplegic. Feeding problems were categorized as inappropriate feeding practices, reduced food intake, parental misperception, and food preferences using the Pediatric Symptom Checklist-17. Nutritional status was assessed using weight-for-age percentiles based on WHO growth charts. History of constipation and dysphagia were also recorded. Data analysis included Chi-square and Mann-Whitney U tests. Among the participants, 38.9% had hemiplegia, 33.3% diplegia, and 25.9% quadriplegia. Feeding problems were prevalent, with inappropriate feeding practices being the most common (70.4%). Malnutrition was identified in 59.3% of the children. However, no significant associations were observed between CP subtype or demographic variables and the types of feeding problems. Similarly, the type of feeding problem was not significantly associated with malnutrition. Constipation and dysphagia were reported in 31.5% and 37.0% of participants, respectively, and were significantly associated with nutritional status (p<0.001). In conclusion, feeding problems and malnutrition are common in children with cerebral palsy, with inappropriate feeding practices being the most prevalent issue. Although no significant associations were found between CP subtypes or the types of feeding problems and malnutrition, the findings emphasize the multifactorial nature of feeding challenges.
Hydroxyurea therapy for children with sickle cell anemia: A systematic review and meta-analysis Khansa, Firyal; Ghifari, Muhammad H.; Daffa, Muhammad B.; Nasywa, Fiola; Enitan, Seyi S.; Eleojo , Itodo G.; Ali, Mazen EI.
Narra X Vol. 2 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i2.164

Abstract

Sickle cell anemia (SCA) is a major global health issue, particularly among pediatric population, influenced by factors such as malaria susceptibility and genetic distribution. On the other hand, hydroxyurea therapy has been a well-established and accepted treatment for SCA, with over 25 years of clinical experience. It has been proven to be safe and effective in preventing vaso-occlusive events and chronic organ damage. The aim of this study was to assess the efficacy of hydroxyurea in alleviating pediatric SCA. This study was comprised of a systematic literature search and meta-analysis in accordance with the PRISMA and the Cochrane Handbook guidelines. A systematic search was performed on PubMed, Cochrane, and ScienceDirect databases for relevant literature published as of January 2024. Placebo-controlled clinical trials reporting the efficacy of hydroxyurea in managing SCA among pediatric patients were included in the systematic review. The eligible studies were further assessed for its reporting quality using Risk of Bias 2.0. Pooled analysis was carried out using a random effect model, where the effect size was calculated based on the mean difference (MD) and 95% confidence interval (95%CI). Three randomized clinical trials comprised of 423 participants were included in the studies. Among patients receiving hydroxyurea, significant improvement was observed in fetal hemoglobin (HbF) with MD of 9.45% (95%CI: 2.15–16.75), but not in mean corpuscular volume (MCV) (MD=8.77 fL (95%CI: -28.85–46.39). Hydroxyurea also significantly reduced white blood cell (WBC) (MD=-4.21 cells/mm3; 95%CI: -5.68–-2.93), absolute neutrophil count (ANC) (MD=-1.43 cells/mm3; 95%CI: -2.11–-0.74), absolute reticulocyte count (ARC) (MD=-141.85 cells/mm3; 95%CI; -172.77–-110.94), and platelet count (MD=-74.92 cells/mm3; 95%CI: -117.05–-32.78). In conclusion, hydroxyurea is efficacious in treating pediatric SCA, as observed in the HbF, WBC, ANC, ARC, and platelet count.
Association of functional levels and serum vitamin D among children with cerebral palsy Yusnita, Afni; Saing, Johannes H.; Hobani, Alhassan H.; Aziz, Abdul; Nasution, Badai B.
Narra X Vol. 2 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i3.167

Abstract

Children with cerebral palsy are more susceptible to deficiency of vitamin D due to less sunlight exposure, poor dietary intake, and long-term use of anti-epileptic drugs, which disrupt their metabolism, resulting in changes in bone mineral density, osteopenia, and rickets. The aim of this study was to investigate the association between gross motor functional levels and vitamin D status in cerebral palsy children. A cross-sectional study was conducted among cerebral palsy patients aged 2–6 years at Haji Adam Malik Hospital, Medan, Indonesia, from November 2022 to April 2023. The levels of the gross motor function classification system (GMFCS) were classified into two groups: ambulatory (GMFCS I, II, III) and non-ambulatory (GMFCS IV, V). Vitamin D status was classified based on serum 25(OH)D levels as normal (30–100 ng/mL), insufficiency (21–29 ng/mL), and deficiency (<20 ng/mL). A total of 85 children with cerebral palsy were included in this study, categorized as ambulatory (n=28, 32.9%) and non-ambulatory (n=57, 67%). The mean serum vitamin D level was 21.92±9.07 ng/L. As many as 54.1% (n=46) of the total children were categorized as vitamin D deficient, followed by insufficient (n=25, 29.4%) and normal vitamin D level (n=14, 16.5%). Age (p=0.310), sex (p=0.590), nutritional status (p=0.269), and types of cerebral palsy (p=0.271) were not associated with vitamin D status. However, there was a significant association between GMFCS levels and circulating vitamin D levels (p<0.001). In a logistic regression model, children classified as ambulatory were more likely to have better vitamin D status, with odds ratios of 12.30 (95%CI: 3.61–41.90) for deficient versus insufficient and 10.93 (95%CI: 2.67–44.69) for deficient versus normal. In conclusion, there was a significant association between functional levels and vitamin D status among children with cerebral palsy.
Associations between seizure management and sleep disorders in children with epilepsy: A cross-sectional study in Medan, Indonesia Suistaya, Novi A.; Dimyati, Yazid; Siregar, Olga R.; Harahap, Juliandi; Dewi, Ika C.; Lubis, Mahrani; Mukhtar, Fatima AS.; Alharbi, Olayan
Narra X Vol. 3 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v3i1.168

Abstract

Sleep disorders are prevalent in children, particularly those with chronic illnesses such as epilepsy, where they disrupt sleep quantity, quality, or timing. The aim of this study was to analyze factors associated with sleep disorder among epileptic children admitted to Haji Adam Malik General Hospital, Medan, Indonesia. The study employed cross sectional design, recruiting 49 children (4–10 years old) with epilepsy at Haji Adam Malik General Hospital from February to June 2024. Data collection was carried out using the Children's Sleep Habit Questionnaire (CSHQ) questionnaire. Further, data on Anti-Epileptic Drugs (AED) intake and history and type of seizures were collected. Pearson’s Chi-square test was employed to analyze the association of the demographic, seizure characteristics, and AED with sleeping disorder. The findings suggest that sleep disorder in children with epilepsy was prevalent (n=26, 53.1%), mostly occurring in boys (32.7%) and those receiving valproic acid (n=9, 34.6%) and its combination with levetiracetam (n=8, 30.8%). Chi-square test results showed that seizure history intake (p<0.001), AEDs intake (p<0.001), and type of AED (p=0.010) were significantly associated with sleep disorder. In conclusion, seizure management strategies and AED regimens can influence sleep disorders in children with epilepsy. Therefore, revisiting and modifying AED treatments may be required to improve both seizure control and sleep quality in affected patients.
Revitalizing the state of primary healthcare towards achieving universal health coverage in conflict affected fragile northeastern Nigeria: Challenges, strategies and way forward Musa, Shuaibu S.; Ibrahim, Adamu M.; Ogbodum, Molly U.; Haruna, Usman A.; Gololo, Ahmed A.; Abdulkadir, Abdulafeez K.; Ukaegbu, Enyinnaya; Agyapong, Joseph; Shallangwa, Muktar M.; Adamu, Nuruddeen A.; Muhammad, Bello A.; Lucero-Prisno III, Don E.
Narra X Vol. 2 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i3.178

Abstract

The Alma-Ata Declaration of 1978 defined primary healthcare as a critical way to obtain universal healthcare and 'health for all.' In Nigeria, the National Health Policy (NHP) and the subsequent formation of the Primary Health Care System aim to modernize healthcare delivery, at the grassroots level. In recent decades, however, the status of primary healthcare in Nigeria, particularly in the northeastern region, has significantly deteriorated, further posing significant threats to health equity and universal access to healthcare. Armed conflicts, humanitarian crises, insufficient finance, inadequate infrastructure, and labor shortages have negatively impacted the region's primary healthcare facilities. This article discusses the poor state of primary healthcare in northeastern Nigeria and its implications for achieving universal health coverage in the region. In addition, the article elaborates on the historical context, highlights the difficulties and challenges in the development of primary healthcare, and explores potential solutions to improve the system.
Enhancing primary healthcare delivery in Nigeria through the adoption of advanced technologies Umar, Abbas B.; Sani, Saifuddeen K.; Aliyu, Lukman J.; Hassan, Musa; Imam, Maryam; Haruna, Usman A.; Ibrahim, Adamu M.; Lucero-Prisno III, Don E.
Narra X Vol. 2 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i3.180

Abstract

Enhancing primary healthcare delivery in Nigeria by adopting advanced technologies holds substantial promise for improving healthcare accessibility, quality, and efficiency. Primary healthcare focuses on community-based, essential care that is practical, socially acceptable, and affordable. Despite efforts to improve healthcare delivery, challenges persist, particularly in rural and underserved areas. The aim of this study was to explore the transformative potential of technologies such as telemedicine, electronic health records (EHRs), health information systems (HIS), artificial intelligence (AI), and medical drones in addressing these challenges. Telemedicine facilitates access to healthcare in remote areas by overcoming geographical barriers. EHRs streamline administrative and clinical processes, enhancing patient care and safety. HIS improves data management, patient safety, and provider communication. AI revolutionizes diagnostics, treatment personalization, and operational efficiency. Medical drones offer innovative solutions for delivering medical supplies to remote locations. The paper also addresses the challenges associated with these technologies, including infrastructure limitations, regulatory issues, and data privacy concerns. Recommendations include investing in infrastructure, developing regulatory frameworks, building capacity, fostering public-private partnerships, engaging communities, and implementing robust data security measures. By addressing these recommendations, Nigeria can leverage advanced technologies to enhance healthcare delivery and achieve better health outcomes.
Global prevalence of natural disaster-induced acute respiratory infections: A systematic review and meta-analysis of 290,380 participants Daffa, Muhammad B.; Khansa, Firyal; Ghifari, Muhammad H.; Zaskia, Siti R.; Jung, Yoonju
Narra X Vol. 2 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i3.181

Abstract

Acute respiratory infections (ARI) can be caused by the occurrence of natural disasters such as earthquakes, volcanic eruptions, landslides, tsunamis, floods, and droughts. The aim of this study was to determine the global prevalence of acute respiratory infections during post-natural disasters across countries. A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines. Studies reporting acute respiratory infections prevalence in natural disaster-impacted areas were identified and screened from PubMed, Scopus, Crosreff, Scilit, and medRxiv as of March 16th, 2024. The meta-analysis was conducted using the Freeman-Tukey double arcsine transformation with a random-effects model. A total of 15 out of 2,052 studies, covering 290,380 subjects, were included in the meta-analysis. The pooled estimate of acute respiratory infection prevalence following natural disasters across multiple countries was 43.0% (95% confidence interval (CI): 31–55%; p-Het<0.01; I²=99.97%). No statistical significance was observed between subgroups, including population density (p=0.281), country income (p=0.583), and types of disasters (p=0.468), suggesting the indiscriminate nature of disaster-induced acute respiratory infections. The highest prevalence was observed in studies from 2015–2019, with a prevalence of 52% (95%CI: 32.7–72.2%; p-Het<0.001; I²=99.97%). In conclusion, the global prevalence of disaster-induced ARI is considered high, reaching 43%, highlighting the need for countermeasures to address these diseases during disasters.
Prognostication of differentiated thyroid cancer recurrence: An explainable machine learning approach Idroes, Ghazi M.; Noviandy, Teuku R.; Idroes , Ghalieb M.; Hardi, Irsan; Duta, Teuku F.; Hamoud, Lama MA.; Al-Gunaid , Hala T.
Narra X Vol. 2 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i3.183

Abstract

Differentiated thyroid cancer (DTC) generally has a favorable prognosis, but recurrence remains a concern for a subset of patients, highlighting the need for accurate predictive tools. While traditional methods, such as the American Thyroid Association (ATA) guidelines, are widely used, they may not fully capture the complex patterns in clinical data. To address this, we developed a machine learning model using LightGBM and enhanced its interpretability with SHAP (SHapley Additive exPlanations). Our model, trained on data from 383 DTC patients, identified response to initial therapy as the most significant predictor of recurrence, alongside age and risk level. The model achieved an accuracy of 93.51%, with precision and sensitivity of 94.23% and 96.08%, respectively, using only five key features selected through Recursive Feature Elimination (RFE). SHAP analysis provided clear insights into how these features influenced predictions, offering a transparent and interpretable approach to risk stratification. These results highlight the potential of explainable machine learning to improve recurrence prediction, support personalized care, and build clinician trust, while laying the groundwork for further validation in diverse populations.
Burnout and study engagement among medical students during COVID-19 pandemic: A cross-sectional study in Aceh, Indonesia Al-Gunaid, Seba; Syukri, Maimun; Kurniawan , Ferry D.; Rizal, Syamsul; Novirianthy, Rima
Narra X Vol. 3 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v3i1.165

Abstract

Medical students are particularly vulnerable to burnout due to the demanding and resource-constrained nature of their training. Burnout negatively impacts academic and personal well-being, potentially impacting future professional practice and patient care. To date, no studies have examined burnout prevalence among medical students in Aceh. The aim of this study was to determine the association between burnout and academic engagement among medical students at Syiah Kuala University, as well as the relationship with age, sex, and year of study. This cross-sectional study was conducted among medical students in Aceh, Indonesia, between October 1, 2021, and March 13, 2022. Total sampling was employed to select study participants. Data were collected using an e-questionnaire using the Oldenburg Burnout Inventory questionnaire adapted for students (OLBI-S) and Utrecht Work Engagement Scale for Students (UWES-S-9) for academic engagement. The total number of participants was 286 students. Most participants were female (n=202, 70.6%), while male students were 84 (29.3%). The prevalence of burnout was 36% (n=102). Gender (p=0.65) and study year (p=0.62) were not associated with disengagement, a subscale of the OLBI-S. Similarly, exhaustion scores did not differ significantly by gender (p=0.48) or study year (p=0.28). In conclusion, fewer than half of the medical students experienced burnout during the COVID-19 pandemic, with no association found between burnout and gender or study year.
Role of vitamin C in reducing cardiovascular oxidative stress: An in vivo study using sepsis rat models Raihani, Rifa; Sovira, Nora; Andid, Rusdi; Yusuf, Sulaiman; Safri, Mulya; Dimiati, Herlina; Fajri, Fauzan; Sentosa, Sukmawan F.; Hasan, Denny I.
Narra X Vol. 3 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v3i1.179

Abstract

The aim of this study was to evaluate the effect of vitamin C on reducing cardiovascular oxidative stress in sepsis rat models. An experimental animal study with a post-test control group design was conducted at the Laboratory of Animal Research, Faculty of Veterinary Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia, from September to December 2023, using 18 male Wistar strain rats (Rattus norvegicus). Rats were divided into three groups: control (Group K), lipopolysaccharide 5 mg/kg body weight (BW) (Group L), and lipopolysaccharide 5 mg/kg BW with oral vitamin C (18 mg/day) (Group LC). Rats were euthanized after two weeks with ketamine (15–20 mg/kg intraperitoneally) and cervical dislocation. Blood samples (3 mL) and heart organs were collected. Nitric oxide (NO) levels were measured through enzyme-linked immunosorbent assay (ELISA), and cardiac muscle cells were observed using an Olympus CX21 microscope.  The LC group exhibited a significantly lower mean endothelial dysfunction score than the L group (p<0.001), although no significant difference in NO levels was observed between L and LC groups (p=0.262), indicating that vitamin C did not significantly affect NO levels. This suggests that the improvement in endothelial function observed in the LC group may be mediated through mechanisms other than NO modulation. The MANOVA test revealed that vitamin C administration accounted for 84.8% of changes in endothelial function in the sepsis rat model (p<0.001). In conclusion, vitamin C confers a protective effect against severe cardiac and endothelial damage, as evidenced by the amelioration of necrosis, inflammatory cell infiltration, congestion, and vacuolization caused by lipopolysaccharide.

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