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CORRELATION OF CYSTOSTOMY TO LOW URETHROCUTANEOUS FISTULA INCIDENT IN HYPOSPADIA SURGERY Laura, S. F.; Duarsa, G. W. K.; Mahadewa, T. G.
BALI MEDICAL JOURNAL Vol 3 No 3 (2014)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Hypospadia is the most common congenital abnormalities to the penis. The most common post-operative complications and hypospadias is uretherocutan fistula. Uretherocutan fistula is arising from an infected wound, hematoma, urinary extravasations, ischemic necrosis of the flap or graft, technical errors, and postoperative care. Although, reconstruction of the urethra without cystostomy results in patients discharged quickly, some sources still recommend the use of cystostomy in hypospadias surgery. This is because of lower complication rate and more comfortable for the children during the postoperative period. The purpose of this study was to determine the incidence of fistula uretherocutan correlation with cystostomy using hypospadia operation. Methods: This study was carried out with cross-sectional design involving 68 patients, comprising 34 people with operating groups and 34 other people of hypospadias surgery without cystostomy. This is a retrospective study by observing medical record of the patients at Sanglah General Hospital from December 2013 until May 2014. All data obtained were assayed with Chi-square and Person Correlation and considered significant at p < 0.05. Results: This Study reports that the value of r = -0.364, p = 0.034, and PR = 0.16. However, there is a correlation in the use of cystostomy to a lower incidence of fistula in operation uretherocutan hypospadia. In cystostomy surgery, fistula incidence was 2.9% and operating without cystostomy was 17.6%. In operation hypospadia using cystostomy is expected to reduce the incidence of fistula.
REGIONAL ANESTHESIA CONTINUOUS BRACHIAL PLEXUS BLOCK WITH ULTRASONOGRAPHY GUIDANCE A., Senapathi T. G.; M., Wiryana; P., Astawa; M., Astawa N.; S., Maliawan; M., Bakta; T., Suryadi N.; M., Sukrama D.; D., Satoto; B., Mahadewa T. G.; Ekaputra, Ekaputra; A., W.
BALI MEDICAL JOURNAL Vol 4 No 1 (2015)
Publisher : BALI MEDICAL JOURNAL

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Background: Regional anesthesia has an anti-inflammatory effect that blockade the C-fiber hence reduced cytokine production and blocked the activity of the sympathetic nerve fibers. Postoperative pain caused primarily by tissue inflammation and activity of the C-fibers in the manner of reduced the production of cytokines, regional anesthesia may limit the inflammatory response after surgery and severity of postoperative pain. Methods: This study is a clinical experimental study with randomized pre and post test control group design. A total of 24 samples were recruited in this study divided into two groups each consisting of 12 samples. The first group was given regional anesthesia method of continuous brachial plexus block with ultrasound guidance and the second group with general anesthesia method. T-test or Mann Whitney continued multivariate linear regression analysis was performed to analyze the differences in treatment and not because of differences in the initial values with significance level of p
NON NEUROLOGICAL OUTCOME COMPARISON OF EARLY AND DELAYED SURGICAL STABILIZATION IN C-SPINE FRACTURES Mahadewa, T. G. B.; Subawa, and D. M.
BALI MEDICAL JOURNAL Vol 3 No 1 (2014)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Non neurological outcome postsurgical stabilization in C-spine injury has not been reported. Non neurological outcome i.e. the risk of lung infection (pneumonia), systemic inflammation response syndrome (SIRS), length of postoperative care (LOPOC) which can compromise the recovery process and treatment period. This study aims to investigate non neurological outcome comparison after early surgical stabilization (ESS) and delayed surgical stabilization (DSS) in patients with C-spine fractures. Methods: The author retrospectively reviews 59 of 108 consecutive patients who met the inclusion criteria with C-spine fractures who underwent surgical stabilization at the Sanglah General Hospital, between 2007 and 2010. Consisting of 25 patients underwent ESS and 34 patients were treated by DSS. The last follow up period range was 3-36 months. Non neurological outcome were evaluated and compared; the risk of pneumonia, SIRS and LOPOC. Results: Significant statistically between ESS and DSS in; the risk of pneumonia (ESS: DSS= 1:9) by Chi-square-test (p=0.023); the risk of SIRS (ESS: DSS= 1:11) by Chi-square-test (p=0.008); and the LOPOC (ESS: DSS= 6.84:9.97) by independent t-test (p=0.000). Application of ESS for C-spine fractures could provide early mobilization, prompt treatment and facilitate early rehabilitation thus significantly reduces complications due to prolong immobilization and reduces LOPOC. Conclussion: It can be concluded that the ESS strategy is effective and efficient thus may propose an option of surgical timing in C-spine fractures.
HIGH ARTERIAL BLOOD LACTATE AS SIRS PREDICTOR IN PATIENTS WITH SEVERE HEAD INJURY Lengkong, L. R. M.; Maliawan, S.; Mahadewa, and T. G. B.
BALI MEDICAL JOURNAL Volume 2 Number 2, May-August 2013
Publisher : BALI MEDICAL JOURNAL

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Objectives:  Lactate is one of the prognostic factor for evaluation of clinical severe head injury patients outcome. Lactate is also known as a factor to support diagnostic and prognosis of SIRS cases. Severe head injury is a head traumatic case frequently found in Emergency Units, where some cases result in mortality. Based on Glasgow Coma Scale (GCS), severe head injury is define as a head injury with GCS score between 3 and 8. This study aims to determine whether high arterial blood lactate can be used as predictor that causes the occurrence of SIRS. Method. A Cohort prospective study applied in this research to determine arterial blood lactate as a predictor that causes the occurrence of SIRS. This study was conducted at Sanglah General Hospital Bali-Indonesia from May 2013 to July 2013 with 40 patients who fulfilled the inclusive criteria. Data were presented in tables and analyzed by applying Chi Square Test with CI 95% and p <0.05 was considered significant. Results: From 40 samples, 27 were male (62.5%) and 17 female (37.5%) at the age of 0-10, 2 people (5%), 10-20 years 7 people (17.5%), 20-40 years 14 people (35%), 40-60 years 12 people (30%) and over 60 years 5 people (12.5%). On the first day, patients with normal level blood arterial lactate 2 (5%), and high 38 (95%) causing SIRS (+) 39 (97.5%) and SIRS (-) 1 (2.5%) samples to occur. Using bivariate analysis between arterial blood lactate level and the amount occurrence of SIRS, we obtain p < 0.05 and variable control using multivariate analysis we obtained variable of liver dysfunction that give significant value with level arterial blood lactate with p < 0.05). Conclusion: From 40 samples of Severe head injury, there were 38 (95%) whose blood arterial lactate level increased on the first day, 2 (5%) in normal limit and 39 (97.5%) with SIRS on the third day when p < 0.05) so that high level arterial blood lactate can be used as predictor that causes SIRS to occur.
HIGH SERUM C-REACTIVE PROTEIN AS PREDICTOR OF SYSTEMIC INFLAMATORY RESPONES SYNDROME IN SEVERE HEAD INJURY PATIENTS Bomba, G. I. B; Maliawan, and, S; Mahadewa, T. G. B
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objectives: Despite the fact that many studies have shown that the role of high sensitivity C-reactive protein (Hs-CRP) in inflammation diseases, the role of this molecule in severe head injury (SHI) has not been understood clearly. Severe head injury was defined as a trauma to the head frequently found in Emergency Units where some cases result in mortality. Severe head injury was defined as Glasgow Coma Scale (GCS) score between 3 and 8. Based on this data, we felt that it was important to determine the role of Hs-CRP as a predictor of SIRS in SHI patients. Method: This was a Cohort prospective study about the role of serum Hs-CRP as a predictor for Systemic inflammatory response syndrome (SIRS) in SHI patients at Sanglah General Hospital, Bali-Indonesia from August 2012 to February 2013. A number of 60 patients fulfilled the inclusive criteria. The data were analyzed descriptively to show the characteristics of the samples and was analyzed using univariate and multivariate analysis to determine the predictor factors for SIRS in SHI patients. A confidence interval of 95% (p < 0.05) was applied. Results: From 60 samples collected, there were 43 males (71.7%) and 17 females (28.3%), the majority age of the samples were 20-40 years old (21 samples, 35%). On the first day 49 samples (81.6%) had elevated serum Hs-CRP levels. Fifty seven samples (95%) had SIRS, and only 3 samples (5%) did not have SIRS. Bivariate analysis between Hs-CRP level and SIRS was significant (p = 0.001). Multivariate analysis showed that pneumonia and high Hs-CRP serum levels were significant predictor factors for SIRS in SHI patients. Conclusion: High serum Hs-CRP levels could be used as a reliable predictor factor for SIRS in SHI patients.
THE CORRELATION BETWEEN SERUM PSA LEVEL AND PROSTATE HISTOLOGIC AGGRESSIVENESS WITH PROSTATIC VOLUME IN BPH PATIENTS Duarsa, Gede Wirya Kusuma; Oka, AA Gde; Santosa, Kadek Budi; Yudiana, Wayan; Tirtayasa, Pande Wisnu; Udiyana, Nyoman Dwi Maha; Mahadewa, Tjok Gede Bagus
Indonesian Journal of Urology Vol 26 No 1 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v26i1.465

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Objective: Prostate inflammation is one of pathophysiology of prostate hyperplasia in benign prostatic hyperplasia (BPH). There are several factor that involved in prostatic inflammation, such as prostate specific antigen (PSA) that play a role as an autoantigen. The objective of this study was to assess the correlation between free PSA level with prostate histologic aggressiveness, and also the correlation between prostate histologic aggressiveness with prostatic volume in BPH patients. Material & Methods: The design of this study was cross-sectional analytic observational study to determine correlation between serum PSA level with prostatic aggressiveness, and prostatic volume with prostatic aggressiveness. This study was performed from June to November 2016 in Sanglah Public Hospital, Surya Husadha, Balimed, Bhakti Rahayu, and Ganesa Hospital. Eighty three patients with BPH undergoing transurethral resection of the prostate (TURP) were recruited. Results: The result of gamma correlation analysis using Chi-square of PSA level with aggressiveness (p=0.000) and aggressiveness with prostatic volume (p=0.012). Conclusion: Serum PSA level were correlated with prostatic aggressiveness. Prostatic aggressiveness also correlated with prostatic volume.
STUDENT RESPONSES IN LEARNING INQUIRY MODEL INTEGRATING ARCS MOTIVATION STRATEGY ON ACID-BASE MATERIALS Tukan, Maria Benedikta; Komisia, Faderina
JCER (Journal of Chemistry Education Research) Vol 1, No 2 (2017): Volume 1 No. 2 December 2017
Publisher : Universitas Negeri Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26740/jcer.v1n2.p67-72

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The purpose of this research was to describe the response of grade XI students of SMAK Saint Carolus Kupang in the learning that integrated the ARCS motivation strategy in the inquiry model on the acid-base materials. This type of research is quasy experiment design. This research was conducted at SMAK Saint Carolus Kupang, East Nusa Tenggara. The design of this research using Nonequivalen Control Group Design. The instrument in this research is using student response questionnaire. The data collection procedure in this research is questionnaire. The result of his research is that the students' responses in learning that integrate ARCS motivation strategy in inquiry model is good.
PERLINDUNGAN HUKUM TERHADAP KONSUMEN PT. PLN (PERSERO) DALAM KESALAHAN PENCATATAN KWH METER LISTRIK Mahadewa, Kadek Genta; Kasih, Desak Putu Dewi
Kertha Desa Vol 9 No 7 (2021)
Publisher : Kertha Desa

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Abstract

Penulisan jurnal ini memiliki tujuan adalah untuk mengeatahui secara jelas kepastian perlindungan hukum bagi konsumen PT. PLN apabila terjadi kesalahan pembacaan kWh meter listrik yang tentunya merugikan konsumen itu sendiri serta untuk mengetahui tanggung jawab PT. PLN terkait kesalahan pencatatan kWh meter listrik. Metode yang digunakan untuk penelitian ini adalah metode yuridis normatif. Adapun hasil dari penelitian ini ialah perlindungan konsumen berasaskan kepastian hukum, keselamatan, dan keamanan konsumen yang dapat kita lihat dalam Undang-Undang Perlindungan Hukum, dan Undang-Undang Ketenagalistrikan dimana sudah dapat menjamin kepastian hukum serta hak-hak bagi konsumen pengguna tenaga listrik. Terkait kesalahan pembacaan kWh meter listrik jelas bahwa PT. PLN tidak memenuhi kewajibannya dengan baik serta konsumen tidak mendapatkan haknya yang tentu saja PT. PLN wajib bertanggung jawab dimana PT. PLN wajib memberikan pengurangan apabila realisasi lama dan/atau jumlah gangguan serta tingkat kesalahan pembacaan kWh meter listrik jumlahnya melebihi di atas tingkat mutu pelayanan yang ditetapkan PT. PLN maka PT. PLN wajib memberikan pemotongan tagihan listrik sebesar 20% sampai 35% dari biaya beban konsumen dan diperhitungkan dibulan berikutnya. Kata Kunci: Kepastian Hukum, Perlindungan Konsumen, Tanggung Jawab ABSTRACT The purpose of writing this journal is to clearly know the certainty of legal protection for consumers of PT. PLN if there is an error in reading the kWh electricity meter which is certainly detrimental to the consumer itself and to find out the responsibility of PT. PLN related to the error in recording the electricity kWh meter. The method used for this research is the normative juridical method. The results of this study are consumer protection based on legal certainty, safety, and consumer security which we can see in the Law on Legal Protection, and the Electricity Law which can guarantee legal certainty and rights for consumers who use electricity. Regarding the error in reading the electricity kWh meter, it is clear that PT. PLN does not fulfill its obligations properly and consumers do not get their rights which of course PT. PLN is obliged to be responsible where PT. PLN is obliged to provide a reduction if the realization of the old and/or the number of disturbances and the error rate of reading the kWh meter of electricity exceeds the level of service quality set by PT. PLN then PT. PLN is required to provide electricity bill cuts of 20% to 35% of the cost of consumer expenses and calculated in the following month. Keywords: Legal Certainty, Consumer Protection, Responsibility
HIGH INTENSITY INTERVAL TRAINING LEBIH MENINGKATKAN KAPASITAS AEROBIK DARIPADA LOW INTENSITY STEADY STATE PADA ATLET KARATE DOJO CAMPUHAN ASRI DI DENPASAR I Ketut Wedarthana Aditya Prana; I Putu Gede Adiatmika; Tjokorda Gde Bagus Mahadewa; Dewa Putu Sutjana; Ketut Tirtayasa; I Putu Adiartha Griadhi
Sport and Fitness Journal Volume 7, No.3, September 2019
Publisher : Program Studi Magister Fisiologi Keolahragaan, Fakultas Kedokteran, Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (581.152 KB) | DOI: 10.24843/spj.2019.v07.i03.p02

Abstract

Decreased physical endurance impacts for human fitness. The occurrence of decline in activities that can make physical decline of heart and lung function and decreased metabolic system. This physical endurance is divided into two parts, namely general durability and muscular endurance. This research aims to know HIIT training further increase aerobic capacity than in training of LISS in Dojo Campuhan Asri Denpasar. Type of experimental research with the randomized pre-posttest control group design. Aerobic capacity is measuring by MFT (multistage fitnest test). The research subjects were male karate athletes between 7-12 years, totaling 16 people and divided into two different treatment groups. Group I was given training in High Intensity Interval Training with training based on maximum repetition and Group II was given Low Intensity Steady State training with training based on a maximum time of 60 minutes with frequency of exercise 3 times a week for 6 weeks in both group. The result of increased aerobic capacity between the two Groups before and after the training was tested with t-independent, with the significant value ? = 0.05. Average aerobic capacity in both Groups before training with the value P = 0.339 and after training with the value P = 0.001. It shows that the group I and group II both gave an improved effect (P < 0.05). But in group I better than the group II (p < 0.05). It was concluded that aerobic capacity in Group I and Group II had both increased. However, the High Intensity Interval Training Group training is better than the Low Intensity Steady State Training Group. High Intensity Interval Training suggested training is recommended for athletes training. Keywords: High Intensity Interval Training , HIIT , Low Intensity Steady State, LISS, Capacity Aerobic, Karate.
PERBANDINGAN EFEK MUSCLE ENERGY TEHNIQUE DENGAN INTEGRATED NEUROMUSKULER INHIBITION TECHNIQUE TERHADAP NECK DISABILITY KONDISI MYOFASCIAL PAIN SYDROME UPPER TRAPEZIUS Sulfandi Sulfandi; I Made Muliarta; Wahyuddin Wahyuddin; Alex Pangkahilla; Susy Purnawati; Tjokorda Gde Bagus Mahadewa
Sport and Fitness Journal Vol 8 No 1 (2020): Volume 8, No. 1, Januari 2020
Publisher : Program Studi Magister Fisiologi Keolahragaan, Fakultas Kedokteran, Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (692.057 KB) | DOI: 10.24843/spj.2020.v08.i01.p03

Abstract

Pendahuluan: Myofascial Pain Sydrome merupakan suatu keadaan yang dapat menimbulkan nyeri lokal dan nyeri menjalar yang dikarakteristikkan dengan adanya ketidaknormalan pada motoris (taut band yang keras di dalam otot) dan ketidaknormalan pada sensoris (nyeri tekan dan nyeri menjalar). Tujuan: Untuk membuktikan dan mengkaji efektifitas kedua efek terapi Muscle Energy Tehnique dan Integrated Neuromuscular Inhibition Technique dalam mengatasi masalah disabilitas leher pada kasus myofascial pain sydrome upper trapezius. Metode: Penelitian ini adalah penelitian eksperimental pretest and posttest comparison group design. Sebanyak 18 orang subjek penelitian, berusia 20-55 tahun, mengalami disabilitas leher, dan tidak pernah mengalami spondylolisthesis, cedera, fraktur dan hernia nucleus pulposus pada area leher, direkrut untuk mengikuti penelitian ini. Subjek penelitian dibagi menjadi 2 Kelompok. Kelompok I diberikan program Muscle Energy Tehnique dan Kelompok II diberikan program Integrated Neuromuscular Inhibition Technique dengan durasi latihan yang sama, yaitu 30 menit per hari selama 4 minggu. Alat ukur yang digunakan untuk mengevaluasi perubahan nyeri mekanik leher adalah Neck Disability Index. Analisis statistik menggunakan uji Paired Sampel T test untuk membandingkan hasil prestest dan posttest tiap Kelompok, dan uji Independent T Test untuk membandingkan perubahan nyeri antara kedua Kelompok. Hasil: Ditemukan penurunan disabilitas leher yang signifikan (p=<0,05) baik pada Kelompok I maupun Kelompok II, yaitu dari rerata (45,33±4,690 menjadi 13,78±3,930 vs. 43,78±3,232 menjadi 12,89±2,667). Hasil perbandingan penurunan disablitas leher menunjukkan bahwa tidak ada perbedaan yang signifikan (p=0,360) antara Kelompok I dan Kelompok II. Simpulan: Program Muscle Energy Tehnique dan Integrated Neuromuscular Inhibition Technique efektif dalam mengatasi disabilitas leher pada kondisi Myofascial Pain Sydrome Upper Trapezius dengan efektivitas yang sama baiknya antara kedua teknik tersebut.
Co-Authors A. Winata, A. Adityas Sukmadi Karjosukarso Adityawarma, Anak Agung Ngurah Agung Harawikrama Agung Bagus S. Satyarsa Akbar Wido Alex Pangkahilla Aluh Sri Yuliana Ulfa Alvin Hendellyn Anak Agung Gede Eka Septian Utama and D. M. Subawa Arasy, Mohd Firdaus Ariyanta, Kadek Deddy Astawa N. M., Astawa N. Astawa P., Astawa B. Sinaga Bagus Komang Satriyasa Bertha Melyana Bianca Jeanne Bramastha A Rosadi, Bramastha A Budiarta, Ida Bagus Chriswidarma, Dewa Gede Cita Rosita Sigit Prakoeswa Citra Aryanti D.P.W. Wardhana Desak Made Wihandani Desak Putu Dewi Kasih Desie Yuliani Dewa Putu Gede Purwa Samatra Dewa Putu Wisnu Wardhana Dwikinta, Made Anindya Dyah Esti Pranwengrum Ekaputra Ekaputra, Ekaputra Fenty Fauziah G. I. B Bomba Gede Andry Nicolas Gede Wirata Gede Wirya Kusuma Duarsa Glen Sandi Saapang Gunawan, Made Favian Budi Gungun Gunardi Hizkia Lumban Gaol I Dewa Made Sukrama I Dewa Putu Sutjana I Gede Suwedagatha I Gusti Agung Bagus Krisna Wibawa I Gusti Bagus Dharma Prakasa Musti I Gusti Ketut Agung Surya Kencana I Gusti Putu Agung Pratama Putra I Ketut Wedarthana Aditya Prana I Ketut Wiargitha I Komang Yose Antara I Made Bakta I Made Kasmadi Gunawan, I Made Kasmadi I Made Maha Satya Dwi Palguna I Made Mahayasa I MADE MULIARTA . I Made Prema Putra I Made Stepanus Biondi Pramantara I Nyoman Semadi I Putu Adiartha Griadhi I Putu Gede Adiatmika I Putu Gede Sudiartha I W. Sudarsa I Wayan Juli Sumadi I Wayan Niryana I Wayan Yudiana I. B. Tjakra Wibawa Manuaba Ida Ayu Putu Sri Widnyani Inge Kurniawati Intan Permata Wijaya John Nolan K.K. Putra Kadek Biondi Kadek Budi Santosa Kendarini, Ni Putu Yenny Ketut Sudiasa Ketut Tirtayasa Koerniawan, Heru Sutanto Krishna, I Komang O. Kurniyanta, I Putu L. R. M. Lengkong Lauren, Christopher Luh Made Indah Sri Handari Adiputra M Wiryana Made Agus Dwianthara Sueta Made Indra Erlangga Prathiwindya Manuaba, Ida Bagus Tjakra Wibawa Mardliyah, Mumtazah Marleen Marleen Marleen Melissa Krisanty Moses Kharisma Setyawan Muh. Ali Imron Nani Darmayanti Ni Luh Putu Julita Yanti Ni Nyoman Ayu Dewi Niryana, , I Wayan Nova Juwita Nyoman Golden Oka, AA Gde Oka, Anak A.G. Pande Made Wisnu Tirtayasa Paulus Adrianus K. L. Ratumakin Pertiwi, Putu Febry Krisna Pradiptha, I Nyoman Tri Prayuda, Prayuda Putu Astawa Putu Eka Mardhika Putu Eka Mardhika Putu Pramana Suarjaya Rajab Bahry Raka Janitra Raka-Sudewi A. A. Regitha Aulia Putri Rika Lesmana, Rika S Indra Lesmana S. Awyono S. F. Laura, S. F. Satoto D., Satoto Sidemen, IGP Sukrana Sista Satyarsa, Agung Bagus Sista Soetomo, Cindy Thiovany Sri Maliawan Stanley-Ketting Oliver Steven Awyono Sugianto, Ronald Sugijanto - Sulfandi Sulfandi Sunanda Naibaho Suryadi N. T., Suryadi N. Suryawisesa, Ida Bagus Made Susy Purnawati Tito Ade Putra Tjokorda Gde Agung Senapathi Udiyana, Nyoman Dwi Maha W. A., W. Wahyuddin, Wahyuddin Wibawa, I Gusti Agung Bagus Krisna Wildan Wildan Wiryana M., Wiryana Yustinus Robby Budiman Gondowardojo