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All Journal Jurnal Gizi dan Pangan JURNAL PROMOSI KESEHATAN INDONESIA Jurnal Kebijakan Kesehatan Indonesia Medula Juke Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Jurnal Media Gizi Indonesia (MGI) Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) Jurnal Gizi Klinik Indonesia JMM (Jurnal Masyarakat Mandiri) SELAPARANG: Jurnal Pengabdian Masyarakat Berkemajuan Amerta Nutrition Jurnal Kreativitas PKM SRIWIJAYA JOURNAL OF MEDICINE Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Jurnal Kesehatan Community Development Journal JURNAL PENELITIAN PERAWAT PROFESIONAL Reswara: Jurnal Pengabdian Kepada Masyarakat JK Unila (Jurnal Kedokteran Universitas Lampung) Poltekita: Jurnal Pengabdian Masyarakat Jurnal Abdimas ADPI Sains dan Teknologi ADMA: Jurnal Pengabdian dan Pemberdayaan Masyarakat ACADEMIA: Jurnal Inovasi Riset Akademik Jurnal Bina Pengabdian Kepada Masyarakat Jurnal Pengabdian Pada Masyarakat Jurnal Keperawatan Profesional (KEPO) Jurnal Riset Ilmu Kesehatan Umum dan Farmasi Journal of Innovative and Creativity JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia JPM (Jurnal Pengabdian Masyarakat) Ruwa Jurai Jurnal Agromedicine Unila: Jurnal Kesehatan dan Agromedicine
Dian Isti Angraini
Department Of Community Medicine And Public Health, Faculty Of Medicine, Universitas Lampung, Jalan Prof. Soemantri Brojonegoro 1, Bandar Lampung
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Peningkatan Pengetahuan Kesehatan Reproduksi Remaja untuk Mewujudkan Remaja Sehat Berprestasi Carolia, Novita; Angraini, Dian Isti; Sidharti, Liana; Mayasari, Diana
ADMA : Jurnal Pengabdian dan Pemberdayaan Masyarakat Vol 5 No 1 (2024): ADMA: Jurnal Pengabdian dan Pemberdayaan Masyarakat
Publisher : LPPM Universitas Bumigora

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30812/adma.v5i1.3919

Abstract

Ada sekitar 64 juta remaja berusia antara 10 hingga 24 tahun, atau 28,64% dari total populasi Indonesia. Pendidikan kesehatan reproduksi bagi remaja merupakan upaya penting untuk menghindari pergaulan bebas, penyebaran penyakit menular seksual dan kehamilan yang tidak diinginkan. Tujuan dari pengabdian masyarakat ini adalah untuk memberikan penyuluhan tentang kesehatan reproduksi kepada remaja guna mewujudkan remaja yang sehat dan berprestasi. Metode pelaksanaan promosi kesehatan yang digunakan adalah Participatory Action Research (PAR) dengan pelatihan tentang masalah kesehatan reproduksi dan pencegahan penyakit menular seksual yang diikuti oleh siswa-siswi Madrasah Aliyah (MA) Dinniyah Putri, Kabupaten Pesawaran, Lampung. Hasil pengabdian ini menunjukkan terdapat perbedaan yang signifikan antara nilai rerata pretest (63,96) dan nilai posttest (92,2) tentang kesehatan reproduksi pada remaja di MA Dinniyah Putri, Pesawaran, Lampung. Kegiatan pengabdian ini terbukti dapat meningkatkan pengetahuan dan pemahaman remaja tentang kesehatan reproduksi sehingga dapat menjadi salah satu upaya dalam mencegah terjadinya penyakit.
Training on Early Detection of Chronic Energy Deficiency in Pregnancy Angraini, Dian Isti; Apriliana, Ety; Zuraida, Reni; Saftarina, Fitria
Community Development Journal Vol 8 No 1 (2024): Community Development Journal
Publisher : Universitas Nahdlatul Ulama Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/cdj.v8i1.5728

Abstract

Chronic Energy Deficiency in pregnancy is a condition where pregnant women suffer from a lack of food that lasts for a long time. Pregnant women with chronic energy deficiency have poor eating behavior, which is influenced by knowledge, perception, beliefs and health education. Health education provided by health workers can increase knowledge and change eating behavior and can be done better if assisted by an expert system. The aim of this activity is to train health workers (doctors, midwives, nutritionists) to carry out early detection of chronic energy deficiency in pregnancy using an expert system, increasing knowledge, attitudes and eating behavior of pregnant women. The method that will be carried out is training using the web-based expert system modelangraini.com for health workers, health education for pregnant women, and increasing knowledge and changing eating behavior of pregnant women. This activity was carried out for 1 day and took place in Faculty of Medicine, University of Lampung on Saturday 30 September 2023 with 45 family doctors, midwives and nutritionists in Bandar Lampung City participating. The results of the evaluation of the implementation of the service showed that there was an increase in participants' understanding by 91.1% to good understanding, 8.9% of participants had a fairly good understanding, and no participants had a poor understanding of the causes, risk factors, impacts, prevention methods, and early detection of chronic energy deficiency in pregnancy with techniques that are fast, easy and can help health workers in providing education and interventions on the eating behavior of pregnant women. This training activity can improve the skills of health workers in an effort to increase knowledge, attitudes and eating behavior of pregnant women so that they can prevent, overcome and help reduce the prevalence of chronic energy deficiency in pregnant women and prevent stunting in toddlers. Keywords: early detection, chronic energy deficiency, training, health workers
The Effect of History of Low Birth Weight in Newborns and Maternal Anemia in Pregnancy on the Risk of Stunting in Toddlers Age 0-24 Months in Tanjung Bintang Health Center South Lampung Regency Dian Isti Angraini; Kristian Pieri Ginting; Efriyan Imantika
Sriwijaya Journal of Medicine Vol. 4 No. 2 (2021): Vol 4, No 2, 2021
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sjm.v4i2.104

Abstract

Stunting is the condition in children when their height is shorter than a child of his age because of stunted growth due to chronic malnutrition. Stunting can be caused by low birth weight in newborns and maternal anemia. The objective of the study is to know the effect of low birth weight in newborns and maternal anemia on the risk of stunting in the toddler with the age range between 0-24 months in the Tanjung Bintang Primary Health Care. This research is an observational-analytic study with a cross-sectional approach. This research was conducted in the region of Tanjung Bintang Primary Health Care. The sample was 73 toddlers with an age range between 0-24 months. Data were analyzed with a Chi-square test to know the influence of the independent variable with a value of α = 0,05. The results found a 37% risk of stunting, 12.3% history of low birth weight in newborns, and 34.2% history of maternal anemia. The results of the bivariate analysis was no influence of a history of low birth weight in newborns on the risk of stunting (p-value = 0.718) and there was an influence of maternal anemia on the risk of stunting in toddlers (p-value = 0.001). There is no influence history of low birth weight in newborns on the risk of stunting and there is an influence of maternal anemia on the risk of stunting in toddlers aged range between 0-24 months in the region of Tanjung Bintang Primary Health Care.
Peningkatan Kemampuan Pekerja Peternakan Ayam Petelur dalam Identifikasi Bahaya Potensial dan Masalah Kesehatan Angraini, Dian Isti; Febriani, Wiwi; Daulay, Suryani Agustina; Nisa, Lutfi Khoirun; Ramadhan, Rifqi Ihza
ADMA : Jurnal Pengabdian dan Pemberdayaan Masyarakat Vol 5 No 2 (2025): ADMA: Jurnal Pengabdian dan Pemberdayaan Masyarakat
Publisher : LPPM Universitas Bumigora

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30812/adma.v5i2.4486

Abstract

Peternakan ayam petelur merupakan salah usaha yang banyak ditemukan termasuk di Lampung Selatan. Usaha ini sangat menjanjikan karena permintaan akan telur ayam yang selalu tinggi untuk pemenuhan kebutuhan protein. Pada lingkungan kerja di peternakan ayam petelur memiliki bahaya potensial, yang dapat berupa bahaya fisika, biologi, kimia, ergonomi, maupun psikososial. Pajanan bahaya potensial secara berlebihan menjadi potensi risiko masalah kesehatan berupa gangguan, cedera ataunkerusakan pada tubuh pekerja sehingga diperlukan upaya untuk mengidentifikasi dan menganalisis bahaya potensial yang berisiko untuk menjaga kondisi pekerja dan lingkungan kerja yang aman dan sehat. Tujuan dari kegiatan ini adalah meningkatkan kemampuan para pekerja di peternakan ayam petelur “X” di Lampung Selatan dalam mengidentifikasi bahaya potensial dan masalah kesehatan di lingkungan kerja. Metode yang akan dilakukan adalah dengan edukasi melalui ceramah dan diskusi interaktif, pemutaran video, dan simulasi. Kegiatan ini dilaksanakan selama 3 hari dan bertempat di peternakan ayam petelur “X” Kabupaten Lampung Selatan. Peserta berjumlah 7 orang yang merupakan karyawan dan pimpinan peternakan ayam petelur tersebut. Hasil pengabdian didapatkan bahwa terjadi peningkatan pemahaman peserta sebanyak 85,7% menjadi pemahaman yang baik, 14,3% peserta memiliki pemahaman cukup baik, dan tidak ada peserta memiliki pemahaman yang kurang mengenai identifikasi bahaya potensial dan masalah kesehatan di lingkungan kerja. Hasil kegiatan ini mendapatkan bahwa bahaya potensial yang ada berasal dari ergonomi dan psikologis; Pimpinan peternakan ayam petelur tersebut telah menetapkan waktu untuk melakukan stretching bagi para pekerja dan meningkatkan komunikasi dua arah dalam menghadapi permasalahan yang ditemui. Kesimpulan hasil kegiatan ini yaitu peningkatan kemampuan identifikasi bahaya potensial dan masalah kesehatan di lingkungan kerja ini dapat mencegah pekerja mengalami masalah kesehatan, cedera atau penyakit akibat kerja.
Analysis of The Association Between Nutrient Intake and Bone Mineral Density in College Students Angraini, Dian Isti; Firdawati, Firdawati; Indriani, Yaktiworo
Jurnal Promosi Kesehatan Indonesia Vol 20 No 1: January 2025
Publisher : Master Program of Health Promotion Faculty of Public Health Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jpki.20.1.8-15

Abstract

Background: Osteoporosis is a condition characterized by brittle bone prone to fracture. The risk increases significantly with age, particularly among women. An effective approach for understanding and preventing the progression of osteoporosis is by examining bone mineral density (BMD), with diet playing an essential role. Therefore, this study aimed to analyze the association between nutrient intake and BMD in female students at the University of Lampung.Method: This analytical observational study adopted a cross-sectional design. A total of 150 female students at the University of Lampung, were selected as samples using a multistage random sampling technique. The study variables were BMD and nutrient intake, specifically calcium, phosphorus, magnesium, vitamin C, vitamin D, and protein. BMD was assessed based on examination using an ultrasound bone densitometer, while nutrient intake was measured through 2x24h food recall. In the process, data analysis was conducted using the chi-square test.Result: The results showed that female students had BMD in the osteopenia category of 52.7% and osteoporosis of 10%. Calcium and phosphorus intake were associated with BMD in Lampung University female students (p<0.01; p=0.11), while intake of magnesium, vitamin C, vitamin D, and protein did not correlate (p=0.751; p=0.382; p =0.41; p=0.694). Therefore, meeting calcium and phosphorus needs from an early age is essential to prevent osteoporosis.
Hubungan antara Pengetahuan Gizi dan Asupan Zat Imunonutrisi dengan Status Imunitas Pascapandemi Covid-19 pada Mahasiswa Fakultas Kedokteran Universitas Lampung: Association between Nutritional Knowledge and Immunonutrients Intake with Immunity Status Post-Pandemic COVID-19 in College Students Angraini, Dian Isti; Maulidia, Anisa; Sutarto
Amerta Nutrition Vol. 8 No. 4 (2024): AMERTA NUTRITION (Bilingual Edition)
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/amnt.v8i4.2024.602-610

Abstract

Background: The occurrence of COVID-19 pandemic has affected various aspects of life. Several studies have shown that the ability to recover and avoid COVID-19 infection depends on the level of immunity, which is influenced by the intake of immunonutrients. However, healthy eating habits, such as the consumption of these immononutrients, are influenced by a good nutrition understanding. Objectives: This study aimed to determine the association between nutritional knowledge and immunonutrients intake with immunity status post-pandemic COVID-19 in college students. Methods: The study procedures were carried out using an observational analytical method with a cross-sectional design. The sample population comprised 104 first-year students from Medical Education Study Program at Medical Faculty of Lampung University. Students were determined using the unpaired categorical comparative analytics sample size formula and selected with a straightforward simple random sampling method. Data were collected using a questionnaire, including nutritional knowledge, immunonutrients intake, and immune status. Analysis was carried out using Chi-Square test and logistic regression. Results: The result showed that 51.9% of respondents had decreased immunity status. The bivariate test revealed that protein intake (p-value<0.001), zinc (p-value=0.006), iron (p-value<0.001), vitamin A (p-value<0.001), and vitamin C (p-value=0.002) had a relationship with immunity status, while nutritional knowledge (p-value=0.708) had no association. In addition, the factors most related to immunity status were protein, iron, and vitamin C intake. Conclusions: Immunonutrients intake is a factor that directly influenced immunity status, while nutritional knowledge is an indirect factor.
PENATALAKSANAAN HOLISTIK PASIEN LAKI-LAKI 52 TAHUN DENGAN SKIZOFRENIA PARANOID DI FASILITAS KESEHATAN PRIMER Taufiqy, Athaya; Angraini, Dian Isti
Medula Vol 14 No 7 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i7.1295

Abstract

Schizophrenia is characterized by fundamental and characteristic deviations from thought and perception, as well as by abnormal affect. Based on Riskesdas in 2019, the prevalence of schizophrenia in Indonesia was 6.7% per 1000 households. Proper handling holistically using a family medicine approach is needed to improve the patient's quality of life. Applying the principles of a holistic and comprehensive family doctor approach in detecting internal and external risk factors and solving EBM problems. This study is a descriptive study of case reports. Primary data were obtained through autoanamnesis and alloanamnesis, mental examination, and home visits. Secondary data were obtained from the patient's medical record. Patient Mr. P, 52 years old, has been diagnosed with schizophrenia paranoid, has difficulty sleeping at night accompanied by frequent talking to himself, hearing voices, and seeing shadows that others cannot see. Furthermore, comprehensive management is carried out, namely carrying out interventions using poster media and inviting patients to socialize. In the evaluation, the results were obtained in the form of a better understanding of the disease and changes in behavior that have an impact on the success of therapy. Holistic management with family medicine approach is needed for patients with paranoid schizophrenia disease to identify problems in various aspects to support the success of therapy and improve the patient's quality of life.
Penatalaksanaan Pasien Perempuan Usia 33 Tahun dengan Infeksi Saluran Kemih dan Dispepsia melalui Pendekatan Dokter Keluarga di Wilayah Puskesmas Rawat Inap Kedaton Anjaya, Putri Ulayya; Angraini, Dian Isti
Medula Vol 14 No 7 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Urinary tract infection (UTI) is an infection caused by the growth of microorganisms in the urinary tract that causes inflammation and bacteriuria. It is estimated that there are around 150 million cases of UTIs occurring each year worldwide, which can burden health care expenditures. Dyspepsia is a group of symptoms that include uncomfortable sensations in the abdomen, such as pain, bloating, nausea, and vomiting. It is estimated that almost 30% of cases encountered in general practice and 60% in gastroenterology practice are dyspepsia. Implementing comprehensive and holistic family doctor services by identifying risk factors, clinical problems, and patient management based on evidence-based medicine with a patient-centered, family approach and community-oriented strategy. This study is a case report. Primary data were obtained through anamnesis, physical examination and home visits. Secondary data were obtained from the patient's medical records. Patient Mrs. H, 33 years old, came to the polyclinic with pain when urinating for 2 days, and nausea that had been felt for 7 days. The patient was diagnosed with UTI and Dyspepsia. Interventions were carried out in the form of providing health promotion using health posters regarding UTI and dyspepsia. The results of the intervention in patients were increased knowledge about the disease and compliance in implementing hygiene patterns, regular eating patterns, physical activity and reduced complaints experienced by patients. Holistic management can improve the knowledge, attitudes and behavior of patients and families in maintaining health.
A case report PENATALAKSANAAN PASIEN PEREMPUAN USIA 72 TAHUN DENGAN ANEMIA PADA PENYAKIT GINJAL KRONIS MELALUI PENDEKATAN KEDOKTERAN KELUARGA DI PUSKESMAS KEDATON Salsabila, Hasri Aghnia; Angraini, Dian Isti
Medula Vol 14 No 7 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i7.1326

Abstract

Anemia is a body condition characterized by a lower number of red blood cells or hemoglobin concentration than normal limits. According to WHO, 64 million or 23.9% of elderly suffer from anemia worldwide. One of the causes of anemia in the elderly is chronic kidney disease (CKD). According to RISKESDAS, the reported prevalence of CKD at ages ≥15 years is 0.38% in Indonesia with the highest incidence at ages 65-74 years. Appropriate holistic treatment using a family medicine approach is needed to improve the patient's quality of life. Implement comprehensive and holistic family doctor services by identifying risk factors, clinical problems, and patient management based on evidence-based medicine with strategies that are patient centered, family approach and community oriented. This study is a case report. Primary data was obtained through history taking, physical examination and home visits. Secondary data was obtained from patient medical records. Patient Mrs. T, 72 years old, has been diagnosed with anemia, complains of weakness accompanied by fatigue, dizzy eyes and unsteadiness when walking. An intervention was carried out in the form of providing health promotion using health posters regarding anemia in chronic kidney disease. The results of the intervention in patients obtained increased knowledge about the disease and compliance in maintaining health for successful therapy. Holistic management can improve the knowledge, attitudes and behavior of patients and families in maintaining health. Key words: Family Doctor, Anemia, Chronic Kidney Disease.
Penatalaksanaan pada Nn. I Usia 21 Tahun dengan Demam Dengue Melalui Pendekatan Kedokteran Keluarga di Puskesmas Kedaton Bandar Lampung Winata, Afriza; Angraini, Dian Isti
Medula Vol 14 No 7 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i7.1334

Abstract

Dengue fever (DF) is an acute viral infectious disease caused by the dengue virus which in general can be characterized by symptoms of fever for 2-7 days, accompanied by other symptoms in the form of bleeding, such as nosebleeds and red spots on the body (ptekiae), bleeding gums, decreased platelets, the form of hemoconcentration in the form of plasma leakage with signs such as increased hematocrit, ascites, pleural effusion. The purpose of this case report is to Implementing family doctor services by identifying risk factors, clinical problems, and patient management based on Evidence-Based Medicine that is family-approach, patient-centred and community-oriented. The study conducted is a case report. Primary data were obtained through history taking, physical examination and home visits. Secondary data were obtained from the patient's medical records at the puskesmas. Assessment is carried out based on a holistic diagnosis from the beginning, process, and end of the study quantitatively and qualitatively. Patient is female with complaints of fever since 4 days ago. Fever followed by weakness, hedache, and nausea. In this case, the diagnosis and treatment have been carried out according to the latest theory and journals. After the intervention, there was an improvement in patient symptoms and an increase of patient knowledge.
Co-Authors Adelia Meutia Putri agustyas tjiptaningrum Ahdalifa, Pinkan Akhmad Rizki Farhan Akmal, Vina Amelia Al Supartinah Al Supartinah, Al Ali, Muhammad Chaidar Amourisva, Assyiva Putri Andriansah, M. Anggraeni, Liza Anisa Maulidia Anisa Nuraisa Jausal Anjaya, Putri Ulayya Athallah, Dimas Rifqi Aurelina, Renata Bachtiar, Nabylly Aghna Bagus Pratama Bambang Pujianto Bayu Anggileo Pramesona Carolia, Imelda Daulay, Suryani Daulay, Suryani Agustina Deddy Nur Wachid Delmi Sulastri Diana, Mayasari Dita Rifzian, Malyca Rachmaniar Dwi Indria Anggraini Dwita Oktaria Dyah Wulan S.R Wardani Dyah Wulan Sumekar Rengganis Wardani Efrida Warganegara Efrida Warganegara Efriyan Imantika Eka Putri Rahmadhani Eka Putri Rahmadhani Emantis Rosa Ernawaty, Tutik Ety Apriliana Ety Apriliana Fathaniah, Widya Fauzi Ahmad Muda Febilla Naili Alfalah Firdawati, Firdawati Fitri, Dilla Syahra Noor Fitria Saftarina Ginting, Kristian Pieri Giska Tri Putri Habsari, Maharani Kusuma Hafizha, Syifa Happy, Terza Aflika Hardisman Harmaina Harmaina, Harmaina Indria, Anggraini Dwi Intanri Kurniati Islami, Andi Rassya Daffa Jausal, Anisa Nuraisa Jhons Fatriyadi Suwandi Kania, Susi Karima, Nisa Karimah Khitami Aziz Karyus, Aila Khairun Nisa Khairunnisa, Lyliani Khairunnisa, Salma Kirana, Falahdila Rebika Kristian Pieri Ginting Larasati, Ratri Mauluti Leni Ervina, Leni Liana Sidharti, Liana Lidya Angelina Purba Maya Ganda Ratna Mayasari, Diana Meiyanti Meiyanti, Meiyanti Merry Indah Sari Merry Indah Sari Miranda, Alyzah Nabila Muhamad Fathurrahman Zain Muhammad Abdul Ghoni Muhammad Iz Zuddin Adha Muhammad Jundi Nasrullah Muhammad Yusran Mukhlis Imanto Mukhlis Imanto, Mukhlis Naila Fathiya Isnanto Nisa Karimah Nisa, Lutfi Khoirun Nixon Steven Novita Carolia Novita Carolia Novita Carolia Nur Indrawaty Lipoeto Nurtandhee, Mutiara Oktadoni Saputra Perdana, Azzahra Gadis Junita Putu Risyaning Ayu Rahmani, Adrina Rizka Ramadhan, Rifqi Ihza Ramadhana Komala Ratna, Maya Ganda Reni Zuraida Renti Kusumaningrum Samosir Risda Yana Riska Oktavioni Salsabilla Rizki Arisandi Rizki Hanriko Rodiani Roro Rukmi Windi Perdani, Roro Rukmi Rudiyanto, Waluyo Salsabila, Hasri Aghnia Sangging, Putu Ristyaning Ayu Sari, Merry Indah Sekar Ronna Fiskasari Sembiring, Dustin Delano Pranata Sharlene Sabrina Azzahra Sofyan Musyabiq Wijaya Soraya Rahmanisa Sormin, Merris Hartati Sri Hasnawati Suharmanto Suharmanto Suharmanto Suryadi Suryadi Susianti Susianti Susmalini, Susmalini Sutarto Sutarto Taufiqy, Athaya Tutik Ernawati Utari Gita Mutiara Wachid, Deddy Nur Winata, Afriza Wiwi Febriani Wuryaningsih Dwi Sayekti Wuryaningsih Wuryaningsih Yaktiworo Indriani Yana, Risda Yoga, M. Agung Prasetya Adnyana Yoga, Made Agung Prasetya Adnyana Yuliana Yunianto, Andi Eka Yuningrum, Hesti Yusrawati Yusrawati Zenith Puspitawati