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All Journal International Journal of Public Health Science (IJPHS) Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Medical Journal of Indonesia Global Medical and Health Communication Biomedika MNJ (Malang Neurology Journal) Universa Medicina Jurnal Keperawatan Padjadjaran Smart Medical Journal Indonesian Journal of Medicine SEMAR (Jurnal Ilmu Pengetahuan, Teknologi, dan Seni bagi Masyarakat) Smart Society Empowerment Journal
Budianto, Pepi
Universitas Sebelas Maret
Humanities Biochemistry, Genetics & Molecular Biology Dentistry Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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A rare case of Fahr's syndrome with dissociative amnesia Faizal Muhammad; Wilson Arpin; Yeremia Suryo Pratama; Cynthia Hanny Lestari; Pepi Budianto; Rivan Danuaji; Ervina Arta Jayanti Hutabarat; Stefanus Erdana Putra; Muhammad Hafizhan
Jurnal Keperawatan Padjadjaran Vol. 10 No. 3 (2022): Jurnal Keperawatan Padjadjaran
Publisher : Faculty of Nursing Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkp.v10i3.2134

Abstract

Background: Fahr's syndrome (FS) is a movement and psychiatric disorder characterized by symmetrical and bilateral calcification of the basal ganglia. Dissociative amnesia is a rare psychiatric disorder that occurs after stressful events and is classified as a dissociative disorder. In addition, dissociation is the process by which the mind conceals stressful events from consciousness. Several neuropsychiatric manifestations in FS have been reported. However, due to their rarity, FS and dissociative amnesia can be misdiagnosed. Case: A 43-year-old female presented with Parkinsonian symptoms and an inability to recall important personal information. FS and dissociative amnesia were diagnosed after a thorough medical, psychiatric, and diagnostic investigation. Subsequently, correction of calcium and phosphate levels by α-hydroxy-vitamin-73 D3 and psychotherapy were administered for two-months until there were no neuropsychiatric symptoms reported. Conclusion: This research highlights a rare case of FS with dissociative amnesia which pathophysiology is not completely understood due to limited research.
Penyuluhan Dampak Lama Waktu Membatik dengan Kejadian Carpal Tunnel Syndrome (CTS) di Kampoeng Batik Laweyan Diah Kurnia Mirawati; Pepi Budianto; Hanindya Riani Prabaningtyas; Stefanus Erdana Putra; Muhammad Hafizhan; Wahyu Agung Susilo; Novian Anindito Santosa
SEMAR (Jurnal Ilmu Pengetahuan, Teknologi, dan Seni bagi Masyarakat) Vol 10, No 1 (2021): Mei
Publisher : LPPM UNS

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/semar.v10i1.45576

Abstract

Pengabdian masyarakat berjudul “Penyuluhan Dampak Lama Waktu Membatik dengan Kejadian Carpal Tunnel Syndrome (CTS) di Kampoeng Batik Laweyan” bertujuan untuk meningkatkan pengetahuan dan kesadaran para pengrajin batik akan dampak negatif gerakan tangan yang repetitif atau berulang selama membatik dalam jangka waktu yang lama. Kegiatan ini juga bertujuan mengarahkan para pembatik untuk melakukan modifikasi posisi kerja yang ergonomis dalam proses membatik sehingga dapat mencegah timbulnya kejadian CTS. Target yang dicapai adalah peningkatan pemahaman dan informasi terkait dampak lama waktu membatik serta pencegahan kejadian CTS pada pembatik. Metode pelaksanaan kegiatan pemberdayaan dan pengabdian masyarakat pada mitra berupa pemetaan demografi pengrajin batik dengan cara mendata jumlah pembatik, jenis kelamin, umur, lama masa kerja sebagai pembatik, frekuensi gerakan repetitif pada pergelangan tangan, riwayat penyakit sebelumnya, pemeriksaan elektromiografi (EMG) gratis pada pembatik, dan analisa hasilnya. Selanjutnya, peneliti melakukan penyuluhan dengan cara menjelaskan hasil pemeriksaan EMG, dampak negatif yang ditimbulkan dari gerakan tangan repetitif dalam membatik, diskusi dan tanya jawab, edukasi posisi kerja yang ergonomis dalam membatik, serta evaluasi. Hasil pengabdian ini menunjukkan bahwa para pembatik memiliki pemahaman yang meningkat dibandingkan sebelum penyuluhan tentang hubungan lama waktu membatik dan dampak buruknya, sehingga meningkatkan kesadaran para pembatik akan kejadian CTS yang dapat timbul akibat posisi kerja yang tidak ergonomis. Kata kunci: Carpal Tunnel Syndrome, pengabdian masyarakat, pengrajin batik, penyuluhan
Efektifitas Promosi Kesehatan Menggunakan Video Senam Rehabilitasi Vestibuler untuk Mengurangi Keluhan Vertigo di Masa Pandemik Diah Kurnia Mirawati; Raden Andi Ario Tedjo; Pepi Budianto; Hanindia Riani Prabaningtyas; Ira Ristinawati; Subandi Subandi; Rivan Danuaji; Muhammad Hafizhan; Stefanus Erdana Putra
SEMAR (Jurnal Ilmu Pengetahuan, Teknologi, dan Seni bagi Masyarakat) Vol 12, No 2 (2023): November (Article in Press)
Publisher : LPPM UNS

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/semar.v12i2.68328

Abstract

Vertigo merupakan sensasi gerakan atau rasa gerak dari tubuh seperti sensasi berputar namun tanpa adanya sensasi berputar yang sebenarnya. Vertigo paling sering disebabkan oleh disfungsi pada sistem vestibular dari lesi perifer maupun sentral. pada masa pandemi COVID-19 sebagian besar pasien vertigo mengalami kesulitan untuk rutin memeriksakan diri di rumah sakit. Oleh karena itu, dicari alternatif berupa perawatan non farmakologis agar pasien bisa tetap mengontrol keluhan penyakitnya di masa pandemi ini. Senam rehabilitasi vestibular melatih otak melalui petunjuk visual dan proprioseptif alternatif untuk menjaga keseimbangan. Penelitian ini dibuat untuk mengetahui efektifitas promosi kesehatan menggunakan video senam rehabilitasi vestibuler untuk mengurangi keluhan vertigo. Penyelenggaran penyuluhan pada anggota posyandu lansia ANTHURIUM, Kelurahan Tegalrejo yang diikuti sebanyak 47 orang. Sebelum dan sesudah penyuluhan dilakukan evaluasi terkait pengetahuan peserta mengenai vertigo melalui pretest dan posttest. Data hasil evaluasi menunjukkan adanya perbaikan pengetahuan peserta dari skor rata rata awal 62.4 menjadi 83.7.
Hematomyelia Akibat Traumatic Lumbar yang Menyebabkan Syok Spinal: Sebuah Laporan Kasus Raden Andi Ario Tedjo; Lawly Arrel Dionnie Greatalya; Vivienne Tjung; Muhammad Hafizhan; Stefanus Erdana Putra; Suroto Suroto; Diah Kurnia Mirawati; Subandi Subandi; Rivan Danuaji; Pepi Budianto; Yetty Hambarsari; Baarid Luqman Hamidi; Hanindia Riani Prabaningtyas; Ervina Arta Jayanti Hutabarat; Ira Ristinawati; Teddy Tejomukti
Jurnal Keperawatan Padjadjaran Vol. 11 No. 3 (2023): Jurnal Keperawatan Padjadjaran
Publisher : Faculty of Nursing Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkp.v11i3.2352

Abstract

Background: Spinal cord hemorrhage or hematomyelia can arise from trauma or non-trauma causes, adverse effect of anticoagulation therapy and ruptured vascular malformation. Bleeding in epidural space is common and complications such as acute spinal cord syndrome can arise due to the compression and destruction of the spinal cord. Symptoms of hematomyelia might be varied depending on location of the lesion, often accompanied with acute radicular pain. In this case study, we reported a case of spinal shock after traumatic lumbar hematomyelia. Case: A 13-year-old girl presented to Dr. Moewardi General Hospital with inferior paraparesis, bladder and bowel incontinence, a day after falling on her gluteus. Physical examination revealed reduced motoric and sensory function below 12th thoracal dermatome, with no patellar and reduced Achilles reflexes. Conventional X-ray was unremarkable and further investigation with MRI showed a hematoma on thoracal 10 to 12 vertebrae. Motor and sensory functions were improved after 12 days administration of corticosteroids and further improvement was seen almost immediately after decompression surgery. Objective: To describe a case of spinal shock caused by traumatic lumbar hematomyelia Method: This is a case report study describing spinal shock which improved after administration of corticosteroid and decompression surgery. Conclusion: Spinal shock could be caused by traumatic lumbar hematomyelia, which is characterized by loss of motor, sensory, and bladder function, and decompression surgery improved the prognosis.
Correlation between Neutrophil/Lymphocyte Ratio (NLR), lipid profile, lesion location and vascular cognitive impairment in acute ischemic stroke patients Ira Ristinawati; Kenneth Tan; Benedictus Benedictus; Muhammad Hafizhan; Stefanus Erdana Putra; Suroto Suroto; Diah Kurnia Mirawati; Subandi Subandi; Rivan Danuaji; Pepi Budianto; Yetty Hambarsari; Baarid Luqman Hamidi; Hanindia Riani Prabaningtyas; Ervina Arta Jayanti Hutabarat; Teddy Tejomukti; Raden Andi Ario Tedjo
Jurnal Keperawatan Padjadjaran Vol. 12 No. 2 (2024): Jurnal Keperawatan Padjadjaran
Publisher : Faculty of Nursing Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkp.v12i2.2526

Abstract

Background: Stroke is the leading cause of long-term disability with significant clinical and socioeconomic impact worldwide. Hyperlipidemia and inflammation play major roles in ischemic stroke. This research focuses on the correlation of three factors, namely Neutrophil-Lymphocyte Ratio (NLR), lipid profile, and lesion location, with Vascular Cognitive Impairment (VCI). These factors may serve as potential predictors for VCI. Purpose: This research aims to study the correlation between NLR, lipid profile, and lesion location with vascular cognitive impairment. Besides, this research aims to explore those potential biomarkers as predictors of vascular cognitive impairment. Methods: This was a cross-sectional study which included 107 patients diagnosed with ischemic stroke from February 2022 to January 2023 with a history of admission to the hospital within 72 hours. After signed an informed consent form, every patient had history taking, physical exam, lipid profile, routine blood test, Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment Indonesian Version (MoCA-Ina) on the first hospital day. Statistical tests were done with Spearman correlation method. Results: The data distribution was not normal for INR and MoCA-INA values (p<0.05).  Total cholesterol was insignificantly (p=0.092) correlated with MoCA-INA score with low correlation value (r=-0.293). HDL was significantly (p=0.035) correlated with MoCA-INA score with moderate correlation value (r=0.461). LDL was significantly (p=0.028) correlated with MoCA-INA score with low correlation value (r=-0.387). Triglycerides was insignificantly (p=0.440) correlated with MoCA-INA score with very weak correlation value (r=-0.137). NLR was significantly (p=0.015) correlated with MoCA-INA score with moderate correlation value (r=-0.412). Conclusions: Lipid profile is correlated with cognitive impairment in post stroke patients, with HDL being a protective factor, and LDL as risk factor. NLR was associated with worse cognitive function and LDL was directly proportional to NLR. Lesion location reporting was highly heterogeneous and more uniformed reporting is recommended for future research.
Coronavirus disease 2019 (COVID-19) related stroke incidence: a case series Prabaningtyas, Hanindia Riani; Hapsari, Maria Yosita Ayu; Putra, Stefanus Erdana; Hafizhan, Muhammad; Mirawati, Diah Kurnia; Budianto, Pepi; Subandi, Subandi; Danuaji, Rivan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 3 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005503202307

Abstract

Coronavirus disease 2019 (COVID-19) can cause systemic and respiratory symptoms. Acute respiratory distress syndrome (ARDS), anemia, acute heart injury, secondary infection, and stroke are the complications of COVID-19. Age, oxidative stress, endothelial dysfunction, inflammatory status, vascular risk factors, and hypoxemia are risk factors for stroke associated with COVID-19. In this case report, two cases of COVID-19 complicated by stroke and other thromboembolic diseases were discussed. Case 1: a 46-year-old man presented with right extremities weakness, dysarthria, cough, colds, chest pain radiating to left upper extremity. He was diagnosed with moderate COVID-19, with complication of embolic stroke and myocardial infarction. After administration of IV furosemid and recombinant tissue plasminogen activator (rTPA), his condition improved, and he was discharged from our facility. Case 2: a 54-year-old woman presented with a decreased level of consciousness, skin discoloration, tenderness on her left calf, cough, fever, and shortness of breath. She was diagnosed with moderate COVID-19 with a complication of thrombotic stoke and deep vein thrombosis (DVT). She was treated with rTPA, IV citicoline, and fondaparinux for 5 days. In conclusion, COVID-19 carries a risk of thromboembolic complication. COVID-19 patients have a higher risk of bleeding, therefore, medications, particularly anticoagulant, should be administered with more caution.
ANGIOPLASTIC STENOSIS IN SPONTANEOUS BILATERAL CAROTIC ARTERY DISSECTION: A CASE REPORT Subandi, Subandi; Danuaji, Rivan; Suroto, Suroto; Mirawati, Diah Kurnia; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Luqman; Prabaningtyas, Hanindia Riani; Hutabarat, Ervina Arta Jayanti; Ristinawati, Ira; Tejomukti, Teddy; Tedjo, Raden Andi Ario; Santosa, Novian Anindito; Putra, Stefanus Erdana; Hafizhan, Muhammad
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.01.20

Abstract

Case: A 28-years-old woman presented with sudden right extremities weakness, right sided facial droop, and not being able to speak. On examination, the patient had upper motor neuron (UMN) hemiplegia and motor aphasia. On blood laboratory, we found D-dimer level of 1068 ng/dl. A non-contrast head CT-scan and CT-angiography showed left cerebral hemisphere infarction, and bilateral carotid artery stenosis. Further investigation with transcranial Doppler demonstrated partial stenosis of internal carotid artery (ICA). On cerebral digital subtraction angiography (DSA), we observed pseudoaneurysm on the right ICA and flame-shaped appearance on the left ICA, both are common radiological finding of ICA dissection. Then we performed stenting angioplasty on bilateral ICA to provide recanalization, and aspirin 80mg q.d. and clopidogrel 75mg q.d. was initiated. Conclusion: Spontaneous dissection of the carotid artery can occur on young adults. DSA is considered as the gold standard for vascular examination, and stenting with angioplasty was performed for recanalization to prevent the progression to severe stroke.
COMPARISON OF EFFICACY BETWEEN EDARAVONE AND RILUZOLE COMBINATION THERAPY FOR PATIENT WITH AMYOTROPHIC LATERAL SCLEROSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS Budianto, Pepi; Mirawati, Diah Kurnia; B, Benedictus; Tan, Kenneth; Hafizhan, Muhammad; Putra, Stefanus Erdana
MNJ (Malang Neurology Journal) Vol. 11 No. 1 (2025): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2025.011.01.13

Abstract

Background: Amyotrophic Lateral Sclerosis (ALS) is a fatal neuromuscular disease with a survival period of less than 5 years. Although the past decade has shown a major growth of interest in Edaravone research due to its superior efficacy, a growing number of research done on Riluzole combinations for ALS therapy. Objective: A systematic review is needed to compare the patient outcomes as shown in the ALS functional rating scale (ALSFRS-R) of Edaravone and Riluzole combinations. Methods: This research is a systematic review from PubMed, ProQuest, and Science Direct. The studies included were randomized controlled trials (RCT) and post-hoc analysis of RCT published from 2012 to 2023. This research included 16 studies (11 RCT studies and 5 post-hoc studies of RCT). The studies discussed the patient population, side effects, and ALSFRS-R scores. Results: Edaravone showed better efficacy than Riluzole combination in maintaining ALSFRS-R score with mean difference between Edaravone (MD=2.19, 95% CI: 0.42-3.96, p=0.02) and Riluzole (MD=1.67, 95% CI: -0.19-3.52, p=0.08). The meta-analysis showed heterogeneity in both Edaravone (I2=90%, p<0.00001) and Riluzole (I2=77%, p=0.004) studies. Conclusion: The results conclusively showed that Edaravone was more efficacious than the explored Riluzole combinations so far. Nevertheless, Riluzole-Masitinib showed promising results to be further explored.
Association between vaspin rs2236242 gene polymorphism and atherosclerosis in ischemic stroke patients with diabetes mellitus in the Indonesian population Danuaji, Rivan; Suroto; Purwanto, Bambang; Indarto, Dono; Muhammad, Faizal; Mirawati, Diah Kurnia; Widyaningsih, Vitri; Soetrisno; Subandi; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Luqman; Prabaningtyas, Hanindia Riani; Hutabarat, Ervina Arta Jayanti; Ristinawati, Ira; Tejomukti, Teddy; Tedjo, Raden Andi Ario
Medical Journal of Indonesia Vol. 33 No. 4 (2024): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247566

Abstract

BACKGROUND Stroke is the third leading cause of morbidity and second in mortality worldwide. Diabetes mellitus (DM) is a risk factor for stroke. Vaspin and single nucleotide polymorphism (SNP) rs2236242 involved DM pathogenesis. This study aimed to explore the correlation between SNP rs2236242, serum vaspin levels, and atherosclerosis in patients with ischemic stroke and DM. METHODS This study was conducted in Dr. Moewardi Hospital from 2022 to 2023. The case group included patients with ischemic stroke and DM, while the controls were those with ischemic stroke only. Tetra-primer amplification refractory mutation system-polymerase chain reaction was used to determine the genotypes. RESULTS There were 31 cases and 33 control. SNP rs2236242 showed that odds ratio (OR) (95% confidence interval [CI]) for AA-TT was 0.273 (0.241–0.305) and for TA-TT was 0.315 (0.298–0.341). The OR (95% CI) for allele A to T was 0.789 (0.373−1.669). The mean (standard deviation) serum vaspin level in the case group compared to the control was 1,570 (2,108) ng/ml versus 1,630 (1,428) ng/ml (p = 0.064). Higher vaspin levels were found in T allele of the TT (1,523 [2,269] ng/ml, p = 0.021) and TA (1,760 [1,349] ng/ml, p = 0.004) genotype groups than the A allele of the AA genotype group (0.914 [0.329] ng/ml). CONCLUSIONS Vaspin gene polymorphism AA genotype or A allele significantly reduces vaspin levels in patients with ischemic stroke with DM.
EFFICACY OF ELECTRICAL STIMULATION (ES) ON DYSPHAGIA IN POST-STROKE PATIENTS: A SYSTEMATIC REVIEW Modesty, Kyra; Sitepu, Brigitta Ellycia; Budianto, Pepi; Probandari, Ari; Tandiyo, Desy Kurniawati
MNJ (Malang Neurology Journal) Vol. 11 No. 2 (2025): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2025.011.02.08

Abstract

Background: Stroke is a disease that can occur in both developed and developing countries and is the second leading cause of death in the world. Stroke can cause various complications such as dysphagia. This study examines the efficacy of electrical stimulation (ES) as a treatment for dysphagia in post- stroke patients with various measurements of the severity of dysphagia. Objective: This study aims to review the efficacy of electrical stimulation on dysphagia in post-stroke patients. Methods: This study uses a systematic review method by following the guidelines from PRISMA. Articles are arranged based on keywords that have been determined in PICO, namely electrical stimulation, dysphagia, and stroke. Articles included in the inclusion criteria are RCTs, in English, and published between January 2013 and January 2023. Results: Eighteen studies that met the inclusion criteria were critically reviewed by the two authors. There were ten types of outcomes included in this systematic review and six of them had significant results for reducing the severity of dysphagia. Conclusion: ES can be given as the main therapy for post-stroke dysphagia patients. The six types of outcomes used to measure the degree of dysphagia, namely FOIS, PAS, FDS, PTT, OTT, and MASA, showed high significance associated with a reduction in the degree of dysphagia thereby reducing the risk of aspiration pneumonia by using this ES therapy.
Co-Authors Apriyanto, Arif Ari Probandari Arif Apriyanto Astrida Fesky Febrianty B, Benedictus Baarid Lukman Hamidi Baarid Luqman Hamidi Bambang Purwanto Benedictus Benedictus Cynthia Hanny Lestari Damayanti, Elok Dewi Hayu Kirana Dewi, Endang Kusuma Diah Kurnia Mirawati Diah Kurnia Mirawati Diah Kurnia Mirawati Diah Kurnia Mirawati Diah Kurnia Mirawati Dono Indarto Endang Kusuma Dewi Ervina Arta Jayanti Hutabarat Faizal Muhammad Fauzi Novia Isnaening Tyas Hafizhan, Muhammad Hambarsari, Yetty Hamidi, Baarid Lukman Hamidi, Baarid Luqman Hanindia Riani Prabaningtyas Hanindia Riani Prabaningtyas Hanindia Riani Prabaningtyas Hanindya Riani Prabaningtyas Hanindya Riani Prabaningtyas Hapsari, Maria Yosita Ayu Hutabarat, Ervina Arta Jayanti Kenneth Tan Lawly Arrel Dionnie Greatalya Modesty, Kyra Muhammad Hafizhan Muhammad Hafizhan Muhammad, Faizal Novian Anindito Santosa Novian Anindito Santosa Prabaningtyas, Hanindia Riani Prabaningtyas, Hanindya Prabaningtyas, Hanindya Riani Raden Andi Ario Tedjo Rakhma, Titian Ristinawati, Ira Rivan Danuaji Rivan Danuaji Rivan Danuaji Rivan Danuaji Rivan Danuaji Sitepu, Brigitta Ellycia Soetrisno Stefanus Erdana Putra Subandi Subandi Subandi Subandi Subandi Subandi Subandi Subandi Subandi Subandi Subandi Subandi Sulistyani Sulistyani Sulistyani Sulistyani SUROTO Suroto Suroto Suroto Suroto Suroto Suroto Tan, Kenneth Tandiyo, Desy Kurniawati Teddy Tejomukti Tedjo, Raden Andi Ario Tejomukti, Teddy Vitri Widyaningsih Vivienne Tjung Wahyu Agung Susilo Wahyu Gusti Randa Widhianingsih, Nella Lusti Wilson Arpin Yeremia Suryo Pratama Yetty Hambarsari Yetty Hambarsari