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Journal : Heart Science Journal

The circadian based hypertension-management: new approach for better blood pressure goals Firdaus, Muhammad; Tjahjono, Cholid Tri
Heart Science Journal Vol. 5 No. 4 (2024): The Current Perspective About Cardiometabolic Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2024.005.04.2

Abstract

Hypertension, a primary changeable risk factor for overall mortality, affects approximately 1.4 billion people worldwide, accounting for about 31% of the global adult population. The primary method of diagnosis is through in-office or clinic blood pressure readings, which do not consider the circadian rhythm’s fluctuations. Various homeostatic parameters, including blood pressure, are influenced by circadian rhythms, which follow a day-night cycle. Blood pressure typically decreases at night and rises during the day in line with the circadian rhythm. 24-hour ambulatory blood pressure monitoring offers a more comprehensive evaluation of hypertension. The phenomena of nocturnal blood pressure and the dipping pattern are closely interconnected characteristics that provide comparable therapeutic insights. In hypertensive patients, nighttime blood pressures were found to be a better predictor of cardiovascular and all-cause mortality outcomes than daytime systolic pressures. The current range of anti-hypertensive medications used to manage hypertension reveals that while some have an impact on circadian rhythms, others do not. Existing research on these drugs presents mixed views on the benefits of administering hypertension medication in the morning versus the evening. A significant study, known as the BedMed trial, is currently in progress to assess the cardiovascular effects of administering hypertension medication at bedtime as opposed to the traditional morning administration. This study could potentially provide valuable insights for improved future management of hypertension.
Navigating Complex Cardiovascular Pathologies: A Case Report on Aortic Arch Replacement in a Middle-Aged Male with Stanford A DeBakey I Aortic Dissection Handari, Saskia Dyah; Firdaus, Muhammad; Sembiring, Yan Efrata
Heart Science Journal Vol. 5 No. 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.02.14

Abstract

Background: Aorta dissection is characterized by the presence of an intimal tear, which permits the passage of blood through the tear and into the aorta media. This process leads to the separation of the intimal and the formation of a dissection flap, representing the true lumen and a newly formed false lumens. The incidence of aortic dissection varies between 0.2% and 0.8%. Management of acute aortic standford A aortic dissection primarily involves invasive surgical procedures.Case presentation: A middle-aged male patient, aged 40, who possesses risk factors including uncontrolled hypertension and obesity, arrived to the emergency room with symptoms of chest pain. He described the pain as tearing in nature and said that it radiated towards the abdominal. The examination findings included a blood pressure reading of 255/143, a widened mediastinum and cardiomegaly observed on the chest X-ray, a slight elevation in Hs-Troponin levels, and the presence of sinus rhythm with left ventricular hypertrophy. He underwent CT scan, which demonstrated the presence of an aortic dissection extending from the ascending to descending aorta, with no associated damage to the aortic valve from echocardiography. He was diagnosed with Standford A DeBakey I Aortic dissection and underwent preference replacement of the aortic arch and elephant trunk implantation instead of Bentall procedure.Conclusion: The surgical and perioperative methods employed may differ based on the specific clinical presentation and the nature of the aortic disease. Because there was no involvement of the aortic valve, we performed total aortic arch replacement and elephant trunk procedure over the Bentall procedure.
Unprovoked transformation of saddle back to coved ST-segment elevation ECG pattern Firdaus, Muhammad; Ardian Rizal
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.23

Abstract

Background  Brugada syndrome (BrS) is a heritable arrhythmia that is clinically characterized by spontaneous coved ST segment elevation and a negative T wave in the right precordial lead. Some psychotropic medications, anesthetics, cocaine, excessive alcohol consumption, and fever have been identified as potential causes of VF and SCA in BrS. Case Illustration A 35-year-old man was hospitalized after experiencing unexplained syncope. It was felt 3 times within an hour and was preceded by lightheadedness, nausea, and vomiting. He did not experience palpitations, chest pain, or shortness of breath prior to the syncope. Prior to syncope, he had no history of fever, dehydration, drinking, or taking any medications. There was no family member died suddenly because of heart disease. The physical examination, CXR, laboratorium, and echocardiography were all within the normal range, but the electrocardiogram showed a coved ST segment elevation with an inverted T wave at V1-V2, as well as a saddle back ECG pattern two weeks later with a J point of 2 millimeters at V2. The combination of symptoms and ECG findings led to the BrS diagnosis. He underwent ICD implantation at RSUD Dr Saiful Anwar Malang for secondary prevention. After several months of ICD check-ups, there were no VT/VF events or ICD shock therapy. Conclusion A change in the ecg of the brugada pattern from type 2 to 1 is often accompanied by known ethiologies. But an unprovoked conversion of the BrS type is possible in rare cases.
Benefits of exercise training on pulmonary arterial pressure as measured by echocardiography in patients with pulmonary hypertension Firdaus, Muhammad; Martini, Heny
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.7

Abstract

Pulmonary hypertension (PH) is a substantial worldwide health concern that impacts around 1% of the population, in especially among the elderly. PH is defined by a mean pulmonary arterial pressure (mPAP) over 20 mmHg and is linked to significant morbidity and mortality. Optimal care depends on precise evaluation of mPAP, which acts as a crucial diagnostic and prognostic marker. Recent research emphasizes the significance of exercise training as a secure and economical intervention that can result in significant enhancements in hemodynamic parameters, such as decreased mPAP and increased cardiac output. Engaging in exercise training stimulates the expansion of blood vessels in the lungs, enhances the functioning of the right ventricle, and reduces persistent inflammation, therefore enhancing the overall ability to exercise and the quality of life for those with pulmonary hypertension. Echocardiography is crucial for monitoring mean pulmonary arterial pressure and evaluating right ventricular function. mPAP is a critical parameter in the evaluation and diagnostic testing for pulmonary hypertension (PH) due to its strong correlation with disease severity and prognosis. Exercise training confers a multitude of advantages to both the cardiovascular system and skeletal muscle systems. Exercise training is generally considered safe, yet, it is important to provide thorough supervision to reduce the occurrence of negative outcomes, especially in patients with advanced illness. In summary, including exercise training into the treatment plan for patients with pulmonary hypertension shows encouraging advantages, justifying more investigation and standardization of exercise procedures to enhance patient results.
The effect of exercise training as adjuvant treatment on mean pulmonary arterial pressure by echocardiography and functional capacity in congenital heart disease with negative vaso reactivity test pulmonary hypertension patient at Saiful Anwar Hospital Malang Firdaus, Muhammad; Heny Martini; Wella Karolina; Valerinna Yogibuana; Cholid Tri Tjahjono
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.13

Abstract

  Background : PH is defined by mPAP >20 mmHg at rest. Exercise training enhances hemodynamics and exercise capacity in PH patients. Echocardiography is essential for assessing and evaluating PAP in PH cases. Objective : This study aims to determine the effect of 12-weel exercise training on mPAP by echocardiography and functional capacity Methods : A prospective cohort study at Saiful Anwar General Hospital (Sept 2024-Jan 2025) investigated exercise effects on mPAP and functional capacity in pulmonary hypertension patients. Participants were randomized to control (medication only) or treatment (medication plus exercise training) groups. Both underwent SMWT and echocardiography at baseline and after 12 weeks. Standardized exercise was monitored by healthcare experts. Result : This study compared 12 non-vasoreactive PH patients receiving standard therapy to 12 undergoing exercise training. The treatment group showed a significant mPAP decrease (66.8 to 63.4 mmHg, p=0.006), while the control group's reduction was non-significant (53.1 to 51.7 mmHg, p=0.061). Both groups improved 6MWT distances significantly after 12 weeks from 306.5 ± 72.7 meters to 318.3 ± 74.0 meters in the control group (p=0.041) and from 363.8 ± 63.6 meters to 382.9 ± 64.7 meters in the treatment group (p=0.000). No significant correlation was found between mPAP decrease and 6MWT increase in either group Conclusion : This study demonstrates improvements in mPAP and functional capacity following exercise training as an adjunctive therapy. However, no correlation was observed between the enhancement in functional capacity and the reduction in mPAP.  
Unprovoked transformation of saddle back to coved ST-segment elevation ECG pattern Firdaus, Muhammad; Ardian Rizal
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.23

Abstract

Background  Brugada syndrome (BrS) is a heritable arrhythmia that is clinically characterized by spontaneous coved ST segment elevation and a negative T wave in the right precordial lead. Some psychotropic medications, anesthetics, cocaine, excessive alcohol consumption, and fever have been identified as potential causes of VF and SCA in BrS. Case Illustration A 35-year-old man was hospitalized after experiencing unexplained syncope. It was felt 3 times within an hour and was preceded by lightheadedness, nausea, and vomiting. He did not experience palpitations, chest pain, or shortness of breath prior to the syncope. Prior to syncope, he had no history of fever, dehydration, drinking, or taking any medications. There was no family member died suddenly because of heart disease. The physical examination, CXR, laboratorium, and echocardiography were all within the normal range, but the electrocardiogram showed a coved ST segment elevation with an inverted T wave at V1-V2, as well as a saddle back ECG pattern two weeks later with a J point of 2 millimeters at V2. The combination of symptoms and ECG findings led to the BrS diagnosis. He underwent ICD implantation at RSUD Dr Saiful Anwar Malang for secondary prevention. After several months of ICD check-ups, there were no VT/VF events or ICD shock therapy. Conclusion A change in the ecg of the brugada pattern from type 2 to 1 is often accompanied by known ethiologies. But an unprovoked conversion of the BrS type is possible in rare cases.
Co-Authors ., Kamelia .Gandri Haryono, M Abdul Jabarsyah, Abdul Abdul Zaky Abdullah, Maulidati Achyani, Ratno Adawiah, Intan Ade Permana, Angga Ade Siti Haryanti Adiguna Adiguna, Adiguna Agus Indarjo Agus Indarjo Agus Salim Agus Sujarwanta, Agus Agus Sutanto Agus Yulianto Agustin, Aisyah Sovia Agustina Agustina Agustina, Winarti Agustiyara Ahmad Faried Ahmad Suriansyah Ahmad, Fahmi Salam aida ningsih, nur Akbar, Muh Rizky Al Kahfi, Al Kahfi Alfarisy, Salman Alfauzu, Alfauzu Algafari Bakti Manggara Alhaq, Dinda Luthfiaturrahmah Aliannur, Ahmad Alimuddin aliya setiyani, metty Alukadinata, Atra Alvin, Teuku ALWIZAR ALWIZAR, ALWIZAR Alzena, Ardela Clarissa Amanda, Ressa Ambariyanto Ambariyanto Amelinda, Juana Amiati, Devy Amiruddin Saleh Amirul Mukminin Amiwarti, Amiwarti Ananda, Putri Ananda, Yosi Anas Hidayat, Anas ANASTASYA SHINTA YULIANA anda restu, delpa Andri Wijaya Andriani, Marisa Putri Andriyanto Andriyanto Andy, Safria Angglena, Melly Ani Suryani Aninda, Ni Made Dwi Anjas Alpata, Anjas Alpata Anna Fatchiya Annisa Bela Pertiwi, Annisa Bela Annisa Fitria Annisa, Aulia Anwar, Syahferi Aphafield, Tresna Ligar Aprilia, Ajeng Rachma Ardhyantama, Vit Ardian Rizal Arfani, Arlinda Ayu Diah Arif Rahman Arifudin arifudin Ariyantiningsih, Febri Arizona, Salsa Dinta Arrum, Puan Gustama Arya Hadi Dharmawan Asbar Laga, Asbar Asep Marzuki Aslamiah Aslamiah Asmaul Husna Astuti, Leni Atika, Faizah Nur Auliya, Rizki Avianto, Terry Previo Azhar, Firman Azizah, Ratu Nur Azkia, Ulfa Azwa, Rusmadi Bakti Pratama, Hadimas Balqis Nurmauli Damanik Bobi Handoko BONAR M. SINAGA Brian Bonte, Stenly Budi Juliandi Budiman Budiman Bulkis, Putri Bunasor Sanim cahyadi, jimmy Cahyanti, Ice Cahyo, Andhika Suryo Dwi Candra Adi Intyas, Candra Adi Chai, Som Chairana, Raji chaniago, alfi Chasani, Muchamad Toif Cholid Tri Tjahjono Cholid Tri Tjahjono Dalima, Dalima Danny Halim Darliah, Lilis Dedy Wijaya Kusuma Desti Monika Uli Dewi Anggreini, Dewi Dewi Iriani Dewi, Eva Dewi, Nilasari Dhimas Wiharyanto Diani Ayu Pratiwi Dicky Wahyudi Didit Endriawan Dina, Sarah Dinata, Syaiful Dwi Sartika, Dwi Dwi Setijawati Dwilaksana, Chryshnanda Dyah Ita Mardiyaningsih, Dyah Ita Efni Noor Salam Eko Widodo Eksanti, Wanda Rosi Elyawati, Dini Ermawaty - Maradhy Evawani Elysa Lubis Fadil, Jazuli Fadinah, Siti Rosyidah fadlilah, hana Fahm, AbdulGafar Olawale Fahrizal Amir Farid, Rudy Fascal, Muhammad Fauz, Dwina Tetiany Fauzi, Muhammad Rizki Fazri, Muhammad Febra Robiyanto Fikriadi, Ahmad Bagas Firda Utami, Silvia Firdaus, Muhammad Verry Verry Firmansyah, Nedi Fitrah, Aldo Destu Fitri Handayani Fitri, Hanifa Asya Fitri, Imayatul fitriyasari Fristasya, Andra Gazali Salim Ghazalba, Ahmad Giovani Siahaan, Fery Giovaningrum, Putri GS , Achmad Daengs Gusman, Ery Habib, Ahmad HABIBI, ERFAN Hadi Purnomo, Yuda Hadi Purnomo Hadi, Firman Hafiani, Muhammad Hafidhah, Nor Jinan Hafsah Hafsah Hamdan Haniah Hanifah, Intan Hanik, Hanik Haris, Al Hartati Hartati Hartati, Kurnia Hartono, Rudi Haryadi - Haryadin, Muhammad Nur Haryono, M Gandri Haryono, M. Gandri Hasan, Mustofa Hasbi, Hartas Hasibuan, Mhd. Usni Zamzami Hastuti Heni Irawati Hening Widowati Heny Martini Heriyana Heriyana Hermanto Siregar Hermawan Susanto Herri Purwanto Hidayanti, Vike Ayunita Hidayat, Rachma Wahyu Hidayat, Rezaldi Hidayat, Yunus hidayati, iik yani Hidayatul Mukaromah Hidayatullah, Muhammad Afsar Hilda Ramadhani Hoirul, Hoirul Huljannah, Angela Humaira, Anggi I Made Mara Ihtizar, Azizul Nur Irza Ilham Ilham ilmi , Nur Ilmi, Mainatul Indah Handayani, Yuniorita Indra Suharman Indra, Hamdi Ine Rachmawati Iqbal Prabawa Wiguna Ira Maya Abdiani Iradhad Taqwa Sihidi Irawan, Ahmad Maulana Irawan, Toni Irfan Syauqi Beik Islami, Nurul Hida Wahyuni Ismunandar Izzaturrahman, Fauzan JAENAL EFFENDI Jajuli, Ahmad Sahal Alamsyah Jalili, Ismail Jalu Sakti, Arjun Adi Luhung Jojon, Husnul Julian Ransangan Juliono, Juliono Jully Handoko Kaharuddin Kamaluddin Abunawas, Kamaluddin Kamelia . Karinda, Kisman Karury, Anindyah Sutra Kase, Ardy Andreas Bernard Khairani Putri, Khairani Kharyani, R. Aldini Khoir, Imam Mukhlis Komar Sumantadinata Kriswandini , Indah Kurniyatillah, Nisfu Lahab, Ratchanok Laily, Fajar Kurnia Lala M Kolopaking Lathifa, Nurul Lestia, Aprida Siska Liliyana Sari Linda, Junita Rosa Lubis, Sylvi Chairuniza Luki Wicaksono Lukytawati Anggraeni M. Yakub Maghfiroh, Putri Nisful Lailatul Mahindra, Haidil Maisharoh, Maisharoh Margaretha, Novia Marhamah Marhamah Marian Tonis Marido Bisra Martini, Heny Maulana, M. Maulana, Nouval Mauleni, Silvia Maulianawati, Diana Meildia Sari Mirza, Dhea MISYKAT MALIK IBRAHIM Mohamad Syahri MT, Sugiono Mubarokah, Aiqe Seprinanda Muh. Wahyu Syabani Muhaimin Dimyati Muhammad Azilla Yandre Muhammad Fajar Alvian Muhammad Ibrahim Muhammad Ridwan Muhammad Rizki Muhammad Roem Muhammad Yunus Muhammad Yusron Maulana El-Yunusi Muhammad Yusuf Awaluddin Muhtar, Dian Islamia Mukminati, Mayasirul Mulya Fitranda Mulyanto Mulyanto Mulyono, Abel Rahmad Mumtaza Putri, Anne Mursalin, Muhammad Musa Muslim Muslim Muslimin Muslimin Mustafa Kamal Musyahadati, Shufi Muthiatulmillah, Siti Nabil, Farrel Rayhan Nadia Ayuna Nafisa, Ayu Naibaho , Pio Ranap Tua Nanang Tri Haryadi Nanda Widaninggar, Nanda Nashih, Muhammad Naufa Muna, Naufa Nazmi, Syahrul Nia Kurniawati Hidayat, Nia Kurniawati Ningsih, Agus Tia Noer Rahmi Ardiarini, Noer Rahmi Noor Jannah, Noor nopika, depi Nova Diana, Nova Novandika, Dida Novita Listyaningrum, Novita Nugraeni, Christine Dyta Nugraha, Yusuf Nugraha Nunik Cokrowati Nur Afni Nur Farida Haryanto, Lailin Nur Salam Nur Yanti, Nur Nurdin Hendri Nurfaisah, Anggie Nurhayati Nurkholis, Ryan Nursandi, Muhammad Diky Nursyawal Nacing Nurul Fadilah, Nurul Nurul Huda Nurul Mukhlisah, Nurul Nurwijayanti Oktavianti, Rahma Dila Onielda, Muhammad Daffa Auliarizky Pamungkas, Ardhi Satrio Paramitha, Ni Ketut Rizka Widya Paripurna, Arbi Wardana Permana Ari Soejarwo Permana Ari Soejarwo Permana, Adi Prakoso, Lukman Yudho Pramana, Yoga Tri Prameswari, Sekar Faradita Prasetio, Heri Pratama, Imam Akbar Pratiwi, Rosi Puspahati, Shela Puspita, Cahaya Endah Puspitasari, Yeni Putra, Imam Pangestiansyah Putri, Dea Ariesta Putri, Nabila Putri, Rosalia Putri, Wini Amelia Putria, Nazwani Dwi R. A Simanjuntak, Manlian Rachman, Tezar Aulia Rachmawani, Dori Rachmawanti, Dori Rachmawati, Rizki Amelia Rafiqie, Musyaffa Raga Sitandang, Galang Rahayu, Rika Rahmadania, Sabrina Nourramzy Rahmah, Ghina Maulida Rahman, Cipta Ismaya Rahmasari, Fenny Rahmat Hidayat Rahmatillah, Rais Rahmawati, Ade Siti Rahmawati, Dwi Ulan Raiyan, Raiyan Ramadianto, R. Helmy Rambe, Mgr Sinomba Randini, Aditia Putri Rasi, Moh. Rasina, Siti Ratna Juwita Razai, Tengku Said Reffanda Kurniawan, Reffanda Refia Rafianti, Wahdah Reinhardt Nielsen, Martin Revita, Nifka Juli Rezki Amalia Nurshal REZKI, REZKI Rezky, Ainur Rian Hidayat Rian Maulana, Rian Ries Wulandari, Ries Rifany, Nadia Rifki Ristiawan Rifly, Nadya Faradhifa Rihadini, Rihadini Rinda Meilatul Janah Ringgo Eldapi Yozani Risky Syahputra, Hari Roem, Muhamad Rohasad, Rohasad Romadhoni Romadhoni, Romadhoni Romdoni, Taufiq Ahmad Rosidah, Erin Indriana Ruslan Ruslan Rusmadi Awza Ruspiansyah Sabilah, Ammaya Sabri, L M Sahbana, M. Dwi Rahman Salahudin Salahudin samsurizal, nazifa Sani, Amalia Putri Santosa, Enjel Meylita Sapna, Sapna saputri, lia Saputri, Resti Amelia Sarah Dina Sarbana, Baban Sari Anggraini, Dian Sari, Cindi Pradita Sari, Meildia Sari, Mutia Novela Sari, Wulan Puspita Saskia Dyah Handari Saskia, Yola Sasono, Marendra Satriani, Rini Sauri, Salsabila Sembiring, Yan Efrata Setiobudi, Agus Setyawati, M.I. Rita Shabrina, Ahda Shafiq Ryadi, Agus Shedriko, Shedriko Sherly Mutiara Shiddikia, Nanda Shinta, Salsabila Nur Shintya, Melfa Silaen, Joshua Riski Simanjuntak, Ricky Febrinaldy Sinaga, Harta Veronica Priskila Singh, Arwinder Siti Fauziah Siti Julaiha Siti Nurhalimah Situmorang, Jawalter Slamet Sutomo Solihah, Sinta Sopia, Nadia Soraya Devy Sri Andayani Sri Mulatsih Sri Widiastuti, Sri Stenly Brian Bonte Stephanie Bija Styaji, Hary Suci Wulandari Sugiarto, Yosafat Kurniawan Suharman Suharman, Suharman Suharti SUHARTO, ZANUAR Suhefri, Suhefri Suhri, Akhmad Suhud, M. Aris Sujoko, Anang Sukoso Sukoso Sukuredo, Sukuredo Sunarko Sunarko Suprayoga, Tito Supriadi Supriadi Suprihhartini, Suprihhartini Suriyatun, Suriyatun Susanti, Pratiwi Suwignyo Widagdo Syafruddin Syafruddin Syahada, Jihan Syahril Alzahri, Syahril Syahruddin Usman, Syahruddin Syahrun - Syaifuddin, Raden Syamsidar Gaffar Syarifah Amaliah Syifa, Maulidhia Tahang, Sunardi Tahir, Usman Tampubolon, Bahroin Idris Tanjung, Hadi Gunawan Tanti Novianti Taqwa, Amrullah Taufiq Ahmad Romdoni Terry Previo Avianto Theresia Theresia Tinuk Dwi Cahyani Tuty Alawiyah Ummah , Dwi Rahmatul Usman, Fathoni Utami, Tanti Valerinna Yogibuana Vera Lisna Wadinka, Akbar Dani Warni, Rozita Warol, Khoirul Weliyadi, Encik Wella Karolina Widarta, Oskar Ady Wijayanti, Triyana Windayanti, Asti Wiranda, Oja Wiwik Suryandartiwi Anggarawati Yaqub, M. Yasir Yasir Yenny Risjani Yeti Lis Purnamadewi Yozani, Ringgo Yudha Ardiansyah, Muhammad Yudha, Yoga Prisma Yudianti, Adinda Novi Yulanda Trisula Sidarta Yohanes Yulma, Yulma Yuniarti Yuniarti Yunita, Yessi Yuridistya Primadhita Yushra, Yushra Yusuf, Muhammad Yusfi Zein, Khairani Zulfaidah Penata Gama Zulhalim, Zulhalim ZULHAM WAHYUDANI, ZULHAM Zunianto, Anang ZURAIDAH ZURAIDAH