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Journal : Paediatrica Indonesiana

Association of HLA class II and history of atopy and frequent relapse of childhood steroid-sensitive nephrotic syndrome Dany Hilmanto
Paediatrica Indonesiana Vol 47 No 2 (2007): March 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (389.111 KB) | DOI: 10.14238/pi47.2.2007.60-4

Abstract

Background The association between HLA class II and frequentrelapse of nephrotic syndrome (FRNS) has been reported.Objective To identify the association between HLA class II,history of atopy, and upper respiratory tract infection (URTI)with FRNS.Methods This was a case control study conducted at theDepartment of Child Health, Hasan Sadikin Hospital Bandungand Cipto Mangunkusumo Hospital Jakarta from November 2002to October 2003 on children aged 1-14 years with FRNS. Thesubjects consisted of 40 FRNS and 84 healthy children. HLAclass II was typed by polymerase chain reaction-sequence specificoligonucleotide (PCR-SSO) in Leiden, the Netherlands. Theassociation between HLA class II and FRNS was expressed byodds ratio (OR). The association between such factors and FRNSwas analyzed by logistic regression.Results Atopy was higher in patients than that in controls(P=0.013). URTI did not differ in both groups (P=0.173). HLA-DRB1*03 and DRB1*04 (OR=4.43, P=0.03), DQB1*02(OR=3.43, P=0.00), and DQB1*04 (OR=12.06, P=0.01) weresignificantly higher among patients than those in controls whereasHLA-DRB1*12 (OR=0.34, P=0.02) and DQB1*0301p(OR=0.35, P=0.02) were significantly lower among patients thanthose in controls. Using logistic regression analysis, only HLA-DRB1*12, DQB1*02 and atopy took part in FRNS.Conclusion HLA-DRB1*12, DQB1*02, and atopy all togetherhave association with FRNS.
Score for Neonatal Acute Physiology Perinatal Extension II (SNAPPE II) as the predictor of neonatal mortality hospitalized in neonatal intensive care unit James Thimoty; Dany Hilmanto; Tetty Yuniati
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (132.045 KB) | DOI: 10.14238/pi49.3.2009.155-9

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Background The assesment of severity of illness with scoringsystem has been used to predict neonatal mortality in neonatalintensive care unit (NICU). Score for Neonatal Acute PhysiologyPerinatal Extension II (SNAPPE II) is the best scoring systemalthough most of the studies were commonly conducted indeveloped countries.Objective To evaluate SNAPPE II as the predictor of neonatalmortality in NICU Hasan Sadikin General Hospital (HSGH)Ban dung.Methods This was a longitudinal observational study. All neonateshospitalized in NICU HSGH during the period of August toNovember 2008 were investigated according to SNAPPE IIrequirements. We excluded subjects admitted more than 48hours of age, who were discharged or moved to intermediatenewborn care ward less than 24 hours after admission. Predictionof mortality and determination of SNAPPE II cut-off point wereanalyzed using logistic regression. Discrimination was analyzedusing receiver operating characteristic (ROC) and calibration wasanalyzed using Hosmer-Lemeshow goodness-of-fit.Results Forty subjects fulfilled the inclusion criteria. There was agood relation between SNAPPE II and mortality prediction (P =0.007). The cut-off point for predicting mortality was 51. SNAPPEII showed good discrimination with AUC 0.933 (95% CI 0.843to 1.0) and good calibration 1.69 (P = 0.97).Conclusion SNAPPE II can be used to predict neonatal mortalityin NICU similar to that found in developed countries.
Relationship between fat distribution ratio and blood pressure in obese adolescents Henny Marina; Dany Hilmanto; Julistio Tb Djais
Paediatrica Indonesiana Vol 48 No 5 (2008): September 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (101.552 KB) | DOI: 10.14238/pi48.5.2008.274-7

Abstract

Background The incidence of obesity in big cities increasessignificantly. The association between obesity and increased riskof cardiovascular disease and hypertension in adults has beenknown but less information is available in adolescents. Similarly,the relationship between body-fat distribution and cardiovasculardiseases in adolescents is less clear tha that in adults.Objective This study aimed to determine the association betweenbody fat distribution and increased blood pressure in obeseadolescents in Bandung.Methods This cross-sectional study was conducted from June toAugust 2006. Subjects were students aged 15-18 years at highschools in Bandung with body mass index (BMI) measured usingCDC chart 2000 (> P95) and increased blood pressure (> P90)depended on age and gender according to National High BloodPressure Education Program Working Group on High BloodPressure in Children and Adolescents 2004. Waist-to-hip ratio(central fat), and subscapula skinfold-to-triceps skinfold ratio(peripheral fat) were used to measure fat distribution. Correlationbetween body fat distribution and blood pressure was analyzedusing Pearson correlation statistical test.Results Out of 3170 adolescents examined, 34 obese adolescentgirls and 43 obese adolescent boys had increased blood pressure.Correlation between waist-to-hip ratio and systole blood pressurein boys showed by r=0.495; P=0.003 and girls showed r=0.494;P=O.OOl. Correlation between subscapula skinfold-to-tricepsskinfold ratio in boys showed r=0.289; P=0.097 and girls showedby r=0.248; P=0.109.Conclusion Central fat is moderately correlated with increasedblood pressure in obese adolescents.
Renal tubular function of the child with thalassemia major who received repeated blood trransfusion Dany Hilmanto; Boed Sinai Singadipoera; Ponpon Ijradinata
Paediatrica Indonesiana Vol 39 No 7-8 (1999): July - August 1999
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (535.391 KB) | DOI: 10.14238/pi39.7-8.1999.193-200

Abstract

A descriptive study was done from December 2 , 1994 to January 5,1995, at the Department of Child Health of Hasan Sadikin General Hospital Bandung. A total of 50 thalassemia major patients who bad received 5,000 ml or more of blood transfusions and never received desfenioxamine underwent a renal tubular function test using a radionuclide technique (l-123 Hippuran) to determine the effective renalplasmft flow (ERPF). The subjects were div:ided into two groups according to the amount of transfusion. Group A who received a total of 5,000 to 10,000 mL of blood transfusion consisted of 23 children (11 boys and 12 girls); group B, those who received a total of 10,000 ml or more of blood transfusion, consisted of 27 children (14 boys and 13 girls). The total average of blood transfused for group A and B were 7563.91 (1780.59) and 20,665.93 (6632.39) rnl, respectively. The ERPF of all subjects were below the normal standard. The average value of ERPF of group A and B were 205.78 (62 .08) and 214.09 (59.44) ml/minute/1.73 m2, respectively. The correlation between the total amount of blood transfusion and ERPF of the subjects was not significant (Group A had r=O.l63, p=0.458; Group B had r=0.084, p=0 .934).
Serum creatinine levels to estimate kidney function in small-for-gestational age and appropriate-for-gestational age newborns Indra Sandinirwan; Aris Primadi; Dany Hilmanto
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (346.957 KB) | DOI: 10.14238/pi58.6.2018.305-11

Abstract

Background The main parameter used to determine renal function in newborns is serum creatinine. Fetal growth restriction during pregnancy can cause the baby to be born small-for-gestational age. Serum creatinine levels in newborns are affected by muscle mass, gestational age, as well as the number of nephrons and kidney development. Objective To determine the usefulness of serum creatinine levels as an estimate of glomerular filtration rate in small-for-gestational age and appropriate-for-gestational age newborns. Methods This cross-sectional study was conducted in May-June 2018. The subjects were full term newborn infants consisting of small-for-gestational age and appropriate-for-gestational age groups (16 subjects each), born in Bandung City Regional Public Hospital. Serum creatinine level was tested by the Jaffe method. The estimated glomerular filtration rate was calculated based on serum creatinine, infant height, and a proportionality constant using the original Schwartz method, eGFR = [k * height]/SCr. Results Of 32 subjects, there were 17 spontaneous deliveries, 14 males, and 18 females. Mean serum creatinine levels in the small-for-gestational age and appropriate-for-gestational age groups were 0.94 (SD 0.36; 95%CI 0.75 to 1.14) mg/dL and 0.69 (SD 0.18; 95%CI 0.60 to 0.79) mg/dL (mean difference 0.25; 95%CI 0.05 to 0.46; P=0.009), respectively. The median estimated glomerular filtration rates (eGFR) in the small-for-gestational age and appropriate-for-gestational age groups were 25.69 mL/min/1.73m2 and 30.10 mL/min/1.73m2 (median difference 4.42; 95%CI 2.04 to 15.8; P=0.008), respectively. There was a weak negative correlation between serum creatinine and birth weight (r=-0.344; P=0.027). Conclusion Serum creatinine levels in small-for-gestational age newborns are significantly higher than in appropriate-for-gestational age newborns.
Correlation of serum level of albumin with platelet count and platelet aggregation assessed by adenosine diphosphate agonist in children with nephrotic syndrome Andar Laura Nainggolan; Sri Sudarwati; Dany Hilmanto
Paediatrica Indonesiana Vol 59 No 1 (2019): January 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (448.641 KB) | DOI: 10.14238/pi59.1.2019.7-12

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Background Nephrotic syndrome (NS) is the most common renal disease among children, and contributes to life-threatening complications such as thromboembolic disease. Platelets are considered to be important agents in thrombotic events among NS patients. The gold standard assessment for platelet aggregation is the use of adenosine diphosphate (ADP) agonist, however, it is expensive and not accessible in smaller health facilities. Thus, other thrombosis parameters are needed. Previous studies suggested that low albumin increased the risk of thrombosis in NS patients. Objective To assess for a possible correlation between albumin level and platelet count as well as platelet aggregation. Methods This cross-sectional study was conducted in children with nephrotic syndrome who were admitted to the Pediatric Nephrology Department in Dr. Hasan Sadikin General Hospital, Bandung, West Java, from November 2017 to March 2018. Subjects were selected by consecutive sampling. Serum albumin, platelet count, and platelet aggregation were measured. Statistical analysis was conducted by Spearman’s test. Results A total of 32 patients participated in the study, with mean age of 109 (SD 7.4) months. Most subjects were male (56%). Subjects’ mean serum albumin level was 2.06 (SD 1.23) g/dL; mean platelet count was 453,062.5 (SD 187,443.90)/mm3; and mean platelet aggregation values for ADP agonist concentrations of 10, 5, 2.5, and 1 mM were 86.8 (SD 8.63)%, 82.4 (SD 15.33)%, 66.6 (SD 24.90)%, 34.95 (SD 31.69)%, respectively. Partial correlation analysis revealed significant negative associations between albumin and platelet count as well as platelet aggregation assessed with 1 mM of ADP concentration (P<0.001), with Spearman correlation coefficients of -0.641 and -0.634, respectively. Conclusion Serum albumin level had a moderately negative correlation with platelet count and platelet aggregation value.
Relationship between serum zinc and homocysteine in children with nephrotic syndrome Welli Hamik; Dany Hilmanto; Sri Endah Rahayuningsih
Paediatrica Indonesiana Vol 59 No 2 (2019): March 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (243.604 KB) | DOI: 10.14238/pi59.2.2019.98-103

Abstract

Background In children, most idiopathic nephrotic syndrome (NS) is a minimal lesion, which responds well to steroids. Hyperhomocysteinemia is pathologic and worsens NS by causing chronic inflammation, leading to glomerular sclerosis. Zinc metalloenzymes are involved in homocysteine metabolism. Objective To assess for a possible relationship between serum zinc and homocysteine in children with NS. Methods A cross-sectional study was conducted in children with NS aged 1-18 years, who were admitted to Hasan Sadikin Hospital from November 2017 - January 2018. Subjects were selected consecutively. Serum zinc and homocysteine were measured in all subjects. Statistical analysis was done with Pearson's correlation test. If the distribution was not linear, the analysis was continued with non-linear regression. Results There were 23 children who met the inclusion criteria. Mean serum homocysteine and zinc levels were 10.37 (SD 4.11) µmol/L and 51.13 (SD 29.69) µg/dL, respectively. Pearson's correlation analysis showed no linear correlation between them (r coefficient -0.173; P=0.430). However, after adjusting for age and serum albumin level, multiple regression analysis suggested a cubical relationship between serum homocysteine and zinc, using the equation: homocysteine = -4.572 + 0.735 x zinc - 0.0012 x zinc2 + 0.00005 x zinc3 x age (months) (R2 multiple=53.2%; P=0.012). This equation indicates that 53.2% of homocysteine variation was influenced by serum zinc concentration. Conclusion In childhood NS, homocysteine is not correlated linearly with zinc, but related with cubical model.
Comparison of GeneXpert MTB to Mycobacterium tuberculosis culture in children with tuberculosis Betty Agustina; Cissy Kartasasmita; Dany Hilmanto
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (242.458 KB) | DOI: 10.14238/pi59.3.2019.113-8

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Background Diagnosing tuberculosis (TB) in children is difficult. Typical methods take a long time to achieve results, or have a low sensitivity. GeneXpert is a nucleic acid amplification test used to identify Mycobacterium tuberculosis bacteria (MTB) in only 2 hours. Objective To compare the sensitivity and specificity of GeneXpert MTB to MTB culture in children with TB, and to assess factors associated with GeneXpert MTB test in predicting which children were likely to have positive results. Methods This descriptive, analytical study was done in children with suspected TB, aged 1 month to 18 years in Hasan Sadikin Hospital, Bandung, West Java, from January 2016 to December 2017. The data were taken from the medical records and included age, gender, nutritional status, symptoms of TB, chest x-ray, and tuberculin test results. The GeneXpert MTB test was compared to cultures from the same patient, with regards to sensitivity, specificity, and agreement using Kappa index. We analyzed factors associated to GeneXpert MTB test using logistic regression analysis. Results From 454 inpatients and 1,750 outpatients with suspected TB, there were 251 children who were tested by MTB culture and 722 children tested by GeneXpert MTB. Of the 70 cases who met the inclusion criteria and underwent both tests, factors associated with positive GeneXpert MTB results were age 10 to 18 years, female gender, and positive tuberculin skin test (TST). The GeneXpert MTB test showed sensitivity 78.9% (95%CI 56.7 to 91.5) and specificity 86.3% (95%CI 74.3 to 93.2), with accuracy of 84.3% (95%CI 74 to 91), and agreement value of Æ™=0.62 (95%CI 41.6 to 82.7). Conclusion Specificity of GeneXpert MTB is higher than its sensitivity compared to TB cultures in children. The tests were in good agreement. Age 10 to 18 years had the strongest association with positive GeneXpert MTB results.
Waist circumference and waist-hip ratio as screening tools for hypertension in children aged 6–11 years Esti Istiqomah; Dida A. Gurnida; Dany Hilmanto; Dzulfikar Djalil Lukmanul Hakim; Prima Nanda Fauziah
Paediatrica Indonesiana Vol 59 No 5 (2019): September 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (232.952 KB) | DOI: 10.14238/pi59.5.2019.265-70

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Background Hypertension in children is associated with obesity. 7 The renin-angiotensin-aldosterone system has been associated with intra-abdominal fat tissue. Anthropometric parameters for determining nutritional status include waist circumference and waist-hip ratio. Many studies have shown that waist circumference and waist-hip ratio are more precise to determine overweight or obese. Objective To determine the usefulness of waist circumference and waist-hip ratio as hypertensive screening tools for children aged 6-11 years. Methods This analytical study with cross-sectional design and multistage cluster sampling method was conducted in August-September 2017 at a primary school in Bandung, West Java, Indonesia. Subjects underwent height, weight, waist circumference, hip circumference, and blood pressure measurements. Receiver operating characteristic (ROC) curve analysis was done to obtain the area under curve (AUC), cut-off point, sensitivity, specificity, and prevalence ratio. Results Subjects were 325 children consisting of 187 males and 138 females. Hypertension was diagnosed in 47 children (37 males and 10 females). Mean waist circumference and waist-hip circumference ratio were significantly higher in the hypertensive group than in the normotensive group. The hypertensive group had a mean waist circumference of 72.6 (SD 12.8) cm, AUC 0.779 (95%CI 0.730 to 0.823; P<0.001), cut-off point >65 cm, sensitivity 66.0%, specificity 76.3%, and prevalence ratio 4.55. This group had mean waist-hip ratio of 0.94 (SD 0.10), AUC 0.724 (95%CI 0.672 to 0.772; P<0.001), waist-hip ratio cut-off >0.91, sensitivity 59.6%, specificity 77.0%, and prevalence ratio 3.73. Conclusion Waist circumference >65 cm or waist-hip ratio >0.91 can be used to screen for hypertension in children aged 6-11 years with negative predictive values of 92.0% and 91.8%, respectively.
Presepsin level as risk factor for mortality in premature infants with neonatal sepsis Muhammad Ifan Romli; Tetty Yuniati; Dany Hilmanto
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.165-70

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Background Prematurity is a risk factor of neonatal sepsis and its associated morbidities and mortality. Most deaths in neonatal sepsis occur within the first seven days. Presepsin has been reported as one of the earliest biomarkers for predicting mortality. Objective To determine the association between presepsin levels and mortality risk, as well as the optimal presepsin cut-off point for predicting mortality, in premature infants with neonatal sepsis. Method This was an observational prospective cohort study on 62 preterm infants born at 28 to <37 weeks' gestation. We recorded clinical and laboratory characteristics, performed blood culture, and measured presepsin levels at initial diagnosis of sepsis. Subjects were followed for seven days and their outcome (death or survival) recorded. We evaluated the association between clinical and laboratory characteristics, including presepsin levels, with sepsis outcome. We also constructed a receiver-operator characteristics curve to determine the optimal cut-off point of presepsin as a predictor of sepsis mortality. Results Only blood culture results (P=0.006) and presepsin level (P<0.001) were significantly associated with sepsis outcome on the seventh day. The optimal presepsin cut-off value for predicting mortality was 1057 ng/mL, with an area under curve of 80.4%, sensitivity of 60.71%, and specificity of 88.24%. A presepsin level of >1057 ng/mL was associated with increased mortality [RR 3.02; 95%CI 68.3 to 89.4; P<0.001]. Conclusion In preterm infants with neonatal sepsis, an elevated presepsin level at diagnosis is a significant risk factor for mortality within seven days. Presepsin can be used as an early biomarker of sepsis outcome.
Co-Authors Achadiyani Achmad Fauzan, Achmad Adhi Pribadi Adi Utomo Suardi Ahmedz Widiasta Allania Hanung Putri Sekar Ningrum Andar Laura Nainggolan Ani Kusumastuti Ani Melani Maskoen Anita Deborah Anwar Aprianti, Nurul Azmi Aris Primadi Ariyati Mandiri Arva Rochmawati Ashifa, Ade Nurul Astuti Dyah Bestari Bagaskara, Danang Pangestu Gusti Balkis Fitriani Faozi Benny Muliawan Betty Agustina Boed Sinai Singadipoera Bony Lestari Budi Handono Cissy Kartasasmita Dadang Hudaya Somasetia dadang Hudaya Somasetia Dedi Rachmadi Dedi Rachmadi Dedi Rachmadi Deni Sunjaya Dewi Marhaeni Diah Herawati Dewi, Ni Wayan Eka Rahayu Dewi, Ni Wayan Eka Rahayu Dewi, Sawitri Dian Marta Sari Diana Rosifah Dida A Gurnida Dida A. Gurnida Dida Gurnida Dwi Agustian Dwi Agustian Dwi Prasetyo Dzulfikar Djalil Lukmanul Hakim Eddy Fadlyana Eky Setiawan Soeria Soemantri Elsa Pudji Setiawati Elsa Pudji Setiawati Elsa Pudji Setiawati Endah Purnawati Endang Sutedja Endang Sutedja Endang Sutedja Esti Hitatami Esti Istiqomah Evicenna Naftuchah Riani, Evicenna Naftuchah Fardila Elba Fardila Elba Farid Husin Farid Husin Farid Husin Firman Fuad Wirakusumah Fitria Fitria Fitria Prabandari Fitriah, Iin Prima Gaga Irawan Nugraha Gizella Gizella Gizella, Gizella Gusti Ayu Pramita aswitami Gustomo Panantro Guswan Wiwaha Hadyana Sukandar Hadyana Sukandar Hardisiswo Soedjana Hasan Purwana Hassan, Hafizah Che Henni Djuhaeni Henny Marina Henny Marina - Herman Susanto Herman Susanto Herman, Herry Husnida, Nintinjri I Made Jawi Ike MP Siregar Imelda M.G Sianipar Indah Yulika Indra Sandinirwan Indria Astuti Intan Karlina Irvan Afriandi Ishak Abdulhak James Thimoty Johanes C Mose Johanes C. Mose Julistio Tb Djais Julistio TB Djais - Kurniaty Ulfah Kurniawati Kurniawati Lestari, Lara Santi Indah Lisa Hasibuan Lisbeth Maria Laurentia Lisbeth Maria Laurentia, Lisbeth Maria Luh Nik Armini Marietta Shanti Mastiur Julianti Merry Wijaya Moudy Emma Unaria Djami Muhammad Ifan Romli Muhammad Ilham Muttaqin Muhammad Nurhalim Shahib Muttaqin, Muhammad Ilham Nanan Sekarwana Nasroen, Saskia Lenggogeni Neneng Syarifah Syafei Neneng Syarifah Syafei, Neneng Syarifah Nita Arisanti Nita Arisanti Nita Arisanti Noormartany Noormartany Noormartany Nopi Anggista Putri Nur hasanah Nurhalim Shahib Nurhasanah Nurhasanah Nurihsan, Achmad Juntika Oki Suwarsa Panantro, Gustomo Ponpon Ijradinata Ponpon S Idjradinata Pratiwi, Erlina Lutfiayu Prima Nanda Fauziah Putra Haqiqie Adnantama Lubis Qorinah Estiningtyas Sakilah Adnani Raden Tina Dewi Judistiani Rahadi, Raden Aswin Rahmah, Hasni Ratnasari, Eka Ridha Mustika Zaif Ridha Mustika Zaif, Ridha Mustika Rosalinna Rosalinna Ruswana Anwar Sari Puspa Dewi Setiawan Setiawan Setyorini Irianti Sri Endah Rahayuningsih Sri Endah Rahayuningsih Sri Sudarwati Suri, Mulhamatus Latifatus Susi Susanah Susiarno, Hadi Sutriningsih Syahdony, Farrel Nolan Syahradian Hasbrima Tetty Yuniati Tetty Yuniati Tetty Yuniati Tina Judistiani Tita Husnitawati Madjid8 Tita Madjid Tri Hanggono Achmad Ulfi Ainun Hanifah Ulfi Ainun Hanifah, Ulfi Ainun Umar, Nur Syazana Veranita Pandia Vita Murniati Tarawan Vita Murniati Tarawan Wahidah Sukriani Welli Hamik Wenny Friska Wilis Dwi Pangesti Wiryawan Permadi Yani Dewi Suryani Yoni Syukriani Yundari, Yundari Yuni Susanti Pratiwi Yuni Susanti Pratiwi, Yuni Susanti Zulvayanti Zulvayanti