I Made Kardana
Bagian Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas Udayana, RSUP Sanglah, Denpasar

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Peran Eritropoetin pada Anemia Prematuritas I Nyoman Sartika; Wayan Retayasa; Made Kardana; Ida Bagus Mudita
Sari Pediatri Vol 9, No 6 (2008)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp9.6.2008.375-80

Abstract

Eritropoetin merupakan molekul glikoprotein yang terdiri dari 165 asam amino dan 4 gugus karbohidratdengan berat molekul sekitar 34 k dalton. Peran eritropoetin dalam produksi sel darah merah melaluimeningkatkan survival, proliferasi dan diferensiasi dari progenitor eritroid pada sumsum tulang. Eritropoetinberikatan dengan reseptor selanjutnya terjadi aktivasi ras/mitogen intraselular yang berperan dalam proliferasisel. Regulasi produksi eritropoetin adalah peran dari hypoxia-inducible transcription factor-1 (HIF-1). Padabayi yang lahir prematur terjadi penurunan kadar Hb yang berlebihan dibandingkan dengan bayi cukupbulan. Banyak faktor yang mempengaruhi anemia prematuritas, salah satu di antaranya adalah kurang responeritropoetin terhadap penurunan kadar Hb. Penggunaan eritropoetin rekombinan mengurangi frekuensitransfusi darah dan meningkatkan retikulosit dengan cepat. Eritropoetin rekombinan belum merupakanstandar pengobatan anemia prematuritas secara universal
Electroencephalogram abnormalities in full term infants with history of severe asphyxia Susanti Halim; I Gusti Nyoman Made Suwarba; I Made Kardana
Paediatrica Indonesiana Vol 55 No 6 (2015): November 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (94.104 KB) | DOI: 10.14238/pi55.6.2015.297-301

Abstract

Background An electroencephalogram (EEG) is an electroimaging tool used to determine developmental and electrical problems in the brain. A history of severe asphyxia is a risk factor for these brain problems in infants. Objective To evaluate the prevalence of abnormal EEGs in full term neonates and to assess for an association with severe asphyxia, hypoxic ischemic encephalopathy (HIE), and spontaneous delivery. Methods This cross-sectional study was conducted at the Pediatric Outpatient Department of Sanglah Hospital, Denpasar, from November 2013 to January 2014. Subjects were fullterm infants aged 1 month who were delivered and/or hospitalized at Sanglah Hospital. All subjects underwent EEG. The EEGs were interpreted by a pediatric neurology consultant, twice, with a week interval between readings. Clinical data were obtained from medical records. Association between abnormal ECG and severe asphyxia were analyzed by Chi-square and multivariable logistic analyses. Results Of 55 subjects, 27 had a history of severe asphyxia and 28 were vigorous babies. Forty percent (22/55) of subjects had abnormal EEG findings, 19/22 of these subjects having history of severe asphyxia, 15/22 had history of hypoxic-ischemic encephalopathy (HIE), and 20/22 were delievered vaginally. There were strong correlations between the prevalence of abnormal EEG and history of severe asphyxia, HIE, and spontaneous delivery. Conclusion Prevalence of abnormal EEG among full-term neonates referred to neurology/growth development clinic is around 40%, with most of them having a history of severe asphyxia. Abnormal EEG is significantly associated to severe asphyxia, HIE, and spontaneous delivery.
Comparison of the accuracy of body temperature measurements with temporal artery thermometer and axillary mercury thermometer in term newborns Markus Gunawan; Soetjiningsih Soetjiningsih; I Made Kardana
Paediatrica Indonesiana Vol 50 No 2 (2010): March 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (171.852 KB) | DOI: 10.14238/pi50.2.2010.67-72

Abstract

AbstractBackground Rectal mercury thermometer (RT) has beenconsidered to be a clinical thermometer that measures bodytemperature close to core temperature. Unfortunately it is relativelyuncomfortable to the patient. Axillary mercury thermometer (AT)is a relatively safe method, but time consuming and its accuracyhas been questioned. Temporal artery thermometer (TAT) isrelatively a new method that can measure body temperaturefaster, and well tolerated.Objective To compare the accuracy of temperature measurementbetween TAT and AT in neonates.Methods Cross-sectional analytic study was conducted atNeonatology Division at Sanglah Hospital, Denpasar. Every healthyterm newborn who met the criteria were measured their bodytemperature by using three kinds of thermometer consecutively. Thelimits of agreement, correlation and linear regression analysis weredone to find TAT and AT’s agreement and correlation to RT.Results One hundred and thirty four newborns were enrolledin this study. TAT had a better agreement to RT with the mean􀁇􀁌􀁉􀁉􀁈􀁕􀁈􀁑􀁆􀁈􀀃􀁒􀁉􀀃􀀐􀀓􀀑􀀓􀀔􀂞􀀦􀀃􀁚􀁌􀁗􀁋􀀃􀀕􀀃􀀶􀀧􀀃􀁏􀁒􀁚􀁈􀁕􀀃􀁏􀁌􀁐􀁌􀁗􀀃􀁒􀁉􀀃􀀐􀀓􀀑􀀕􀀙􀂞􀀦􀀃􀁄􀁑􀁇􀀃􀁘􀁓􀁓􀁈􀁕􀀃􀁏􀁌􀁐􀁌􀁗􀀃􀁒􀁉􀀃􀀓􀀑􀀕􀀖􀂞􀀦􀀏􀀃􀁆􀁒􀁐􀁓􀁄􀁕􀁈􀁇􀀃􀁗􀁒􀀃􀁄􀁊􀁕􀁈􀁈􀁐􀁈􀁑􀁗􀀃􀁅􀁈􀁗􀁚􀁈􀁈􀁑􀀃􀀤􀀷􀀃􀁄􀁑􀁇􀀃􀀵􀀷􀀏􀀃􀁚􀁌􀁗􀁋􀀃􀁐􀁈􀁄􀁑􀀃􀁇􀁌􀁉􀁉􀁈􀁕􀁈􀁑􀁆􀁈􀀃􀀐􀀓􀀑􀀖􀀘􀂞􀀦􀀏􀀃􀀕􀀃􀀶􀀧􀀃􀁏􀁒􀁚􀁈􀁕􀀃􀁏􀁌􀁐􀁌􀁗􀀃􀀐􀀓􀀑􀀚􀀓􀂞􀀦􀀃􀁄􀁑􀁇􀀃􀁘􀁓􀁓􀁈􀁕􀀃􀁏􀁌􀁐􀁌􀁗􀀃􀁒􀁉􀀃􀀓􀀑􀀓􀀓􀂞􀀦􀀑􀀃􀀷􀁋􀁈􀁕􀁈􀀃􀁚􀁄􀁖􀀃􀁄􀀃􀁖􀁌􀁊􀁑􀁌􀁉􀁌􀁆􀁄􀁑􀁗􀀃􀁏􀁌􀁑􀁈􀁄􀁕􀀃􀁄􀁖􀁖􀁒􀁆􀁌􀁄􀁗􀁌􀁒􀁑􀀃􀁅􀁈􀁗􀁚􀁈􀁈􀁑􀀃􀀷􀀤􀀷􀀃and RT with correlation coefficient 􀁕􀀃􀀠􀀃􀀓􀀑􀀛􀀚􀀃􀀋􀁓􀀟􀀓􀀑􀀓􀀓􀀔􀀌􀀏􀀃􀁌􀁑􀁗􀁈􀁕􀁆􀁈􀁓􀁗􀀃􀀓􀀑􀀜􀀛􀀚􀀃􀁄􀁑􀁇􀀃􀁖􀁏􀁒􀁓􀁈􀀃􀀓􀀑􀀘􀀓􀀜􀀑􀀃􀀷􀁋􀁈􀀃􀁏􀁌􀁑􀁈􀁄􀁕􀀃􀁄􀁖􀁖􀁒􀁆􀁌􀁄􀁗􀁌􀁒􀁑􀀃􀁅􀁈􀁗􀁚􀁈􀁈􀁑􀀃􀀤􀀷􀀃􀁄􀁑􀁇􀀃􀀵􀀷􀀃􀁖􀁋􀁒􀁚􀁈􀁇􀀃􀁗􀁋􀁈􀀃􀁆􀁒􀁕􀁕􀁈􀁏􀁄􀁗􀁌􀁒􀁑􀀃􀁆􀁒􀁈􀁉􀁉􀁌􀁆􀁌􀁈􀁑􀁗􀀃􀁕􀀃􀀠􀀃􀀓􀀑􀀚􀀙􀀃􀀋􀁓􀀟􀀓􀀑􀀓􀀓􀀔􀀌􀀏􀀃􀁌􀁑􀁗􀁈􀁕􀁆􀁈􀁓􀁗􀀃􀀔􀀓􀀏􀀕􀀚􀀔􀀃􀁇􀁄􀁑􀀃􀁖􀁏􀁒􀁓􀁈􀀃􀀓􀀏􀀚􀀖􀀓􀀑Conclusion TAT is more accurate than AT for body temperaturemeasurement in the healthy term newborns. [Paediatr Indones.2010;50:67-72].
Efficacy of dexamethasone for lung maturity in preterm delivery in association with lamellar bodies count Ni Made Sumiartini; Hendra Santoso; Wayan Retayasa; Made Kardana
Paediatrica Indonesiana Vol 47 No 3 (2007): May 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (372.286 KB) | DOI: 10.14238/pi47.3.2007.115-9

Abstract

Background Organ immaturities in preterm infants may result inperinatal death. One of the diseases is respiratory distress syndrome(RDS) which is caused by lung immaturity. Dexamethasone is oftenused to accelerate maturity of infant lungs.Objective To determine the efficacy of dexamethasone on lungmaturity measured by lamellar bodies count.Methods A quasi experimental study was done at PerinatologyDivision, Department of Child Health, Medical School, UdayanaUniversity, Sanglah Hospital, Denpasar. We recruited 72 subjects;36 subjects were given four times intramuscular dexamethasone5 mg every twelve hours before delivery. Thirty six subjects whodid not receive dexamethasone belonged to control group. Infants’lungs maturity assessment was performed using lamellar bodiescount taken from amniontic fluid.Results The gestational age ranged between 28 to 36 weeks, withthe mean gestational age in dexamethasone group was 32.2 (SD1.76) weeks and that in control group was 31.7 (SD 2.65) weeks.The efficacy of dexamethasone therapy on lung maturity wassignificant with Fisher’s exact test P<0.0001, 95%CI 2.546;11.173. Using multivariate logistic regression analysis, there wassignificant correlation between dexamethasone and lung maturitymeasured by lamellar bodies count [OR=239.39; P<0.0001,95%CI 22.12;526.53].Conclusion Administration of dexamethasone in pregnantwomen during preterm delivery significantly improves lungmaturity measured by lamellar bodies count.
Risk of early onset pneumonia in neonates with abnormal gastric aspirate IB. Mahendra; I Wayan Retayasa; I Made Kardana
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (321.02 KB) | DOI: 10.14238/pi48.2.2008.110-3

Abstract

Background Early onset neonatal pneumonia is the risk factorfor neonatal sepsis that increases risk for neonatal deaths.Recognition, prevention, and treatment of this problem is majorfactors in the managemant of high risk neonates. Analysis ofgastric aspirate, collected soon after birth is a useful screeningtest for predicting pneumonia.Objective To evaluate the risk of early onset of neonatalpneumonia in neonates with abnormal gastric aspirate.Methods A case control study was done on infants with earlyonset neonatal pneumonia born in Sanglah Hospital during theperiod of July 2004 until November 2005. The control groupconsisted of high risk infants without early onset pneumonia.Multiple logistic regressions was performed to determine theconfounding effects of multiple variables that were considered asrisk factors for early-onset neonatal pneumonia.Results Forty-five infants with early onset neonatal pneumoniawere recruited. Multivariate analysis showed that abnormal gastricaspirate and low APGAR score were significant factors associatedwith early-onset of neonatal pneumonia with OR 4.05 (95%CI1.26;13,02), P=0.019, and OR 6.95 (95%CI 2.45;19.77),P<0.0001, respectively.Conclusion Abnormal gastric aspirate and low APGAR score arerisk factors for early onset neonatal pneumonia in high risk infants.
Effect of kangaroo method on the risk of hypothermia and duration of birth weight regain in low birth weight infants: A randomized controlled trial I G. A. P. Eka Pratiwi; Soetjiningsih Soetjiningsih; I Made Kardana
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (115.801 KB) | DOI: 10.14238/pi49.5.2009.253-8

Abstract

Background In Indonesia, the infant mortality rate in 2001 was 50 per 1000 live births, with 34.7% due to perinatal death. This perinatal death was associated with low birth weight (LBW) newborn, which was caused by prematurity, infection, birth asphyxia, hypothermia, and inadequate breast feeding. In developing countries, lack of facilities of LBW infant care leads to the utilization of kangaroo method as care to prevent hypothermia in LBW newborn.Objective To evaluate the differences of hypothermia event andduration of birth weight regain in LBW newborns between earlykangaroo care (EKC) and conventional care (CC).Methods This was an open label randomized controlled trial. The1500-2250 g LBW newborns who were born in Sanglah Hospitalwere randomized to EKC and CC groups.Results Hypothermia events were found more often in CC groupthan EKC group (RR=0.645, 90% CI 0.45 to 0.92, P=0.05). Thisdifference was influenced by breast feeding frequency. Duration of birth weight regain in EKC group (median 5 days (SE=0.31, 90% CI 4.49 to 5.51) was shorter than CC group (median 6 days (SE=0.52, 90% CI 5.15 to 6.85), but this difference wasn't statistically significant (P=0.40). Percentage of birth weight decrease, breastfeeding frequency, and hyperbilirubinemia events that needed phototheraphy were associated with the duration of birth weight increase.Conclusion EKC helps to decrease the incidence of hypothermiaevents, but fails to shorten duration of birth weight increase.Percentage of birth weight decrease, breast-feeding frequency, and hyperbilirunemia events that need phototheraphy are associated with the duration of birth weight increase in LBW newborn.
Early neonatal mortality rate and the risk factors in Wangaya hospital Made lndah Nastiti Utami Budha; Wayan Retayasa; Made Kardana
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 (123.2 KB) | DOI: 10.14238/pi48.5.2008.306-11

Abstract

Background The first week of life of a neonate is a critical period.In Asia, early neonatal mortality rate remains high.Objective To investigate early neonatal mortality rate and the riskfactors in Wangaya Hospital.Methods A cross sectional study was carried out retrospectivelyon neonates registered at Perinatology Unit, Wangaya HospitalDenpasar, Bali since January 2006. The study was done fromOctober to November 2007. Data was obtained from medicalrecord, analyzed as univariate using chi-square test or Fisher'sexact test and multivariate logistic regression analysis model.Results Early neonatal mortality rate in Wangaya Hospital was 38.7per 1000 livebirths. Univariate analyses showed that there werefive significant risk factors of early neonatal death, i.e., respiratorydistress, asphyxia, birth weight less than 2500 grams, sepsis, andgestational age less than 3 7 weeks. Multivariate analysis showedthat those five variables were significant as risk factors of earlyneonatal death i.e., OR (95% confidence interval) for respiratorydistress: 16.8 (3.7 to 76.6)], asphyxia: 13.5 (6.1 to 29.9)], birthweight <2500 grams: 8.1 (3.3 to 19.9)], sepsis: 7.3 (3.1 to 17.1),and gestational age <37 weeks: 3.5 (1.6 to 7.8)].Conclusions Early neonatal mortality rate in Wangaya Hospitalremains high. Respiratory distress, asphyxia, birth weight <2500gram, sepsis, and gestational age <37 weeks were independent riskfactors of early neonatal death.
Characteristics and prognostic factors of intracranial hemorrhage in children Made Kardana; Komang Kari; Made Widia
Paediatrica Indonesiana Vol 43 No 1 (2003): January 2003
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (346.976 KB) | DOI: 10.14238/pi43.1.2003.14-9

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Objective Finding the characteristics and risk factors associatedwith prognosis in children suffering from intracranial hemorrhage.Methods This was a retrospective medical record review of chil-dren (older than 1 month old) admitted with intracranial hemor-rhage to the Department of Child Health the Sanglah Hospital,Denpasar, during the period of January 1998 to December 2000.Prognostic factors were identified by chi-square and multivariateanalysis with significance of p<0.05Results There were 56 patients eligible for the study. Among themwere 35 (63%) males and 21 (27%) females. Forty-three (77%)were less than one year of age, 40 (71%) without history of traumaand the major clinical manifestation was paleness (89%). The mostcommon location was subdural bleeding, 21 patients (38%). Fac-tors associated with prognosis was the bleeding location (p<0.05)Conclusions Intracranial hemorrhage was more common in malesand in infants. The most common clinical manifestation was pale-ness. Bleeding location was associated with prognosis
Incidence and factors associated with mortality of neonatal sepsis I Made Kardana
Paediatrica Indonesiana Vol 51 No 3 (2011): May 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (109.172 KB) | DOI: 10.14238/pi51.3.2011.144-8

Abstract

Background Neonatal sepsis is one of the major causes of mortality and long term morbidity in neonates, particularly in premature and low birth weight infants. The incidence of neonatal sepsis varies from 1 to 4 in 1000 live births in developed countries and 10 to 50 in 1000 live births in developing countries. The mortality rate of neonatal sepsis remains high, especially in developing countries.Objective To describe the incidence, mortality rate, and factors associated 'With mortality in neonatal sepsis in Sanglah Hospital, Denpasar.Methods A retrospective, cohort study was conducted in the Perinatology Ward, Department of Child Health, Sanglah Hospital, Denpasar, Bali from January to December 2008. One hundred thirty􀁄eight patients 'With neonatal sepsis were enrolled in this study. Patients' characteristic data were collected including sex, mode of delivery (spontaneous, non􀁄spontaneous), condition at birth (vigorous, asphyxic), gestational age (premature, full tenn), birth weight «2500 grams, > 2500 grams), and sepsis classifica􀁄tion (early onset sepsis, late onset sepsis). Outcomes were grouped into alive and dead.Results A total of 138 cases of neonatal sepsis were reviewed, 59.4% of whom were boys, 63.0% spontaneously delivered,39.1 % asphyxic, 53.6% 'With low birth weight, 50.7% premature, and84.8% with early onset sepsis. The incidence of neonatal sepsis was 5% of babies admitted, 'With a mortality rate of 28.3%. Low birth weight and prematurity were significantly associated withmortality in neonatal sepsis (RR8.4, 95% CI 2.4 to 29.0, P = 0.001 and RR3.4, 95% ClI.O to 11.0, P 􀀂 0.042, respectively). Conclusion The incidence of neonatal sepsis in Sanglah Hospital was 5% of babies admitted, with a mortality rate of 28.3%. Low birth weight and prematurity were significantly associated with mortality in neonatal sepsis. 2011;51:144-8].
Predictive value of Score for Neonatal Acute Physiology and Perinatal Extension II for neonatal mortality in Sanglah Hospital, Denpasar, Indonesia I Gede Ketut Aryana; I Made Kardana; I Nyoman Adipura
Paediatrica Indonesiana Vol 56 No 5 (2016): September 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (259.911 KB) | DOI: 10.14238/pi56.5.2016.257-61

Abstract

Background Neonatal mortality, which is largely caused by severe illness, is the biggest contributor to overall infant mortality. The World Health Organization (WHO) estimated that 4 million neonates die yearly worldwide, often due to severe infection and organ system immaturity. Neonates with severe illness require treatment in the neonatal intensive care unit (NICU), in which a reliable assessment tool for illness severity is needed to guide intensive care requirements and prognosis. Neonatal disease severity scoring systems have been developed, including Score for Neonatal Acute Physiology and Perinatal Extension II  (SNAPPE II), but it has never been validated in our setting.ObjectiveTo study the prognostic value of SNAPPE II as a predictor of neonatal mortality in Sanglah Hospital, Denpasar, Indonesia.Methods This prospective cohort study was conducted in the NICU of Sanglah Hospital, Denpasar from November 2014 to February 2015. All neonates, except those with congenital anomaly, were observed during the first 12 hours of admission and their outcomes upon discharge from the NICU was recorded. We assessed the SNAPPE II cut-off point to predict neonatal mortality. The calibration of SNAPPE II was done using the Hosmer-Lemeshow goodness-of-fit test, and discrimination of SNAPPE II was determined from the receiver-operator characteristic (ROC) curve and area under the curve (AUC) value calculation.ResultsDuring the period of study, 63 children were eligible, but 5 were excluded because of major congenital abnormalities. The SNAPPE II optimum cut-off point of 37 gave a high probability of mortality and the ROC showed an AUC of 0.92 (95%CI 0.85 to 0.99). The Hosmer-Lemeshow goodness-of-fit test showed a good calibration with P = 1.0Conclusion The SNAPPE II  has a good predictive ability for neonatal mortality in Sanglah Hospital, Denpasar, Indonesia.
Co-Authors Anak Agung Ngurah Subawa Ariputra -, Ariputra Artana, Wayan Dharma Ayu Ketut Surya Dewi Ayu Setyorini Mestika Mayangsari Bowolaksono * Carissa Lidia Cempaka, Putu Mas Vina Paramitha Clearesta, Kartika Eda Desak Laksmi DIAN SAVITRI Dyah Kanya Wati Ekaputri, Dian Sulistya Franky Luhulima Gusti Ayu Putu Nilawati Hendra Santoso Hendry Raymen Satria Hendy Hendy I Gde Raka Widiana I Gede Deden Susma Sugara I Gede Ketut Aryana, I Gede Ketut I Gusti Agung Ngurah Sugitha Adnyana I Gusti Ayu Putu Eka Pratiwi I Gusti Ngurah Made Suwarba I Made Arimbawa I Nyoman Adipura I Nyoman Budi Hartawan I Nyoman Sartika I Nyoman Wande I Putu Sidhi Rastu Karyana I Wayan Darma Artana I Wayan Dharma Artana I Wayan Dharma Artana, I Wayan Dharma I Wayan Retayasa IB. Mahendra Ida Bagus Agung Winaya Ida Bagus Mudita Ida Bagus Subanada IM Dharmajaya Kadek Deddy Ariyanta Kadek Deddy Ariyanta Kadek Deddy Ariyanta Ketut Dewi Kumara Wati Ketut Siki Kawiyana Ketut Suarta Ketut Suarta Ketut Suarta Komang Ayu Witarini Komang Kari Kristopher May Pamudji Lim, Heriyanto Lufyan, Reddy Luh Gede Yuliadewi NS Made Bandem Kenny Wijaya Nugraha Made Darmajaya Made Darmajaya Made Indah Nastiti Utami Budha Made lndah Nastiti Utami Budha Made Sukmawati Made Widia Markus Gunawan Ni Kadek Mulyantari Ni Luh Gede Wahyuni Suismaya Ni Made Sukewanti Ni Made Sumiartini Ni Nyoman Mahartini Ni Nyoman Mahartini Ni Putu Siadi Purniti Novita Purnamasari Assa Novita Purnamasari Assa NP Veny Kartika Yantie Nyoman Gina Henny Kristianti Putu Junara Putra Putu Junara Putra, Putu Junara Rathasari, Ni Made Dea Adilla Setya Wandita Sianny Herawati Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Sukmawati, Made Susanti Halim Wayan Retayasa Wayan Retayasa Wayan Sulaksmana Sandhi Parwata Wijaya, I Made Samitha Yoga Putra