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All Journal Medicina E-Jurnal Medika Udayana Sari Pediatri Paediatrica Indonesiana ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
I Made Kardana
Bagian Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas Udayana, RSUP Sanglah, Denpasar
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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Efficacy of aminophylline vs. caffeine for preventing apnea of prematurity Hendy Hendy; Setya Wandita; I Made Kardana
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi54.6.2014.365-71

Abstract

Background Apnea of prematurity (AOP) usually occursin neonates with a gestational age < 34 weeks. The WorldHealth Organization has recommended the administration ofcaffeine or aminophylline to prevent AOP, but the efficacy ofaminophylline remains unclear, and caffeine citrate is not availablein Indonesia.Objective To compare the efficacy of aminophylline to that ofcaffeine for preventing AOP.Methods This single-blind, clinical trial was conducted onneonates (gestational age 28-34 weeks) who were able to breathespontaneously within the first 24 hours of life and admitted toSanglah Hospital from December 2012 to April 2013. Subjectswere randomly allocated into two groups, namely groups ofaminophyllin and caffeine. The aminophylline group receivedaminophylline dihydrate at an initial dose of 10 mg/kg body weight,then continued with a maintenance dose of 2.5 mg/kg body weightevery 12 hours. The caffeine group received anhydrous caffeineat an initial dose of 10 mg/kg body weight, then continued witha maintenance dose of 1.25 mg/kg body weight every 12 hours.We followed subjects up until they were 10 days old. Subjectsreceived per oral therapy for seven days. The efficacy comparisonbetween the two groups was assessed by Chi-square test with 95%confidence interval (CI) and a statistical significance value of P< 0.05. We used multivariate test to analyze the confoundingfactors.Results Ninety-six subjects participated in this study; 48 subjectsreceived aminophylline therapy and the other 48 subjects receivedcaffeine therapy. Twenty-eight subjects experienced apnea: 13subjects from the aminophylline group (27.1%), and 15 subjectsfrom the caffeine group (31.3%). It appeared that aminophyllinewas slightly better compared to caffeine, but the difference wasnot statistically significant, with a relative risk of 0.9 (95% CI0.5 to 1.3; P=0.8). We found vomiting to be a side effect of boththerapies, and not significantly different between groups. SepsisFrom the Department of Child Health, Udayana University MedicalSchool/Sanglah Hospital, Denpasar1 and Gadjah Mada University MedicalSchool/Sardjito Hospital, Yogyakarta2.Reprint requests to: Hendy, Department of Child Health, UdayanaUniversity Medical School, Sanglah Hospital, Jl. Pulau Nias, Denpasar,Bali 80114. Tel./Fax: +62-361-244038. E-mail: hendyhalim.md@gmail.com.Infant prematurity is defined as a gestationalage of < 37 weeks. Africa has the highest birthrate of premature infants of 11.9%, while thatof Southeast Asia is approximately 11.1%.1The main issue that premature infants face is apnea.Apnea is caused by incomplete development ofthe respiratory center, and is known as apnea ofprematurity (AOP). Several factors underlie thenecessity of AOP prevention: an 85% incidence ofAOP in infants with gestational age <34 weeks,2difficulty in diagnosing AOP, unpredictable onset,short- and long-term effects, long treatment lengthand requirement of intensive care. The World Healthand hyaline membrane disease were found to be confoundingfactors in this study.Conclusion Aminophylline and caffeine have similar efficacywith regards to preventing AOP.
Diagnostic value of mean platelet volume in neonatal sepsis Kristopher May Pamudji; I Made Kardana
Paediatrica Indonesiana Vol 59 No 6 (2019): November 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (235.559 KB) | DOI: 10.14238/pi59.6.2019.289-93

Abstract

Background Neonatal sepsis is a severe disease with potentially serious impacts if not treated early. However, the symptoms and clinical signs are not specific. Several studies have been conducted to find early infection markers for detection of neonatal sepsis, but without satisfactory results. Mean platelet volume (MPV) is a new marker of infection that has good potential for diagnosing neonatal sepsis. Objective To assess the diagnostic value of MPV in early detection of neonatal sepsis. Methods This retrospective study with diagnostic testing was done with data collected from medical records of neonates with neonatal sepsis who were admitted to the Neonatology Department in Sanglah Hospital, Denpasar from December 2018 to March 2019. Mean platelet volume cut-off point was determined using a receiver-operating characteristic (ROC) curve. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MPV in neonatal sepsis were determined using a 2x2 table. Results Of 82 subjects, 55 subjects were male (67%). Positive blood culture results were found in 25 subjects (30%). Mean platelet volume with a cut-off point of 7.44 fL had 80% sensitivity, 84.2% specificity, 69% PPV, and 90.6% NPV. Conclusion Mean platelet volume with a cut-off point of 7.44 fL can be used to diagnose neonatal sepsis with a sensitivity of 80% and specificity of 84.2%.
Full outline of unresponsiveness score as a predictor of outcomes in critically ill pediatric patients Novita Purnamasari Assa; Dyah Kanya Wati; Ida Bagus Subanada; Soetjiningsih Soetjiningsih; Made Kardana; Made Sukmawati
Paediatrica Indonesiana Vol 60 No 2 (2020): March 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (222.985 KB) | DOI: 10.14238/pi60.2.2020.77-82

Abstract

Background Mortality predictions are very important for improving service quality in the pediatric intensive care unit (PICU). The full outline of unresponsiveness (FOUR) is a new coma scale and is considered capable of predicting mortality and outcome. Objective To assess the ability of FOUR scores to predict outcomes of critically ill patients in the PICU. Methods This prospective cohort study included children aged 1 months - 18 years who were admitted to the PICU. Subjects were assessed by FOUR, grouped into score < 9 or score >9, and followed until outcomes were obtained. Bivariate analysis to assess the risk of death was made by cross-tabulation and the strength of the association in the form of risk ratio by Chi-square test. Multivariate analysis was done by logistic regression test. Results Of 94 subjects, 47 had FOUR scores <=9 and 47 subjects had FOUR >9. Bivariate analysis revealed that PICU patients with FOUR score <=9 had a higher risk of death than those with FOUR score >9 (RR 12.5; 95%CI 3.1 to 49.8; P<0.0001). Multivariate analysis revealed that FOUR score, length of stay <=7 days, and non-surgical disease significantly increased the risk of mortality in PICU patients (by 42.8 times, 8.9 times, and 5.9 times, respectively). Conclusion The FOUR scores have good ability to predict the outcomes of critically ill pediatric patients. A FOUR score <=9 at the beginning of treatment is significantly associated with the outcome of mortality during treatment in the PICU.
Phototherapy and serum calcium levels in full term neonates with hyperbilirubinemia Carissa Lidia; I Made Kardana; Gusti Ayu Putu Nilawati; Ida Bagus Subanada; I Gusti Agung Ngurah Sugitha Adnyana; Ayu Setyorini Mestika Mayangsari
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.8-11

Abstract

Background Hyperbilirubinemia is one of the most common problems in newborns. Severe hyperbilirubinemia, known as kernicterus, can suppress O2 consumption and oxidative phosphorylation, as well as damage brain cells, resulting in neuronal dysfunction and encephalopathy. Phototherapy is a common therapy for neonatal hyperbilirubinemia, but may rarely lead to the adverse effect of hypocalcemia. Objective To investigate serum calcium levels in full term neonates with hyperbilirubinemia, before and after phototherapy. Methods This cohort study compared total serum calcium level before and after phototherapy in full term neonates with hyperbilirubinemia. Subjects were full term neonates aged 2-14 days with high total serum bilirubin levels, according to the Bhutani curve, and were treated with phototherapy at Sanglah Hospital, Denpasar, Bali, Indonesia. Paired T-test was used to compare serum calcium levels before and after phototherapy. Results There were 35 subjects in this study. Paired T-test revealed that subjects’ serum calcium significantly decreased after phototherapy [before: 9.47 mg/dL vs. after: 9.23 mg/dL; mean difference 0.24; (95%CI 0.03 to 0.46; P=0.025)]. None of our subjects had hypocalcemia after phototherapy. Conclusion Full term neonates with hyperbilirubinemia have reduced serum calcium levels after phototherapy.
Dermatitis atopi pada bayi usia 0-12 bulan kelahiran RSUP Sanglah Denpasar dengan riwayat atopi keluarga antara bulan Desember 2015-Januari 2016 Made Bandem Kenny Wijaya Nugraha; Ketut Dewi Kumara Wati; I Made Kardana
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (240.987 KB) | DOI: 10.15562/ism.v11i3.205

Abstract

Atopy disease is a genetic predisposition to develop any allergies in person. The example of atopic disease is atopic dermatitis, a chronic residual skin disorder that often occurs in infancy to children with itching, redness, and vesicles on the skin as its symptoms. The causes of atopic dermatitis are a family history of atopy, age, and environmental factors. If the parent or the family has a history of atopy, there will be a chance for the child to has dermatitis atopy in the next time.Aim: This study aims to determine the role of family history in atopy dermatitis’s incidence in infants aged 0-12 months.Method: Total sampling method used in the study obtained 39 samples with a family history of atopy. Anamnesis was conducted to determine the history of atopy which is owned by the samples.Result: It showed that 22 samples had atopy dermatitis and 17 samples didn’t have atopy dermatitis.Conclusion: The results of this study indicated that family history of atopy has a role in atopy dermatitis’s incidence in infants aged 0-12 months. Penyakit atopi merupakan salah satu penyakit genetik yang mengembangkan suatu alergi pada individu. Contoh dari penyakit atopi adalah dermatitis atopi, yaitu penyakit kulit kronik residif yang umumnya terjadi saat usia bayi hingga anak-anak dengan gejala berupa rasa gatal, kemerahan, serta terbentuknya vesikel pada kulit. Pencetus munculnya dermatitis atopi adalah faktor riwayat atopi pada keluarga, faktor usia, dan faktor lingkungan. Apabila orang tua atau keluarga memiliki riwayat atopi, maka semakin besar kemungkinan untuk anak mengalami dermatitis atopi dikemudian hari.Tujuan: Penelitian ini bertujuan untuk mengetahui peran riwayat atopi yang dimiliki keluarga terhadap kejadian dermatitis atopi pada bayi usia 0-12 bulan.Metode: Dari total sampling diperoleh 39 sampel dengan riwayat atopi. Anamesis dilakukan untuk mengetahui riwayat atopi yang dimiliki sampel.Hasil: Hasil anamnesis mendapatkan 22 sampel mengalami dermatitis atopi dan 17 sampel tidak mengalami dermatitis atopi.Simpulan: Riwayat atopi keluarga memiliki peran terhadap kejadian dermatitis atopi pada bayi usia 0-12 bulan.
The characteristic of neonatal hyperbilirubinemia before and after phototherapy at Sanglah Hospital, Denpasar, Bali in 2017 Wayan Sulaksmana Sandhi Parwata; Putu Junara Putra; Made Kardana; Wayan Dharma Artana; Made Sukmawati
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (223.866 KB) | DOI: 10.15562/ism.v10i2.312

Abstract

Background: Hyperbilirubinemia is the most clinical problem in newborn babies.  Hyperbilirubinemia occurs 60% in aterm babies and 80% in premature babies. This study aims to know the incidence of hyperbilirubinemia, characteristics of hyperbilirubinemia and effect of phototherapies to bilirubin levels.Methods: A cross-sectional retrospective study was conducted using medical records among 94 neonates with hyperbilirubinemia who treated with phototherapies at Sanglah hospital during 2017. Data regarding gender, gestational weeks, type of delivery, size for gestational age, the onset of hyperbilirubinemia, etiology, birth weight, maternal gravid status, and bilirubin levels were collected and analyzed using SPSS version 20 software descriptively.Results: From 94 neonatal hyperbilirubinemia that meet the inclusion criteria, 51 (54.3%)  males and 43 (45.7%) females based on gender. Mean gestational ages were 36.35±2.921 weeks. The major etiology of neonatal hyperbilirubinemia were breastfeeding jaundice 33 (25.8%), Prematurity 23 (18.7%), ABO incompatibility 13 (10.6%), Breast milk jaundice 11 (8.9%), gastrointestinal malformation 6 (4.9%), G6PD deficiency 5 (4.1%), and sepsis 3 (2.4%). The mean total bilirubin prior to phototherapy was 15.6±4.11 mg/dL whereas the indirect bilirubin was 14.56± 3.55 mg/dL. The duration of phototherapy in this study was 2.8±0.65 days.Conclusions: The incidence of neonatal hyperbilirubinemia during 2017 at Sanglah Hospital were predominantly caused by breastfeeding jaundice, prematurity, and ABO incompatibility. There were decreased bilirubin levels following phototherapies.
Korelasi kadar laktat dengan Score for Neonatal Acute Physiology Perinatal Extension II (SNAPPE II) pada neonatus yang dirawat di NICU RSUP Sanglah, Bali, Indonesia I Gede Deden Susma Sugara; I Wayan Dharma Artana; Ketut Suarta; Soetjiningsih Soetjiningsih; Ni Putu Siadi Purniti; Dyah Kanya Wati; Made Sukmawati; Made Kardana
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (423.462 KB) | DOI: 10.15562/ism.v10i2.505

Abstract

Background: Infant mortality rate is one of the indicators of public health degree that determines the human development index. Various attempts were made to early detect the problems, one of which was by assessing the severity of neonatal disease using Score for Neonatal Acute Physiology Perinatal Extension-II (SNAPPE II) which was associated with lactate levels as a metabolic response and organ dysfunction due to critical illness that were suffered at the Neonatal Intensive Care Unit (NICU).Methods: A cross-sectional analytic study was conducted among 48 critically ill neonates treated at the Sanglah Hospital Denpasar NICU. Samples were selected from affordable populations by consecutive sampling. Data analysis was performed by Saphiro-Wilk data normality test, correlation analysis using the Pearson correlation coefficient, significant results if the value of p <0.05. Data were analyzed using SPSS version 17 for Windows.Results: Most of the respondents were males (67%), the mean of neonatal gestational age was 33 (± 3,2) weeks with the median neonatal age at lactate sampling being 24 (24-48) hours. The average age of the mother at delivery was 24 (21-40) years. The mean lactate level in critically ill neonatal patients admitted to the NICU was 3.2 (± 0,5) mmol / L. The mean SNAPPE II score on the subject was 32 (20-42). There was a significant positive correlation between the levels of lactate and the severity of the disease in critically ill neonates in the NICU assessed by SNAPPE II (r = 0.45; p = 0.004).Conclusion: Lactate levels has a moderate positive correlation with the severity of the disease in critically ill neonates in the NICU assessed by SNAPPE II
The characteristics of neonatal sepsis in Low Birth Weight (LBW) infants at Sanglah General Hospital, Bali, Indonesia Novita Purnamasari Assa; I Wayan Dharma Artana; I Made Kardana; Putu Junara Putra; Made Sukmawati
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (308.125 KB) | DOI: 10.15562/ism.v11i1.522

Abstract

Backgrounds: Neonatal sepsis is a significant cause of mortality and long-term morbidity. The preterm infant has high-risk sepsis and its sequelae. Low birth weight infants were more susceptible to sepsis. Initial infections in neonates may not be identified due to non-specific symptoms and sign with the limited laboratory criteria. This study aims to describe the characteristics of neonatal sepsis in low birth weight infants in the neonatology intensive care unit of Sanglah Hospital.Methods: A retrospective cross-sectional study was conducted among 168 infants aged zero to 28 days with birth weights <2,500 grams from May 2017 – April 2018 at Sanglah General Hospital, Bali, Indonesia using a purposive sampling technique. The inclusion criteria were sepsis infants who were hospitalized in neonatology care rooms during the study period at Sanglah General Hospital. Variables assessed in this study were sex, location and mode of delivery, birth weight, gestational age, number of parity, length of stay, the onset of sepsis, as well as the outcome. Data were analysed using SPSS version 17 for Windows.Results: The mortality rate of sepsis in low birth weight infants was 29.8%. Most of the subjects were male (53%), location of delivery at Sanglah Hospital (60.7%), born spontaneously (51.2%), birth weight were 1500-2499 grams (58,3%) and the most gestational ages were 32-36 weeks (44,6%). Early-onset neonatal sepsis (EONS) dominates patients with neonatal sepsis, with a mean length of stay was 23.27±20.32 days. The major infection risk factor was premature rupture membrane (PRM) >24 hours (14.9%), and minor infection risk factor was gestational age <37 weeks (78%), very low birth weight (44.6%) and asphyxia (41.1%). The total blood culture positivity was 38 (22.6%) cases, and Enterococcus faecalis was the most common organism in this study.Conclusion: The incidence and mortality of neonatal sepsis in LBW infants were still high. The importance of knowledge and awareness of pregnant women about danger signs and the risk of infection can reduce the incidence of early-onset neonatal sepsis. Prevention of healthcare-associated infections can reduce the incidence of late-onset neonatal sepsis.
Jejunal atresia in the newborn: three cases after resection and end-to-end anastomoses Ni Made Sukewanti; I Wayan Dharma Artana; Putu Junara Putra; I Made Kardana; Made Sukmawati; Kadek Deddy Ariyanta
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1204.964 KB) | DOI: 10.15562/ism.v11i1.538

Abstract

Background: Intestinal atresia is a common cause of neonatal intestinal obstruction. Jejunal atresia occurs more frequent than duodenal or colonic atresias while single atresias are most commonly encountered. Jejunal atresia is classified into 4 types: Type I (a mucosal/septal), Type II (a fibrous cord/band), Type III (blind ends are entirely separated without a fibrous cord between them and a large mesenteric defect), and Type IV (combination of atresia type I to III). This study aims to elaborate jejunal atresia in the newborn after resection and end-to-end anastomoses.Case Description: We report three cases of jejunal atresia consists of different types: type IV (first case), type IIIa (second case) and type I (third case). Cases were neonates born with signs of upper gut obstruction. Bile-stained vomiting was reported a few hours after birth and failed to pass meconium in the first 24 hours. Postnatal abdominal X-ray showed dilatation of the gaster and no gas present in the pelvic floor. In the third case, it showed a triple bubble sign on abdominal x-ray and a laparotomy revealed the type of jejuno-ileal atresia. Also, the resection on the atresias and end to end anastomosis were performed. Cases were admitted to neonatal intensive care unit with total parenteral nutrition. The first two cases died due to sepsis, while the third case survived.Conclusion: Jejunal atresia is a rare disease among newborn. All of the patients have provided resection and end-to-end anastomoses, although 2 of them did not survive. 
Annular pancreas in two cases after diamond-shaped anastomosis duodenoduodenostomy: case reports Ni Luh Gede Wahyuni Suismaya; I Made Kardana; Kadek Deddy Ariyanta
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (770.558 KB) | DOI: 10.15562/ism.v11i2.581

Abstract

Background: Annular pancreas is an infrequent congenital disorder characterized as a partial or complete pancreatic tissue around the descending part of the duodenum. Prenatal control is essential in the early detection of the annular pancreas. Initial management might increase better prognosis. We report two cases of the annular pancreas in Sanglah General Hospital, Denpasar, Bali in 2016-2019 to describe the clinical characteristics and outcome of different ages in annular pancreas managed by diamond-shaped duodenoduodenostomy.Case Description: The first case was a six days old baby boy with bile stained vomiting every time he breastfed when she was three days old and got worsen. USG fetal showed polyhydramnios with duodenal or jejunal stenosis. Besides, the abdominal X-ray showed double bubble sign and the laboratory findings were in a standard limit. The second case was a nine months old girl with bile-stained vomiting when she was eight months old and got worsen along with the time. She found with severe malnutrition and mild-moderate dehydration. The laboratory examination revealed electrolyte imbalanced, and abdominal X-ray showed double bubble sign. Postoperative to first feed was 1 day in both cases and full feed duration was 5 and 10 days. Length of stay was 16 and 25 days—both of the cases without complication after surgery.Conclusion: Annular pancreas is a rare congenital malformation that manifests primarily by signs related to duodenal obstruction. Earlier identifications will help to ensure that appropriate treatment can be instigated as soon as possible. Treatment by surgical with duodenoduodenostomy procedure is a surgical technique in the treatment of annular pancreas, with the advances in neonatal intensive care, may reduce the postoperative complications and will make a better outcome.
Co-Authors Anak Agung Ngurah Subawa Ariputra -, Ariputra Artana, Wayan Dharma Ayu Ketut Surya Dewi Ayu Setyorini Mestika Mayangsari Bowolaksono * Carissa Lidia 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