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Laboratory Examination in Hemophagocytic Lymphohistiocytosis Wulyansari Wulyansari; Yetti Hernaningsih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1881

Abstract

Hemophagocytic Lymphohistiocytosis (HLH) is derived from the word hemophagocytosis, in which macrophages infiltrate tissue extensively, and unspecifically phagocyte blood and bone marrow cells. The deviant activation of cytotoxic CD8+ T-cells causing the release of inflammatory cytokines is the core pathogenesis of HLH. Hemophagocytic lymphohistiocytosis is a regulatory disorder of the immune system, with clinical signs and symptoms of extreme inflammation and cytopenia, hepatitis, and severe and life-threatening central nervous system dysfunction. The name of the HLH disorder was recently proposed to be "Hyperinflammatory Lymphohistiocytosis" (also known as HLH). Enforcement of HLH diagnosis by the Histiocyte Society based on HLH 2004 updated diagnostic criteria consists of five of the following eight diagnostic criteria: fever, splenomegaly, cytopenia (two or more of three lineages in peripheral blood), hypertriglyceridemia or hypofibrinogenemia, hyperferritinemia, hemophagocytes in the bone marrow/lien/lymph, the low or non-existent activity of Natural Killer (NK) cells, increased sCD25. H-score, MH-score, and systemic Juvenile Idiopathic Arthritis (sJIA)/Macrophage Activated Syndrome (MAS) classification criteria are also used to enforce HLH diagnoses. Hemophagocytic lymphohistiocytosis is challenging to recognize and has a high mortality rate, especially in adults, ranging from 42 to 88%. Therefore, immediate diagnosis and therapy are essential. The introduction of HLH triggers is critical because treatment is based on the underlying trigger. Cytokine storms due to Coronavirus Disease 19 (COVID-19) infection have significant similarities to the clinical and laboratory findings of HLH. Secondary HLH (sHLH) is suspected in severe COVID-19 patients, so early diagnosis is potentially made based on the H-score.
MANIFESTASI NEUROPSIKIATRIK PADA LUPUS ERITEMATOSUS SISTEMIK DI RSUD DR. SOETOMO SURABAYA Nadya Rinda Eka Rana; Awalia Awaliah; Yetti Hernaningsih; Hanik Badriyah Hidayati
NEURONA Vol 36 No 4 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i4.88

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    NEUROPSYCHIATRIC MANIFESTATION AMONG SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS IN GENERAL HOSPITAL SURABAYAABSTRACTIntroduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease with unknown causes and extensive clinical manifestations and diverse disease pathways. The clinical manifestations of SLE are very diverse, including the involvement of the nervous system and psychiatric syndrome (neuropsychiatric).Aims: To describe clinical neuropsychiatric manifestations of   patients with SLE in Soetomo General Hospital Surabaya.Methods: This was a cross-sectional study based on medical record data on all SLE patients treated at Dr. Soetomo Hospital Surabaya, from January-December 2017. Neuropsychiatric manifestations assessment were based on the nomenclature of the American College of Rheumatology (ACR) in 1999.Results: There were 49 patients, mostly women (98%) with mean age 30,8±10,2 years old. Neurological manifestation was the 3rd  most common diagnosis (43%) after hematologic disorder (73.5%) arthritis (53.1%). The manifestations of neuropsychiatric manifestation were mainly seizures (40.8%), headache (34.7%), cerebrovascular disease (26.5%), acute confusional state (20.4%), cognitive dysfunction (6.1%), and polyneuropathy (8.2%).Discussion: The most common neuropsychiatric clinical features in SLE patients are seizures, headache, cerebrovascular disease, and acute confusional state.Keywords: Lupus neuropsychiatry, prevalence, systemic lupus erythematosusABSTRAKPendahuluan: Lupus eritematosus sistemik (LES) merupakan penyakit inflamasi autoimun kronik yang belum diketahui penyebabnya dengan perjalanan penyakit yang luas. Manifestasi klinis LES sangat beragam, antara lain keterlibatan sistem saraf dan sindrom psikiatri (neuropsikiatri).Tujuan: Untuk mengetahui manifestasi neuropsikiatrik pasien dengan LES di RSUD Dr. Soetomo, Surabaya.Metodologi: Penelitian potong lintang berdasarkan data rekam medik terhadap semua pasien LES yang dirawat di RSUD Dr. Soetomo, Surabaya, pada bulan Januari hingga Desember 2017. Manifestasi neuropsikiatrik dinilain berdasarkan nomenklatur American College of Rheumatology (ACR) tahun 1999.Hasil: Didapatkan 49 subjek yang hampir semuanya (98%) adalah perempuan dengan rerata usia 30,8±10,2 tahun. Gangguan neurologis merupakan ketiga tersering (43%) setelah gangguan hematologi (73,5%) dan artritis (53,1%). Manifestasi neuropsikiatri terutama kejang (40,8%), nyeri kepala (34,7%), penyakit serebrovaskular (26,5%), keadaan konfusi akut (20,4%), dan polineuropati (8,2%).Diskusi: Manifestasi klinis neuropsikiatri yang paling banyak dialami oleh pasien LES adalah kejang, nyeri kepala, penyakit serebrovaskular, dan keadaan konfusi akut.Kata kunci: Lupus eritematosus sistemik, manifestasi klinis, neuropsikiatri  
DIFFERENTIATION T LYMPHOCYTE CELLS EXPRESSING INTERLEUKIN-17 PERCENTAGE ON HEALTHY PERSON AND ADULT ACUTE MYELOID LEUKEMIA PATIENT Elvan Dwi Widyadi; Yetti Hernaningsih; Endang Retnowati; Ugroseno Ugroseno; Ryzky Widi Atmaja
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1383

Abstract

Acute Mieloid Leukemia (AML) is a hematologic cause of cancer deaths of 1.2% including a relatively rare disease but by the end of the decade there is an increase in the number of new cases. The immune system in AML is caused by gene mutations giving immunosuppressive effects so that the immune system will be inhibited in eliminating leukemia cells. The immune response of tumors is important to determine the prognosis, development of new cancer immunotherapy as well. One of the subset of lymphocytes T is  gdT lymphocyte cell with innate nature, but until now no information is required about gdT cell profile in AML patients. gdT cells have properties as antitumors played by Interferon production g (INF g), and the nature of protumor by interleukin 17 (IL-17). The percentage of lymphocyte T (CD3 +) of AML patients and healthy people did not differ (p = 0.528), indicating, not being activated for proliferation. gdT Lymphocyte cells percentage in healthy people by race, genetic and exposure to the surrounding environment such as infection. Percentage of gdT lymphocyte of AML patients and healthy people was not different from (p = 0.694), showed an immune response by gdT cells Unefected to proliferate. The percentage of gdT llimfocytes expressing the interleukin 17 (gdT17 cells)in patients AML and healthy people did not differ significantly (p = 0.436), this indicates inhibited proliferation.
Correlation Glucose, Uric Acid, and Cholesterol Levels Towards Health Conditions in the Highlands: POCT Approach Arifa Mustika; Yetti Hernaningsih; Puspa Wardhani; Siti Khaerunnisa; Nastasya Nunki; Baiq Nasha Islaeli; Uli Mas'uliyah Indarwati; Musholli Himmatun Nabilah; Teguh Satrio; Alfino Validita Sidiq; Fita Triastuti; Mochammad Reza Desianto; Agil Saputra; Novi Ersanto; Widaninggar Rahma Putri; Desty Indah Sari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 3 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i3.2203

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Degenerative diseases arise when age increases due to the weakening of the body's physiological condition. The purpose of this study was to measure glucose, uric acid, and cholesterol levels in residents of Segunung Village to improve lifestyles and quality of life. As many as 110 residents of Segunung Village were used as subjects in this cross-sectional study. Glucose, uric acid, and cholesterol levels were measured using Point of Care Testing (POCT). A cut-off value of <200 was used to define high cholesterol levels. Only cholesterol levels showed an increase when compared with reference values, while glucose and uric acid levels were normal. Interestingly glucose was significantly correlated with age (r=0.309, p=0.001). The approach using POCT describes the overall condition of Segunung villagers and can be used as a basis for glucose, uric acid, and cholesterol screening tests.
Clinical and laboratory effects of exchange transfusion in pediatric acute lymphoblastic leukemia with hyperleukocytosis Lazuwardi, Rasya Azka; Andarsini, Mia Ratwita; Hernaningsih, Yetti
Paediatrica Indonesiana Vol. 63 No. 6 (2023): November 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.6.2023.464-71

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Background Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. Emergency complications such as hyperleukocytosis can arise as the disease develops. Exchange transfusion is one of many cytoreductive modalities to resolve the condition. Objective To analyze the clinical and laboratory effects of exchange transfusion in childhood acute lymphoblastic leukemia patients with hyperleukocytosis. Methods This analytical retrospective cohort study with a pre- and post-test design used secondary medical record data. The obtained characteristics were the incidences of dyspnea, tachypnea, headache, intracranial bleeding, hepatomegaly, splenomegaly, lymphadenopathy, abdominal pain, fever, pallor, nausea/vomiting, and skin or mucosal bleeding; hemoglobin, white blood cell, and platelet counts; and serum potassium, sodium, calcium, phosphate, blood urea nitrogen, and creatinine levels. Results A total of 16 patients underwent exchange transfusion; they had significant reductions of the incidence of dyspnea, tachypnea, hepatomegaly, and pallor and significant improvement in the form of elevation of hemoglobin level and decrease in white blood cell counts (P<0.05 for all) compared to pre-treatment. The remainder of the variables were not significantly different between pre- and post-treatment, but a general decrease in all clinical manifestations except intracranial bleeding was observed. Conclusion Exchange transfusion has the beneficial effect of resolving hyperleukocytosis and its manifestations, although correction in laboratory outcomes that remained abnormal are still needed.
PLATELET RICH PLASMA PREPARATION PROTOCOLS: A PRELIMINARY STUDY Nugraha, Hans Kristian; Muljanti, Meiti; Hernaningsih, Yetti; Nugraha, Jusak
Indonesian Journal of Tropical and Infectious Disease Vol. 3 No. 2 (2012)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (101.43 KB) | DOI: 10.20473/ijtid.v3i2.216

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Currently, therapy with Platelet Rich Plasma (PRP) has been widely used and continues to grow for various clinical applications. Along with its development, there are various options in the method of obtaining PRP, either automatic or manual, while one of the most reliable methods according to the literature is a double centrifugation method. The purpose of this research is to produce anoptimization of the double centrifugation method. This study used experimental data obtained by conducting a research at the Clinical Pathology Laboratory of Dr. Soetomo Hospital, Surabaya. Experiments were conducted on stored blood obtained from the blood bag from Indonesian Red Crossand fresh blood from healthy donors with CPD anticoagulant. Results: PRP with optimum platelet count could be made with sufficient personal laboratory skills and amounted to 4.11 times with the platelet count of 1.152 million using 1300 rcf for 5 minutes for the first centrifugation, and 2300 rcf for 7 minutes for the second centrifugation.
Correlation Between Risk of Febrile Neutropenia Based on Rondinelli Score with Clinical Outcomes in Acute Lymphoblastic Leukemia Patients Alifadiningrat, Dianira Hanum Febia; Puspitasari, Dwiyanti; Hernaningsih, Yetti
Indonesian Journal of Tropical and Infectious Disease Vol. 10 No. 1 (2022)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v10i1.31916

Abstract

Febrile neutropenia (FN) is the most severe complication in patients with blood cancer and chemotherapy. Acute lymphoblastic leukemia (ALL) is the most common type of cancer in children and the most common cause of febrile neutropenia. The low number of neutrophils in ALL patients due to lymphoblast cancer cells and the toxicity of chemotherapy makes patients susceptible to infection which, if not treated immediately, can lead to death. Early risk assessment for infectious complications in FN patients is needed to increase clinician awareness in high-risk patients and eliminate unnecessary therapy for low-risk patients. The Rondinelli scoring system is a reasonably good instrument for predicting severe infectious complications in pediatric patients with ALL who have febrile neutropenia. This study aims to determine the relationship between the risk category for febrile neutropenia (FN) based on the Rondinelli score with clinical outcomes in FN patients with acute lymphoblastic leukemia (ALL) in the Hematology-Oncology division of the child health department of RSUD Dr. Soetomo. This analytic observational study used secondary data FN patients with acute lymphoblastic leukemia (ALL) implementing a total sampling. From 30 samples of pediatric ALL patients with febrile neutropenia at Dr. Soetomo Hospital for June 2018-June 2020 it was found 17 patients (56.7%) had a moderate risk score category, and 13 others were in a low-risk category (43.3 %). Patients were dominated by moderate and severe severity of neutropenia respectively, 43.3%, had neutropenia for 1-7 days (50%), fever less than seven days (66.7%), had a length of stay of 8-14 days, and 15-30 days 33.3% each. Conclusion from this research is that there was a signifi cant relationship between the Rondinelli score category in pediatric ALL patients with FN with the severity of neutropenia p=0.037; R=0.383), duration of neutropenia (p=0.021; R=0.420), duration of fever (p=0.000; R=0.618), and length of stay (p-value 0.005; R=0.496).
Hemocoagulation Conditions Associated with Venom-Induced Consumption Coagulopathy due to Snakebite in Humans Rinta Prasetiyanti; Yetti Hernaningsih
Folia Medica Indonesiana Vol. 60 No. 2 (2024): June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v60i2.49436

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Highlights:1. This review comprehensively highlighted aspects of hematologic abnormalities in snakebites, a topic that remains understudied globally.2. This review contributes insights into the field of snakebite research and improves the management of snakebites by examining the diverse effects of different types of snakebites on hemocoagulation status.   Abstract Snakebite remains an underreported health hazard worldwide. The most common effects of snakebite envenomation globally are hematological disorders, with venom-induced consumption coagulopathy (VICC) being the most prevalent and significant condition. This review aimed to explore the hematological aspects of snakebite, with a focus on snakebite-induced consumption coagulopathy. We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines through a search across several databases, namely PubMed, ScienceDirect, and Google Scholar. The inclusion criteria for this review were studies on snakebite envenomation in humans with a discussion of relevant cases. Additionally, the included studies were conducted between 2010 and 2023 and published in the English language. Studies on animal models were excluded. We used the keywords “venom-induced consumption coagulopathy AND snake" in the search. The critical appraisal was performed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports and the Mixed Methods Appraisal Tool (MMAT). The findings were presented as a qualitative synthesis of 14 articles covering 316 patients and various snakebite types. The studies on snakebite came from various countries, but mostly from Sri Lanka. The snake types exhibited variation, with certain species existing only in specific areas. The subjects fell into different age groups, from children to the elderly. The majority of the subjects were male. The subjects' youngest age was 6 years old, while the oldest was 70 years old. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were the most discussed variables. Some of the studies demonstrated an increase in PT and APTT, although other studies reported contrasting findings. In conclusion, certain types of snakebite have a different impact on the hemocoagulation status.
The Differences between Pre- and Post-Therapy Levels of Platelet Count and Platelet Indices in Children with Immune Thrombocytopenia Purpura -, Regina Rania Cahya Kusumaningrum; Mia Ratwita Andarsini; Yetti Hernaningsih; Pradana Zaky Romadhon
Folia Medica Indonesiana Vol. 60 No. 4 (2024): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v60i4.65626

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Highlights:1. This study was the first to analyze the therapeutic response in children with ITP at Dr. Soetomo General Academic Hospital, Surabaya.2. This study analyzed the response of platelet count and indices, including MPV, PDW, P-LCR, and PCT to therapy, which provides a more comprehensive perspective on therapy response in children with ITP.3. This study explored the effectiveness of various therapeutic approaches based on ITP categories, offering new insights into the most effective treatment options for children with ITP. AbstractImmune Thrombocytopenia Purpura (ITP) is an autoimmune disorder triggered by antiplatelet autoantibodies. Clinically, ITP is classified into three phases including Newly-Diagnosed ITP, Persistent ITP, and Chronic ITP, each with distinct durations and therapy implications. Patients with ITP who do not receive appropriate or optimal treatment are at a heightened risk of morbidity and mortality related to bleeding complications, the condition could worsen, potentially resulting in fatal consequences. In ITP patients, platelet counts decrease, accompanied by abnormal shifts in platelet indices, including Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet Large Cell Ratio (P-LCR), and Plateletcrit (PCT). Thus, therapeutic response in ITP patients can be evaluated through increased platelet counts and normalization of platelet indices. This study aimed to assess the therapeutic response of platelet counts and platelet indices in pediatric ITP patients by comparing pre- and post- therapy levels overall by category, across all medication types administered, and according to the specific medication used within each category. The result of this study are expected to provide an overview of the most effective treatments across all ITP categories in order to prevent severe complications and reduce the risk of mortality. This retrospective study included ITP patients under 18 years old at Dr. Soetomo General Academic Hospital, Surabaya, conducted from September 2023 to March 2024. Platelet count and platelet indices pre- and post-therapy levels were analyzed using the Paired T-test for normally distributed data and the Wilcoxon test for non-normally distributed data, with significance set at p < 0.05. In summary, there were notable changes in the pre- and post-therapy levels of platelet, MPV, PDW, P-LCR, and PCT in each ITP category and for all therapies. Platelet count and PCT increased, while MPV, PDW, and P-LCR decreased. Patients treated with prednisone exhibited the best therapeutic response. Among the categories, Newly Diagnosed ITP demonstrated the most optimal therapeutic response. Overall, ITP therapy led to significant differences between pre- and post-therapy levels, marked by an increase in platelet counts and normalization of platelet indices.
OPTIMATION OF PLATELET RICH PLASMA PRODUCTION PROTOCOL USING DOUBLE CENTRIFUGATION METHODS Nugraha, Hans Kristian; Hernaningsih, Yetti; Nugraha, Jusak
Folia Medica Indonesiana Vol. 51 No. 3 (2015): July - September 2015
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (42.569 KB) | DOI: 10.20473/fmi.v51i3.2832

Abstract

Currently, therapy with Platelet Rich Plasma (PRP) has been widely used and continues to grow for various clinical applications. Along with its development, there are various options in the method of obtaining PRP, either automatic or manual, while one of the most reliable according to the literature is a double centrifugation method. The purpose of this research is to produce an optimization of the double centrifugation method. This study uses experimental data obtained by researchers at the Clinical Pathology Laboratory of Dr. Soetomo Hospital, Surabaya. Experiments generally were conducted on stored blood obtained from the blood bag from PMI with CPD anticoagulant. Optimization of double centrifugation method to produce PRP with optimum platelet count could be obtained by using an "I"-shaped tube as well as other specialized equipment which are currently not available in standard clinical pathology laboratory, and also fresh blood. The resulting increase amounted to 4.11 times with the platelet count of 1.152 million.
Co-Authors -, Regina Rania Cahya Kusumaningrum Adil Dinata Simangunsong Agil Saputra Alfino Validita Sidiq Alifadiningrat, Dianira Hanum Febia Almira, Naufalia Ghina Alpha Fardah Athiyyah Amalia, Yustisia Anang Endaryanto Andi Cahyadi Andrianto Andy Cahyadi Ardhi, Mohammad Saiful Arifa Mustika Arifa Mustika Arifoel Hajat Armayani, Erawati Aryati Aryati Aulia, Fauqa Arinil Awalia Awaliah Baiq Nasha Islaeli Bintoro, Siprianus Ugroseno Yudho Budi Utomo Chelssi Gloria Tessari Cita Rosita Sigit Prakoeswa Citra Amaniah Anhar Danny Meganingdyah Primartati Deasy Fetarayani Desty Indah Sari Diah Puspitarini Dwiyanti Puspitasari, Dwiyanti DYAH FAUZIAH, DYAH Elvan Dwi Widyadi Elvan Dwi Widyadi Endang Retnowati Endang Retnowati Endang Retnowati Erawati Armayani Esti Rohani Farida Nur’Aini Fauqa Arinil Aulia Fita Triastuti Gatot Soegiarto Hanik Badriyah Hidayati,* Mohammad Hasan Machfoed,* Kuntoro,** Soetojo,*** Budi Santoso,**** Suroto,***** Budi Utomo****** Hans Kristian Nugraha, Hans Kristian Hartono Kahar, Hartono Hasan, Helmia Heny Arwati I Dewa Gede Ugrasena Indrasari, Yulia Indrasari, Yulia Nadar Indriastuti, Endah INGRID SURYANTI SURONO Jusak Nugraha Juwita, Syntia Tanu Kezia Warokka Putri Koko Aprianto Kusuma, Edward Putra Lazuwardi, Rasya Azka Lefi, Achmad Meiti Muljanti, Meiti Mia Ratwita A Mia Ratwita Andarsini Mochammad Reza Desianto MOCHAMMAD THAHA Musholli Himmatun Nabilah Nadya Rinda Eka Rana Nanda Aulya Ramadhan Narazah Mohd Yusoff Nastasya Nunki Nathalya Dwi Kartikasari Ni Made Rindra Hermawathi Notopuro, Paulus Budiono Novi Ersanto Nugraha, Hans K Nunki, Nastasya Nur‘ Aini, Farida Puspa Wardhani Puspa Wardhani, Soebagijo Adi Puspitasari, Yessy Putri Rahayu Putri, Aditea Etawati Rahmi Rusanti Rahmi Rusanti, Rahmi RINI RINI Rinta Prasetiyanti Romadhon, Pradana Zaky Rusli, Musofa Ryzky Widi Atmaja Ryzky Widi Atmaja S.Pd. M Kes I Ketut Sudiana . Sellynastiti, Sarah Triwinar Shinta Lungit Ambaringrum Sidarti Soehita Siti Khaerunnisa Soeprapto Ma’at Sri Ratna Dwiningsih Suprapto Ma&#039;at Ma&#039;at Suprapto Ma’at Syntia TJ Tanzilia, May Fanny Teguh Satrio Thengkano, Irwanto Ugroseno Ugroseno Uli Mas'uliyah Indarwati Ummi Maimunah Veithzal Rivai Zainal Wardhani, Puspa Widaninggar Rahma Putri Widodo Widodo Widodo Widodo Widodo Widodo Wulyansari Wulyansari Yanuari Primariawan, Relly Yosua Butar Butar Yulia Nadar Indrasari Yusuf, Moch Zaky Firmawan El-Hakim