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All Journal Resona : Jurnal Ilmiah Pengabdian Masyarakat Martabe : Jurnal Pengabdian Kepada Masyarakat PHARMACY: Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia) Jurnal Ilmu Kefarmasian Indonesia Jurnal Surya Lumbung Farmasi : Jurnal Ilmu Kefarmasian Journal Pharmasci (Journal of Pharmacy and Science) Jurnal Ilmiah Ibnu Sina (JIIS): Ilmu Farmasi dan Kesehatan Strada Jurnal Ilmiah Kesehatan (SJIK)
Iin Ernawati
Akademi Farmasi Surabaya
Agriculture, Biological Sciences & Forestry Arts Humanities Biochemistry, Genetics & Molecular Biology Chemistry Dentistry Education Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Nursing Public Health Social Sciences

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Hubungan Kepatuhan Penggunaan Obat Anti Epilepsi terhadap Kejadian Kejang Pasien Epilepsi menggunakan kuesioner ARMS (Adherence Refill Medication Scale) Ernawati, Iin; Islamiyah, Wardah Rahmatul
Journal of Pharmacy and Science Vol. 4 No. 1 (2019): Journal of Pharmacy and Science
Publisher : Akademi Farmasi Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53342/pharmasci.v4i1.128

Abstract

ABSTRAKEpilepsi termasuk penyakit kronis otak yang dikarakterisasi dengan kejang berulang (2 kali atau lebih), dimana terjadi gerakan involunter yang melibatkan sebagian tubuh (partial) atau seluruh tubuh (generale), dan seringkali disertai dengan hilangnya kesadaran dan kontrol fungsi saluran cerna atau saluran kemih. Pengobatan epeilepsi sering menggunakan OAE (Obat AntiEpilpsi). Diketahui 70% anak-anak dan dewasa dengan epilepsi berhasil diterapi dengan obat antiepilepsi. Salah satu ukuran manajemen terapi obat pada penyakit epilepsi adalah menurun atau hilangnya kejang, sehingga adanya kejadian kejang menjadi salah satu ukuran pencapaian end outcome. Kejadian kejang dipengaruhi oleh beberapa faktor diantaranya ada tidaknya faktor pemicu kejang dan kepatuhan konsumsi obat antiepilepsi. Penelitian ini merupakan penelitian observasional cross sectional yang dilakukan di poli neurologi Instalasi Rawat Jalan RSUD dr. Soetomo dan Instalasi rawat Jalan RS Universitas Airlangga. Selama penelitian diperoleh 52 pasien epilepsi yang menggunakan obat antiepilepsi. Padapenelitian ini diamati hubungan kepatuhan terhadap adanya kejang pasien epilepsi dalam penggunaan obat anti epilepsi. Pada penelitian ini diketahui nilai koefisien korelasi/ nilai rho (r) sebesar -0,348 dengan nilai p= 0,011 (p<0,05) atau signifikan secara statistik. Hasil tersebut menunjukkan adanya hubungan antara kategori kepatuhan (menggunakan kuesioner ARMS) dengan kejadian kejang, dimana semakin tinggi skor ARMS (dianggap semakin tidak patuh) berbanding lurus dengan peningkatan kejang.Kata kunci: Epilepsi, Kepatuhan, OAE, Kejang, ARMS ABSTRACTEpilepsy is a chronic brain disease characterized by recurrent seizures (2 times or more), in which involuntary movements involve part of the body (partial) or whole body (general). Treatment of epilepsy uses antiepileptic drugs. It is known that 70% of children and adults with epilepsy are successfully treated with antiepileptic drugs. One of measurements of drug therapy management in epilepsy is decreasing or losing seizures, so that the event of seizures is one measure of end outcomes. Seizure events are influenced by severalfactors including the presence or absence of seizure trigger factors and adherence with the consumption of antiepileptic drugs. This study was an observational cross sectional study conducted at the neurology department dr. Soetomo and Airlangga University hospital. This study aims to observe the relationship of adherence of antiepileptic drug consumption with seizures of epilepsy patients. This study observed 52outpatients with epilepsy taking antiepileptic drugs. This study showed that the correlation coefficient / rho value (r) is -0,348 with a value of p = 0.011 (p <0.05). These results indicate that an association between adherence categories (using the arms questionnaire) with the events of seizures, whereas the higher of the arms score (considered to be increasingly disobedient) is directly proportional to the increase in seizures.Keywords: Epilepsy, Adherence, AED, Seizure, ARMS
UJI VALIDITAS DAN RELIABILITAS KUESIONER KEPATUHAN MGLS (MORISKY, GREEN, LEVINE ADHERENCE SCALE) VERSI BAHASA INDONESIA TERHADAP PASIEN EPILEPSI Iin Ernawati; Wardah Rahmatul Islamiyah
Jurnal Ilmiah Ibnu Sina (JIIS): Ilmu Farmasi dan Kesehatan Vol 4 No 2 (2019): JIIS
Publisher : Sekolah Tinggi Ilmu Kesehatan ISFI Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (251.407 KB) | DOI: 10.36387/jiis.v4i2.330

Abstract

Epilepsy is a chronic brain disease that is characterized by seizures spontaneously, recurs and there is no improvement in each seizure. One measure of therapy epilepsy is decreased or loss of seizures. One of the things that still causes the uncontrolled seizure is adherence. Measurement of adherence in epilepsy patients is one of the tool for know related to the type of therapy and intervention provided. One of the adherence questionnaires that can be used is MGLS (Morisky, Green, Levine Scale Adherence Scale). The MGLS questionnaire is a adherence questionnaire with 4 items of questions, where the questionnaire questions can describe the level of patient adherence in drug consumption. The purpose of this study is to test the validity and reliability of the MGLS questionnaire with the intention that the questionnaire can be applied to patients.This study was a descriptive observational study conducted on epilepsy patients at Airlangga University Hospital. Sampling was done through consecutive sampling method, obtained 42 epilepsy patients between May-July 2018. Validity test was carried out using the Pearson correlation method (correction value ≥0.3) and the reliability test using internal cronbach alpha coefficient ≥0.6. Based on the results of the validity test it is known that the correlation score of each question with the total score is known to correlate more than r table (N = 42) 0.3496. These results indicate that all questions on the Indonesian version of the MGLS questionnaire are valid. Reliability test showed cronbach alpha coefficient 0.634> 0.6 (p <0.05). The conclusion of this study is the valid and reliable MGLS Indonesian version of the questionnaire instrument to determine the level of adherence in epilepsy patients.
SOSIALISASI PERAN TENAGA FARMASI DALAM PENYIAPAN DAN PENGELOLAAN OBAT DAN PERBEKALAN FARMASI SEBAGAI UPAYA TANGGAP BENCANA Iin Ernawati; Silfiana Nisa Permatasari; Safira Yulita Fazadini; Satriyo Nurseno
Martabe : Jurnal Pengabdian Kepada Masyarakat Vol 5, No 3 (2022): Martabe : Jurnal Pengabdian Kepada Masyarakat
Publisher : Universitas Muhammadiyah Tapanuli Selatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31604/jpm.v5i3.1024-1030

Abstract

Indonesia merupakan negara yang secara geografis berada di garis khatulistiwa, kepulauan dengan potensi besar adanya berbagai jenis bencana alam seperti banjir, kekeringan, banjir bandang, cuaca ekstrim, gempa bumi, kebakaran lahan dan hutan  dan gelombang ekstrim. Manajemen dalam penanggulangan bencana dilakukan seluruh kejadian bencana (sebelum, saat dan setelah bencana). Pemahaman mengenai jenis-jenis bencana, antisipasi dan manajemen individu maupun komunitas dalam menyikapi dampak dari kejadian bencana termasuk kondisi krisis kesehatan yang dialami saat bencana. Melalui upaya pemberian informasi mengenai kesiapsiagaan bencana, penyiapan pengobatan mandiri oleh masyarakat sebagai bentuk pencegahan terjadinya krisis kesehatan yang mengancam jiwa dan munculnya masalah kesehatan yang terjadi akibat terjadinya bencana. Peran tenaga farmasi dalam penanggulangan bencana terjadi pada pra (sebelum), saat, dan pasca (setelah) bencana. Pengabdian masyarakat yang dilakukan dalam bentuk sosialisasi ini mendatangkan narasumber dari BPBD (Badan Penanggulangan Bencana Daerah) Provinsi Jawa Timur terkait pengenalan bencana dan kondisi tanggap bencana, kemudian masalah lain terkait pengelolaan serta jenis obat dan alkes yang harus diketahui oleh tenaga teknis farmasi pada saat tanggap bencana dipaparkan oleh dosen dari Akademi Farmasi Surabaya. Peserta pengabdian masyarakat diberikan pre-test sebelum acara pemaparan materi dan sosialisasi dimulai untuk melihat sejauh mana pengetahuan mereka terkait bencana, edukasi dan peran farmasi. Berdasarkan hasil dari rekapitulasi penilaian skor dari hasil pre-test mayoritas mendapatkan skor rata-rata 50. Kenaikan tingkat pengetahuan terjadi setelah mendapatkan sosialisasi dan berdasarkan hasil uji statistic non-parametric Wilcoxon diketahui bahwa adanya sosialisasi memberikan pengaruh yang signifikan terhadap kenaikan skor pengetahuan (p-value=0.000 <0,05).
Profil Penggunaan Obat Antianemia, Antihipertensi, dan Antidiabetik pada Pasien Penyakit Ginjal Kronik di Salah Satu Rumah Sakit Wilayah Surabaya Selatan Ninik Mas Ulfa; Iin Ernawati; Purwanti Purwanti; Riki Kurniawanto; Ari Indrawati
PHARMACY: Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia) Jurnal Pharmacy, Vol. 16 No. 02 Desember 2019
Publisher : Pharmacy Faculty, Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/pharmacy.v16i2.5724

Abstract

Penyakit ginjal kronis (PGK) merupakan gangguan fungsi renal yang progresif dimana kemampuan tubuh gagal untuk mempertahankan metabolisme dan keseimbangan cairan elektrolit dan menyebabkan uremia. Tujuan penelitian ini untuk mengetahui profil penggunaan obat antianemia, antihipertensi, dan antidiabetik pada pasien PGK dengan hemodialisa. Penelitian ini dilakukan di Rumah Sakit Wilayah Surabaya Selatan. Penelitian ini bersifat deskriptif observasional menggunakan data secara retrospektif, pada bulan Januari-Maret 2018. Berdasarkan hasil penelitian diperoleh pada pemakaian obat antianemia dengan menggunakan  EPO alfa 2000 IU dan 3000 IU, keduanya dapat meningkatkan kadar Hb. Variasi dosis EPO alfa yang digunakan yaitu dosis 2000 IU sebanyak 60% pasien dan 3000 IU sebanyak 40% pasien. Untuk obat antihipertensi pemakaian terbanyak kombinasi irbesartan 300 mg dan amlodipine 10 mg dengan frekuensi pemberian 1 kali sehari 1 tablet. Antidiabetik yang digunakan pada pasien PGK adalah kombinasi insulin basal dan prandial sebanyak 80% daripada terapi OAD atau insulin tunggal. Pada golongan sulfonilurea digunakan gliquidone dosis 30 mg dengan frekuensi satu kali sehari (20%). Golongan insulin paling banyak diberikan adalah kombinasi insulin analog kerja panjang dan insulin aspart analog kerja cepat (34%).
PENINGKATAN PENGETAHUAN MASYARAKAT MENGENAI BIJAK PENGGUNAAN SUPLEMEN DI ERA COVID-19 Iin Ernawati; Safira Yulita Fazadini
RESONA : Jurnal Ilmiah Pengabdian Masyarakat Vol 6, No 1 (2022)
Publisher : Lembaga Penerbitan dan Publikasi Ilmiah (LPPI) Universitas Muhammadiyah Palopo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35906/resona.v6i1.787

Abstract

COVID-19 saat ini telah menjadi penyebab masalah kesehatan di dunia. Salah satu upaya pencegahan melalui peningkatan daya tahan tubuh masyarakat dengan mengkonsumsi suplemen kesehatan. Pada saat awal pandemi COVID-19 terjadi kelangkaan suplemen, hal ini dikarenakan terjadinya Panic Buying, sehingga perlu dilakukan upaya untuk meningkatkan pengetahuan tentang penggunaan suplemen. Vitamin dan suplemen sebaiknya dikonsumsi di saat tubuh memang membutuhkan. Konsumsi vitamin dan suplemen yang tidak tepat dapat menyebabkan efek yang tidak diharapkan dan interaksi dengan obat lain yang mungkin dikonsumsi bersamaan. Peningkatan pengetahuan tentang suplemen ini pada pengabdian masyarakat ini dilakukan melalui penyuluhan yang dilakukan secara daring/online agar tidak terjadi kerumunan serta penyebaran brosur kepada warga tentang bijak penggunaan suplemen. Penyuluhan ini dilakukan pada warga Kampung Gadukan, Kecamatan Krembangan, Surabaya.  Untuk melihat pemahaman masyarakat terhadap penggunaan suplemen dilakukan pemberian kuesioner sebelum dan setelah pemberian informasi. Berdasarkan hasil tersebut diketahui bahwa pemberian penyuluhan melalui daring pada 114 warga Kampung Gadukan dapat memberikan pengaruh secara signifikan secara statistic (p=0,005) terhadap peningkatan pengetahuan mengenai bijak penggunaan suplemen di Era Covid 19.  Abstract. COVID-19 has now become the cause of health problems in the world. One of the prevention efforts is to increase the community's immune system by consuming health supplements. At the beginning of the COVID-19 pandemic, there was a shortage of supplements, this was due to Panic Buying, so it was necessary to make efforts to increase knowledge about the use of supplements. Vitamins and supplements should be taken when the body really needs it. Inappropriate consumption of vitamins and supplements can cause unwanted effects and interactions with other drugs that may be taken at the same time. Increased knowledge about this supplement in community service is carried out through online counseling so that there are no crowds and distributing brochures to residents about the wise use of supplements. This counseling was carried out to residents of Kampung Gadukan, Krembangan District, Surabaya. To see the public's understanding of the use of supplements, questionnaires were administered before and after the provision of information. Based on these results, it is known that providing online counseling to 114 residents of Kampung Gadukan can have a statistically significant effect (p = 0.005) on increasing knowledge about wise use of supplements in the Covid 19 Era.
Profil Penggunaan Obat Antihipertensi di Puskesmas Surabaya. Iin Ernawati; Selly Septi Fandinata; Silfiana Nisa Permatasari
Lumbung Farmasi: Jurnal Ilmu Kefarmasian Vol 3, No 2 (2022): Juli
Publisher : UNIVERSITAS MUHAMMADIYAH MATARAM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31764/lf.v3i2.7679

Abstract

ABSTRAKHipertensi adalah penyakit kronis dengan tekanan darah sistolik dan diastolic meningkat ≥140/90 mmHg. Prevalensi pasien hipertensi meningkat di Puskesmas, sehingga perlu adanya observasi penggunaan obat antihipertensi sebagai data awal untuk melakukan monitoring penggunaan dan pengadaan obat. Penelitian ini dilakukan untuk mengetahui profil penggunaan obat antihipertensi yang meliputi nama obat, golongan dan aturan pakai obat antihipertensi. Penelitian ini merupakan penelitian observasional cross-sectional, yang dilakukan di 5 Puskesmas di Surabaya antara lain Puskesmas Benowo, Jeruk, Tambak Rejo, Gayungan, dan Ketabang. Pengumpulan data retrospektif dilakukan selama 2 bulan pada bulan Mei-Juni 2020. Berdasarkan hasil penelitian diketahui bahwa mayoritas pasien mendapatkan obat antihipertensi golongan CCB (Calcium Channel Blocker ) sebesar 82,37% dengan obat amlodipine 5 mg (49,19%) dan amlodipine 10 mg (32,95%), sedangkan untuk penggunaan obat antihipertensi kombinasi, mayoritas golongan CCB dan Diuretik Thiazid dengan nama obat Amlodipine 5 mg dan Hidroklorotiazid 25 mg (6,63%). Obat Amlodipine sebagai obat antihipertensi golongan CCB yang paling banyak digunakan dengan aturan pakai sekali sehari. Amlodipine salah satu obat antihipertensi yang toleran terhadap pasien geriatri dengan efek samping vasodilatasi yang lebih rendah dibanding obat lain dari golongan CCB dan memiliki waktu paruh yang panjang sehingga dapat diaplikasikan pada pasien kronis rawat jalan hipertensi dengan pemberian sekali sehari. Kata kunci : Obat antihipertensi; Puskesmas; Hipertensi; Profil. ABSTRACTHypertension is a chronic disease that is an increase in systolic and diastolic blood pressure 140/90 mmHg. The prevalence of hypertension patients is increasing at the Puskesmas, so it is necessary to observe the usage profile of antihypertensive drugs. This research is needed as initial data to monitor the use and procurement of drugs. This study aims to determine the profile of the use of antihypertensive drugs which includes the name of the drug and the rules of antihypertensive drugs. This observation is a cross-sectional study, which was conducted in 5 Public Health Center (Puskesmas) in Surabaya, including Benowo, Jeruk, Tambak Rejo, Gayungan, and Ketabang Public Health Center. Retrospective data collection was carried out for two months in May-June 2020. Based on the results of the study, it was found that the majority of patients received antihypertensive drugs from the Calcium Channel Blocker (CCB) class of 82.37% with amlodipine 5 mg (49.19%) and amlodipine 10 mg (32.95%), while for the use of combination antihypertensive drugs, the majority CCB and Thiazide Diuretics with the drug names Amlodipine 5 mg and Hydrochlorothiazide 25 mg (6.63%). Amlodipine as an antihypertensive drug of the CCB class is the most widely used in this research. Amlodipine is an antihypertensive drug that is tolerant to geriatric patients with lower vasodilation side effects than other drugs from the CCB group and has a long half-life so it can be applied to chronic hypertension outpatients and is given once a day. Keywords : Antihypertensive drug; Community Health Center; Hypertension; Profile.
Association of side effects to medication adherence of antiepileptic drug use in epileptic patients Ernawati, Iin; Wyono, Oktaviani Putri; Yunitasari, Fitria Dewi; Pradani, Erwindy Yastika; Islamiyah, Wardah Rahmatul
JURNAL ILMU KEFARMASIAN INDONESIA Vol 22 No 1 (2024): JIFI
Publisher : Faculty of Pharmacy, Universitas Pancasila

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35814/jifi.v22i1.1269

Abstract

Epilepsy is a chronic neurological disorder with symptoms characterized by seizures, arising spontaneously with brief episodes with the main symptom of decreased or loss of consciousness. This study aims to examine the effect of side effects of medication adherence to antiepileptic drug use in epilepsy patients. This research is an observational study that was analyzed using quantitative descriptive methods in Neurology patients at the Airlangga University Hospital from March until May 2022. Side effects were measured using the LAEP (Liverpool Adverse Effects Profile) questionnaire and adherence was measured using a pill count. Results showed that the influence of side effects on medication adherence (pill count method) to antiepileptic drugs using linear regression, it is known that the P-value is 0.501. There is no significant relationship between the category of side effects and medication adherence to antiepileptic drugs. Another factor that influences compliance with medication use is the appearance of seizures. Based on the results of this study, it is known that the greater the frequency of seizures, the more likely patients are to be non-compliant (P-value 0.006). To increase adherence, it is necessary to pay attention to other factors such as knowledge, economy, and type of therapy in epilepsy patients so that therapeutic outcomes can be achieved.
The Effect of The Number of Drugs Received On The Level of Adherence to Drug Consumption (Morisky, Green, Levine Adherence Scale Questionnaire) of Hypertensive Patients Iin Ernawati; Selly Septi Fandinata; Silfiana Nisa Permatasari
STRADA : Jurnal Ilmiah Kesehatan Vol. 9 No. 2 (2020): November
Publisher : Universitas STRADA Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30994/sjik.v9i2.394

Abstract

Hypertension is a chronic disease that requires long-term treatment, where it is very prone to non-adherence in taking antihypertensive drugs. This study aims to determine the effect of the number of drugs received by patients on the level of adherence to the consumption of antihypertensive drugs. This research is a cross-sectional observational study that was conducted in 4 community health centers in Surabaya City. The measurement of adherence in this study used the Indonesian version of the MGLS questionnaire. The number of subjects in this study was 143 which fit the inclusion criteria. The majority of the adherence levels of the study subjects were moderate (MGLS questionnaire). Based on statistical analysis, it is known that there is a significant effect (P = 0.035) of the number of drugs received by patients on the level of drug consumption adherence e as measured using the Indonesian version of the MGLS questionnaire.
The Effects of Self Reminder Card to the Successful Treatment of Blood Pressure of Hypertension Patients in Community Health Centers in Surabaya Selly Septi Fandinata; Iin Ernawati
STRADA : Jurnal Ilmiah Kesehatan Vol. 9 No. 2 (2020): November
Publisher : Universitas STRADA Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30994/sjik.v9i2.395

Abstract

Hypertension treatment aims to control blood pressure. Self-reminder card is a tool that can help patients to avoid forget in taking the medicine. The purpose of determine the effects of self-reminder cards on the successful treatment of blood pressure in hypertension patients at community health centers in Surabaya. Research design Quasi Experimental control and self-reminder card group pre post prospective with Wilcoxon and Mann Whitney test Analysis. The sample was 115 patients. The results showed that the systolic blood pressure of the patients pre post the intervention group (p = 0.009) and test of both groups (p = 0.009) so that effect the successful in reducing systolic blood pressure of hypertension patients. In the pre post diastolic blood pressure of the intervention group (p = 0.016) and test was conducted for both groups (p = 0.935) so that no effect the successful in reducing diastolic blood pressure in hypertension patients.
Physical Characteristics of Lip Cream Preparations with Natural Coloring Beetroot Extract (Beta Vulgaris L.) Fazadini, Safira Yulita; Ernawati, Iin
Jurnal Surya Vol 16 No 1 (2024): VOL 16 NO 01 APRIL 2024
Publisher : Universitas Muhammadiyah Lamongan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.38040/js.v16i1.896

Abstract

Introduction: Cosmetics are a primary need for women to help them appear more attractive, one of the lip coloring cosmetics that is currently in great demand among consumers is lip cream. Lip cream is a liquid lipstick preparation that can moisturize the lips for a long time compared to solid form and produces a more even color on the lips. Lip cream coloring ingredients can be obtained from synthetic dyes and natural dyes. The coloring (pigment) found in red beets is betalain which can be used as an antioxidantMethods: The research method is experimental. This research was carried out to formulate beetroot (Beta vulgaris L.) extract as a natural coloring for lip cream preparations. The independent variable in this research is beetroot (Beta vulgaris L.) extract as a natural coloring and the dependent variable is the physical characteristics of lip cream including organoleptic (shape, color and odor), pH, homogeneity and spread ability. Data analysis is descriptive.Results: The results of this research show that the lip cream preparation has the characteristics of being in a semi-solid form, with a purplish red color, and a distinctive rose smell. The color and smell did not change until day 7. The pH test showed a pH of 3.39 on day 1 and 5.49 on day 7. The homogeneity test showed it was homogeneous until day 7. The spreadability test showed that it could be spread with an average spreadability of 5 cm.Conclusion: This research shows that the lip cream color is dark or thick red in the preparation, organoleptic test, pH test, spreadability is in accordance with the desired design.
Co-Authors Ari Indrawati Fazadini, Safira Yulita Islamiyah, Wardah Rahmatul Nurseno, Satriyo Permatasari, Silfiana Nisa Pradani, Erwindy Yastika Purwanti Purwanti Riki Kurniawanto Safira Yulita Fazadini Safira Yulita Fazadini Satriyo Nurseno Septi Fandinata, Selly Ulfa, Ninik Mas Wyono, Oktaviani Putri Yulita Fazadini, Safira Yunitasari, Fitria Dewi