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All Journal Medical Journal of Indonesia Indonesian Journal of Urology Indonesian Journal of Cancer Indonesian Journal of Obstetrics & Gynecology Science Oto Rhino Laryngologica Indonesiana Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Narra J Cermin Dunia Kedokteran Indonesian Journal of Cancer Makara Journal of Health Research IJRETINA - International Journal of Retina Neurona Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute
Joedo Prihartono
Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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A novel diastolic dysfunction score: A proposed diagnostic predictor for left ventricular dysfunction in obese population Kamelia, Telly; Rumende, Cleopas M.; Makmun, Lukman H.; Timan, Ina S.; Djauzi, Samsuridjal; Prihartono, Joedo; Fardizza, Fauziah; Tabri, Nur A.
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1564

Abstract

Obesity-related diastolic dysfunction is an emerging contributor to heart failure and cardiovascular mortality. However, effective and accessible diagnostic tools are still limited. Current methods for assessing diastolic dysfunction are often invasive or technologically demanding, making them impractical for routine clinical use and community settings. The aim of this study was to develop a novel, non-invasive scoring system designed to predict diastolic dysfunction in obese adults, addressing this diagnostic gap. This community-based, prospective cross-sectional study was conducted in Jakarta, Indonesia, from March to November 2021, and included 82 participants aged 18 to 60 years, all with a body mass index (BMI) ≥25 kg/m². Patients with acute or critical illnesses, valvular heart diseases, or acute confusional states were excluded. Each participant underwent blood tests, polysomnography, and echocardiography. Of the study population, 80.5% were diagnosed with obstructive sleep apnea (OSA), and 12.2% exhibited diastolic dysfunction, all within the OSA group. The novel scoring system integrates four predictors: oxygen desaturation index (ODI) ≥39 (score 1; prevalence ratio: 4.31 (95% confidence interval (CI): 1.58–11.75)), HbA1C ≥5.95% (score 2; prevalence ratio: 6.32 (95%CI: 2.84–14.06)), pulmonary artery wedge pressure (PAWP) ≥10 mmHg (score 1; prevalence ratio: 5.95 (95%CI: 2.30–15.39)), and global longitudinal strain (GLS) ≥-16.95% (score 1; prevalence ratio: 4.32 (95%CI: 1.87–9.99)). A score of ≥2 predicted diastolic dysfunction with 90% sensitivity, with positive predictive value and negative predictive value of 40.91% and 98.33%, respectively. In conclusion, the diastolic dysfunction score is a simple and practical tool for the early detection of diastolic dysfunction in obese individuals without cardiovascular symptoms.
Tumor apparent diffusion coefficient value and ratio in magnetic resonance imaging on cervical cancer Siregar, Trifonia Pingkan; Wanandi, Septelia Inawati; Darmiati, Sawitri; Kusuma, Fitriyadi; Sekarutami, Sri Mutya; Lisnawati; Prihartono, Joedo; Ilyas, Muhammad; Amalia, Ginva; Elfahmi, Khalida Ikhlasiya Tajdar Gefariena
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257715

Abstract

BACKGROUND Diffusion-weighted magnetic resonance imaging (DW-MRI) is a noninvasive, non-contrast sequence for cancer detection. Research involving DW-MRI in cervical cancer has revealed lower apparent diffusion coefficient (ADC) values. This study aimed to evaluate the difference in tumor ADC values and ADC ratios (tumor-to-urine and tumor-to-muscle) with respect to tumor staging (early versus late) and histopathology (squamous cell carcinoma versus adenocarcinoma). METHODS This retrospective study included 56 patients with cervical cancer, divided into early- and late-stage groups. DW-MRI was performed in all patients, and the tumor ADC value, ADC ratio between the tumor and urine (ADC ratiot−u), and ADC ratio between the tumor and gluteal muscle (ADC ratiot−m) were measured. Statistical methods were employed to assess the difference in the tumor ADC value, ADC ratiot−u, and ADC ratiot−m with respect to cervical cancer stages and histopathological findings. RESULTS The median tumor ADC value was lower in the early-stage group than in the late-stage cervical cancer (0.75 × 10−3 mm²/s versus 0.8 × 10−3 mm²/s, p = 0.022). However, no differences were observed in ADC ratiot−u and ADC ratiot−m concerning the tumor staging, nor in ADC value, ADC ratiot−u, and ADC ratiot−m concerning histopathological findings (p = 0.29, 0.67 and 0.35, respectively), with no significant differences in the ADC ratiot−u (p = 0.153) and ADC ratiot−m (p = 0.260). In receiver operating characteristic analysis, the tumor ADC value was 75.0% sensitive and 50.0% specific in predicting late-stage cervical cancer with a cut-off value of 0.750 × 10−3 mm2/s. CONCLUSIONS The median tumor ADC value in early-stage patients was significantly lower than in the late-stage patients, suggesting that tumor ADC value has valuable potential for characterizing cervical cancer staging.
Multifocal Electroretinogram, Central Macula Thickness and Visual Acuity in Diabetic Macular Edema Following Intravitreal Injection of anti-VEGF Nusanti, Syntia; Sampurna, Kirana; Djatikusumo, Ari; Yudantha, Anggun Rama; Prihartono, Joedo
International Journal of Retina Vol 4 No 2 (2021): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2021.vol004.iss002.156

Abstract

Introduction : Diabetic Retinopathy (DR) is one of the major cause of visual acuity deterioration in diabetic patients. The loss of central visual acuity in diabetic patients are mainly due to macula edema, which is found in 29% diabetic patients with the over 20 years duration of disease. The aim of this study is to evaluate and investigate the possible correlation among changes of visual acuity (VA), central macular thickness (CMT) using Spectral Domain Optical Coherence Tomography (SD-OCT). Electrophysiological responses using multifocal electroretinography (MfERG) in diabetic macular edema (DME) following intravitreal injection of bevacizumab. Methods: Single arm clinical trial. Thirty-three eyes of 33 DME patients (16 non-proliferative diabetic retinopathy and 17 non-high-risk proliferative diabetic retinopathy), receives intravitreal bevacizumab 1,25mg. All patients underwent complete ophthalmic examination including ETDRS VA testing, Sixty-one scaled hexagon MfERG and SD-OCT scan at baseline, 1-week and 1-month post-injection. Components of the first order kernel (N1, N2 and P1) in central 2o were measured. Result : MfERG showed reduced P1 amplitude (P<0.05) at 1-week after injection followed by increased P1 amplitude (P>0.05) at 1-month after treatment as compared to the baseline in all subjects. There was 19% improvement CMT and 0.2Logmar VA improvement in 1-month post-injection compared to the baseline (P<005). This study showed no serious ocular adverse effects. There was no significant correlation between changes in visual acuity with changes in CMT or other MfERG parameters. Conclusion: Intravitreal injection bevacizumab resulting in improved VA, reduction in CMT and mild improvement in the MfERG responses. Although VA changes did not correlate with reduced CMT nor with improved responses of MfERG, the combined use of SD-OCT and MfERG may be used to evaluate macular function in DME patient with worsened visual acuity post anti-VEGF injection.
Ratio of Vascular Pedicle Width and Thoracic Diameter to Differentiate Cardiogenic and Non-Cardiogenic Pulmonary Edema Afifi, Rahmi; Fachri, Achmad; Madjid, Amir Sjarifuddin; Prihartono, Joedo; Prasetyo, Marcel; Christian, Andreas
Makara Journal of Health Research Vol. 26, No. 3
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background: Excess intravascular volume evaluation is essential in the intensive care unit (ICU); however, clinical information to differentiate cardiogenic and non-cardiogenic pulmonary edema has been proven ineffective. Thus, this study aimed to distinguish cardiogenic from non-cardiogenic pulmonary edema using the ratio of vascular pedicle width (VPW) to thoracic diameter (VPTR). Methods: This cross-sectional study was conducted based on secondary data from chest radiographs of 100 patients with clinical symptoms of pulmonary edema in the ICU from January 2013 to December 2015. Cardiogenic and non-cardiogenic pulmonary edema were distinguished using VPW and cardiothoracic ratio measurements (CTR). VPTR was measured to differentiate between the two types of pulmonary edema, and the cut-off value was obtained using a receiver operating characteristic curve. Results: This study revealed a prevalence of 21% and 79% for cardiogenic and non-cardiogenic pulmonary edema, respectively. A VPTR cut-off value of 25.1% with a sensitivity of 90% and specificity of 86%, may distinguish cardiogenic from non-cardiogenic pulmonary edema. Conclusions: VPTR is an alternative method to differentiate between cardiogenic and non-cardiogenic pulmonary edema, and this ratio measurement is useful in cases where radiograph films are not standardized.
Kegel exercises with a guidebook for stress urinary incontinence treatment Hakim, Surahman; Santoso, Budi Iman; Rahardjo, Harrina Erlianti; Setiati, Siti; Kusumaningsih, Widjajalaksmi; Prihartono, Joedo; Ibrahim, Nurhadi; Indriatmi, Wresti; Erwinanto
Medical Journal of Indonesia Vol. 33 No. 2 (2024): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247142

Abstract

BACKGROUND Stress urinary incontinence (SUI) is uncontrollable urine leakage when intra-abdominal pressure increases. Behavioral therapy with Kegel exercise is currently the best conservative management recommendation for treating SUI patients. This study aimed to investigate the success of supervised Kegel exercises using the Kegel exercises guidebook in women with SUI. METHODS This quasi-experimental study involved both groups being taught the same regiment of Kegel exercises, but the intervention group was given the Kegel exercises guidebook. After 12 weeks, the compliance, subjective, and objective success rates were evaluated through the patient’s notes, Urinary Distress Inventory-6, Incontinence Impact Questionnaire-7, perineometer, and pad test. RESULTS Patients with a higher level of education had lower compliance to Kegel exercises (p = 0.01; odds ratio [OR] 0.38; 0.18–0.79). No significant difference was observed in the subjective symptom improvement between the two groups. The intervention group had a significantly higher success rate based on objective success by analyzing the 1-hour pad test results. The intervention group was also more adherent (p<0.001; OR 4.78; 2.51–9.0). CONCLUSIONS Patients who received the Kegel exercises guidebook were more compliant and more objectively successful than those who did not receive the manuals.
Estrogen receptor expression in type 1 endometrial cancer and its association with lymphovascular space invasion Fidiawati, Wiwit Ade; Andrijono; Siregar, Nurjati Chairani; Prihartono, Joedo; Purwoto, Gatot; Hellyanti, Tantri
Medical Journal of Indonesia Vol. 34 No. 4 (2025): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257842

Abstract

BACKGROUND Endometrial cancer (EC) ranks sixth in female genital malignancy and originates in the endometrial lining. Estrogen receptor (ER) expression is important in EC prognosis and recurrence, influenced by the presence of lymphovascular space invasion (LVSI). This study aimed to determine the association between ER expression and LVSI in type 1 EC. METHODS A retrospective analysis was conducted on 135 patients with type 1 EC who underwent surgery at the Cipto Mangunkusumo Hospital, Jakarta, Indonesia, between January 2012 and December 2022. Immunohistochemistry (IHC) with ER antibodies was performed on all samples in April 2023. ER expression was evaluated using the Allred scoring system, and its association between ER expression (percentage and intensity stain) and LSVI was statistically analyzed. RESULTS Of 135 samples, 44 (32.6%) were LVSI-positive. No significant association was found between IHC percentage stain and LVSI (p = 0.994). However, a significant association was found between IHC stain intensity and LVSI-positive in patients with type 1 EC (p = 0.022). ER intensity score 2 had a higher LVSI risk compared to score 1 and score 3 (from 51%, 26%, and 26%, respectively). CONCLUSIONS ER expression is associated with LVSI of type 1 EC. While IHC stain percentage showed no correlation with LVSI, stain intensity was significantly linked to LVSI-positive in patients with type 1 EC. Regular assessment of ER expression can provide significant prognostic information, support hormonal therapy, and identifying clinical characteristics of tumors.
Non-Severe Preeclampsia and Subclinical Inflammation: A Study of Cyclophilin A, NF-κB, PARP- 1, and Apoptosis in Human Placentas Resistantie, Novi; Wibowo, Noroyono; Prasmusinto, Damar; Jusman, Sri Widia Azraki; Yamin, Muhammad; Siregar, Nurjati Chairani; Prihartono, Joedo; Mose, Johannes Cornelius; Suhendro, Suhendro; Yunita, Ferdiana; Rosmanah, Lis; Margyaningsih, Nur Ita; Qotrunnada, Labibah; Roviqoh, Cindy Fawwaz; Rauf, Saidah
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 3 November 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i3.947

Abstract

Objective: To compare the expression of CyP-A, NF-κB, PARP-1, and apoptotic index in Non-Severe Preeclampsia (NS-PE) and Normal Pregnancy (NP) and explore their roles in inflammation during preeclampsia.Methods: Conducted in Depok, Indonesia, the cross-sectional study involved 28 participants divided into NS-PE and NP groups based on ISSHP criteria. NP was defined as uncomplicated pregnancies at 38–40 weeks gestation. Placental weight was measured, and ELISA was used to assess biomolecule levels. Data were analyzed using T-tests or Mann-Whitney tests.Result: Maternal gestational age, body mass index, and leukocyte levels were significantly higher in NS-PE. The apoptotic index, measured by TUNEL assay, was also significantly elevated in NS-PE (41.56 ±24.87) compared to NP (23.96 ±18.79; p = 0.044). While CyP-A, PARP-1, and NF-κB levels were higher in NS-PE eventhough they were not statistically significant. Immunohistochemistry confirmed an overall increase in these molecules, supporting their clinical relevance.Conclusion: Despite the lack of statistical significance, increased inflammation and apoptosis in NS-PE may contribute to placental dysfunction and adverse pregnancy outcomes.Non-Severe Preeclampsia dan Inflamasi Subklinis: Studi CyP-A, NF-κB, PARP-1, dan Apoptosis pada Plasenta ManusiaAbstrak Tujuan: Penelitian ini bertujuan untuk mengetahui perbedaan ekspresi CyP-A, NF-κB, PARP-1, dan indeks apoptosis antara preeklamsia non-severe (NS-PE) dan kehamilan normal (NP), serta perannya dalam proses inflamasi pada preeklamsia.Metode: Metode penelitian yang digunakan dalam penelitian ini adalah cross-sectional. Penelitian ini dilakukan di Depok, Indonesia, dengan 28 partisipan yang dikelompokkan menjadi NS-PE dan NP berdasarkan kriteria ISSHP. Berat plasenta diukur dan kadar biomolekul dianalisis menggunakan ELISA. Uji T dan alternatif Mann-Whitney digunakan untuk analisis statistik.Hasil: Hasil penelitian menunjukkan bahwa usia kehamilan, indeks massa tubuh (IMT), dan kadar leukosit secara signifikan lebih tinggi pada NS-PE. Indeks apoptosis (TUNEL) juga lebih tinggi secara signifikan pada NS-PE (41,56 ±24,87) dibandingkan NP (23,96 ±18,79; p = 0,044). Kadar CyP-A, PARP-1, dan NF-κB lebih tinggi pada NS-PE meskipun tidak signifikan secara statistik, pemeriksaan IHK mengonfirmasi relevansi klinis peningkatan pada keseluruhan biomolekul tersebut. Kesimpulan: Meskipun signifikansi statistik rendah, peningkatan peradangan dan apoptosis pada NS-PE dapat menyebabkan disfungsi plasenta dan dampak buruk pada kehamilan.Kata kunci: Apoptosis; inflamasi; preeklamsia.
Association between Musculoskeletal Status and Genetic Mutations in Patients with Hemophilia A Primacakti, Fitri; Wahidiyat, Pustika Amalia; Sjarif, Damayanti R.; Chozie, Novie Amelia; Candini, Naura Anindya; Prihartono, Joedo; Sukartini, Ninik; Ramadhani, Nadhifa Tazkia; Lubis, Bidasari
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.316

Abstract

Introduction: Hemophilia A is an inherited bleeding disorder caused by mutations in the factor VIII (FVIII) gene. These mutations result in either reduced FVIII synthesis (null variants) or loss of FVIII function (non-null variants). Null variants are typically associated with more severe FVIII deficiency and recurrent joint bleeding, which may adversely affect musculoskeletal health.  Objective: To evaluate the relationship between musculoskeletal status and genetic mutations in patients with hemophilia A. Methods: A cross-sectional study was conducted at the Faculty of Medicine Universitas Indonesia-Dr. Cipto Mangunkusumo Hospital from June 2024 to March 2025. Genetic analysis was performed at the Human Genetic Research Center using inverse-shifting PCR and Sanger sequencing. Mutations were classified as null variants (intron-22 inversion, intron-1 inversion, large deletion, and nonsense mutations) and non-null variants (missense and non-conserved splice mutation). Musculoskeletal status was assessed by the presence of target joints and the Hemophilia Joint Health Score (HJHS), which evaluates global gait and joint function of the elbows, knees, and ankles. Higher HJHS scores indicate worse joint health.  Results: Sixty patients were included in this study, of which 39 had severe, 15 had moderate, and the remaining 6 had mild hemophilia A. The median age was 9.5 years (range 2-18). Null variants were identified in 45/60 patients and non-null variants in 15/60 patients. The most common target joints were the knees in patients with null variants and the ankles in those with non-null variants. The median HJHS was 4 (Q1-Q3: 2-13.5) in the null variant group and 2 (Q1-Q3: 1-11) in the non-null variant group. No significant association was observed between the target joint and the HJHS and genetic mutations. Further subgroup analysis showed no difference in HJHS between mutation groups among patients receiving prophylaxis (p=0.366) or on-demand treatment (p=0.458). Conclusion: No association was found between genetic mutation type and musculoskeletal status in patients with Hemophilia A. HJHS did not differ between mutation groups regardless of treatment regimens.  
Co-Authors -, Lisnawati Abidin Widjanarko Achmad Tjarta Afifi, Rahmi Alida Harahap Amalia, Ginva Amelia, Yustie Anak Agung Istri Sri Wiadnyani Andi A. Victor Andreas Christian Andrijono Arief, Wresty Ariyati, Ira Arman Muchtar Arman Mukhtar Asmarinah Asmarinah Averdi Roezin Aziza Icksan Bambang Supriyatno Bernie Endyarni Medise Bidasari Lubis Biddulth Sujana, Biddulth Billy, Christy Amanda Budi Iman Santoso Budi Wiweko Budianto Komari, Budianto Candini, Naura Anindya Damar Prasmusinto Damayanti R. Sjarif Darmiati, Sawitri Deddy Hermawan, Deddy Diani Kartini Didid Tjindarbumi Djajadiman Gatot Djatikusumo, Ari Drupadi Dillon Drupadi S. Dillon Elfahmi, Khalida Ikhlasiya Tajdar Gefariena Elida Ilyas Elisna -, Elisna Endang Hardjolukito Endang S. Roostini Endang Windiastuti Ening Krisnuhono Erwinanto Esti Soetrisno Evert D.C. Poetiray Evert Poetiray EVLINA SUZANNA, EVLINA Fachri, Achmad Faisal - Fardizza, Fauziah Fatimah Eliana, Fatimah Fitri Primacakti, Fitri Fitriyadi Kusuma FLORENSA SIHALOHO, FLORENSA Gatot Purwoto Goi Sakamoto Gunawan Tjahjadi Hakim, Manfaluthy Harrina Erlianti Rahardjo, Harrina Erlianti Hellyanti, Tantri Heri Wibowo Heriawaty Hidayat, Heriawaty Herman Cipto Hutabarat, Hernayati I Made Nasar Idral Darwis Idwal Darwis Iik Wilarso Ina S. Timan, Ina S. Indrati Suroyo Iris Rengganis Irwan Ramli Iskandar, Adhi Teguh Perma Jusman, Sri Widia Azraki Kardinah -, Kardinah Kautsar, Ahmad Kenji Wakai Kenzi Wakai Ketut Mulyadi Kusmarinah Bramono Lisnawati Lukman Edwar Lukman H. Makmun M. Kurniawan, M. Madjid, Amir Sjarifuddin Marcel Prasetyo Margyaningsih, Nur Ita Marwali, Muhammad Luky Satria Masamitsu Ichihashi Masato Ueda Mawardi, Prasetya Minarma Siagian Mochtar Hamzah Mose, Johannes Cornelius Mpu Kanoko Muchlis Ramli Muhammad Ilyas Muhammad Yamin Mulyadi M. Djer Muslim, Refni N. D. Yulisa Nafrialdi Nafrialdi Najib Advani Nakako Kubo Nobuo Munakata Noorwati Sutandyo Noroyono Wibowo Novie Amelia Chozie Nurhadi Ibrahim Nurjati Chairani Siregar Nurul Akbar Olivia P. Perdana, Olivia P. Philip Waruna, Philip Ponco Birowo Pradana Soewondo Pradana Suwondo Pratamisiwi, Rindy Yunita Prawirodihardjo, Bonita Priya Darsini, Indira Priyono, Harim Pudjo Astowo, Pudjo Purwita Wijaya Laksmi Pustika Amalia Wahidiyat, Pustika Amalia Qotrunnada, Labibah R. R. Mangunkusumo Rahmad Mulyadi Rahmadhany, Anisa Ramadhani, Nadhifa Tazkia Resistantie, Novi Risma Kerina Kaban, Risma Kerina Rosmanah, Lis Roviqoh, Cindy Fawwaz Rumende, Cleopas M. Sadao Suzuki Saidah Rauf Salim Harris, Salim Sampurna, Kirana Samsuridjal Djauzi Santoso Cornain Santoso, Dewi Irawati Soeria Sekarutami, Sri Mutya SEPTELIA INAWATI WANANDI Setiawati Budiningsih Setyawati Budiningsih Setyo Handryastuti Sigit Pribadi Siregar, Trifonia Pingkan Siti Setiati Sonar S. Panigoro Sonar Soni Panigoro Sri M.S. Utami Starry H Rampengan Suhendro Suhendro Suhendro Sukartini, Ninik Surahman Hakim Susilowati Herman Susumu Watanabe Sutjipto, Fiolita Indranita Suyatna, Fransiscus Dhyanagiri Suzanna Immanuel Syntia Nusanti Tabri, Nur A. Telly Kamelia Tetty Yuniati Tirza Z Tamin Tjokorda Gde Dalem Pemayun Virna D. Oktarina, Virna D. Wahyuni, Luh Kurnia Wasilah Rochmah Widjajalaksmi Kusumaningsih, Widjajalaksmi Wijaya, Ade Wilfried H. Sibuea Windy Keumala Budianti Wiwit Ade Fidiawati Wresti Indriatmi B. Makes Yoshiyuki Ohno Yoshiyuki Ohno Ohno Yudantha, Anggun Rama Yunita, Ferdiana Zizlavsky, Semiramis Zizlavsky, Semiramis