Joedo Prihartono
Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta

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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.
Pemanfaatan MRI Pelvis untuk Memprediksi Kedalaman Infiltrasi Endometriosis Susukan dalam Posterior ke Rektosigmoid: Studi Komparasi Amelia, Yustie; Muslim, Refni; Marwali, Muhammad Luky Satria; Prawirodihardjo, Bonita; Prihartono, Joedo
Majalah Kedokteran Indonesia Vol 69 No 4 (2019): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.69.4-2019-64

Abstract

Introduction: Rectosigmoid infiltration in posterior deep infiltrating en-dometriosis (DIE) requires radical and interdisciplinary surgery. Standard di-agnostic modalities such as ultrasound and laparoscopy are weak in assesingposterior DIE infiltration to inaccessible areas. MRI has the potential value tobe modality of choice because it is multiplanar and excellent in soft tissuedifferentiation. This study aimed to compare pelvic MRI with surgical findingsand histopathology to predict depth of rectosigmoid infiltration in posteriorDIE. Methods: Thirty-seven patients who underwent surgery and pelvic MRI ex-aminations for posterior DIE at the endometriosis referral center (2015-2018)were studied retrospectively. MRI images were analyzed by a gynecology ra-diologist independently then compared to the surgical report and histopatho-logical analysis. Statistical analysis was performed using the McNemar testand the Cohen’s Kappa coefficient. Results: Concordance values (McNemar p) and Kappa coefficients (p) forassesment of rectosigmoid extension in posterior DIE were 100% (1,000) and1 (0,000); infiltration into themuscular layer of rectosigmoid were 89.2% (0.617)and 0.78 (0.001); infiltration into the (sub)mucosal layer of rectosigmoid were81.1% (1,000) and 0.35 (0.146). Conclusion: There was good concordance between pelvic MRI and surgical-histopathologic findings to predict depth of rectosigmoid infiltration in poste-rior DIE.
Pengaruh Stres Kerja Berat Terhadap Kecenderungan Gangguan Mental Emosional Pada Staf Manajerial Perusahaan Penanaman Modal Asing Azhariya, Rachmawati Ayu; Prihartono, Joedo; A Kusumawardhani, A Kusumawardhani
Majalah Kedokteran Indonesia Vol 69 No 12 (2019): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, V
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.69.12-2019-167

Abstract

Introduction: This study aims to assess the association of severe occupational stress among managerial staff with the tendency of mental emotional disorder. Methods: The study was conducted from March to May 2016 at a Foreign Cooperation in West Java with comparative cross-sectional method. Occupational stress was measured with Stress Diagnostic Survey (SDS), whilst the tendency of mental emotional disorder was assessed with Symptom Check List 90 (SCL 90). A hundred and five respondents were asked to fill out the SDS questionnaire. Furthermore, 30 respondents were randomly selected from each group of mild-moderate and severe occupational stress. Results: The prevalence of severe occupational stress on managerial staff is 35.2%. There was a significant association between severe occupational stress with the tendency of mental emotional disorder (OR 47; 95% CI 7.37-300.17; p less than sign 0.001). Components of occupational stressors which statistically significant with mental emotional disorder are the qualitative workload (OR 10.67; 95% CI 1.03-109.94; p 0.047) and career development (OR 10.83; 95% CI 1.03 -114.15; p 0.047). Education is an individual factor that statistically significant against the tendency of mental emotional disorder (OR 0.17; 95% CI 0.03 to 0.83; p 0.029). Conclusion: There was no significant relationship between work factors with the tendency of mental emotional disorder.
Korelasi Nilai T2*, T2 Relaksometri dan SIR T2* Hipofisis dengan Kadar FSH dan LH pada Pasien Thalassemia Mayor Septiyanti, Wita; Sekarsari, Damayanti; Amalia W, Pustika; Prihartono, Joedo
Majalah Kedokteran Indonesia Vol 70 No 2 (2020): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.70.2-2020-174

Abstract

Background: Thalassemia is a hereditary hemolytic anemia disorder. Periodic transfusion for thalassemia patients may lead iron deposit in pituitary gland and induce hypogonadotropic hypogonadism. MRI examination has been started to be used for measurement of iron level in pituitary gland. Method: This study uses cross sectional method. MRI T2 and T2* relaxometry value and SIRT2* of pituitary gland was correlated with FSH and LH level in patients with major thalassemia. This study involves 28 subjects and conducted from December 2016 to March 2017. Result: There is correlation between relaxometry values of coronal slice T2 pituitary with FSH and LH level. There is also a correlation between pituitary SIRT2* value with LH level. Conclusion: Relaxometry value of coronal slice T2 pituitary and pituitary SIRT2* value may be use as reference for iron deposit on pituitary gland as well as to monitor chelating therapy in major thalassemia â patients.
Nilai Diagnostik Sonografi Saraf Median Pada Kasus Carpal Tunnel Syndrome Fase Kronis Di Indonesia Prasetyo, Marcel; Widya, Widya; Safri, Ahmad Yanuar; Prihartono, Joedo; Setiawan, Stefanus Imanuel
Majalah Kedokteran Indonesia Vol 72 No 4 (2022): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.72.4-2022-550

Abstract

Background. Ultrasound evaluation on the median nerve in carpal tunnel syndrome (CTS) patients by measuring cross-sectional area (CSA) is widely known. However, studies have shown that CSA of the median nerve could vary in different demographical factors. Therefore, the cut-off CSA value for CTS in the Indonesian population could be significantly different. Purpose. To compare mean CSA of the median nerve between normal and CTS populations and establish a cut-off point of CSA to diagnose CTS. Materials and Methods. A comparative cross-sectional study was conducted involving 40 people divided equally into CTS and normal groups. Normal and CTS subjects are determined by Electrodiagnostic study (EDx) using EMG and Nerve Conduction Study (NCS). The CSA measurement was performed at the level of the carpal tunnel inlet. Results. The mean CSA value at the level of tunnel inlet of the normal group was 8.3 ± 1.4 mm2 and for the CTS group is 15.4 ± 4.4 mm2. The receiver operating characteristics (ROC) analysis showed 10.6 mm2 as the cut-off point with 95% sensitivity and 95% specificity (P less than 0.001). Conclusion. The median nerve CSA at the tunnel inlet is significantly larger in the CTS population and the cut-off point can be recommended in detecting CTS in the Indonesian population.
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 Online First
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.
Co-Authors -, Lisnawati A Kusumawardhani, A Kusumawardhani Abidin Widjanarko Achmad Tjarta Afifi, Rahmi Alida Harahap Amalia W, Pustika Amalia, Ginva Amelia, Yustie 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 Azhariya, Rachmawati Ayu Aziza Icksan Bambang Supriyatno Bernie Endyarni Medise Biddulth Sujana, Biddulth Billy, Christy Amanda Budi Iman Santoso Budi Wiweko Budianto Komari, Budianto Damar Prasmusinto Damayanti Sekarsari Darmiati, Sawitri Deddy Hermawan, Deddy Diani Kartini Didid Tjindarbumi Djajadiman Gatot Djatikusumo, Ari Djer, Mulyadi Muhammad 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 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 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 Muslim, Refni Muslim, Refni N. D. Yulisa Nafrialdi Nafrialdi Najib Advani Nakako Kubo Nobuo Munakata Noorwati Sutandyo Noroyono Wibowo 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 Prawirodihardjo, Bonita Priya Darsini, Indira Priyono, Harim Pudjo Astowo, Pudjo Purwita Wijaya Laksmi Qotrunnada, Labibah R. R. Mangunkusumo Rahmad Mulyadi, Rahmad Rahmadhany, Anisa Rauf, Saidah Resistantie, Novi Risma Kerina Kaban, Risma Kerina Rosmanah, Lis Roviqoh, Cindy Fawwaz Rumende, Cleopas M. Sadao Suzuki Safri, Ahmad Yanuar Salim Harris, Salim Sampurna, Kirana Samsuridjal Djauzi Santoso Cornain Santoso, Dewi Irawati Soeria Sekarutami, Sri Mutya SEPTELIA INAWATI WANANDI Septiyanti, Wita Setiawan, Stefanus Imanuel Setiawati Budiningsih Setyawati Budiningsih Setyo Handryastuti, Setyo Sigit Pribadi Siregar, Trifonia Pingkan Siti Setiati Sonar S. Panigoro Sonar Soni Panigoro Sri M.S. Utami Starry H Rampengan Suhendro Suhendro Suhendro 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 Widya Widya, Widya 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