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All Journal Medical Journal of Indonesia Majalah Obstetri dan Ginekologi Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Jurnal Ilmiah Kesehatan Jurnal Ilmiah Kebidanan Indonesia (Indonesian Midwifery Scientific Journal) Makara Journal of Health Research
Gatot Purwoto
Devisi Onkologi, Departemen Obstetri Dan Ginekologi, Fakultas Kedokteran, Universitas Indonesia - RSUPN Cipto Mangunkusumo, Fakultas Kedokteran, Universitas Indonesia
Health Professions Medicine & Pharmacology Public Health

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Level of Retinol Deposit and Cervical Cancer Utami, Tofan W; Ibrahim, Fera; Purwoto, Gatot; Tiffani, Wely L; Aziz, Muhammad F; Andrijono, Andrijono
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 1, January 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (131.483 KB) | DOI: 10.32771/inajog.v5i1.465

Abstract

Objective: To analyze level of retinol deposit sufficiency in the natural history of cervical cancer. Methods: Serum retinol level was measured by ELISA from peripheral blood of subjects with normal cervix, cleared and persistent high risk human papilloma virus (HR-HPV) subclinical infection, and cervical cancer who fulfilled the inclusion and exclusion criteria. The study was held in Dr. Cipto Mangunkusumo and Fatmawati Hospital, Jakarta, within 2 years (August 2013- 2015). Blood was taken twice, consisting of post-8-hour fasting blood and 2 hours after 6000 IU retinyl palmitate oral administration. Results: Of 47 total samples, sufficient level of retinol deposit in normal cervix, cleared and persistent HR-HPV subclinical infection, and cervical cancer group was 85.0% (reference), 75.0% (OR 1.89), 33.3% (OR 11.33), and 75% (OR 1.89); respectively. Statistically, there was no significant difference from sufficiency level of retinol deposit between normal cervix and clearance HR-HPV subclinical infection (p=0.628), normal cervix and persistent HR-HPV subclinical infection (p=0.078), normal cervix and cervical cancer (p=0.433), cervical cancer and clearance HR-HPV subclinical infection (p=1.000), cervical cancer and persistent HR-HPV subclinical infection (p=0.430), persistent and clearance HR-HPV subclinical infection group (p=0.740). Conclusion: This study proves that normal cervix group has the highest level of retinol deposit sufficiency; however, it cannot be stated that cervical cancer group has less sufficiency level. Persistent HR-HPV subclinical infection group has the lowest level of retinol deposit (OR 11.33). There is no association between sufficient level of retinol deposit and clearance of HR-HPV. [Indones J Obstet Gynecol 2017; 5-1: 46-54] Keywords: cervical cancer, HR-HPV clearance, retinol deposit
Efficacy and Safety of Cryotherapy in "See and Treat" Program in Jakarta Primary Health Centre Lestari, Linda; Purwoto, Gatot; Nuranna, Laila
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (100.393 KB) | DOI: 10.32771/inajog.v4i4.453

Abstract

Objective: To evaluate the efficacy and safety of cryotherapy in "See and Treat" program in Jakarta Primary Health Care. Method: Using descriptive cross-sectional design, data from medical records were taken with total sampling method. We took the VIA result, cryotherapy procedure, first-marriage age, number of marriage, parity, smoking habit, and the use of contraception. Data were analyzed univariately. Result: Of 86 data, the percentage of cryotherapy to change from positive to negative of VIA result was 90.70%. We did not find the progressivity to invasive cancer. Conclusion: Cryotherapy is effective to manage the cervical precancerous lesion in "See and Treat" program. [Indones J Obstet Gynecol 2016; 4-4: 227-233] Keywords: cryotherapy, Indonesia, see and treat, visual inspection of acetic acid (VIA)
Knowledge and behavior of Indonesian general practitioners on cervical cancer early detection Laila Nuranna; Nessyah Fatahan; Alfu Nikmatul Laily; Gatot Purwoto
Majalah Obstetri dan Ginekologi Vol. 28 No. 1 (2020): April
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V28I12020.20-23

Abstract

Objective: Outline the correlation between cervical cancer-related knowledge and voluntary enrollment on early detection of cervical cancer.Material and Methods: Cross sectional design was performed. The inclusion is general practitioner women which currently married. Knowledge and behavior were assessed using questionnaire.Results: Among 367 respondents who filled the questionnaire, 77.4% of them (284) satisfy the inclusion criteria. 56% has high knowledge, and 42.3% has adequate knowledge. Moreover, 62.7% subjects ever performed cervical cancer early detection to themselves; 39.8% with VIA (visual inspection with acetic acid) and 46.5% with Papsmear and/or HPV DNA. Proportion of no early detection history with low and adequate knowledge 1.9 and 1.5 times simultaneously higher than proportion of no early detection with high knowledge. There is no significant correlation between level of knowledge and early detection history.Conclusion: There was no significant correlation between the level of knowlegde and voluntary enrollment for early detection of cervical cancer for general practitioners in Indonesia.
Prevalence of High-Risk Human Papillomavirus (HPV) among Negative Visual Inspection of Acetic Acid (VIA): Prevalensi Human Papillomavirus (HPV) Risiko Tinggi pada Hasil Inspeksi Visual dengan Asam Asetat (IVA) yang Negatif Tofan W Utami; Muhammad F Aziz; Gatot Purwoto; Alexander AW Peters; Gert J Fleuren; Vivian Spaans; Sigit Purbadi
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 3, July 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (110.835 KB) | DOI: 10.32771/inajog.v2i3.398

Abstract

Objective: Persistence of high-risk HPV infection is known to be the major cause of cervical cancer. It is important to differentiate the genotype of HPV infection, whether it is high, intermediate or low risk. The aim of this study was to assess the prevalence of high-risk HPV types among Indonesian women with negative VIA. Method: We analyzed cervical swabs from 1,214 patients with negative VIA. By using INNO-Lipa HPV DNA test, we detected the HPV DNA and its genotype. Result: From the 1,214 women with negative VIA, 48 (3.95%) samples were confirmed to have positive HPV DNA by using PCR and electrophoresis. However, hybridization test were not able to detect HPV genotypes in 9 samples. These 9 samples were tested again with PCR and electrophoresis and resulted in negative HPV DNA. Among the remaining 39 samples (3.21%), we detected 19 types of HPV, consisting of 13 types of high-risk HPV, 5 types of low-risk HPV, and 1 type of unknown HPV (type X). Conclusion: Among patients with negative VIA, 3.21% was found to be positive for HPV DNA. From this percentage, the prevalence of high-risk HPV is higher than the low-risk and unknown HPV. Therefore we cannot ignore results of negative VIA, particularly in highrisk group, because there is a slight possibility that presence of HPV can be identified, especially the high risk ones which have a tendency to be persistent. We support the importance of HPV DNA test as cervical cancer screening method. Keywords: cervical cancer, high-risk HPV, negative VIA
Papsmear Examination for Diagnosing PreCancer Lesion in Invisible SquamoColumnar Junction Laila Nuranna; Sulaeman Daud; Gatot Purwoto; Hariyono Winarto; Kartiwa H Nuryanto
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No.3, July 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (105.731 KB) | DOI: 10.32771/inajog.v4i3.439

Abstract

Objective: To know the concealed pre-cancer lesion in women with invisible squamo-columnar junction (SCJ) by Papsmear examination. Method: This study was a descriptive cross-sectional design starting from August 2014 to March 2015 at several Public Health Cares in Jakarta. A total of 1,682 subjects were screened by Acetoacetate Visual Inspection (AVI) examination. After the data was collected, the process was continued by verification, editing, and coding. The descriptive analysis showed the percentage of SCJ in age distribution, the percentage of AVI examination based on SCJ, and the percentage of Papsmear examination in invisible SCJ according to negative AVI result. Result: There were 1,484 (88.2%) women with the visible SCJ and 198 (11.8%) women with invisible SCJ. The percentage of invisible SCJ in the menopausal women group was 122 (61,6%); meanwhile, in the non-menopausal women group, it was 76 (38.4%). Almost half of the percentage from visible SCJ was found in menopausal women group 45.8% (103/225 women). The positive AVI result was 4 (7.1%) in the menopausal women group and 52 (92.9%) in non-menopausal women group. The result of Papsmear examination with invisible SCJ were 197 (100%) normal. Conclusion: Almost half of visible SCJ was found in menopausal women group. Most of positive AVI result was found in the nonmenopausal women group. All women with the invisible SCJ have a normal Papsmear result. Keywords: acetoacetate visual inspection, papsmear, pre-cancer lesion, squamo-columnar junction
Agreement Test of Documentation of Visual Inspection with Acetic Acid “DoVIA” and Colposcopy findings as a Screening Tool for Cervical Cancer: Kesesuaian Hasil Tes Dokumentasi Inspeksi Visual dengan Asam Asetat (DoVIA) dan Kolposkopi sebagai Alat Skrining untuk Kanker Servik Laila Nuranna; Renny Surya Wardany; Gatot Purwoto; Tofan W. Utami; Lex Peters
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 1 January 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (140.704 KB) | DOI: 10.32771/inajog.v8i1.1219

Abstract

Abstract Objective: To find out the suitability of Documentation of Visual Inspection with Acetic Acid (DoVIA) result compare to colposcopy result as a method of cervical cancer screening. Method: This is a descriptive study using cross sectional design that took place from April 2017 until March 2019. One hundred eighty two sampels of documentation photographs taken by the researcher were included. The photographs were reviewed by the 3 selected reviewers: oncology and gynecology consultant, obstetry and gynecology resident, and general practitioner that were trained about DoVIA and colposcopy. The review was based on kappa test which assessed the sharpness, squamo-columnar junction and white epitel visualization on the cervix. Results: Kappa score on DoVIA versus colposcopy was 0,717 (good). Inter-rater test was performed to assess consistency and the result was 0,764 (good) between consultant and resident, 0,703 (good) between consultant and general practitioner. Conclusion: Kappa test of IVA documentation ”DoVIA” gives a good kappa value, so that it is expected to be an alternative screening for precancerous lesions. Keyword: cervical cancer screening, VIA, DoVIA, colposcopy, mini colposcopy Abstrak Tujuan: Untuk menemukan kesesuaian antara dokumentasi hasil inspeksi visual dengan asam asetat (DoVIA) dibanding dengan hasil kolposkopi sebagai metode skrining kanker serviks. Metode Penelitian deskripsi ini menggunakan desain cross sectional yang telah dilakukan sejak April 2017 hingga Maret 2019. Seratus delapan puluh dua sampel dokumentasi telah diambil oleh peneliti telah dimasukkan menjadi sampel. Hasil dokumentasi telah dinilai oleh 3 penilai yang terdiri dari konsultan onkologi dan ginekologi, residen obstetri dan ginekologi, dan dokter umum yang telah dilatih untuk DoVIA dan kolposkopi. Hasil penilaian dilakukan berdasarkan kappa untuk menilai ketajaman, sambungan skuamos kolumner dan visualisasi lesi putih di serviks Hasil Skor kappa pada DoVIA dibanding kolposkopi adalah 0,717 (baik). Hasil prbandingan penilaian antar penilai yang ditunjukkan untuk menilai konsistensi dan hasil adalah 0,764 (baik) antara konsultan dan residen, 0,703 (baik) antara konsultan dan dokter umum. Kesimpulan Tes kappa pada dokumentasi IVA (DoVIA) memberikan hasil kappa baik, sehingga DoVIA diharapkan dapat menjadi alternatif skrining untuk lesi prakanker. Kata kunci : skrining kanker serviks, IVA, DoVIA, kolposkopi, minikolposkopi
The Role of Thrombocytosis as a Prognostic Factor for Epithelial Ovarian Cancer: Peran Trombositosis sebagai Faktor Prognostik pada Kanker Ovarium Jenis Epitelial Andrijono; Heru Prasetyo; Eka R Gunardi; Gatot Purwoto; Hariyono Winarto
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 3 July 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i3.1275

Abstract

Objective: To determine whether thrombocytosis is a prognostic factor for epithelial ovarian cancer and its relationship with 3-year overall survival in epithelial ovarian cancer patients.Methods: This study is a retrospective cohort study using medical record of patients with epithelial ovarian cancer registered in cancer registry of Oncology Division in Obstetrics and Gynecology Department, Dr. Cipto Mangunkusumo National General Hospital from January 2014 - July 2016. Data were collected when subjects were first until diseases outcomes identified in 3 years.Results: : Out of 220 subjects, 132 (60%) were patients with advanced stage epithelial ovarian cancer (stage II/III/IV). 94 (42.7%) subjects had thrombocytosis. Patients with advanced stage of disease had higher risk of having thrombocytosis than the ones with earlier stage (p=0.005; OR=2.329). Correlation between thrombocytosis and 3-year overall survival was known to be insignificant (p=0.555). There was shorter mean time survival between patients with thrombocytosis and the ones without but the there was no significant difference in hazard ratio between the two groups (p = 0.399).Conclusion :Thrombocytosis is not a prognostic factor in patients with epithelial ovarian cancer. There is also no significant difference of 3-year overall survival between patients with or without thrombocytosis.Keywords: epithelial ovarian carcinoma, prognosis, thrombocytosis. Abstrak Tujuan: Membuktikan bahwa trombositosis sebagai faktor prognosis kesintasan pada pasien kanker ovarium jenis epitelial dan hubungannya terhadap kesintasan 3 tahun pasien kanker ovarium jenis epitelial.Metode: Penelitian ini merupakan studi kohort retrospektif menggunakan data rekam medis pasien kanker ovarium epitelial yang terdaftar pada cancer registry Departemen Obstetri dan Ginekologi Divisi Onkologi Rumah Sakit Cipto Mangunkusumo pada tahun Januari 2014-Juli 2016. Pengamatan dilakukan saat subjek pertama kali didiagnosis akhir pengamatan selama 3 tahun.Hasil: Didapatkan 220 subjek penelitian yang merupakan populasi terjangkau dan memenuhi kriteria inklusi dan eksklusi. Dari 220 subjek penelitian, 132 (60%) dari 220 subjek penelitian merupakan pasien dengan kanker ovarium stadium lanjut (Stadium II/III/IV). Trombositosis didapatkan pada 94 orang subjek penelitian (42,7%). Pasien dengan kanker stadium lanjut memiliki risiko trombositosis yang lebih tinggi dibandingkan subjek pada stadium awal (p=0,005;OR=2,329). Trombositosis secara statistik tidak bermakna pada kesintasan 3 tahun (p=0,555). Terdapat mean time survival yang lebih rendah pada pasien dengan trombositosis tetapi tidak ada perbedaan hazard ratio yang bermakna antara subjek dengan atau tanpa trombositosis (p=0,399).Kesimpulan : Trombositosis bukan merupakan faktor prognostik pada pasien kanker ovarium jenis epitelial dan tidak terdapat hubungan antara trombositosis dan 3 tahun pada pasien dengan kanker ovarium jenis epithelial.Kata kunci: karsinoma ovarium epithelial, prognosis, trombositosis
Postradiotherapy Outcome on Cervical Cancer Stage IIIB Patients with and without Paraaortic Lymph Nodes Enlargement: Hasil Pascadiadioterapi pada Pasien Kanker Serviks Stadium IIIB dengan dan tanpa Pembesaran Nodus Paraaorta Fitriyadi Kusuma; Sahat B. Matondang; Laila Nuranna; Gatot Purwoto; Oni Khonsa; Purnomo Hyaswicaksono
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 1 January 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i1.1438

Abstract

Objective : To determine whether there are differences in clinical response after radiotherapy and 1 year survival in patients with advanced cervical cancer with and without enlargement of PALN.Method : An observational analytic study using a retrospective cohort method was done using consecutive sampling. The subjects of this study were all women with a primary diagnosis of stages IIB to IVB cervical cancer who came to the gynecological oncology clinic of Dr. Cipto Mangunkusumo National General Hospital and underwent MRI examination before undergoing treatment in January 2016 to May 2017Results: Among 76 subjects studied, there were 4 (5.1%) subjects who had enlarged PALN. There were no significant differences between the enlargement status of PALN and age (p = 0.829), age of first sexual intercourse (p = 0.33), parity (p = 0.642), mass diameter (p = 0.777). Patients with PALN enlargement have 2.13 times risk of having negative radiotherapy outcome (p = 0.02, OR 2.13, CI95% 1.12 – 4.07). There was no difference in 1-year survival between patients with and without enlargement of PALN (median 201 vs. 293, p = 0.072).Conclusion: Patients with PALN enlargement have increased risk of having negative radiotherapy outcome (p < 0.05). There were no differences in 1 year survival between patients with advanced cervical cancer with enlargement PALN.Keywords : cervical cancer, lymph node enlargement, paraaortic, radiotherapy. Abstrak Tujuan: Mengetahui adakah perbedaan respon klinis pascaradioterapi dan kesintasan 1 tahun pada pasien kanker serviks stadium lanjut dengan pembesaran KGB paraaorta dibandingkan tanpa pembesaran KGB paraaorta.Metode: Penelitian ini merupakan penelitian analitik observasional dengan menggunakan metode kohort retrospektif. Pengambilan sampel dilakukan dengan cara pengambilan sampel berturut-turut. Subyek penelitian ini adalah semua perempuan dengan diagnosis primer kanker serviks stadium IIB hingga IVB yang datang ke poliklinik Onkologi Ginekologi RSUPN Dr. Cipto Mangunkusumo dan menjalani pemeriksaan MRI sebelum dilakukan terapi pada bulan Januari 2016 hingga Mei 2017.Hasil: Dari 76 subjek yang diteliti, didapatkan sebanyak 4 (5,1%) subyek yang mengalami pembesaran KGB paraaorta. Tidak didapatkan perbedaan yang bermakna antara status pembesaran KGB paraaorta dan usia (p = 0,829), usia hubungan seksual pertama (p = 0,333), paritas (p = 0,642), dan diameter massa (p = 0,777). Pasien dengan pembesaran KGB paraaorta memiliki risiko 2,13 kali lipat (p = 0,02, OR 2,13, IK95% 1,12-4,07) memiliki risiko respon terapi negatif. Tidak terdapat perbedaan kesintasan 1 tahun antara pembesaran KGB paraaorta dan tidak (median 201 vs. 293, p = 0,072).Kesimpulan Pasien dengan pembesaran KGB paraaorta memiliki risiko lebih tinggi mengalami respon radioterapi negatif. (p < 0,05). Tidak terdapat kesintasan 1 tahun antara pasien kanker serviks stadium lanjut dengan dan tanpa pembesaran KGB.Kata kunci: kanker serviks, paraaorta, pembesaran KGB, radioterapi.
Thrombositosis sebagai Prediktor Kanker pada Keganasan Ginekologi: a Narrative Review Kusuma, Fitriyadi; Suryoadji, Kemal Akbar; Abdullah, Muhammad Raoul Taufiq; Putra, Abdul Hafiidh Surya; Purwoto, Gatot; Winarto, Hariyono; Utami, Tofan Widya
Jurnal Ilmiah Kebidanan Indonesia Vol 13 No 02 (2023): Jurnal Ilmiah Kebidanan Indonesia (Indonesian Midwifery Scientific Journal) Uni
Publisher : Q PRESS

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33221/jiki.v13i02.2616

Abstract

Thrombositosis, peningkatan jumlah trombosit dalam darah, telah dikaitkan dengan kanker pada keganasan ginekologi. Trombositosis dapat dipicu oleh pelepasan sitokin oleh tumor ganas, seperti IL-6. Trombositosis berperan dalam perkembangan kanker melalui perlindungan terhadap sel tumor, produksi faktor pertumbuhan, dan angiogenesis. Tinjauan literatur ini mengumpulkan dan menganalisis penelitian terkait trombositosis sebagai prediktor kanker pada keganasan ginekologi. Pemahaman yang komprehensif tentang hubungan ini dapat membantu pengembangan metode deteksi dini dan terapi yang lebih efektif untuk kanker pada keganasan ginekologi.
The SDGs Perspective of TeleDoVIA Reliability for Cervical Cancer Elimination in 2030: A Cross Sectional Study in Indonesia Widya Utami, Tofan; Nuranna, Laila; Purwoto, Gatot; Winarto, Hariyono; Fitriyadi Kusuma; Rizky Humairah , Inas; Faisha Rahma, Melly; Kekalih, Aria; Peters, Alexander AW
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 4 October 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i4.1956

Abstract

Objective: To describe the prevalence of HPV infection in women with negative Visual Inspection with Acetic Acid (VIA) and introduce Teleconsultation of Documented VIA (TeleDoVIA) as an objective test and provide a rationalization for recommending TeleDoVIA as a “high-performance” test for cervical cancer screening in lower resource settings, from SDGs perspective, to accelerate the achievement of second pillar elimination and the third SDGs target in 2030. Methods: This is a 7-year cross-sectional study. Subjects were recruited consecutively from several public and private health providers in Jakarta. VIA test was documented and consulted to the experts panel (TeleDoVIA). Negative VIA women underwent HPV-DNA testing using SPF10-DEIA-LiPA25 for PCR and electrophoresis. Results: A total of 1,397 negative VIA subjects were collected, consist of 52 HPV-DNA positive. False-negative of VIA was 3.7% (95% CI 0.027–0.047). Conclusion: VIA is a reliable screening method with a low false-negative rate. TeleDoVIA could be recommended as a reliable cervical cancer screening method in low resource settings such as Indonesia, which is in line with the third SDG: good health and well-being. Keywords: Southeast Asia < Asia; public health.
Co-Authors Abdullah, Muhammad Raoul Taufiq Alexander AW Peters Alexander AW Peters Alfu Nikmatul Laily Andi Darma Putra Andrijono Andrijono Andrijono Andrijono Anggaraeni, Tricia Dewi Anggraeni, Tricia Dewi Aria Kekalih Binathara, Geraldus Sigap Gung Calvin, David Dhanasari Vidiawati Eka R Gunardi Faisha Rahma, Melly Fauzi Ahmad Muda Fera Ibrahim Fitriyadi Kusuma Gert J Fleuren Hariyono Winarto Hellyanti, Tantri Heru Prasetyo Joedo Prihartono Kartiwa H Nuryanto Kartiwa Hadi Nuryanto Laila Nuranna Laila Nuranna Laila Nuranna Laila Nuranna Laila Nuranna Lestari, Linda Lex Peters Madjid, Veinardi Muhammad F Aziz Muhammad F Aziz Nasution, Hiro Hidaya Danial Nessyah Fatahan Nurjati Chairani Siregar Oktalia, Arisda Oni Khonsa Purnomo Hyaswicaksono Putra, Abdul Hafiidh Surya Renny Surya Wardany Ridwan, Alifaturrasyid Syafaatullah Rizky Humairah , Inas Sahat B. Matondang Sigit Purbadi Sini, Kieran Pasha Ivan Soloan, Garry Sulaeman Daud Suryoadji, Kemal Akbar Tiffani, Wely L Tofan W Utami Tofan W Utami Tofan W. Utami Utami, Tofan Widya Vivian Spaans Widya Utami, Tofan Wiwit Ade Fidiawati Wulandari, Anisa Saphira