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All Journal e-CliniC JURNAL BIOMEDIK Jurnal Kedokteran Klinik Science Midwifery Cermin Dunia Kedokteran
Vera Sumual
Universitas Sam Ratulangi
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Benda Asing dalam Kornea akibat Kurangnya Peralatan Keselamatan: Laporan Kasus Sumual, Vera; Nursalim, Ade J.
Jurnal Biomedik : JBM Vol 11, No 3 (2019): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.11.3.2019.26334

Abstract

Abstract: Poor Occupational Safety and Health (OSH) implementation can cause work accidents. Eye trauma related to work is still quite a lot worldwide. We reported a case of work accident due to lack of awareness of personal protective equipment. This case was a male of 21 years old, worked as a welder. Due to working without using any eye protection equipment the patient got an eye trauma. The patient washed his eye with water directly and applied some drops of an eyedrop containing dexamethasone, neomycin sulphate dan polymyxin B sulphate. After three days without improvement, he went to Prof. Dr. R. D. Kandou Hospital Manado. Eye examination revealed visual acuity of the right eye 6/9 and of the left eye 6/6. There were also blepharospasme and lacrimation on the right eye. Slit lamp examination showed a foreign particle of 0.5x0.5 mm in the right cornea, 8 o’clock direction, between paracentral and peripheral regions estimated to be 1/3 of the anterior stromal thickness. Foreign particle removal left an ulcer of 1/3 of the stromal thickness. Gentamycin eye ointment was aplied three times daily and eye patching was performed. After one day of treatment, visus of the right eye became 6/7.5. Slit lamp examination showed epithelialized ulcer sized less than 0.5x0.5 mm. Gentamycin eye ointment was further applied. The patients showed improvement of visus and corneal condition.Keywords: Occupational Health and Safety, welder, cornea, personal protective equipment Abstrak: Pelaksanaan Kesehatan dan Keselamatan Kerja (K3) yang kurang baik dapat menyebabkan terjadinya kecelakaan kerja. Kasus trauma mata yang berhubungan dengan kecelakaan kerja di seluruh dunia masih terbilang cukup banyak. Kami melaporkan kasus kecelakaan kerja akibat kurangnya kesadaran penggunaan alat pelindung diri pada seorang laki-laki pekerja las berusia 21 tahun. Oleh karena tidak menggunakan alat pelindung mata, saat kerja, mata pasien terkena serpihan besi. Segera setelah kejadian itu, pasien langsung mencuci mata dengan menggunakan air kran dan menggunakan tetes mata kombinasi dexamethasone, neomycin sulphate dan polymyxin B sulphate. Setelah tiga hari tidak terdapat perbaikan pasien akhirnya berobat ke RSUP Prof. Dr. R. D. Kandou Manado. Pada pemerik-saan didapatkan tajam penglihatan mata kanan 6/9 dan mata kiri 6/6. Terdapat blefarospasme dan lakrimasi. Pada pemeriksaan dengan slitlamp didapatkan serpihan benda asing dengan ukuran sekitar 0,5x0,5 mm pada kornea mata kanan di arah jam 8 antara regio parasentral dan perifer kornea sekitar 1/3 ketebalan storma anterior. Pengangkatan benda asing menyisakan ulkus 1/3 tebal stroma pasca tindakan. Pasien diberikan gentamycin salep mata dan dilakukan eye patching. Saat kontrol satu hari kemudian didapatkan tajam penglihatan mata kanan 6/7,5 dan mata kiri 6/6. Pada pemeriksaan dengan slit lamp didapatkan ulkus kornea mata kanan berukuran <0,5x0,5 mm yang telah terepitelisasi. Pengobatan dengan gentamycin salep mata dilanjutkan. dan terjadi perbaikan tajam penglihatan dan kondisi anatomis kornea.Kata kunci: Kesehatan dan Keselamatan Kerja, pekerja las, kornea, alat pelindung diri
Hubungan antara tajam penglihatan dengan derajat non-proliferative diabetic retinopathy pada pasien diabetes melitus tipe 2 Nursalim, Ade John; Sumual, Vera
Jurnal Biomedik : JBM Vol 8, No 2 (2016): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.8.2.2016.12673

Abstract

Abstract: This study aimed to determine the relationship between visual acuity and degree of Non Proliverative Diabetic Retinopathy (NPDR) in patients with type 2 diabetes mellitus (T2DM). This study was conducted in Retina Subdivision Ophthalmology Department Prof. Dr. R. D. Kandou Hospital, Manado, North Sulawesi, Indonesia. Samples were 354 eyes. Visual acuity examination was performed on all patients diagnosed with NPDR by using a Snellen chart at 6 meters distance. NPDR degree was graded according to the International Clinical Diabetic Retinopathy Disease Severity Scale of the American Academy of Ophthalmology. Correlation analysis between visual acuity and the NPDR degree was done by using Kruskal Wallis test which showed a P value of 0.185 (> 0.05). Conclusion: Visual acuity had no significant relationship to the degree of NPDR.Keywords: visual acuity, NPDR, T2DMAbstrak: Penelitian ini bertujuan untuk mengetahui hubungan antara tajam penglihatan dengan derajat Non Proliverative Diabetic Retinopathy (NPDR) pada penyandang diabetes melitus tipe 2 (DMT2). Penelitian ini dilakukan di Poliklinik Mata Subdivisi Retina RSUP Prof. Dr. R. D. Kandou Manado, Provinsi Sulawesi Utara, Indonesia. Sampel penelitian berjumlah 354 mata. Pemeriksaan visus dilakukan pada semua pasien yang terdiagnosis NPDR dengan menggunakan Snellen chart pada jarak 6 meter. Penilaian derajat NPDR berdasarkan International Clinical Diabetic Retinopathy Disease Severity Scale dari American Academy of Ophthalmology. Analisis hubungan visus dengan derajat NPDR dilakukan dengan uji statistik Kruskal Wallis yang menunjukkan nilai P = 0,185 (>0,05). Simpulan: Tidak terdapat hubungan bermakna antara tajam penglihatan (visus) dan derajat NPDR.Kata kunci: visus, NPDR, DMT2
GAMBARAN PENGETAHUAN MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS SAM RATULANGI TENTANG GLAUKOMA Theja, Andri; Sumual, Vera; Tongku, Yamin
e-CliniC Vol 4, No 1 (2016): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v4i1.10970

Abstract

Abstract: This study aimed to determine the knowledge about glaucoma of students of Faculty of Medicine, University of Sam Ratulangi Manado. This was a descriptive survey study by using questionnaire. This study was conducted at the Faculty of Medicine, University of Sam Ratulangi from October 2015 until December 2015. There were 81 respondents. Respondents were obtained by stratified random sampling in each batch, and in each batch we used simple random sampling. The results showed that the knowledge categories of students about glaucoma were as follows: moderate category in 57 respondents (70.4%), good category in 2 respondents (2.4%), and poor category in 22 respondents (27.2%). Conclusion: In this study, most of the students of Faculty of Medicine, University of Sam Ratulangi Manado had moderate category of knowledge about glaucoma. Keywords: glaucoma, student knowledge Abstrak: Penelitian ini bertujuan untuk mengetahui pengetahuan mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi tentang glaukoma. Jenis penelitian yang dilakukan ialah survei deskriptif, dengan membagikan kuesioner pengetahuan kepada responden. Penelitian ini dilakukan di Fakultas Kedokteran Universitas Sam Ratulangi sejak bulan Oktober sampai Desember 2015 dengan responden sebanyak 81 orang. Responden diperoleh berdasarkan teknik stratified random sampling pada masing-masing angkatan, kemudian untuk pengambilan sampel di tiap angkatan digunakan teknik simple random sampling. Hasil penelitian memperlihatkan kategori pengetahuan mahasiswa sebagai berikut: pengetahuan kategori sedang sebanyak 57 responden (70,4%), kategori baik sebanyak 2 responden (2,4%) dan kategori kurang sebanyak 22 responden (27,2%). Simpulan: Dalam penelitian ini, sebagian besar mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi mempunyai pengetahuan mengenai glaukoma dengan kategori sedang.Kata kunci: glaukoma, pengetahuan mahasiswa
Idiopathic Macular Hole yang Terjadi setelah Pembedahan Katarak dengan Teknik Fakoemulsifikasi: Laporan Kasus Nursalim, Ade John; Sumual, Vera
Jurnal Biomedik : JBM Vol 11, No 3 (2019): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.11.3.2019.26332

Abstract

Abstract: Macular hole (MH) up to now has an unknown exact etiology or mechanism behind its formation. It can be formed post cataract surgery with phacoemulsification technique with a relatively small probability. We reported a male of 74 years old who came with diminished visual acuity of his left eye three months after cataract surgery with phacoemulsification procedure. In ophthalmologic examination we found the visual acuity of the right eye was 6/60 and of the left eye was 2/60. Fundoscopy of the left eye revealed a depression in fovea region with estimated size of 500 μm. Optical coherence tomography (OCT) examination resulted in intraretinal fluid with multiple cyst appearance in retinal layers associated with retinal thickening. Based on anamnesis, physical examination, and imaging examination, the diagnosis of this patient was stage 3 macular hole with vitreomacular traction. Management of this patient was pars plana vitrectomy (PPV). One week after PPV, the patient gained a remarkable visual acuity improvement (6/12), albeit, there was still slight metamorphosia.Keywords: macular hole, cataract surgery, phacoemulsification Abstrak: Macular hole (MH) hingga saat ini masih tidak diketahui penyebab pastinya ataupun mekanisme dasar terjadinya MH. Penyakit ini juga dapat terbentuk pasca operasi katarak dengan teknik fakoemulsifikasi meskipun dengan probabilitas yang relatif kecil. Kami melaporkan sebuah kasus MH pada seorang laki-laki berusia 74 tahun dengan keluhan pandangan kabur pada mata kiri 3 bulan setelah operasi katarak (teknik fakoemulsifikasi). Pada pemeriksaan oftalmologi didapatkan tajam penglihatan mata kanan 6/60 dan mata kiri 2/60. Pada pemeriksaan lanjut mata kiri menggunakan funduskopi ditemukan cekungan pada bagian fovea dengan ukuran sekitar 500 μm. Pemeriksaan dengan OCT mendapatkan intra-retinal fluid dengan gambaran kista multipel pada lapisan retina disertai penebalan retina. Berdasarkan anamnesis, pemeriksaan fisik, dan imaging, diagnosis pada pasien ini ditegakkan sebagai macular hole stadium 3 dengan vitreomacular traction pada mata kiri. Tata-laksanayang dilakukan ialah vitrektomi pars plana (VPP). Satu minggu setelah VPP, tajam penglihatan pasien membaik secara drastis menjadi 6/12 walaupun masih terdapat metamorphopsia ringan.Kata kunci: macular hole, operasi katarak, fakoemulsifikasi
Central Serous Chorioretinopathy Induced by Work Stress: A Case Report Nursalim, Ade J.; Sumual, Vera
e-CliniC Vol 8, No 2 (2020): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v8i2.31107

Abstract

Abstrak: Central serous chorioretinopathy (CSC) adalah terkumpulnya cairan serosa di bawah lapisan epitel pigmen retina yang mengakibatkan terlepasnya retina neurosensorik (detachment). Keadaan ini dapat disebabkan oleh berbagai faktor risiko, termasuk stres psikologik. Jenis kelamin laki-laki merupakan salah satu faktor risiko CSC. Terapi kondisi psikologik merupakan pena-nganan utama CSC yang diinduksi oleh stres kerja. Kami melaporkan seorang laki-laki berusia 27 tahun yang datang ke Poliklinik Mata RSUP Prof. Dr. R. D. Kandou Hospital dengan keluhan kekaburan mata kanan yang mendadak sejak seminggu lalu tanpa didahului oleh nyeri pada mata. Pasien juga mengalami kesulitan dalam membaca teks dan mengenali wajah bila hanya menggunakan mata kanannya. Pasien telah pergi ke optik tetapi tidak mendapatkan ukuran kacamata yang sesuai. Pasien bekerja sebagai tenaga administrasi dan akhir-akhir ini mendapatkan beban kerja berlebihan. Pasien mengakui bahwa ia mengalami kesulitan dalam mengatur aktivitasnya, dan merasakan kelelahan sepanjang hari serta kehilangan minat kerja. Hasil pemeriksaan mata mendapatkan visus 6/15 untuk mata kanan dan visus 6/6 untuk mata kiri, dan metamorphopsia sedangkan hasil pemeriksaan oftalmoskopi memperlihatkan adanya edema dengan lingkaran kekuningan dan berbatas tidak jelas pada mata kanan. Pemeriksaan lanjut dengan OCT menunjukkan adanya cairan subretinal pada mata kanan disertai terlepasnya lapisan epitel pigmen. Saat kontrol setelah 36 hari, visus mata kanan telah membaik 6/6F2 dan peme-riksaan OCT menunjukkan penurunan tebal makula dari 289 μm pada kunjugan pertama men-jadi 190 μm, serta tidak tampak adanya cairan subretinal. Simpulan kasus ini ialah central serous chorioretinopathy yang diinduksi oleh stres kerja, dengan penanganan utama ialah terapi psikologik untuk memperbaiki kualitas hidup.Kata kunci: central serous chorioretinopathy (CSC), stres kerja Abstract: Central serous chorioretinopathy (CSC) is a condition where serous fluid builds up in the retinal pigment epithelium layer which causes neurosensory retinal detachment. This condition is affected by many risk factors, including psychological stress. Male gender is one of the risk factors for CSC. Treatment to the patient's psychological condition can be the main therapy in handling CSC induced by work stress. We reported a 27-year-old male came to the eye clinic at Prof. dr. R. D. Kandou Hospital complaining of sudden blurred vision in his right eye a week ago without initial pain in the eye. The patient also experienced difficulty in reading text and recognizing people’s face using the right eye. The patient went to an optic store but he did not find suitable glasses. The patient works as an administrative employee and is currently getting a heavy workload at his workplace. The patient admitted that he had issues in managing his life in a day. Patients felt tired throughout the day and had no interest in making any activities. The results of the eye examination showed vision 6/15 in the right eye and 6/6 in the left eye, metamorphopsia, edema with a yellowish circle with an unclear border on the right eye using ophthalmoscopy examination, and a subretinal fluid image in the patient's right eye with epithelial detachment pigment acquired through the examination with OCT. After 36 days from the first visit, the right eye vision was improved to 6/6 F2 and OCT examination resulted in a decrease in macula thickness from 289 μm at the first visit to 190 μm, and there was no subretinal fluid. In conclusion, this was a CSC case induced by work stress, and the main treatment was psychological therapy in order to improve the quality of life (QoL).Keywords: central serous chorioretinopathy (CSC), work stress
Karakteristik Pasien Age-related Macular Degeneration (AMD) pada Fasilitas Kesehatan Tersier di Masa Pandemi Covid 19 Nursalim, Ade J.; Simanjuntak, Elbetty; Sumual, Vera
e-CliniC Vol 9, No 2 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i2.35645

Abstract

Abstract: Age-related macular degeneration (AMD) is a neurodegenerative disease that affects the macula and is characterized by age-related loss of the central visual field. AMD contributes greatly to blindness for people over 50 years old in the world. The prevalence of AMD is increasing from year to year. Albeit, during the Covid-19 pandemic the number of patient visits to health facilities tends to decrease. This study was aimed to report the clinical characteristics of patients with AMD in tertiary health facilities during the covid 19 pandemic and to compare them with previous reports. This was a retrospective and descriptive study using medical record data of the Ophthalmology Clinic of Prof. Dr. R. D. Kandou Hospital Manado from March 2020 to June 2021. There were 12 patients in this study consisting of 10 males and two females. Age range of 56-75 years had the highest percentage (58%). The non-neovascular subtype were found in 7 patients (58.3%) meanwhile the neovascular type in 5 patients (41.7%). The identified risks were hypertension (50%), diabetes mellitus (DM) (8.3%), and DM associated with hypertension (16,7%), meanwhile no risk factor was found in 8.3% of patients. The number of patient visits decreased in the study period compared to previous reports conducted before the pandemic. In conclusion, the majority of AMD patients were male, age group of 56-75 years, and had non-neovascular subtype. The identified risk factors were hypertension and diabetes mellitus.Keywords: age related macular degeneration (AMD); characteristics of patients Abstrak: Age-related macular degeneration (AMD) adalah penyakit neourodegeneratif yang mengenai bagian makula dan ditandai dengan hilangnya lapang pandang sentral yang berhu-bungan dengan usia. AMD berkontribusi besar terhadap angka kebutaan untuk usia di atas 50 tahun di dunia. Prevalensi AMD pun semakin meningkat dari tahun ketahun. Pandemi Covid 19 diketahui mengurangi angka kunjungan pasien ke fasilitas kesehatan. Penelitian ini bertujuan untuk melaporkan karakteristik klinik pada pasien AMD pada fasilitas kesehatan tersier di masa pandemi covid 19 dan membandingkannya dengan laporan sebelumya. Jenis penelitian ialah deskriptif retrospektif dengan menggunakan data rekam medik di Poliklinik Mata RSUP Prof. Dr. R. D. Kandou Manado periode Maret 2020-Juni 2021. Hasil penelitian mendapatkan sebanyak 12 pasien AMD; sebagian besar berjenis kelamin laki-laki (83,3%), berada dalam rentang usia 56-75 tahun (58%), dengan subtipe AMD non neovaskular (58,3%). Faktor risiko yang teridentifikasi ialah hipertensi (50%), diabetes melitus (DM) (8,3%), dan DM disertai hipertensi (16,7%), sedangkan yang tanpa faktor risiko hanya 8,3%. Jumlah kunjungan pasien berkurang di periode waktu penelitian dibandingkan dengan laporan yang dilakukan sebelum masa pandemi. Simpulan penelitian ialah mayoritas pasien AMD berjenis kelamin laki-laki, usia 56-75 tahun, dengan subtipe non neovaskular. Faktor risiko teridentifikasi ialah hipertensi dan diabetes melitus.Kata kunci: age-related macular degeneration (AMD); karakteristik pasien
High-grade myopia and vaginal delivery: A narrative review Sumual, Vera; Chandra, Angelina Patricia; Sutanto, Reynardi Larope
Science Midwifery Vol 12 No 4 (2024): October: Health Sciences and related fields
Publisher : Institute of Computer Science (IOCS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35335/midwifery.v12i4.1700

Abstract

This narrative review explores the risks and management considerations of vaginal delivery in individuals with high-grade myopia, a condition associated with potential complications like retinal detachment and choroidal neovascularization. Utilizing 24 references, the review follows a modified rapid literature review model as outlined by Tjoa and Sutanto (2024). Eleven core studies out of an initial 234, including case reports and retrospective studies, were analyzed in the final qualitative assessment. The findings suggest that high-grade myopia, by itself, generally does not require cesarean section (C-section), and vaginal delivery is considered safe for most patients, provided there is regular ophthalmological monitoring throughout pregnancy. There is no strong evidence supporting a universal recommendation for C-section solely due to high myopia, except in the presence of severe complications, such as choroidal neovascularization. The review emphasizes individualized care, with delivery mode decisions tailored to each patient's specific ocular risk factors. Routine C-sections without additional complicating factors are not justified, underscoring the need for regular ophthalmological evaluations to ensure optimal maternal and fetal outcomes. Due to the limitations of existing studies, further in-depth research is recommended to confirm these findings and refine clinical guidelines.
Long-Term Outcomes of Cataract Surgery: Analysis of Visual Acuity and Intraocular Pressure in a Tertiary Care Center Nursalim, Ade J.; Sumual, Vera; Chietra, Andrew; Emily, Ardelia; Rusli, Richardo
e-CliniC Vol. 12 No. 3 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i3.58044

Abstract

Abstract: Posterior capsule opacity (PCO) is a common complication following cataract surgery, caused by the proliferation of residual lens epithelial cells. This study aimed to evaluate the long-term effects of Nd:YAG laser capsulotomy on intraocular pressure (IOP) and visual acuity in PCO patients. This was a retrospective descriptive study. Samples were 24 patients diagnosed with PCO who underwent Nd:YAG laser capsulotomy at Prof. Dr. R. D. Kandou Hospital, Manado, from January 1, 2022, to January 1, 2024. The study recorded pre- and post-procedure IOP and best-corrected visual acuity (BCVA) data. Descriptive analysis, including paired t-tests, was used to assess changes in IOP and BCVA over an average follow-up period of 19.2 months. The results showed a statistically significant improvement in BCVA (p=0.000), with mean values improving from 0.72 to 0.27 LogMAR. A significant reduction in IOP was also observed (p=0.015), with long-term IOP remaining stable. A weak correlation was found between follow-up duration and IOP variation (p=0.02). In conclusion, Nd:YAG laser capsulotomy significantly improves visual acuity and stabilizes intraocular pressure in the long term for PCO patients, suggesting its effectiveness in managing post-cataract surgery complications. Keywords: posterior capsule opacity; Nd:YAG laser capsulotomy; intraocular pressure; visual acuity; cataract surgery    
Perbandingan TIO Sebelum dan Sesudah Operasi pada Pasien Vitrektomi Berbantuan Triamsinolon dengan dan Tanpa Pembedahan Lensa: Hasil Penelitian Nursalim, Ade John; Sumual, Vera; Wulur, Ardelia Emily
Cermin Dunia Kedokteran Vol 52 No 7 (2025): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i7.1592

Abstract

Introduction: This retrospective study evaluates the impact of triamcinolone-assisted vitrectomy on intraocular pressure (IOP) in patients undergoing vitreoretinal surgery, with particular focus on comparing outcomes in patients with and without lens surgery. Methods: Medical records of patients treated at R.D. Kandou Hospital from May 2019 to May 2024 were reviewed, and pre- and postoperative IOP values were analyzed. A total of 35 patients met the inclusion criteria. Results: The results show a significant reduction in IOP at all postoperative intervals, with mean differences of 11.12 mmHg at 1 day, 8.60 mmHg at 1 week, 13.23 mmHg at 1 month, and 16.91 mmHg at 3 months postoperatively. Analysis revealed no significant difference in IOP outcomes between phakic and pseudophakic patients. Conclusion: These findings indicate that triamcinolone-assisted vitrectomy effectively lowers IOP, regardless of lens status.
Co-Authors Ade John Nursalim Andri Theja, Andri Boedihardjo, Gita P. Chandra, Angelina Patricia Chietra, Andrew Clarissa E. Tany, Clarissa E. Dalope, Junifer M.L. Emily, Ardelia Eunike L. Pietersz, Eunike L. J. S. M. Saerang Kalangi, Wulan Laya Rares Manoppo, Rillya D. P. Najoan, Imelda Nursalim, Ade J. Pantow, Immanuel H. Rohamonangan Theresia Sinaga, Rohamonangan Theresia Rusli, Richardo Saerang, Josefien Simanjuntak, Elbetty Sumanti, Eugeni Sutanto, Reynardi Larope Tiara Ilery Wulur, Ardelia Emily Yamin Tongku Yellien R. Manullang, Yellien R.