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RELATIONSHIP BETWEEN NUTRITION INTAKE AND THE FITNESS OF MANUFACTURING WORKERS IN INDONESIA Muhammad Ilyas; Dewi Sumaryani Soemarko; Nuri Purwito Adi; Dewi Yunia Fitria; Marsen Isbayu Putra; Yessi Kualasari
The Indonesian Journal of Public Health Vol. 16 No. 1SP (2021): SUPPLEMENTARY
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (272.948 KB) | DOI: 10.20473/ijph.v16i1SP.2021.23-33

Abstract

ABSTRACKIndonesia ranks fourth in the world out of 15 countries whose manufacturing industries contribute more than 10% to the Gross Domestic Product (GDP). Nowadays, one of the consequences of the rapid development of the manufacturing industry in Indonesia is related to work productivity. Each person's work productivity is not the same, one of them depends on the availability of nutrients in the body. Lack of nutritional consumption for someone from standard needs will affect health conditions, activities, and work productivity. Nutritional substances in workers also affect fitness in addition to other factors such as age, health status, nutritional status, nutritional status, gender, and psychological conditions. Based on the description above, it is necessary to study the relationship between nutritional status and physical fitness of workers in manufacturing companies in Indonesia. The study was cross sectional on 120 workers from 6 manufacturing companies in Indonesia which was conducted using cluster sampling. Assessment of individual characteristics was conducted by direct interview. Assessment of nutritional intake uses the Food Frequency Questionnaire (FFQ) and the results were categorized as appropriate and inappropriate based on the 2019 nutritional adequacy figure for the Indonesian population. The fitness assessment (physical capacity) used a six-minute walking test by an occupational specialist and was converted to Meters and categorized with a cut off of 4.5 Mets to be sufficient or insufficient. About one third of manufacturing workers were centrally obese. Characteristics The dietary intake according to the recommendation were only about 10%, namely the appropriate carbohydrate intake 11.7% (Frequency 8.46 times (533.22 gr)), suitable fat 12.5% (Frequency 2.75 times (57.14 gr)), and suitable protein 10% (Frequency 6.55 times (101.77 gr)). The physical capacity of manufacturing workers in Indonesia was categorized as sufficient as much as 75.8% of their workload. Factors that affect physical capacity, namely age ≥ 40 years have 4.37 times less physical capacity and protein intake affected physical capacity / fitness for workers (p = 0.02). About a third of manufacturing workers were centrally obese. The characteristic of food intake in accordance with the recommended nutritional adequacy of the Indonesian population was only about 10%. The physical capacity of manufacturing workers in Indonesia was categorized as sufficient as much as 75.8% of their workload. Factors that affected physical capacity were age and protein intake. Keywords: Food Intake, Food Frequency Questionnaire (FFQ), Manufacturing Worker, Fitness, Six-Minute Walking Test.
THE ASSESSMENT OF HEALTH PROTOCOL IMPLEMENTATION IN FOOD AND BEVERAGES BUSINESS DURING COVID-19 PANDEMIC ERA Lusi Sandra Hutahaean; Muhammad Ilyas; Marsen Isbayuputra; Ray Wagiu Basrowi; Dewi Soemarko
The Indonesian Journal of Public Health Vol. 16 No. 1SP (2021): SUPPLEMENTARY
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (466.58 KB) | DOI: 10.20473/ijph.v16i1SP.2021.12-22

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ABSTRACTDuring the COVID-19 pandemic era, the government has implemented a new strategy of health protocol called Adaptation of New Habits to prevent COVID -19 virus spread. By implementing such protocol, it is expected that health and economic sectors can be handled well. The research aims to discover the implementation of health protocol in Indonesia’s food and beverage business, and to analyze factors that support and hamper its implementation.  This research was cross-sectional research with direct observation and brief interviews with 16 food and beverage business places. Observations and interviews were guided using a checklist derived from government policies set by the ministry of health and commerce then the data will be analyzed descriptively. This research shows that the implementation health protocol remained far from expectations. Moreover, business activity, management system, and the awareness of employers, employees, as well as consumers, became a critical key in health protocol implementation. Comprehending the dangers of COVID-19 and committing to comply with health protocols are imperatives to succeed in the health protocol implementation.  Keywords: Adaptation of New Habits, Health Protocol of COVID-19 Pandemic, evaluating health protocols implementation
Correlation of noise level exposure on the reaction time of workers at a manufacturing company in Bandung, Indonesia Herqutanto Herqutanto; Irwan Suhadi; Imron Khazim; Dewi S. Soemarko; Retno A. Werdhani
Health Science Journal of Indonesia Vol 11 No 1 (2020)
Publisher : Sekretariat Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/hsji.v11i1.2447

Abstract

Latar Belakang: Para pekerja sering kali terpaksa berhadapan dengan kebisingan tinggi ditempat kerja. Kebisingan mengganggu perhatian yang diperlukan terus-menerus dan menurunkan produktivitas kerja, oleh sebab itu pekerja yang melakukan pengamatan dan pengawasan terhadap satu proses produksi atau hasilnya, dapat membuat kesalahan akibat dari terganggunya konsentrasi dan kurang fokusnya perhatian. Pada penelitian ini dilakukan pengukuran waktu reaksi cahaya dan suara untuk menilai fokus perhatian/konsentrasi. Metode: Studi analitik dengan desain komparatif cross sectional. Penelitian ini dilakukan pada perusahaan manufaktur yang memproduksi benang nylon sintetik. Membandingkan rerata selisih waktu reaksi cahaya dan suara sebelum dan setelah bekerja dengan pajanan kebisingan pada kelompok subjek yang bekerja pada intensitas kebisingan di atas NAB (area braiding) dibandingkan dengan yang di bawah NAB (area waring), dimana sebelumnya dilakukan pengukuran intensitas tingkat kebisingan di kedua area tersebut. Hasil Penelitian: Perbedaan bermakna waktu reaksi cahaya yang melambat pada subjek yang bekerja dengan pajanan kebisingan di atas NAB sebelum dan setelah bekerja (p=0.007), namun tidak dengan waktu reaksi suara. Tidak terdapat perbedaan bermakna waktu reaksi cahaya dan suara pada subjek yang bekerja dengan pajanan kebisingan di bawah NAB sebelum dan setelah bekerja. Terdapat perbedaan bermakna rerata selisih waktu reaksi cahaya yang melambat pada subjek yang bekerja pada pajanan kebisingan di atas NAB dengan di bawah NAB, p=0,017, namun tidak bermakna terhadap rerata selisih waktu reaksi suara. Kesimpulan: Terdapat perbedaan rerata selisih waktu reaksi cahaya pada pekerja yang bekerja dengan pajanan kebisingan di atas NAB dibandingkan dengan pekerja yang bekerja dengan pajanan kebisingan di bawah NAB, sehingga tingkat intensitas kebisingan tinggi (di atas NAB) mempengaruhi waktu reaksi cahaya dan menjadi lebih lambat. Kata Kunci: waktu reaksi cahaya; waktu reaksi suara; kebisingan Abstract Background: Workers are often exposed to high noise level at their workplaces. Noise can disrupt the worker’s concentration and focus and in the end, may cause lower productivity. Thus, workers whose main job descriptions are to supervise workflow from one phase to another are prone to mistakes due to the loss of concentration and focus. In this research, we used reaction timer with light and sound stimuli to assess attention or concentration. Methods: The study was an analytical study with comparative cross sectional design, comparing a mean difference between light and sound reaction time before and after work. This research was conducted at a manufacturing company that produces synthetic nylon fibers. The subjects were divided into two groups; the workers with noise intensity above TLV (braiding’s area) and with noise intensity below TLV (waring’s area). Prior to the study, the research has measured the intensity of the noise level in the workplace area. Result: A significant difference was found in the light’s reaction time who work with noise exposure above TLV (p= 0.007) and it was found to be slower after work with the workers who are exposed to noise above TLV. There was also a significant mean difference for the light’s reaction time between the above TLV noise group and below TLV noise group (p = 0.017). There was no significant difference in sound reaction time. Conclusion: There was a significant mean difference in light reaction time for the workers who work with noise exposure above TLV compare with the workers who work in below TLV, so that high intensity of noise level is found to affect and decrease the light reaction time of the workers. Keywords: light’s reaction time, sound’s reaction time, noise.
Biomonitoring of Acetylcholinesterase (AChE) Inhibitor and the Association with Hypertension among Farmers in Bandung, Indonesia Mulyana Mulyana; Iwan Sugiarta; Lim Jen Fuk; Vani Nur Pratami; Dewi Yunia Fitriani; Nuri Purwito Adi; Dewi Sumaryani Soemarko
The Indonesian Biomedical Journal Vol 12, No 4 (2020)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v12i4.1220

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BACKGROUND: The use of acetylcholinesterase (AChE) insecticides is still widely used by farmers in flower and agricultural centers. However, biological monitoring of farmers is still very rare in Indonesia. AChE inhibitors are reported to have toxic effects on various organs.METHODS: This study involved 120 subjects in Cihideung, Cikole and Pangalengan areas. All subjects have been interviewed, physically examined and biological sample taken by medical team. Descriptive analysis was performed to assess general conditions of the subjects and AChE erythrocyte activity enzyme at pseudo-baseline and the next 3 months from pseudo-baseline. Statistical analysis have been performed of the pseudo-baseline AChE erythrocyte activity with hypertension and history of exposures.RESULTS: The median value of pseudo-baseline AChE erythrocyte activity was 8.10 (1.3-14.25) U/g hematocrit. In the comparison between pseudo-baseline and 3 month from pseudo-baseline AChE activity, 7 respondents from 19 respondents (36.84%) had lower enzyme activity than 70% and the others subjects have higher activity value. AChE erythrocyte activity is associate with frequency of insecticide exposures. AChE erythrocyte activity (p=0.04; Exp (B)=2.937 CI 95%=1.049-8.224) and age (p=0.025; Exp (B)=3.872 CI 95%=1.180-12.703) are independent risk factors for hypertension in farmworker.CONCLUSION: AChE erythrocyte activity associated with frequency of insecticide exposures and hypertension among farmworkers.KEYWORDS: AChE erythrocyte activity, frequency of insecticide expsoures, hypertension
The influence of sitting work position and sitting time for the risk of hemorrhoid in female production workers at the hand-rolled cigarette factory Izzatul Abadiyah; Dewi Sumaryani Soemarko; Herqutanto2; Suryo Wibowo; Ambar Roestam
The Indonesian Journal of Community and Occupational Medicine Vol. 1 No. 1 (2021): ijcom
Publisher : ILUNI MKK FKUI and PRODI MKK FKUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (639.878 KB) | DOI: 10.53773/ijcom.v1i1.1.3-14

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Introduction: According to medical check up results of the hand-rolled cigarette factory PT. X in 2018, a hemorrhoid prevalence of 33% was found. Several studies have tried to show an association between individual factors such as age, family history, constipation, obesity, pregnancy, fiber consumption, and defecation position in research subjects in clinics and hospitals. Nevertheless, the effects of sitting work position and sitting time on the risk of hemorrhoid is yet to be revealed. This study aims to prove the effect of these factors on the increased risk of hemorrhoids. Methods: An observational study with a 1:1 unmatched case control design with 300 female workers as subjects. The risk factors related with hemorrhoids were obtained from primary and secondary data. Cases were workers diagnosed with hemorrhoids and controls were workers who were not diagnosed with hemorrhoids during a medical check-up 2018. Data analysis was performed using univariate and bivariate analysis. Results: The mean ages of the subjects were 42.49±3.05 years old (cases) and 42.83±3.02 years old (controls), with most education level was a junior high school in both groups. Bivariate analysis pointed out that sitting work position and sitting time did not have a significant relationship with the incidence of hemorrhoids. Meanwhile, consumption of less fruit (OR=3.84;95%CI 1.87-7.91) and less vegetable (OR=2.41;95%CI 1.36-4.28) increased the risk of hemorrhoid compared to sufficient vegetables and fruit consumption. Conclusion: Sitting work position and sitting time were not associated with an increased risk of hemorrhoids. Meanwhile, consumption of less vegetable and fruit increased the risk of hemorrhoids.
A Correlation of Asthma with Ammonia Exposure and Other Risk Factors among Informal Workers of Poultry Farmers Arriz Akbar Sukadi; Dewi Sumaryani Soemarko; Faisal Yunus
The Indonesian Journal of Community and Occupational Medicine Vol. 1 No. 2 (2021): ijcom
Publisher : ILUNI MKK FKUI and PRODI MKK FKUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (140.019 KB) | DOI: 10.53773/ijcom.v1i2.6.56-62

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Objective: To determine the prevalence of asthma and its corelation with ammonia exposure among informal workers of poultry farmers.Method: This study design was a cross-sectional analytic to 69 respondents using questionnaires, field observation, physical examination, spirometry measurement, and peak flowmeter test to diagnose work-related asthma and measurement of ammonia level in air environment of farm. All variable were bivariate tested by using Chi-square test or Fischer test. The variables which have p value <0,25 were included into multivariate analysis by using binary logistic regression.Results: The prevalence of asthma in poultry farmers was 21,74%. In bivariate analysis, there was a significant corelation between working periode (p = 0,035 with OR = 7,00) and smoking habit (p = 0,018 with OR = 5,603) with asthma. There was no significant corelation between age, sex, nutritional status, work location, education level and marital status with asthma. The result of measurement of ammonia level in the poultry farm enclosure on average is 2,329 ppm. Multivariate analysis was performed on several risk factors that fulfilled the requirement p <0,25 ie working periode, smoking habit, nutritional status, and work location. From the results of mutivariate found that workers with a history of smoking habits have the strongest corelation p = 0,013 with OR 17,305.Conclusion: The prevalence of asthma in poultry farmers was 21,74%. There was no significant corelation between ammonia exposure in the work environment with asthma. But there was a significant corelation between working periode and smoking habit with asthma.
Effectiveness of PPE For Prevention of Occupational Ocular Injury Iwan Susilo Joko; Dewi S Soemarko; Nuri Purwito Adi
The Indonesian Journal of Community and Occupational Medicine Vol. 1 No. 2 (2021): ijcom
Publisher : ILUNI MKK FKUI and PRODI MKK FKUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (157.747 KB) | DOI: 10.53773/ijcom.v1i2.7.63-71

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Background: One of the risk factors for Chronic Lymphocytic Leukemia (CLL) is chemical exposure at work. The aim is to determine the relationship between patient who work as a farmer and vegetable seller with the incidence of CLL.Case presentation: A-69-year-old man who has been working as a vegetable seller since 15 years and a chili farmer since 4 years ago. The patient was diagnosed with CLL. In his work as a vegetable seller and chili farmer, the patient gets five hazards ranging from physical, chemical, biological, ergonomic and psychosocial hazards so it is necessary to analyze whether there is a relationship between the patient’s work and the current CLL disease.Discussion: There are seven steps needed in the enforcement of occupational diseases. In addition, additional examinations are needed to determine the biomarkers of pesticides that can cause disease. This requires control for farmers and vegetable sellers who may be exposed to pesticides found in vegetables and chilies. Conclusion: Vegetable seller and farmer have potential hazards, especially chemicals contained in pesticides which have a risk relationship with the incidence of CLL. However, to cause CLL, sufficient doses are required which are influenced by occupation, intensity of use and the type of specific chemical without the need for a long duration of exposure.
Determination of Occupational Disease in Worker with Liver Cirrhosis That Exposed by Vinyl Chloride Superimposed with Hepatitis B Infection Dewi Sumaryani Soemarko; Aditya Agung Prasetyo
The Indonesian Journal of Community and Occupational Medicine Vol. 1 No. 2 (2021): ijcom
Publisher : ILUNI MKK FKUI and PRODI MKK FKUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (305.183 KB) | DOI: 10.53773/ijcom.v1i2.11.78-83

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Background: Liver cirrhosis is the final pathological result of various chronic liver diseases that characterized by the formation of regenerative nodules and fibrotic tissue. The etiology of liver cirrhosis are hepatitis C, hepatitis B, alcohol, nonalcoholic fatty liver disease, and can also be caused by chemicals in the workplace. The occupational diagnosis of Liver Cirrhosis that exposed by vinyl chloride superimposed with hepatitis B infection with was performed by using The Seven Steps of Occupational Diagnosis, a method that issued by PERDOKI (Indonesian Occupational Medicine Association-IOMA). The aim of this case report is to determine whether liver cirrhosis in this patient is an occupational disease or not.Case Presentation: Fifty years old man came to Emergency Room with complaints of vomiting black blood since 4 hours. Vomiting blood as much as 5 times with a volume of about 200 cc each time. One day before, patient admitted that his defecation is black, watery, and smell bloody. Volume of defecation was unknown. Three months before, patient complainted that the stomach often felt bloated, enlarged, and got full quickly. There was no icteric in eyes and body.This complaints (vomiting black blood and black stools) were often occured since 2017. In 2017, 2018 and 2020, this patient was hospitalized once while in 2019, the patient was hospitalized twice for this complaint. In 2017, when the complaint first appeared, the patient was declared to have hepatitis B and in 2019, the patient underwent an endoscopy and was said to have enlarged blood vessels in the esophagus, and an abdominal ultrasound was performed and was said to be suspected of liver cirrhosis.This patient works as a family owned chemical industry. The chemical produced is called zamitex, a mixture for paints. These chemicals contain formaldehyde, Vinyl Chloride, and CMC (Carboxymethyl Cellulose). This patient had worked in this field for 21 years, and was exposed to these chemicals. In addition, there are also dangers of heat, awkward positions, and psychosocial.Conclusion: Based on The Seven Steps of Occupational Diagnosis, Liver cirrhosis in this patient can be categorized as an occupational disease superimposed with hepatitis B infection. Liver cirrhosis in this patient can be caused by prolonged exposure to Vinyl Chloride. Vinyl Chloride is known to cause damage to the liver, especially to cause carcinoma of the liver. There is a synergistic effect between exposure to Vinyl Chloride and hepatitis B infection, exacerbating the condition of liver damage. However, because the exposure to Vinyl Chloride has been going on for a longer time, compared to hepatitis B infection, the condition of liver cirrhosis in this patient is still categorized as an occupational disease.
Occupational Stress and its Relation to Grave’s Disease Ade Mutiara; Dewi S Soemarko; Indah S Widyahening
The Indonesian Journal of Community and Occupational Medicine Vol. 1 No. 2 (2021): ijcom
Publisher : ILUNI MKK FKUI and PRODI MKK FKUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (165.386 KB) | DOI: 10.53773/ijcom.v1i2.14.72-7

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Background: Graves’ disease is an autoimmune thyroid gland disease that causes increased activity of the thyroid hormones. But, the mechanism by which the autoantibodies are generated is still unclear. Some theory suggests that daily life stress may be a risk factor that triggers Graves’ disease. The aim of this report is to enrol a systematically searching in order to get an answer about the risk factor of the Grave’s disease and the prevention measure.Methods: In this case report, a 47-year-old career woman with prominent occupational stress was diagnosed with Graves’ disease. Literature searching was done on database such as Pubmed, Cochrane Library, and Science Direct with occupational stress, stressful life event, and Graves’ disease as the keywords. One article was selected and critically appraised. Results: One case-control study showed that patients with Graves’ disease had odds ratio (OR) of having stressful life events as big as 8.59; 95%CI = 2.35-20.80, and the number needed to harm (NNH) is 2.35.Conclusion: Occupational stress is a prominent risk factor for developing Graves’ disease. However, this is based on one article
Chronic Lymphocytic Leukemia In Farmer And Vegetable Seller Firly Ratsmita; Dewi S. Soemarko
The Indonesian Journal of Community and Occupational Medicine Vol. 1 No. 2 (2021): ijcom
Publisher : ILUNI MKK FKUI and PRODI MKK FKUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (54.133 KB) | DOI: 10.53773/ijcom.v1i2.22.84-8

Abstract

Background: One of the risk factors for Chronic Lymphocytic Leukemia (CLL) is chemical exposure at work. The aim is to determine the relationship between patient who work as a farmer and vegetable seller with the incidence of CLL.Case presentation: A-69-year-old man who has been working as a vegetable seller since 15 years and a chili farmer since 4 years ago. The patient was diagnosed with CLL. In his work as a vegetable seller and chili farmer, the patient gets five hazards ranging from physical, chemical, biological, ergonomic and psychosocial hazards so it is necessary to analyze whether there is a relationship between the patient’s work and the current CLL disease.Discussion: There are seven steps needed in the enforcement of occupational diseases. In addition, additional examinations are needed to determine the biomarkers of pesticides that can cause disease. This requires control for farmers and vegetable sellers who may be exposed to pesticides found in vegetables and chilies. Conclusion: Vegetable seller and farmer have potential hazards, especially chemicals contained in pesticides which have a risk relationship with the incidence of CLL. However, to cause CLL, sufficient doses are required which are influenced by occupation, intensity of use and the type of specific chemical without the need for a long duration of exposure.
Co-Authors -, Herqutanto Ade Mutiara Aditya Agung Prasetyo Agus Sugiharto Agustina, Amilya Ahmad Fuadi Ahmad Fuady Aldri Frinaldi Ambar Roestam Ambar W Roestam Amran Anggraeni, Caroline Anitasari Kusumawati Ari F Syam Aria Kekalih Arman, Fitri Arriz Akbar Sukadi Asep Barliana, Julie D. Bastaman Basuki Bernath Siagian Brastho Bramantyo Cahyono, Arie Denta Aditya Episana Desdiani, Desdiani Dewi Friska Dewi Yunia Fitria Dewi Yunia Fitriani Endang Parahyanti Ermita I. Ibrahim Evy Yunihastuti Faisal Yunus Ferdy Nurhadi Fifinela Raissa Finna Fitriana Firly Ratsmita Fita Rahmasari Fuk, Liem Jen Githa Rahmayunita Harahap, Sabasdin Harahap, Ummi Chairani Hardjono, Indra Herikurniawan, Herikurniawan Herlinah Herlinah Herqutanto - Herqutanto Herqutanto Herqutanto2 Hidayat, Marizca Saras Chitra Imron Khazim Indah S. Widyahening Indri, Olieve Irwan Suhadi Isbayuputra, Marsen Iwan Sugiarta Iwan Susilo Joko Izzatul Abadiyah Jonanda, Herik Okta Khoe, Levina Chandra Kresna, Andreas Kusuma, Mardiansyah Landauw, Martha Lim Jen Fuk Listya Tresnanti Mirtha, Listya Tresnanti Lusi Sandra Hutahaean Maha Putra, I Gede Mardianto, Umar Mariska, Tara Candida Marsen Isbayu Putra Marsen Isbayuputra Mohammad Firmansyah Monintja, Keyne Christa Muchtaruddin Mansyur Muhammad Ilyas Muhammad Ilyas Muhammad Ilyas Muhammad Ilyas Mulyana Mulyana Mulyantini, Astri Mutiara, Ade Novi Silvia Hardiany Nuri Purwito Adi Nuri Purwito Adi Nuri Purwito Adi Prihartanto, Joedo Priyono, Harim Pukovisa Prawiroharjo, Pukovisa Purnama, Ahmad Angga Putra, Marsen Isbayu Rakhmad Hidayat Ray Wagiu Basrowi Restuti, Ratna Dwi Retno A. Werdhani Riani Dwianasari, Riani Rita Ingewaty Wijaya Rita Ingewaty Wijaya Rosady, Dony Septriana Salim, Stellon SEPTELIA INAWATI WANANDI Sjarifuddin, Citra Nurhayati Slamet Ichsan Sofyan, Marwan Sri L. Menaldi Sri Linuwih Susetyo Wardhani, Sri Linuwih Susetyo Sudadi Hirawan Sulistomo, Astrid Sumirat, Ratih Nurdiany Tenny Sutarto Tri Mawanti, Wening Tukimun, Suci Tria Meirisa Vani Nur Pratami Wibowo, Suryo Wiraguna, Andrian Wiratman, Winnugroho Yessi Kualasari Yusuf, Prasandhya Astagiri Zarni Amri  Sugiarta,  Iwan