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Antibacterial Activity and 16S rRNA Gene Sequencing of Lactic Acid Bacteria from Homemade Fermented Milk in Medan, Indonesia Edwin Waroka; Edy Fachrial; I Nyoman Ehrich Lister; Muhammad Aditya Kurnia
Jurnal Ilmiah Kesehatan Vol 16 No 02 (2023): Jurnal Ilmiah Kesehatan (Journal of Health Science) 
Publisher : Universitas Nahdlatul Ulama Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/jhs.v16i02.3959

Abstract

Research indicates that fermented products have nutritional and non-nutritional components that can improve health. Milk is commonly used for fermentation products because its rich nutrients support the growth of Lactic Acid Bacteria (LAB). This paper investigates antibacterial activity and 16S rRNA gene sequencing of LAB from homemade fermented milk in Medan City, Indonesia. This paper was an experimental study by In Vitro Models conducted in August-October 2019. This study used three different homemade fermented milk (SF2-4) and positive control of manufactured fermented milk (SF1). All isolated LABs underwent an antibacterial assay by the Disc diffusion method against two pathogens, including Escherichia coli (Gram-negative) and Staphylococcus aureus (Gram-positive). In addition, there was molecular identification based on 16S rRNA gene sequencing. The zone of inhibition from samples against Escherichia coli ranged from 5.600-12.23 mm. The most potent antibacterial activity was found in SF4 (12.23 mm) and the least in SF2 (5.60 mm). Some samples (SF1 and SF2) showed no antibacterial effect against Staphylococcus aureus bacteria. The antibacterial activity against Staphylococcus aureus bacteria was found only in SF2 and SF3, which were 6.60 mm and 7.14 mm, respectively. Based on the characteristics, enumeration, and antibacterial activity, the authors chose isolated LAB from SF4 for molecular identification based on 16S rRNA gene sequencing. SF4 isolates had a similar 16S rRNA molecule to Lactobacillus fermentum strain NBRC 15885 with a homology level of 99.78%. In conclusion, some homemade fermented milk in Medan City, Indonesia, are potential probiotics.
Determinan kecelakaan kerja pada karyawan di PT. Mujur Timber Sibolga Dameria, Dameria; Neswita, Elfia; Fachrial, Edy; Ongko, Nicolas Xavier; Niranti, Tasya Putri
Buletin Kedokteran & Kesehatan Prima Vol. 1 No. 2 (2022): September
Publisher : Fakultas Kedokteran, Kedokteran Gigi, dan Ilmu Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (300.227 KB) | DOI: 10.34012/bkkp.v1i2.2907

Abstract

Kecelakaan kerja disebabkan oleh banyak faktor, bisa terjadi karena faktor internal seperti human error atau bahkan faktor eksternal seperti lingkungan kerja itu sendiri. Jenis penelitian ini adalah survei analitik dengan rancangan penelitian cross sectional yang bertujuan untuk mengetahui hubungan faktor personal, kondisi lingkungan, beban kerja, shift kerja dan kedisiplinan. Penelitian ini dilakukan di PT. Mujur Timber Sibolga pada bulan Desember 2021. Populasi dalam penelitian ini ialah seluruh pekerja di PT. Mujur Timber Sibolga mencakup pemotong kayu, pemikul kayu, yang jumlah keseluruhannya 340 orang. Pengambilan sampel dalam penelitian ini ialah menggunakan purposive sampling di mana objek yang dapat dijadikan sampel harus pernah mengalami kecelakaan kerja kurang dari 6 bulan terakhir. Adapun sampel dalam penelitian berjumlah sebanyak 77 orang yang diperoleh melalui rumus Slovin. Pengumpulan data menggunakan kuesioner. Uji statistik yang digunakan dalam penelitian ini adalah uji Chi Square. Penelitian ini menyimpulkan faktor personal, beban kerja, kondisi lingkungan, dan shift kerja tidak berhubungan dengan kecelakaan kerja (p > 0,05). Hanya variabel kedisiplinan yang berhubungan dengan kecelakaan kerja. Diharapkan pada pekerja agar lebih memperhatikan kedisiplinan dalam mematuhi aturan kerja serta penggunaan APD yang disediakan oleh setiap industri tempat bekerja sehingga dapat mengurangi resiko terjadinya kecelakaan kerja.
The Effect of Andaliman Fruit Extract on the Incision Wound Healing the Wistar Male White Rats and Collagen Type III Intan Hasibuan, Febria Nurul; Chiuman, Linda; Fachrial, Edy
Jurnal Kesehatan Vol 15 No 2 (2024): Jurnal Kesehatan
Publisher : Poltekkes Kemenkes Tanjung Karang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26630/jk.v15i2.4448

Abstract

The extract of andaliman fruit has antimicrobial activity. The active compounds of andaliman fruit are believed to positively contribute to human health, one of which is flavonoids, which can improve the wound healing process because of their function as an antioxidant and anti-inflammatory. This study aims to determine the effect of giving ethanol extract of andaliman fruit on the healing process of incision wounds in Wistar strain white rats and collagen type III. This research is an experimental posttest-only controlled group design. This study used five groups: NaCL treatment, betadine treatment, 1% andaliman ethanol extract treatment, 3% andaliman ethanol extract treatment, and 5% andaliman ethanol extract treatment, where each group had six rats. Data analysis used normality tests, homogeneity tests, and ANOVA tests. The results showed that the ethanol extract of andaliman fruit contains several active compounds such as alkaloids, saponins, tannins, and glycosides. The fastest incision wound healing was the fourth test group, the test group with 3% andaliman fruit ethanol extract treatment on day 14, with an average length of incision wound healing of 3.44mm. The 3% andaliman ethanol extract had the potential to accelerate wound healing activity.
Effectiveness Analysis of Antidiabetic Property from Dragon Fruit Peel Methanol Extract in Alloxan-Induced Diabetic Rats Sumartin, Sonia Apriani; Lister, I Nyoman Ehrich; Fachrial, Edy
Biology, Medicine, & Natural Product Chemistry Vol 13, No 1 (2024)
Publisher : Sunan Kalijaga State Islamic University & Society for Indonesian Biodiversity

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14421/biomedich.2024.131.57-62

Abstract

Diabetes is a health burden in various countries, one of these countries, is also Indonesia. Dragon fruit peel is an alternative diabetes therapy that has been widely studied. Therefore, this study aimed to investigate an antidiabetic effect of dragon fruit peel methanol extract on alloxan-induced diabetic male Wistar rats. This experimental study used twenty-five male Wistar rats induced by alloxan injection. After 48 hours, all rats were grouped into five different groups, including control (0.5% SCMC), standard (Metformin), Dragon Fruit Peel Methanol Extract-1 (500 mg/kg BW), 2 (750 mg/kg BW), and 3 (1,000 mg/kg BW). These treatments were given for two weeks. After that, all rats were dissected to obtain the pancreas. The results showed that dragon fruit peel methanol extract significantly decreased blood glucose levels after the 7th and 14th days (P value <0.05). In addition, pancreatic histology showed a decrease in the extract dose followed by a smaller size of the pancreatic Langerhans islet. The lowest dose of the extract showed a similar size of pancreatic Langerhans islet to the control group with an atrophic pancreatic Langerhans islet. Therefore, it can be concluded that dragon fruit peel extract can significantly decrease blood glucose levels and improve the structure of pancreatic Langerhans islet at higher doses.
Analgesic and Antipyretic Activity of Sweet Orange Peel Methanol Extract Silalahi, Elsa Debora; Lister, I Nyoman Ehrich; Fachrial, Edy
Biology, Medicine, & Natural Product Chemistry Vol 12, No 2 (2023)
Publisher : Sunan Kalijaga State Islamic University & Society for Indonesian Biodiversity

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14421/biomedich.2023.122.577-584

Abstract

An analgesic-antipyretic drug widely used is paracetamol, which has various health benefits and several adverse effects. Therefore, various natural products have been extensively studied as alternative analgesic-antipyretics, one of which is sweet orange peel. This study aimed to investigate sweet orange peel's analgesic and antipyretic activity by in vivo methods. This experimental study evaluated the analgesic and antipyretic effects of sweet orange peel extract extracted by the maceration method. The analgesic effect was evaluated by tail immersion (Maximum Possible Analgesia) and acetic acid-induced writhing method (total abdominal writhing). Meanwhile, the antipyretic effect was evaluated by the brewer yeast-induced hyperpyrexia (body temperature) method. This study showed that sweet orange peel methanol extract significantly increased the maximum possible analgesia value (132.79%) and reduced the number of abdominal writhing (44.05%) at the highest dose of 750 mg/kg BW. It indicated analgesic activity from sweet orange peels. Meanwhile, the antipyretic effect of sweet orange peel methanol extract was observed from 1-4 hours after administration, and the highest percentage inhibition of body temperature 4 hours after administration was found in a moderate dose, that was 5.98% (P value: 0.042). Therefore, it can be concluded that sweet orange peel methanol extract has analgesic and antipyretic effects with an optimal dose range of 500-750 mg/kg BW.
Efektivitas Ekstrak Etanol Daun Kenitu (Chrysophyllum cainito L.) sebagai Antidiabetes Tikus Putih Jantan (Rattus norvegicus L.) yang Diinduksi Aloksan : Natalia Desvalentina Lase; Girsang, Ermi; Fachrial, Edy
Jurnal Mahasiswa Ilmu Kesehatan Vol. 2 No. 3 (2024): Juli: Jurnal Mahasiswa Ilmu Kesehatan
Publisher : STIKes Ibnu Sina Ajibarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59841/jumkes.v2i3.1411

Abstract

Meningkatnya jumlah kesakitan dan kematian akibat diabetes merupakan masalah kesehatan global. Secara klinis, penggunaan bahan kimia (obat hiperglikemik oral) secara berkelanjutan dapat memberikan efek yang buruk pada tubuh. Pernyataan ini membuat peneliti untuk melakukan penelitian mengenai obat antidiabetes yang terbuat dari bahan alami seperti tanaman kenitu (Chrysophyllum canito L.). Tujuannya adalah untuk melihat efektivitas pada ekstrak etanol daun kenitu (Chrysophyllum canito L.) sebagai antidiabetes serta kandungan kimia pada ekstrak etanol daun kenitu (Chrysophyllum canito L.) dan dosis efektif dari ekstrak etanol daun kenitu (Chrysophyllum canito L.) dalam mengurangi glukosa darah. Metode penelitian yang digunakan eksperimental laboratorium dengan 5 kelompok uji diantaranya K-, K+, dan kelompok dosis dengan konsentrasi 25, 50, dan 75 mg/kgBB. Hasil penelitian ditemukan ketidaksamaan yang bermakna antara kelompok K- dan kelompok K+ serta kelompok K- dan kelompok dosis, tetapi tidak ditemukan ketidaksamaan yang bermakna pada kelompok kontrol positif dan kelompok dosis. Kesimpulannya adalah  pemberian ekstrak etanol daun kenitu melalui dosis 25, 50, dan 75 mg/kgBB dapat mengurangi glukosa darah tinggi dikarenakan senyawa yang ada pada ekstrak etanol daun kenitu, yaitu tanin, flavonoid, saponin, alkaloid dan steroid. Dosis ekstrak yang efektif dalam mengurangi glukosa darah adalah 75 mg/kgBB.
AKTIVITAS Lactobacillus casei SEBAGAI PENURUN KADAR KOLESTEROL SECARA In Vitro Ritonga, Lestina; Saragih, Ria Natalia; Novriani, Erida; Fachrial, Edy
Journal Health & Science : Gorontalo Journal Health and Science Community Vol 8, No 3 (2024): JULI: JOURNAL HEALTH AND SCIENCE : GORONTALO JOURNAL HEALTH AND SCIENCE COMMUNIT
Publisher : Gorontalo State University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35971/gojhes.v8i3.26191

Abstract

Hiperkolesterolemia adalah di mana keadaan tingkat kolesterol dalam darah melebihi batas normal yang ditetapkan, yaitu melebihi 200 mg/dL. Bakteri asam laktat dapat digunakan sebagai terapi alternatif kemampuan untuk menurunkan kadar kolesterol. Kebaruan dari penelitian ini probiotik bakteri asam laktat memiliki manfaat terapeutik seperti kadar kolesterol dalam darah menurun dan mencegah terjadinya kanker usus. Tujuan dari penelitian ini adalah untuk mengetahui apakah Lactobacillus casei dapat menurunkan kolesterol secara in vitro. Metode penelitian aktivitas antimikroba dilakukan dengan metode disc paper, uji ketahanan terhadap pH asam, garam empedu dan pengurangan kolesterol dilakukan dengan metode spektrofotometer. Hasil penelitian uji aktivitas antimikroba isolat Lactobacillus casei menunjukkan aktivitas zona hambat terhadap bakteri E. coli sebesar 28,5 mm dan S. aureus sebesar 33,2 mm. Uji ketahanan terhadap pH asam sebesar 45,42%. Uji ketahanan terhadap garam empedu yaitu 55,39%, penurunan kadar kolesterol secara in vitro cukup baik yaitu 82,20%. Kontrol positif pengurangan kolesterol oleh simvastatin adalah 56,89%. Kesimpulan yang diperoleh dari penelitian ini adalah probiotik isolat Lactobacillus casei dapat menurunkan kadar kolesterol secara In Vitro.
The Effectiveness of ECE (Early Clinical Exposure) on the Integration of Basic Knowledge with Type 2 Diabetes Mellitus Clinical Knowledge and Interprofessional Collaboration in Medical Students of Prima Indonesia University Bella Sari Sijabat; Clarissa Lister; Edy Fachrial
Journal Of Social Science (JoSS) Vol 3 No 11 (2024): JOSS
Publisher : Al-Makki Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57185/joss.v3i11.377

Abstract

Early Clinical Exposure (ECE) is a teaching-learning methodology that involves exposing medical students to patients or clinical scenarios early in the first year of medical education. In this study, the focus is on fifth-semester students, particularly on the integration of basic knowledge with clinical knowledge of Type 2 Diabetes Mellitus (DMT2), the role of multidisciplinary teams, and interprofessional collaboration. The purpose of this study is to determine the effectiveness of early clinical exposure in integrating basic knowledge with clinical knowledge of DMT2 and knowledge of interprofessional collaboration among medical students at Universitas Prima Indonesia. The method used in this research is a quantitative approach with an experimental design, specifically quasi-experimental research. In this design, 124 fifth-semester medical students from Universitas Prima Indonesia will be given a pretest before participating in Early Clinical Exposure (ECE) and a posttest after completing Early Clinical Exposure (ECE). The results of this study indicate a significant difference in the integration of basic knowledge with clinical knowledge of DMT2 and knowledge of interprofessional collaboration among medical students at Universitas Prima Indonesia, with a p-value of 0.000 (p < 0.05). Therefore, it can be concluded that Early Clinical Exposure (ECE) is effective in improving the integration of basic knowledge with clinical knowledge of DMT2 and knowledge of interprofessional collaboration among medical students at Universitas Prima Indonesia.
AKTIVITAS PROBIOTIK ISOLAT DNH 16 YANG DIISOLASI DARI DALI NI HORBO Vicky; Yasmin, Nabila; Sianturi, Naomi; Fachrial, Edy
JURNAL KIMIA SAINTEK DAN PENDIDIKAN Vol. 6 No. 2 (2022): Jurnal Kimia Saintek dan Pendidikan
Publisher : Program Studi Kimia - Universitas Sari Mutiara Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51544/kimia.v6i2.3496

Abstract

Dali Ni Horbo merupakan makanan tradisional khas batak yang difermentasi dari susu kerbau mengandung bakteri asam laktat bersifat probiotik yang dapat memberikan dampak positif terhadap kesehatan. Penelitian ini bertujuan untuk mengetahui karakterisasi probiotik isolat DNH 16 yang meliputi aktivitas antimikroba, toleransi terhadap asam dan garam empedu. Aktivitas antimikroba dilakukan terhadap Staphylococcus aureus menggunakan metode difusi cakram. Toleransi terhadap asam dan garam empedu dilakukan dengan menentukan pertumbuhan isolat pada media MRS Broth pH3 dan MRS Broth dengan 0,3 % garam empedu berturut – turut pada λ 600 nm. Hasil penelitian menunjukkan isolat DNH 16 berbentuk basil, katalase negatif, heterofermentatif. Aktifitas antimikroba dari isolat DNH 16 yaitu 4,6mm. Viabilitas pertumbuhan terhadap asam yaitu 91,6 %, viabilitas pertumbuhan terhadap garam empedu yaitu 66,5%. Hasil menunjukan bahwa isolat DNH 16 berpotensi sebagai bakteri probiotik.
Comparison of Interleukin-1b-511 C/T Polymorphism in Schizophrenia of Batak and Minangkabau Ethnicities in Pematang Siantar Wijaya, Raysha Awlia; Fachrial, Edy; Lister, I Nyoman Ehrich; Ariatama, Bayu
Biology, Medicine, & Natural Product Chemistry Vol 13, No 2 (2024)
Publisher : Sunan Kalijaga State Islamic University & Society for Indonesian Biodiversity

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14421/biomedich.2024.132.601-608

Abstract

This research is an overview of a comparative study on the Interleukin-1β-511 C/T polymorphism in individuals with schizophrenia of Batak and Minangkabau ethnicities in Pematang Siantar, Indonesia. The study aims to investigate genetic differences among these ethnic groups to better understand susceptibility to schizophrenia, which is influenced by multiple factors including genetics. The research uses a comparative categorical analytic approach with a cross-sectional method and involves DNA isolation and polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) examinations. Based on the results,  significant demographic differences between the Batak and Minangkabau ethnic groups, particularly in gender distribution, age, onset of illness, duration of illness, and PANSS scores. Notably, it finds a significant difference in the occurrence of the C allele and the T allele between the two ethnic groups, with the C allele being more prevalent in the Minangkabau group and the T allele more so in the Batak group. This suggests that the IL-1β -511 C/T polymorphism may play a differential role in the susceptibility to schizophrenia among these ethnicities, indicating a potential for ethnic-specific risk factors or protective elements.
Co-Authors Abednego S. Karosekali Adek Amansyah Afif P Jati Ainy, Al-Annisa Fadhila Aisar Novita Alhoi Hendry Henderson Aloysius Aloysius Aloysius, Aloysius Amelia Trisnawati Lubis Angelin Christin Anggita Kasih Fianti Situmorang Anggraini, Sari Anjurniza Ulfa Annisa Amalia Ariatama, Bayu Arma Citra Armansyah, Adek Asyrun Alkhairi Lubis Asyrun Alkhairi Lubis Bayu Pratomo Bayu Pratomo Bella Sari Sijabat Buter Samin Buter Samin Calvin Christian Karo Karo Chiuman, Linda Chrismis Novalinda Ginting Chrismis Novalinda Ginting Christine Halawa Clarissa Lister Cory Oriensia Siahaan DAMERIA DAMERIA Dea Christa Amanda Deborah Angelin Purba Delyuzar, Delyuzar Dianda, Feby Dini Ariyska Edward Kosasih Edward Waroka Edwin Waroka Eka Susilawati Erika Yolanda Ginting Ermi Girsang Ermi Girsang Ester Putri Mentary Mendrofa Feby Dianda Felix Felix Femy Cecilia Marbun Ferdinand, Sahna Fibrina, Dewi Finna Piska Fioni, Fioni Ginting, Chrismis Novalinda Girsang, Ermi Girsang, Ermi Gusbakti Rusip Hanna Christsela Purba Hanna Sari Widya Kusuma, Hanna Sari Widya Hariyadi Dharmawan Syahputra Hariyadi Dharmawan Syahputra Harmileni Henderson, Alhoi Hendry Henny Safrita Ginting I Nyoman Ehrich Lister I Nyoman Ehrich Lister I Nyoman Ehrich Lister I Nyoman Ehrich Lister I Nyoman Ehrich Lister I Nyoman Ehrich Lister I Nyoman Ehrich Lister I Nyoman Ehrich Lister I Nyoman Ehrich Lister I Nyoman Ehrich Lister I. Nyoman Ehrich Lister Ikhwanul Hakim Nasution Iksen Iksen Indra Setiawan Rambe Inesha Viata Melika Purba Intan Aryanti Intan Hasibuan, Febria Nurul Intisari, Yayo Ira Manda Sari Berampu Ismawati Ismawati Ismawati ismawati Joshua Asley Juli elisabeth mayen Juli Elisabeth Mayen Meliala Juliana Hasan Jusri, Ridza Karo Sekali, Abednego Suranta Khainir Akbar, Khainir Komala, William Laura J. Pinem Liana Liana Liena Liena Lina, Juliana Linda Chiuman Lisma Viany Lister Ehrich I Nyoman Lister, Clarissa Lister, I Nyoman Ehrich Lister, I Nyoman Ehrich Lister, I Nyoman Ehrich Lister, I Nyoman Enrich Lister, I. Nyoman Ehrich Lister, Nyoman Ehrich Lokot Donna Lubis M. Andriady Saidi Nst Mahani, Yensielia Marbun, Togi Rut Marlita Marpaung, Hans Hotma Masdalena Nasution Muhammad Aditya Kurnia Muhammad Yunus Muhammad Yunus Nabila Hasibuan Nabila, Pivi Naidu, Ramawathy Nasution, Muhammad Hasan Basri Natalia Desvalentina Lase Natalia Natalia Nerly Juli Pranita Simanjuntak Nerly Juli Pranita Simanjuntak Leki Neswita, Elfia Nicolas Xavier Ongko Niranti, Tasya Putri Novitaria Br Sembiring Novitasari Tarigan Novriani, Erida Nyi Raden Siti Vissy Puspa Dewi Muharam Obet Edom Ginting Ongko, Nicolas Xavier Pinem, Laura Juita Purba, Greace Hasianna Purba, Rosi Krisdayanti Putri Giri Anjani Putri Nadia Utami Qodariah, Rismawati Laila Raden Roro Jenny Satyo Putri Radhitya Qowiyyul Davin Rama Riana Sitinjak Ramadhani, Shafira Reghita Claudia Manalu Ricky Kinarta Sembiring Rika Silvany Rita Kusuma Ritonga, Lestina Rizal Rizal Rizal Rizal Roy Indrianto Bangar S Rr. Anisa Siwianti Handayani Rudi Chandra Runitasari Saragih Sahna Ferdinand Sahna Ferdinand Ginting Saipul Sihotang Santa Ronauli Matondang Saragih, Ria Natalia Sari Anggraini Sari Anggraini Sari Anggraini Saryono Saryono Saryono Saryono Saryono SARYONO Saryono SARYONO Shafira Ramadhani Shafira Ramadhani Sianturi, Naomi Silaban, Agnes Novica Putri Silalahi, Elsa Debora Sinaga, Ade Putra Fratama Sinaga, Theresia Margaretha Siregar, Hafiz Hawari Siregar, Irma Dolsyeria Situmorang, Anggita Kasih Fianti Sofiyana, Maria Sonya Bonifacia Mahadi Sormin, Delores Elisabeth Suandy Suandy Sumartin, Sonia Apriani Sunarti Sunarti Surya Dharma Tandiah Asan Tarigan, Lela Diyana Br Tarigan, Novitasari Tarigan, Nuzulul Akbar Tengku Muhammad Sahiril Anhar Tengku Rachmi Hidayani Theresia, Yohani Tiara Balkis Titania T Nugroho Titania T Nugroho Titania T Nugroho Titania T. Nugroho Titania Tjandrawati Nugroho Tri Amelia Sari Tri Widyawati Ulfa, Anjurniza Urip Harahap Vebbly, Vebbly Vicky VISENSIUS KRISDIANILO Vrianty, Dela WAHYU WIDOWATI Wahyu Widowati Wahyu Widowati Wahyuni Sihombing Widodo, Wahyu Setia Widya Yanti Sihotang Wienaldi Wienaldi Wienaldi Wienaldi Wienaldi Wienaldi Wienaldi, Wienaldi Wijaya, Raysha Awlia Wilsen Wilsen Yasmin, Nabila Yohana Simamora Yonias Saleh Tria Zebua Yuliani Mardiati Lubis Yunita Dewani