Laniyati Hamijoyo, Laniyati
Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Umum Pusat Hasan Sadikin Bandung

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N-Acetyltransferase 2 (NAT2) Acetylator Status among Systemic Lupus Erythematosus Patients from A Tuberculosis Endemic Area in Bandung, Indonesia Laniyati Hamijoyo; Sasfia Candrianita; Ika Agus Rini; Endang Sutedja; Budi Setiabudiawan; Edhyana Sahiratmadja
The Indonesian Biomedical Journal Vol 11, No 2 (2019)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v11i2.553

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BACKGROUND: Systemic lupus erythematosus (SLE) patients living in Indonesia are prone to tuberculosis (TB) infection, since this country ranks second globally for TB prevalence. Isoniazid, an anti-tuberculosis (TB) drug, is metabolized by enzyme N-acetyltransferase 2 (NAT2) that is encoded by NAT2 gene. NAT2 haplotype, referring as acetylator status, may predispose as genetic factor in SLE development or complicate SLE therapy. This study explored the NAT2 haplotypes and acetylator status among SLE patients living in a TB endemic area.METHODS: Genomic DNA of 260 registered SLE patients at The Rheumatology Clinic of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia were isolated. NAT2 gene was amplified and sequenced, then NAT2 haplotypes and the acetylator status among SLE patients with or without TB history were determined and presented.RESULTS: Most of SLE patients registered were female (n=250; 96.2%). The median age of patients when SLE was diagnosed for the first time was 27 years old (8-69 years), with organ involvement predominantly in musculoskeletal (80.8%) and mucocutaneous (73.1%). TB history, mostly pulmonary TB, was present in 23.1% of SLE patients of whom TB was diagnosed before SLE (10.4%) or after SLE (10.7%) or both before and after SLE (2%). The acetylator status was mostly intermediate (61.5%) with the NAT2*4/*6B was the most prevalent haplotype (25.8%).CONCLUSION: There is a high number of intermediate and low acetylator status among SLE patients. Since these SLE patients live in TB endemic area, the NAT2 acetylator status determination among SLE patients before starting TB therapy may have clinical benefit to decrease a possible drug induced liver injury, and this warrants further study.KEYWORDS: NAT2, acetylator, systemic lupus erythematosus, tuberculosis
Validity test of anti-c1q serum as diagnostic marker for lupus nephritis M Enrica; A Tjandrawati; S Rachmayati; Laniyati Hamijoyo
Indonesian Journal of Rheumatology Vol. 8 No. 1 (2016): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (276.891 KB) | DOI: 10.37275/ijr.v8i1.8

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Background: Lupus nephritis is defined as renal involvement in systemic lupus erythematosus (SLE) patients and the most important cause of morbidity and mortality. The diagnostic criteria that used to diagnose lupus nephritis are 1997 American Collegeof Rheumatology is 24 hours urine protein ≥500 mg and/or cellular cast, but significant renal damage can occur without proteinuria or cellular cast. Anti-C1q is an autoantibody that is produced by a chronic alteration of C1q collagen domain. Anti-C1q is a new specific marker for renal marker.Objective: To determine the validity of anti-C1q serum by using 1997 American College of Rheumatology criteria as a gold standard. Methods: This is a cross sectional study, conducted in October to December 2014 at Hasan Sadikin Hospital Bandung. The subjects had systemic lupus erythematosus with and without renal involvement, based on 1997 American College of Rheumatology criteria for SLE.Results: There were 65 subjects included in this study, 64 subjects were female and 1 subject was male. The age average was 32 (SD 11.7) years old. As many as 66.2% subjects had been diagnosed with lupus erythematosus systemic at least 3 years. Twenty four hours urine protein was measured using spectrophotometry, urine sediment was examinedfor cellular cast, and anti-C1q serum was measured using micro enzyme linked immunosorbent assay. Based on American College of Rheumatology criteria, 34 subjects were classified as lupus nephritis group while 31 subjects were classified as non-lupus nephritis group. The area under the curve of anti-C1q was 0.610. The cut-off value used in this study was 10.43 U/ml. The sensitivity, specificity, positive predictive value,negative predictive value and accuracy of anti-C1q assay were 41.18%, 77.42%, 66.67%, 54.55% and 58.46% respectively.Conclusion: Anti-C1q assay, based on this study, hasa low sensitivity and medium specificity to detect lupusnephritis
Correlation of Random Urine Protein Creatinine (P-C) Ratio with 24-Hour Protein Urine in Lupus Nephritis Patients Y H Aini; A Tjandrawati; N Suraya; Laniyati Hamijoyo
Indonesian Journal of Rheumatology Vol. 8 No. 1 (2016): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (302.289 KB) | DOI: 10.37275/ijr.v8i1.10

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Background : Systemic lupus erythematosus (SLE) is a systemic autoimmune disease involving multiple organs including kidney and known as lupus nephritis (LN). Lupus nephritis has a poor prognosis after a 10-years onset, more than 25% will be ended by end stage renal disease. There are glomerular and tubulointerstitial tissue damages due to immune complex deposits in LN which is activating inflamation cascade and causing disfunction of glomerular filtration and tubular reabsorption resulting proteinuria. In LN, proteinuria is used to diagnose, to assess the disease activity and to monitor the therapy. The gold standard of proteinuria is 24-hour urine protein examination, but the process ofcollecting in 24 hour urine is difficult, then the result is less accurate and reliable. Another alternative parameter is spot urine protein/creatinine ratio. Several studies have found a positive correlation between spot urine protein/creatinine ratio and 24-hour urine protein levels, but in LN, the results are various.Objective: The aim of this study was analyzing the correlation between spot urine protein/creatinine ratio and 24-hour urine protein in lupus nephritis.Methods: The study was conducted at Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia in October 2014 to December 2014. The subjects were 45 patients with lupus nephritis based on the criteria of the American College of Rheumatology. The study analyzedcorrelation through cross-sectional model. Results: The results of Spearman correlation test analysis showed a significantly strong positive correlation between spot urine protein/creatinine ratio and 24-hour urine protein levels in lupus nephritis (rs =0.96; p <0.001). Based on the degree of proteinuria there was a strong positive correlation between spot urine protein/creatinine ratio and 24-hour urine protein levels in lupus nephritis significantly on the degree of protein <1 g/24-h (rs = 0.91; p <0.001) and at 1–3.5 g/24-h (rs = 0.73; p<0.05).Conclusion : There is a significant strong positive correlation between spot urine protein/creatinine ratio and the 24-hour urine protein levels in lupus nephritis, so it is recommended to use spot urine protein/creatinine ratio, as an alternative quantitative examination in lupus nephritis.Keywords: lupus nephritis, 24-hour urine protein, spot urine protein/creatinine ratio
Myelopathy caused by Ossification of Thoracic Ligamentum Flavum Farid Yudoyono; Rully Hanafi Dahlan; Sevline Esthetia Ompusunggu; Laniyati Hamijoyo; Muhammad Zafrullah Arifin
Indonesian Journal of Rheumatology Vol. 8 No. 1 (2016): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (290.231 KB) | DOI: 10.37275/ijr.v8i1.11

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Hypertrophy of the posterior spinal elements leading to compromise of the spinal canal and its neural elements is a well-recognized pathological entity affecting the lumbar or cervical spine. Such stenosis of the thoracic spine in the absence of a generalized rheumatological,metabolic, or orthopedic disorder, or a history of trauma is generally considered to be rare. Spinal ligaments, such as the ligamentum flavum (LF), are prone to degeneration and can lead to back pain and nerve dysfunction. Ossification of ligamentum flavum (OLF) is a pathological condition that cause neurological symptoms and usually occurs in the thoracic spine and less frequently in the cervical spine. However the disease is now being increasingly recognized as acause of thoracic myelopathy. We report a rare case of thoracic myelopathy caused by OLF. A 48-year-old male presented with a chief complaint of weakness of bilateral lower extremities. Neurological examination revealed sensory deficit at Th 11 level below. Magnetic resonance imaging and computed tomography demonstrated OLF at the right T9–11 level. Thoracicmyelopathy caused by OLF was consider and surgical intervention was performed. Posterior decompression and laminoplasty has been performed for this patient. Keywords: ossification of ligamentum flavum, thoracic myelopathy, laminoplasty
Systemic sclerosis in two generations family: a mother and offspring D Nilasari; Laniyati Hamijoyo; Yoga I Kasjmir; Bambang Setiyohadi
Indonesian Journal of Rheumatology Vol. 1 No. 1 (2009): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (188.963 KB) | DOI: 10.37275/ijr.v1i1.18

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Systemic sclerosis (SSc) is uncommon connective tissue disease characterized by a pathological thickening and tethering of the skin and involvement of internal organ (i.e gastrointestinal tract, heart, lungs, and kidneys). Systemic sclerosis seems to result from a multifactorial process (alteration of the immune system, genetic, and  environmental factors) but its pathogenesis remains unclear. A familial history of SSc represents an important risk factor for developing the disease.1 We describe two generations family who developed SSc.
Sclerodermatomyositis M Febyani; H Purbo D; Laniyati Hamijoyo; E Sutedja; O Suwarsa
Indonesian Journal of Rheumatology Vol. 3 No. 1 (2011): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (203.552 KB) | DOI: 10.37275/ijr.v3i1.44

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The classification of rheumatic diseases is still challenging due to several reasons. First, those diseases have several differential clinical features, which giving overlap symptoms. Second, the etiopathogenesis of those diseases remains elusive.Diagnosis of overlap syndrome is made when there are more than one well-defined connective tissue diseases in one patient, which may develop simultaneously or sequentially.1,2 The prevalence of overlap syndrome among autoimmune diseases is25%.2 The term sclerodermatomyositis or scleromyositisis is used to describe an overlap syndrome in patients with scleroderma and dermatomyositis/polymyositis (DM/PM).2,3,4 Sclerodermatomyositis usually affects adults, and it is rarely found in children.4 The clinical features of this syndrome are myalgia or myositis, arthralgia, scleroderma-like skin changes, Raynaud’s phenomenon (RP),2,3 interstitial lung disease, calcinosis,3 mask-like facies, dysphagia or esophageal dysmotility,4 as well as the presence of specific antibody Pm/Scl.2 Skin manifestations as the part of dermatomyositis include periorbital erythema and Gottron’s papules.3 We report this case due to its very rare occurrence. According to medical records in the Department of Dermatology as well as Rheumatology at Hasan Sadikin Hospital, Bandung, this is the first case recorded in the last 10 years.
24-Hour Proteinuria Weakly Correlated with Estimated Glomerular Filtration Rate in Lupus Nephritis Patients Suhendra Praptama; Yulia Hayatul Aini; Mohammad Ghozali; Laniyati Hamijoyo
Indonesian Journal of Rheumatology Vol. 8 No. 2 (2016): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (347.775 KB) | DOI: 10.37275/ijr.v8i2.58

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Background: Lupus Nephritis (LN) is still the most frequent complication in Systemic Lupus Erythematous (SLE) patients which causing the major and significance morbidity and mortality. Proteinuria and Glomerular Filtration Rate (GFR) serves as objective and routine examinations to assessrenal function. 24-hour proteinuria still regarded as gold standard to quantify amount protein in urine. Estimated GFR (eGFR) is preferably used due its convenient. On the hand, estimated GFR (eGFR) is preferably used due its convenient. However, both of them should be measured in order to determine renal progression and prognosis. Only few studies have been conducted to find out the correlation between 24-hour proteinuria and eGFR in lupus nephritis patients as both of them serve as potential marker in progression of renal involvement. Thisstudy addressed to find out correlation between 24-hour proteinuria and eGFR in lupus nephritis patients.Method: Analytic-correlation study with cross-sectional approach at Dr. Hasan Sadikin Hospital, Bandung was done. Secondary data was used and paralleled with previous study entitled “Correlation of Random Urine Protein Creatinine (P-C) Ratio with 24-Hour Protein Urinein Lupus Nephritis Patients” carried out from October to December 2014.Correlation coefficient was analyzed by Spearmans’ correlation test.Results: Forty five samples were obtained based on inclusion criteria. Spearmans’ correlation test revealed non significant and very weak correlation between 24-hour proteinuria and eGFR (r=-0.095) with p>0.05.Conclusion: The 24-hour proteinuria and eGFR are weakly correlated. Despite the weak  correlation, these examinationsshould be considered as important markers to monitor prognosis of renal involvement in lupus nephritis patients Keywords: Estimated glomerular filtration rate (eGFR),Lupus Nephritis (LN), Proteinuria, Systemic Lupus Erythematosus (SLE).
Correlation Betweeen Skin Fibrosis Based On Modified Rodnan Skin Score And B-Cell Activating Factor Serum In Systemic Sclerosis M Arzan Alfarish; Sumartini Dewi; Laniyati Hamijoyo; Rachmat Gunadi Wachjudi
Indonesian Journal of Rheumatology Vol. 9 No. 1 (2017): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (264.803 KB) | DOI: 10.37275/ijr.v9i1.64

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Background: Progression and expansion of skin fibrosis are the most important characteristics in determining clinical responses and prognosis of Systemic Sclerosis(SSc). Using modified Rodnan skin score (mRSS) can not rapidly detect a slight changes of skin fibrosis in SSc patients. Biomarker assessment is needed to make a more objective, quantitative and rapid evaluation of the changes. Suggested potential useful biomarker isB-cell Activating Factor (BAFF), a positive regulator of B cell survival and maturation process. This study aimed to evaluate correlation between skin fibrosis based on mRSS and BAFF serum in SSc patients.Methods: We used cross sectional methods. Enrolled all patients who met ACR EULAR 2013 criteria for SSc in Rheumatology Clinic Hasan Sadikin Hospital, Bandung, from November 2015 to March 2016. Subjects underwent medical record review, physical examination,mRSS measurement by rheumathologist, and blood tests. Data were analized using Rank-Spearman Correlation.Results: Thirty seven subjects, with mean age 40+10 years old. Subjects consisted of 23(62.2%) limited SSc and 14(37.8%) diffuse SSc. Mean BAFF serum was 1160.2+424.7 pg/mL, no statistical difference were found between limited and diffuse type (p=0.662).Median mRSS results was 16 ranged from 2 to 36.Correlation between mRSS and BAFF serum was not significant (r=0.077; p=0.326).Conclusion: There is no correlation between mRSS and BAFF serum in systemic sclerosis at Hasan Sadikin Hospital.Keywords: mRSS, BAFF, Systemic Sclerosis
Mucocutaneous Manifestation of Systemic Lupus Erythematosus Patients At Rheumatology Outpatient Clinic In Dr. Hasan Sadikin General Hospital Chin Annsha Veimern; Ellyana Sungkar; Hartati Purbo Dharmadji; Laniyati Hamijoyo
Indonesian Journal of Rheumatology Vol. 9 No. 1 (2017): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1767.185 KB) | DOI: 10.37275/ijr.v9i1.65

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Background: Systemic Lupus Erythematosus (SLE) is an autoimmune systemic disease which symptoms induced by Ultraviolet rays exposure. It commonly affects women and causes wide range of symptoms. One of the organs affected is mucocutaneous. Our study aims to determine mucocutaneous manifestations of SLE patients in Rheumatology Outpatient Clinic in Dr.Hasan Sadikin General Hospital, Bandung.Methods: A descriptive study with prospective crosssectional design conducted. Data were obtained by interviewing SLE patients as primary data and accessing medical record as secondary data. Ninety-six SLE patients met the inclusion and exclusion criteria wereincluded.Results: From ninety-six subjects, 94.8% subjects are working indoors. Mucocutaneous manifestation were found in most patients. Based on American College of Rheumatology (ACR) criteria, we found mucocutaneous manifestations, such as: oral ulcers in 67 patients(69.8%); malar rash in 63 patients (65.6%); photosensitivity rash in 51 patients (53.1%), and discoid rash erythematous in 21 patients (21.9%). Specific SLE cutanoeus manifestation based on Gilliam classification were found in our study subjects, such as papulosquamous/ psoriasisform (19.5%) , morbilliform (17.7%), vesicobullous annular SCLE (13.5%), annular SCLE (6.3%), and TEN-like LE (1%). Non-specific LE cutaneousmanifestations based on Gilliam classification were also found in our study subjects, such as oral ulcers (69.8%), photosensitivity rash (53.1%), alopecia (86.5%), Raynaud’s Phenomenon (39.6%), nail abnormalities (24.0%), periungual telangiectasia patients (13.5%), vasculitic lesions (12.5%), thrombophlebitis (44.8%), bullous lesion (5.2%) and erythema multiforme (5.2%).Conclusion: Mucocutaneous manifestations in SLE patients based on ACR criteria found most in this study is oral ulcers. Based on Gilliam classification specific LE cutanoeus manifestation was not found in all SLE patients, while non-specific LE mucocutaneous manifestations mostly found is alopecia. Keywords: American College of Rheumatology (ACR) criteria, Gilliam classification, Mucocutaneous manifestations, Systemic Lupus Erythematosus
The Characteristic of Anti dsDNA and Organ System Involved in Systemic Lupus Erythematosus Patient at Hasan Sadikin General Hospital, Bandung Safira Nadifa; Achadiyani Achadiyani; Hartati Purbo Dharmadji; Laniyati Hamijoyo
Indonesian Journal of Rheumatology Vol. 9 No. 1 (2017): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (403.128 KB) | DOI: 10.37275/ijr.v9i1.66

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Background : Clinical manifestation of Systemic Lupus Erythematosus (SLE) may be varies in attacking various body tissue and organ system. Anti-dsDNA is the important antibody indetermining diagnosis and prognosis of SLE. This study was conducted to explain the characteristics of antidsDNA and organ system involved in SLE patients.Method:  We used quantitative descriptive analysis methods. Data were collected from medical records of SLE patients who came to Dr. Hasan Sadikin Bandung General Hospital Rheumatology Clinic from September to November 2016. Using categorical descriptive research equation, we found that total minimum samples were 67 subjects. Data observed included the level of anti-dsDNA antibody and clinical manifestation of organ systeminvolved.Result: From 67 samples, there were 65 females which accounted for 97% of the research subjects. Distribution of organ system involved in our subjects was musculoskeletal (29%), mucocutaneous (27%), hematologic (21%), kidney (15%), neuropsychiatry (4%),lung involvement (4%) and cardiovascular (0%). Organ system involved related with strong positive anti-dsDNA were mucocutaneous (21,6%), hematologic (25%), musculoskeletal (12,5%), kidney (14,3%) and lungs (20%).Conclusion:  The most frequent organ system involved in SLE patients at our setting was musculoskeletal. The common organ involvement related with strong positive antidsDNA were mucocutaneous, musculoskeletal, and hematologic. Keywords: anti-dsDNA, involvement of organ system, clinical manifestation, systemic lupus erythematosus
Co-Authors A Tjandrawati A Tjandrawati A, Muhammad Naufal Achadiyani Achadiyani Achadiyani Adhi Pribadi Afifah, Nadya Nurul Aini, Y H Aini, Yulia Hayatul Alfarish, M Arzan Alfi, Mohammad Abyan Amaylia Oehadian Andiyang R. Diredja Andri Reza Rahmadi Andri Reza Rahmadi Anjalia, Safira Anna Ariane Anna Ariane Anna Tjandrawati Artarini, Aluicia A. Astuti, Intan Widya Aulia Nurlatifah Awalia Awalia Azzahra, Fadhilla Zakya Bambang Setiyohadi Bambang Setiyohadi Bernard Santoso Suryajaya Bethy Suryawathy Hernowo Budi Setiabudiawan Chin Annsha Veimern Coriejati Rita D Nilasari D, H Purbo Dewi Kartika Turbawaty Dewi, Sumartini Dwi Budi Darmawati E Sutedja Edhyana Sahiratmadja Edhyana Sahiratmadja Eka Kurniawan Ellyana Sungkar Endang Sutedja Enrica, M Erica Kwan Yue Fadillah, Viki Faisal Parlindungan Faisal Parlindungan Fajar, Desi Reski Faliq, Muhammad Faza Farid Yudoyono Febyani, M Ferdy Ferdian Gede Kambayana Ghassani, Nadia Gita Guntur Darmawan Guntur Darmawan H Purbo D Habib Burahman Handono Halim Handono Kalim Harry Isbagio Harry Isbagio Hartati Purbo Dharmadji Hartati Purbo Dharmadji Hartati Purbo Dharmadji, Hartati Purbo I Nyoman Suarjana Ignatius Irawan Hidayat Ika Agus Rini Ika Vemilia Warlisti Indrawijaya, Yen YA. Irsan Hasan Ismiana Fatimah Modjaningrat Iwo, Maria I. Kasjmir, Yoga I Kennardi, Gabriel Bagus Lestari, Frida Dwi Lisda Amalia M Arzan Alfarish M Enrica M Febyani Maharani, Khalista Ismaya Malikul Chair Melisa I. Barliana Melisa Intan Barliana, Melisa Intan Modjaningrat, Ismiana Fatimah Mohammad Ghozali Mohammad Ghozali, Mohammad Muhammad Syawal Pratama Muhammad Zafrullah Arifin Mulya Nurmansyah Ardisasmita N Suraya Nadia Gita Ghassani Nadia Gita Ghassani Nadifa, Safira Najirman Najirman Nilasari, D Nita Novita Nita Novita Nur Atik Nur Atik O Suwarsa Ong, Paulus Anam Pande Ketut Kurniari Patrick Philo Paulus Anam Ong Permatasari, Lany Indah Praptama, Suhendra Pratama, Mirza Zaka Pratama, Muhammad Kevin Pratama, Muhammad Syawal Putra, Septian Dwi Putri Vidyaniati Putri, Rahmania Devina Rachmat Gunadi Wachjudi Rachmayati, S Radiyati Umi Partan Rahadian Nugi Sutrisno Rakhma Yanti Hellmi Rakhma Yanti Helmi Ria Bandiara Riardi Pramudiyo Rizky Abdullah RM Suryo Anggoro Rudy Hidayat Rudy Hidayat Rully Hanafi Dahlan Ryan Ardian Saputro S Rachmayati Safira Anjalia Safira Nadifa Santi Andayani Sasfia Candrianita Sasfia Candrianita Septian Dwi Putra Setyorini Irianti Sevline Esthetia Ompusunggu Sevline Esthetia Ompusunggu Shadrina, Siti Azyyati Nur Soeseno Hadi Soeseno Hadi Stefanie Yuliana Usman Stefanie Yuliana Usman Stefanie Yuliana Usman Suhendra Praptama Sulaiman, Aina Zakia Sumariyono Sumartini Dewi Sumartini Dewi Suraya, N Surya Darma Suryana, Bagus Putu Putra Sutedja, E Sutrisno, Rahadian Nugi Suwarsa, O Tear, Alveron Andreas Tina Rostinawati Tjandrawati, A Trinugroho Heri Fadjari, Trinugroho Heri Usman, Stefanie Yuliana Valentine Natasya Moenadi Veimern, Chin Annsha Wahono, Cesarius Singgih Wijaya, Indra Wulansari Manuaba, Ida Ayu Ratih Y H Aini Yoga I Kasjmir Yue, Erica Kwan Yulia Hayatul Aini Yulyani Werdiningsih