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All Journal Medula Jurnal Kreativitas PKM Jurnal Ilmu Kedokteran dan Kesehatan Jurnal Mandala Pharmacon Indonesia JK Unila (Jurnal Kedokteran Universitas Lampung) Jurnal Pengabdian Kepada Masyarakat (JPKM) Tabikpun Buguh: Jurnal Pengabdian Kepada Masyarakat Jurnal Kedokteran Ibnu Nafis JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia JPM (Jurnal Pengabdian Masyarakat) Ruwa Jurai Jurnal Agromedicine Unila: Jurnal Kesehatan dan Agromedicine
Risti Graharti
Bagian Ilmu Patologi Klinik, Fakultas Kedokteran Universitas Lampung
Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Computer Science & IT Dentistry Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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Penggunaan Probiotik sebagai Terapi Adjuvan pada Inflammatory Bowel Disease (IBD): Suatu Tinjauan Sistematis Hafizh, Ahmad Fauzan; Widjaja, Jovan; Prayogi, Norbertus Marcell; Djausal, Anisa Nuraisa; Graharti, Risti
JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia Vol 12 No 2 (2025): JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia Vol. 12.2 (2025)
Publisher : BAPIN-ISMKI (Badan Analisis Pengembangan Ilmiah Nasional - Ikatan Senat Mahasiswa Kedokteran Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53366/jimki.v12i2.828

Abstract

Pendahuluan: Inflammatory Bowel Disease (IBD) merupakan kelompok penyakit inflamasi kronis pada saluran pencernaan. Terapi konvensional seperti aminosalisilat dan kortikosteroid seringkali menimbulkan efek samping dan belum optimal dalam meningkatkan kualitas hidup pasien. Probiotik mulai dilirik sebagai terapi adjuvan karena potensinya dalam memodulasi mikrobiota usus dan respons imun. Tinjauan ini bertujuan mengevaluasi efektivitas probiotik sebagai terapi tambahan pada pasien IBD. Metode: Tinjauan sistematis ini disusun berdasarkan pedoman PRISMA dengan pencarian literatur pada PubMed, Science Direct, dan Scopus. Studi yang diinklusikan adalah uji klinis terkontrol acak (RCT) lima tahun terakhir yang membandingkan probiotik dengan plasebo atau terapi standar pada pasien IBD. Data yang dikumpulkan meliputi karakteristik studi, jenis dan dosis probiotik, lama perlakuan, serta outcome klinis, imunologis, dan kualitas hidup. Pembahasan: Delapan studi RCT terpilih menunjukkan bahwa pemberian probiotik atau sinbiotik, khususnya multi-strain seperti Lactobacillus dan Bifidobacterium, secara konsisten meningkatkan remisi klinis, menurunkan skor aktivitas penyakit, memperbaiki parameter inflamasi (penurunan IL-6, IL-8, TNF-?), perbaikan status nutrisi (BMI, albumin), dan kualitas hidup pasien (skor IBDQ, SF-36). Simpulan: Probiotik terbukti bermanfaat sebagai terapi adjuvan pada pasien IBD ringan hingga sedang, baik dalam meningkatkan remisi klinis, menurunkan inflamasi, maupun memperbaiki kualitas hidup dan status nutrisi. Namun, diperlukan penelitian lebih lanjut untuk menentukan strain, dosis, dan durasi terapi probiotik yang paling optimal pada populasi IBD.
Partus Prematurus Imminens Akibat Penggunaan Obat Uretonika Dosis Tinggi: Sebuah Laporan Kasus Pratiwi, Aulia Sari; Graharti, Risti; Kusumaningtyas, Intan
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

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Abstract

Imminent preterm labor is an obstetric condition characterized by uterine contractions accompanied by cervical changes before 37 weeks of gestation, which can lead to preterm delivery. This condition remains the leading cause of perinatal morbidity and mortality in Indonesia. According to the 2018 Basic Health Research (Riskesdas), the prevalence of premature births reached 29.5 per 1,000 live births and contributed to 35% of neonatal deaths. This study aims to report and analyze cases of imminent premature labor due to the use of high-dose urethronics, as well as to review the latest evidence-based management. Data were obtained through anamnesis, physical examination, and review of patient medical records, which were then supplemented with a literature review related to the mechanism of action of uterotonic drugs, the role of prostaglandins, and management guidelines from the WHO, ACOG, and WAPM-PMF. The results of the report showed that patients experienced active uterine contractions with premature rupture of membranes at 29–30 weeks of gestation after repeated consumption of high doses of misoprostol. The use of uretonic drugs caused an increase in contractions due to excessive prostaglandin stimulation. Management included the administration of antenatal corticosteroids to accelerate fetal lung maturation, short-term tocolytics to delay labor, and magnesium sulfate as a neuroprotective agent. It is concluded that the use of uterotonic drugs without medical supervision can be a factor in triggering imminent premature labor. A comprehensive and evidence-based management approach can reduce the risk of neonatal complications and improve pregnancy outcomes, making strict supervision and patient education important steps in preventing similar cases in the future.
Penggunaan High-Sensitivity Troponin dalam Diagnosis Dini Infark Miokard Nuraini, Bianti; Graharti, Risti; Rakhman, Farid
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1733

Abstract

Infark miokard akut (IMA) masih menjadi salah satu penyebab utama morbiditas dan mortalitas di seluruh dunia, sehingga diagnosis yang cepat dan akurat sangat penting untuk meningkatkan luaran pasien serta menurunkan risiko komplikasi fatal. Keterlambatan diagnosis IMA dapat menimbulkan berbagai konsekuensi serius, termasuk gagal jantung, aritmia maligna, dan peningkatan angka kematian, terutama pada pasien dengan manifestasi klinis yang atipikal. Oleh karena itu, evaluasi dini pada pasien dengan dugaan sindrom koroner akut merupakan komponen krusial dalam pelayanan kegawatdaruratan dan kardiovaskular. Biomarker jantung memiliki peran sentral dalam diagnosis IMA, dengan troponin jantung diakui sebagai indikator paling spesifik dan sensitif terhadap cedera miokard apabila dikombinasikan dengan penilaian klinis dan pemeriksaan elektrokardiografi. Namun, pemeriksaan troponin konvensional memiliki keterbatasan sensitivitas pada fase awal setelah onset gejala, sehingga berpotensi menyebabkan keterlambatan atau kegagalan diagnosis. Untuk mengatasi keterbatasan tersebut, dikembangkan pemeriksaan high-sensitivity cardiac troponin (hs-cTn) yang mampu mendeteksi kadar troponin sangat rendah serta perubahan dinamis kecil dalam interval waktu yang singkat. Penggunaan hs-cTn memungkinkan identifikasi cedera miokard lebih dini, bahkan dalam satu hingga tiga jam setelah terjadinya iskemia, serta mendukung penerapan algoritma diagnosis cepat seperti protokol rule-in dan rule-out 0/1 jam dari European Society of Cardiology. Strategi ini terbukti meningkatkan akurasi diagnosis, mempercepat pengambilan keputusan klinis, dan mengoptimalkan pemanfaatan sumber daya di unit gawat darurat. Meskipun demikian, peningkatan kadar hs-cTn juga dapat ditemukan pada kondisi non-iskemik, seperti penyakit ginjal kronik, gagal jantung, sepsis, dan takiaritmia. Oleh karena itu, interpretasi hasil hs-cTn harus dilakukan secara hati-hati dengan mempertimbangkan gambaran klinis, perubahan elektrokardiografi, serta pemeriksaan troponin serial. Tinjauan ini membahas peran, manfaat, keterbatasan, dan implikasi klinis hs-cTn dalam diagnosis dini infark miokard akut.
Hubungan Dua Arah Antara Gastroesophageal Reflux Disease dengan Gangguan Tidur Rahmadani, Tiara Sekar; Graharti, Risti; Septa, Tendry
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1736

Abstract

Gastroesophageal Reflux Disease (GERD) is a common chronic gastrointestinal disorder characterized by recurrent reflux of gastric contents into the esophagus, causing symptoms such as heartburn, chest pain, chronic cough, and nocturnal discomfort. The global prevalence of GERD continues to increase and is closely associated with lifestyle factors, including high body mass index, excessive caffeine and alcohol consumption, psychological stress, and poor sleep patterns. In Asia, GERD prevalence has risen markedly over the past two decades, with intercountry differences reflecting variations in socioeconomic status and health behaviors. Nocturnal GERD symptoms frequently disrupt sleep quality, most commonly through insomnia and obstructive sleep apnea (OSA). These sleep disorders can physiologically worsen reflux by altering intrathoracic pressure and reducing lower esophageal sphincter tone. Recent evidence suggests a bidirectional relationship between GERD and sleep disorders, in which nocturnal reflux leads to sleep fragmentation, while sleep disturbances increase the frequency and severity of reflux episodes. Other contributing factors include stress, high-fat dietary intake, impaired esophageal motility, and reduced nocturnal acid clearance. This literature review summarizes current evidence regarding the physiological links between GERD and sleep disorders, associated risk factors, and available management strategies. Therapeutic approaches include pharmacological treatments such as proton pump inhibitors (PPIs) and potassium-competitive acid blockers (P-CABs), along with non-pharmacological interventions, including sleeping in the left lateral position, which has been shown to reduce nocturnal reflux events. This review highlights the importance of a multidisciplinary management approach and the need for further research to improve GERD symptoms and sleep quality.
Dampak Konsumsi Pemanis Buatan terhadap Profil Glukosa dan Risiko Diabetes Mellitus: Tinjauan Pustaka Prameswari, Putu Arya Indira; Darwis, Iswandi; Graharti, Risti
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1740

Abstract

Diabetes Mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia resulting from impaired glucose regulation, and its global prevalence continues to rise substantially. Effective management of DM requires an integrated approach involving pharmacological therapy, lifestyle modification, and appropriate dietary strategies, including carbohydrate regulation, consumption of low–glycemic index foods, and restriction of added sugars. Artificial sweeteners such as aspartame, sucralose, saccharin, and stevia are widely utilized as low-calorie sugar substitutes because they provide sweetness without elevating blood glucose levels. Nevertheless, accumulating evidence indicates that the metabolic effects of artificial sweeteners are heterogeneous and depend on the specific compound as well as the physiological condition of the consumer. Experimental studies have shown that stevia and nano-stevia can reduce hyperglycemia in diabetic rat models, while the Rebaudioside M (Reb M) form of stevia has been reported to enhance insulin sensitivity and attenuate weight gain in obese rats. In contrast, intake of sucralose and acesulfame-K at Acceptable Daily Intake levels has been associated with increased subcutaneous and perirenal adipose tissue accumulation, along with vascular endothelial dysfunction in Wistar rats, suggesting a potential elevation in cardiometabolic risk. Saccharin has similarly been shown to disrupt glucose homeostasis and decrease GLP-1 secretion in animal models, independent of insulin release. Human studies yield more variable outcomes. Most individuals with type 2 diabetes exhibit no significant changes in body weight or glycemic control following artificial sweetener consumption, although more than half report gastrointestinal disturbances such as bloating and diarrhea. These divergent findings underscore that each artificial sweetener possesses a distinct metabolic profile; therefore, their use should be tailored to individual needs, particularly among populations with heightened metabolic vulnerability, including patients with diabetes.
Peran Pangan Ultra Proses terhadap Peningkatan Risiko Obesitas Anak Cintawan, Ni Made Karenina Rini Dwi; Graharti, Risti; Sitepu, Ricky Rivalino
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1741

Abstract

The problem of obesity in adolescents has developed into a global health crisis, exacerbated by lifestyle changes and the consumption of ultra-processed foods (UPF). Indonesia is predicted to become one of the countries with the highest cases of childhood obesity, marked by a doubling in the prevalence of adolescent obesity between 2013 and 2018. This literature review aims to comprehensively analyze the role of UPF consumption in increasing the risk of obesity in the child and adolescent population. This study uses a literature review method by searching scientific databases to identify and synthesize articles discussing the relationship between UPF intake and childhood obesity. (Note: The literature search section has been adjusted to focus on UPF and Obesity). Obesity in adolescents is defined based on WHO criteria (BMI/A Z-score >+2 SD) and is classified predominantly as primary obesity (multifactorial). High UPF consumption has been shown to have a positive and significant association with overnutrition; studies show a drastically increased risk of obesity (40% - 66%) in UPF consumers. The etiological mechanisms are multifactorial, including: 1) Energy Balance Disruption (high energy density, poor nutrient profile, fiber deficit); 2) Decreased Thermogenic Effect of Food (TEF) by up to 50; 3) Hormonal Metabolic Disturbances (increased insulin, insulin resistance, changes in brain circuitry); and 4) Exposure to Obesogenic Substances (Endocrine Disruptors) from additives and packaging. Consumption of UPF is a major and complex risk factor for the pathogenesis of childhood and adolescent obesity, acting through metabolic, neurological, and toxicological pathways. Food policy interventions are needed to mitigate these health risks.
Identification of Active Compound and Effectiveness Test of 96% Tithonia diversifolia Ethanol Extract on Mortality of Aedes aegypti Mosquito A.P, Gadila; Mustofa, Syazili; Graharti, Risti; Setyaningrum, Endah
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1758

Abstract

Dengue Hemorrhagic Fever (DHF) remains a major public health problem in tropical regions, with Asia accounting for 70% of global cases and Indonesia reporting a massive 90,269 cases in 2024. Vector control is the primary mitigation strategy due to limitations in available therapies and vaccines, yet reliance on chemical insecticides poses ecological toxicity and resistance risks, driving the need for safer bioinsecticide alternatives. Tithonia diversifolia is known to contain active phytochemical constituents with insecticidal potential. This true experimental study used a Post Test Only with Control Group design conducted from August to September 2025 involving 25 Aedes aegypti per group with four replications. Leaf simplicia were extracted using 96% ethanol, followed by alcohol-free verification, qualitative phytochemical screening, and formulation into spray preparations at concentrations of 5%, 10%, 15%, 20%, and 25%. Mortality was assessed over 24 hours, and statistical evaluation included univariate, bivariate, and probit analyses to determine LC50, LC90, LT50, and LT90. Extraction produced a 12.53% yield containing saponins, flavonoids, phenols, tannins, alkaloids, and steroids. Mosquito mortality increased with rising concentrations, with the highest effectiveness observed at 25%. The Kruskal–Wallis test confirmed significant differences between groups, while LC50 and LC90 values were 2.77% and 5.37%, respectively. Although the highest mortality was observed at 25%, the 20% concentration was considered optimal because it met WHO efficacy standards while using a lower extract concentration.
Mosquito Control Methods and Dengue Fever Disease: a Literature Review Khairunnisa, Aulia; Graharti, Risti
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1772

Abstract

Dengue Hemorrhagic Fever (DHF) is one of the vector-borne diseases that remains a public health challenge in Indonesia, characterized by high incidence rates, widespread vector distribution, and an increased risk of outbreaks in various endemic areas. The transmission of the dengue virus is greatly influenced by community behavior, residential environmental conditions, and the bioecology of the Aedes aegypti mosquito, which is able to breed in clean water puddles around homes. The dengue virus consists of four serotypes and can survive through vertical and horizontal transmission mechanisms, thereby strengthening the chain of transmission in the environment. On the other hand, vector control efforts using larvicides and chemical insecticides are still widely chosen by the community, even though improper use can cause insecticide resistance. This study aims to examine various methods of dengue vector control, including physical, mechanical, biological, chemical approaches, and the EcoHealth concept. The method used was a literature review of official guidelines, research articles, and the latest scientific publications on DHF and vector control. The results of the study show that physical control methods such as 3M Plus are the most effective and safest, while biological control through larval predators and environmentally friendly bacteria can reduce the larval population without causing negative ecological impacts. Chemical control still provides rapid effects, but must be used wisely to prevent resistance. The EcoHealth approach is considered more comprehensive because it involves environmental, social, cultural, and economic aspects of the community in sustainable control. In conclusion, optimal DHF control requires an evidence-based integrated strategy with cross-sector participation and the application of ecological principles to ensure long-term success in reducing disease incidence.
Faktor Yang Mempengaruhi Kepatuhan Penggunaan Alat Pelindung Diri (APD) Pada Tenaga Kesehatan : Literatur Review Ningrum, Kurnia; Graharti, Risti; Larasati, TA
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1812

Abstract

Abstract The use of Personal Protective Equipment (PPE) is a key component of infection prevention and control in healthcare facilities. Compliance among healthcare workers determines the effectiveness of protection against biological, chemical, and physical hazards in the workplace. However, PPE compliance remains a challenge in many healthcare settings. This literature review aims to identify factors influencing PPE compliance among healthcare workers based on recent studies. The review was conducted using Google Scholar, PubMed, and ScienceDirect databases with the keywords “personal protective equipment,” “compliance,” and “healthcare workers.” Articles published between 2015 and 2025 were included. Of the 62 articles identified, 13 met the inclusion criteria and were analyzed in depth. The analysis focused on synthesizing findings related to individual, organizational, and work environment factors affecting PPE compliance. The results show that individual factors such as knowledge, attitude, risk perception, and work experience significantly influence compliance behavior. Organizational factors, including PPE availability, institutional policies, supervision, safety culture, and continuous training, also play an important role in shaping compliance. In addition, work environment factors such as workload, comfort of PPE, and physical conditions of care areas contribute to compliance levels. Understanding these factors is essential for improving patient and healthcare worker safety through comprehensive intervention strategies. Improving education, strengthening institutional policies, and ensuring adequate PPE supply systems are expected to enhance compliance. In Indonesia, integrated studies examining factors influencing PPE compliance remain limited, highlighting the need for further research to support policy development and occupational safety practices for healthcare workers.
Peran Laju Endap Darah dalam Evaluasi Penyakit Inflamasi Kronik Purnama Sari, Faraztya; Sangging, Putu Ristyaning Ayu; Graharti, Risti
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1821

Abstract

Chronic inflammation is a persistent immune response resulting from continuous inflammatory stimuli, such as chronic infections, autoimmune diseases, and metabolic disorders, and plays a significant role in the pathogenesis of various chronic diseases. Continuous evaluation of inflammatory activity requires laboratory parameters that are easily accessible and capable of reflecting long-term inflammatory processes. The erythrocyte sedimentation rate (ESR) is a non-specific hematological test that remains widely used in clinical practice to assess systemic inflammation. Elevated ESR values occur as a result of changes in acute-phase proteins, particularly fibrinogen and immunoglobulins, which promote erythrocyte aggregation and accelerate the sedimentation process. This review article aims to discuss the role of ESR in the evaluation of chronic inflammatory diseases, including the mechanisms underlying ESR elevation, its advantages, limitations, and comparison with other inflammatory biomarkers. ESR has advantages in representing stable chronic inflammation, its simplicity, and relatively low cost; however, it also has limitations, including low specificity and a slow response to changes in inflammatory activity. Therefore, ESR should be interpreted comprehensively in conjunction with clinical evaluation and other inflammatory biomarkers to support optimal management of chronic inflammatory diseases.
Co-Authors A.P, Gadila Ade Yonata, Ade Adrifianie, Femmy aflika happy, terza Agatha Catherine Agung Assirri Agustyas Tjiptaningrum Airlangga Damara Akbar, Fareel Wahyu Al Ghifari, Ghaza Ahmad Ali, Nur Fitriana Muhammad Andika, Gede Agus Andrifianie, Femmy Angga Wijaya, Angga Anggraeni, Ranesya Eka Annisa Fath Ari Wahyuni Arif Yudho Prabowo Arnida Rahman Asep Sukohar Aulia Berliana Avisa Jinan Azura Ayu, Putu Ristyaning Bayu Anggileo Pramesona Benny Syahputra Gumay betta kurniawan Betta Kurniawan, Betta Boy K.H, High Cintawan, Ni Made Karenina Rini Dwi Daffa, Meysha Nur Devya Aulia Dewi Nur Fiana Diaru Fauzan Farizy Disaputera, Alfafa Tsalaatsa Djausal, Anisa Nuraisa Dorisman, Hari Dwiki WIjaya Rahman Endah Setyaningrum, Endah Evi Kurniawati Fardiansyah, Ahmad Irzal Farhah, Putri Dzahabiyyah Farid Rakhman Fatmasari, Dina Fitria Saftarina George Pestalozi Gigaramadan Sema Hadibrata, Exsa Hafizh, Ahmad Fauzan Happy, Terza Aflika Helmi Ismunandar Hendra Tarigan Sibero Idris, Mohamad Indri Windarti Indriyani, Reni Intan Kusumaningtyas Intanri Kurniati Iswandi Darwis Izdihar, Adinda Fairuz Jati, Pandu Kumaya Khairun Nisa Khairunnisa, Aulia Kurniawaty, Evi Kusumaningrum, Desy Liana Sidharti, Liana Maharani, Atifah Fadilah Mallarangeng, Andi Nafisah Tendri Adjeng Maulida, Syakira Zahra Mayasari, Diana Muhammad Ihsan Fariqy Muhammad Maulana Muhammad Ricky Ramadhian Ningrum, Kurnia Nisa, Lutfi Khoirun Novita Carolia Nuraini, Bianti Nurul Utami Oktoba, Zulpakor Prameswari, Putu Arya Indira Pratiwi, Aulia Sari Prayogi, Norbertus Marcell Purnama Sari, Faraztya Putri, Syalika Dianisa Putu Ristyaning Ayu Rachman Aziz Rahmadani, Tiara Sekar Rahmat, Aprin Nabila Rahmayani, Fidha Rani Himayani Rasmi Zakiah Oktarlina Ratna Dewi Puspita Sari Reni Indriyani Retno Mareintika Ricky Rivalino Sitepu, Ricky Rivalino Rika Lisiswanti Rina Hayati Risal Wintoko rizki_novtarina21 Rodiani Roro Rukmi Windi Roro Rukmi Windi Perdani, Roro Rukmi Rudianto, Waluyo Ruslani, Nada Oktista Sangging, Putu Ristyaning Ayu Sany Setiawan Sema Gigaramadan Septa, Tendry Septiani, Linda Setiawan, Putri Ayundari Setiorini, Anggi Sheira Indah Anjani Soemarwoto, Retno Ariza Soeprihatini Sofyan Musyabiq Wijaya Suharmanto Sulthan Alam Yasyfa Susianti Susianti Sutarto Sutarto Sutarto Sutarto Syahrul Hamidi Nasution Syazili Mustofa TA Larasati Tri Umiana Soleha Wardhani, Dyah Wulan Sumekar Rengganis Wardhani, Oktiva Risma Widjaja, Jovan Winda Trijayanthi Utama, Winda Trijayanthi