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All Journal Medical Journal of Indonesia Jurnal Kedokteran Meditek Gadjah Mada Journal of Psychology Majalah Kedokteran Sriwijaya Universa Medicina Paediatrica Indonesiana Jurnal Respirologi Indonesia The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia The New Ropanasuri Journal of Surgery Jurnal Ilmu Bedah Indonesia Indonesia Journal of Physical Medicine and Rehabilitation Cermin Dunia Kedokteran Ophthalmologica Indonesiana The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy IJRETINA - International Journal of Retina Occupational and Environmental Medicine Journal of Indonesia Jurnal Kedokteran Meditek
Aria Kekalih
Departemen Ilmu Kedokteran Komunitas, FK Universitas Indonesia
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Physics Public Health

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Correlation between peripapillary retinal nerve fiber layer thickness and visual function changes in patients receiving ethambutol Dialika, Dialika; Sidik, Muhammad; Nusanti, Syntia; Kekalih, Aria
Medical Journal of Indonesia Vol 24, No 1 (2015): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (414.289 KB) | DOI: 10.13181/mji.v24i1.1065

Abstract

Background: Recent animal studies revealed the decreased amount of retinal ganglion cells after treatment with ethambutol. The aim of this study was to evaluate the changes of peripapillary retinal nerve fiber layer (RNFL) thickness in patients receiving ethambutol therapy, as well as to know the correlation of RNFL thickness changes with the changes of visual function.Methods: This was a cohort study on 29 subjects at one tuberculosis treatment center, Jakarta. Subjects underwent RNFL thickness measurement using optical coherence tomography (OCT) and several visual function parameters (visual acuity, contrast sensitivity, color sensitivity and visual field) before and two-months following ethambutol therapy. Statistical comparison between pre- and post- ethambutol measurements were done using either paired T-test or Wilcoxon test. Correlations between anatomical and functional changes were assessed with Spearman correlation test. Results: There were significant changes of peripapillary RNFL thickness in superior (147 and 141 μm, p = 0.001), nasal (92 and 88 μm, p = 0.045) quadrants and average RNFL thickness (116.77 and 112.65 μm, p = 0.001). No significant correlation between RNFL thickness changes and the changes of visual function parameters (p > 0.05).Conclusion: Ethambutol consumption for two months in recommended dose is still considered safe to human retina and visual status.
Mini Break Intervention in Preventing Asthenopia among Drawing Workers using Standard and Widescreen Size VDT at Construction Company in Jakarta Hidayat, Boy; Kekalih, Aria; Rahayu, Tri
Jurnal Kedokteran Meditek VOL. 22 NO.60 September-Desember 2016
Publisher : Jurnal Kedokteran Meditek

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Abstract

AbstractBackground,Minibreak intervention may solve asthenopia which has a main problem among workers using VDT. Asthenopia is measured with near point convergence (NPC). The purpose of this study was to determine convergence power difference that mini break produces between workers using standard VDT and widescreen VDT. Methods, Sixty six workers were divided into four groups: minibreak and no minibreak intervention in standard VDT users and widescreen VDT users. The difference of NPC before and after 4 hours of VDT exposure and 4 hours of exposure with a 15 minute minibreakwere measured in all groups using RAF ruler.  Results,  Minibreak intervention resulted in a significant difference of convergence power between workers using standard VDT (p=0.000) and widescreen VDT (p=0.000).   But the differences of convergence between standard VDT and widescreen VDT were not significant in those given minibreak (p=0.9694) and those not given (p=0.6251). Conclusion, Mini break intervention produced significant differences in convergence power between both groups but the size of the VDT had no effect. Keywords: Asthenopia, VDT, near point convergence, mini break AbstrakLatar Belakang, Mini break dapat menjadi solusi untuk kelelahan mata yang menjadi masalah utama pada pekerja dengan pekerjaan menggambar menggunakan VDT.  Kelelahan mata dapat diukur dengan mengukurnear point convergence (NPC). Tujuan penelitian ini untuk mengetahui perbedaan NPC yang dihasilkan oleh mini break pada pekerja yang menggunakan VDT standar dan wide screen. Metode, Enam puluh enam pekerja dibagi menjadi empat kelompok: mini break dan tanpa mini break pada pekerja VDT  standar dan wide screen. Perbedaan NPC sebelum dan sesudah pajanan VDT selama 4 jam terus-menerus tanpa mini break dan pajanan selama 4 jam dengan mini break 15 menit di tengah-tengah diukur pada semua grup menggunakan RAF ruler. Hasil, Intervensi mini break menghasilkan perbedaan bermakna pada kekuatan konvergensi antara pekerja yang menggunakan   VDT   standar   (p=0.000)   dan   VDT  widescreen   (p=0.000).   Namun   perbedaan konvergensi antara VDT standar dan widescreen tidak berbeda bermakna pada grup yang diberikan mini break (p=0.9694) dan tanpa mini break (p=0.6251). Kesimpulan, Intervensi mini break menghasilkan kekuatan konvergensi yang berbeda antara dua kelompok pekerja, namun hal tersebut tidak dipengaruhi oleh ukuran VDT. Kata kunci: Mata lelah, VDT, pekerja gambar, near point convergence, mini break 
Comparison of the effects of treadmill and ergocycle exercise on the functional capacity and quality of life of patients with chronic obstructive pulmonary disease Turnip, Helena; Ratnawati, Anita; Tulaar, Angela; Yunus, Faisal; Kekalih, Aria
Medical Journal of Indonesia Vol 23, No 1 (2014): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (527.296 KB) | DOI: 10.13181/mji.v23i1.726

Abstract

Background: Physical excercises are hoped to improve functional capacity and quality of life of patients with chronic obstructive pulmonary disease (COPD). This study is aimed to assess the differences between treadmill and ergocycle exercise on changes in functional capacity and quality of life in patients with stable COPD.Methods: This is an experimental study with complete randomization and repeated pre- and post-intervention observation. The study was conducted on 44 subjects with COPD who were presented at Persahabatan Hospital, Medical Rehabilitation Clinic, consisting of 22 subjects undergoing ergocycle exercise and 22 subjects undergoing treadmill exercise test. Functional capacity was assessed by using the 6 minutes walking test (6 MWT) performed at week I, V and IX. Quality of life was measured using the St. George’s Respiratory Questionnaire (SGRQ) at week I and IX. Training program was conducted for 8 weeks with exercise dosage based on the results of exercise test on week I.Results: Treadmill and ergocycle exercise produce significant improvement in both the 6 MWT and SGRQ test since week I to IX. But in comparison, treadmill exercise improves 6 MWT distance better than ergocycle consistently at week I-V, V-IX and I-IX (p < 0.001). For the SGRQ score, both exercises did not differ significantly. Conclusion: Treadmill exercise is associated with significantly better improvement in functional capacity compared to ergocycle exercise in stable COPD subjects. Concerning quality of life, both exercises gave an equivalent improvement in stable COPD subjects.Keywords: chronic obstructive pulmonary disease, ergocycle exercise, functional capacity, treadmill exercise, quality of life
Microscopic Examination of Fecal Leukocytes as a Simple Method to Detecting Infective Colitis in Children Susanti, Nuraini I; Reynaldo, Reynaldo; Kekalih, Aria; Karuniawati, Anis; Hegar, Badriul
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 2 (2017): VOLUME 18, NUMBER 2, August 2017
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (495.275 KB) | DOI: 10.24871/182201773-79

Abstract

Various pathogenic bacteria are reported as the cause of infectious colitis in children. Infectious colitis does not have a specific sign, therefore an accurate examination is required. The implementation of fecal cultures accompanied with drug resistance tests often have constraints, beside the relatively expensive costs, longer times are needed, and not all health care facilities have required instruments. On the other hand, this condition requires an immediate antibiotic therapy, so that the infection should not be continued. In daily practice, it is not uncommon to find diarrhea with the amount of fecal leukocyte < 10/hpf with pathogenic bacteria on the examination of the fecal culture.Cross-sectional study was conducted to observe the pattern of bacterial distribution in children’s fecal who have acute diarrhea and  the correlation between the existence of pathogenic bacteria and the number of leukocytes in the fecal, as well as antibiotic resistance patterns. The population of this study is children with age of 6 months old - 18 years old who were suffering from acute diarrhea with the  amount of  fecal leucocyte  ≥ 5/hpf, who recruited from polyclinic or patient admitted at Cipto Mangunkusumo Hospital and Fatmawati  General Hospital, Jakarta. Based on examinations of fecal cultures and PCR, Salmonella sp and C. dificille were found subsequently in 2 children (33.3%), Enterophatogenic E. Coli(EPEC) and Shigella were found subsequently in 1 child (16.7%). Based on the ROC curve, it was found that there was no intersection of maximum and  minimal leukocyte value with the midline, whereas the best sensitivity and specificity value was found at the cut-off point of 8.5, hence the cut-off  point  of leukocytes was determined at < 8 and > 8. The sensitivity value was 83.3% and the specificity value was 45.1%. The antibiotic sensitivity test showed that one child infected  by EPEC was sensitive to ciprofloxacin. Two children infected  by Salmonella, were still sensitive to chloramphenicol, cotrimoxazole, cefixime, and ceftriaxone. Two children infected by C. Difficile were sensitive to ceftriaxone, and 1 child infected by Shigella was sensitive to cefixime, ceftriaxone and ciprofloksazine.
Kinerja Akseleran dalam Rotasi Klinik: suatu Kajian terhadap Pencapaian Kompetensi Klinik Mahasiswa Kedokteran Wardhani, Sri Linuwih Susetyo; Kekalih, Aria; Dwiprahasto, Iwan; Emilia, Ova; Prabandari, Yayi Suryo; Kumara, Amitya
Jurnal Psikologi Vol 41, No 1 (2014)
Publisher : Faculty of Psychology, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (452.903 KB) | DOI: 10.22146/jpsi.6956

Abstract

Sebagian kecil mahasiswa fakultas kedokteran adalah mahasiswa dengan riwayat pernah mengikuti program akselerasi ditingkat pendidikan dasar dan menengah, dan kelompok ini disebut sebagai akseleran. Akseleran merupakan siswa berbakat dan memiliki inteligensi serta kemampuan akademik yang tinggi, namun, akseleran umumnya imatur baik sosial, emosional maupun fisik. Dengan demikian dapat diprediksi akan mengalami penurunan kompetensi ketika berada pada tahap rotasi klinik. Tujuan penelitian ini adalah untuk melakukan evaluasi kinerja akseleran dalam pencapaian kompetensi di rotasi klinik. Penelitian ini menggunakan rancangan penelitian campuran, dengan pendekatan kualitatif lebih dominan. Responden penelitian ialah mahasiswa fakultas kedokteran di semester tujuh dan delapan dengan riwayat pernah mengikuti program akselerasi. Hasil penelitian ini mendapatkan bahwa kemampuan dasar akseleran berada pada skala baik dan baik sekali; sikap kerja cukup hingga baik, sedangkan kepribadian pada komponen stabilitas emosi serta daya tahan stres berada pada skala kurang hingga cukup. Nilai median kompetensi klinik akseleran sedikit lebih tinggi dibandingkan non-akseleran, tetapi secara satistik perbedaannya tidak bermakna. Kesimpulan penelitian adalah, kinerja akseleran dalam rotasi klinik cukup baik, namun akseleran menghadapi masalah non-akademik terutama aspek kepribadian yang dapat memengaruhi nilai akademik. Perlu pertimbangan seleksi calon mahasiswa kedokteran terhadap akseleran dengan menggunakan pemeriksaan psikologik untuk menilai kematangan kepribadian. Kata kunci: akseleran, kompetensi klinik, seleksi calon mahasiswa
BAGAIMANA MEMBUAT KOMUNITAS USIA LANJUT PUAS DENGAN EDUKASI KESEHATAN DAN KONSULTASI KESEHATAN OLEH DOKTER LAYANAN PRIMER? HAL YANG DIPELAJARI DARI PROGRAM KESEHATAN BANK PENSIUNAN Aria Kekalih; Idqan Fahmi
Majalah Kedokteran Indonesia Vol 68 No 10 (2018): Journal of The Indonesian Medical Association Majalah Kedokteran Indonesia Volu
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.1234/jinma.v68i10.212

Abstract

Pendahuluan: Edukasi kesehatan untuk mengenali dan mencegah penyakit degenratif sangat penting untuk usia lanjut, oleh karena itu, sebuah bank pensiunan nasional di Indonesia berinisiatif untuk menyediakan program kesehatan di ruang tunggunya, untuk mengoptimasi momentum ketika para usia lanjut datang dan berkumpul secara regular di bank pensiunan setiap minggu pertama setiap bulan, bank tersebut mengorganisasi edukasi kesehatan dan program konsultasi medis di ruang tunggu, bekerja sama dengan edukator kesehatan terlatih dan dokter. Penelitian ini menginvestigasi kepuasan usia lanjut dengan program tersebut, dan dampak program tersebut serta citra perusahaan. Metode: Tingkat kepuasan terhadap edukasi kesehatan diukur pada 438 lanjut suia di 14 bank pensiunan yang ada di 10 kota menggunakan pendekatan SERVQUAL, yang terdiri dari tangible, reliability, responsiveness, assurance dan empati. Juga diteliti bagaimana edukasi kesehatan yang dilakukan akan memicu peserta untuk secara sukarela menyebarkan informasi kesehatan yang diberikan kepada individu usia lanjut lainya. Pengukuran tersebut menggunakan analisis standardized equation modeling (SEM).Hasil: Sebagian besar individu usia lanjut puas dan mengerti dengan isi edukasi kesehatan (90%) dan menganggap program ini sebagai program yang berarti (84%). Dalam edukasi kesehatan, faktor yang paling berkontribusi terhadap kepuasan individu lanjut usia adalah tangibles (edukator dan penampilan dokter) dan faktor reliabilitas (jadwal yang regular dan metode pemberian konten edukasi kesehatan). Sementara dalam konsultasi medis, penampilan dokter (faktor tangible), responsiveness dan empati terhadap masalah kesehatan usia lanjut juga memiliki kontribusi penting terhadap kepuasan lanjut usia. Konsultasi medis berkontribusi lebih dalam memicu penyebaran informasi untuk mempromosikan program dan institusi (SEM r=0,81) dibandingkan edukasi kesehatan (SEM r=0,58)Kesimpulan: Hal yang penting dalam penyampaian informasi bukan hanya penampilan dokter dan konten kesehatan, namun juga responsiveness dan empati. Individu usia lanjut sangat menghargai inisiatif bank pensiunan dalam menyediakan edukasi kesehatan dan konsultasi sementara mengoptimasi ruang tunggu, sehingga model ini dapat diaplikasikan dalam program kesehatan selanjutnya.
Compliance of Patients with Locally Advanced Colorectal Cancer to Chemotherapy Using FOLFOX compared to XELOX Regimen Kusnadi, Dana S.; Putranto, Agi S.; Saunar, Rofi Y.; Kekalih, Aria; Moenadjat, Yefta
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Adjuvant chemotherapy become the treatment of choice in advance colorectal cancer to prevent recurrence. Studies showed that FOLFOX and XELOX regimen has been proven to increase overall survival rate and disease free survival. This study is aimed to compare XELOX response to FOLFOX regimen in our center, which is characterized by advanced stage neoplasm in the first presentation with low compliance. It also aimed to find out affecting factors of such response. Method. We run a retrospective study enrolled of 133 subjects with colorectal carcinoma of stage III and high–risk stage II who received adjuvant chemotherapy and treated in dr. Cipto Mangunkusumo– and Fatmawati General Hospital. Consecutive sampling was instituted, CEA level and one year mortality rate was recorded as variables of the efficacy, which was then associated with subjects’ compliance. Statistical analysis was done using Chi square or Fisher test, and a multivariate logistic regression. Significance was found as the difference met <0.05 with confidence interval of 95%. Results. We found there is no significant difference between the two regimens with efficacy (p = 0.61). There is significant correlation between the regimen (p = 0.001 and 0.000); with compliance is found much higher in FOLFOX (86% compared to 45%). We also found statistically significant of influencing factors the efficacy, i.e. Karnofsky score >90 (OR = 5.8; p = 0.004), body mass index both of normal and more (OR = 4.7; p = 0.006), and with histopathologic grading of moderate differentiated (OR = 6.3; p = 0.003). Conclusion. FOLFOX and XELOX regimen has been shown to have a same efficacy in response in our center. However, compliance showed a strong correlation to efficacy and FOLFOX regimen showed much higher rather than XELOX. Karnofsky score and body mass index should be subjects of consideration to increase the response of such adjuvant chemotherapy.
Merit of APACHE II, MPI and ARPI scores as determinants On Demand Relaparotomy Kamil, Radhita F.; Lalisang, Toar JM; Kekalih, Aria
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Delayed in decision making to carry out relaparotomy increases the morbidity and mortality. The decision to be made on demand relaparotomy is a kind of one subjectivity on the clinical setting. Therefore, it is necessary to have a thorough physical examination with additional diagnostic tools as the rationale to make an accurate decision that is the scoring system. There were many scoring systems has been proposed, and we run a study aimed to find out the merit of those scoring. Method. We run a case-control study enrolled 32 subjects with on demand relaparotomy and 64 subjects with laparotomy for any indication. APACHE II, MPI, ARPI scores were applied as variables. Data collected retrospectively from those who underwent laparotomy andrelaparotomy in RS dr.Cipto Mangunkusumo General Hospital in period of January 2012 to December 2013. These variables subjected to statistical analysis. Results. Based on statistical analysis of the two groups we found that APACHE II showed no significant difference (p = 0.114), whilst MPI and ARPI showed significant difference (p <0.0001). ROC curve showed that APACHE II had AUC of 59.2% with a cut-off point of 10, MPI had AUC of 86.4% with a cut-off point of 20 and ARPI had AUC of 77.6% with a cut-off point of 10. Conclusion. MPI and ARPI could be used as determinants on demand relaparotomy.
Implementation of revised Baux Score to Predict Mortality Burn Injured Patients in Burn Unit of dr. Cipto Mangunkusumo General Hospital, Jakarta Wardhana, Aditya; Mulyantara, Irwan; Kekalih, Aria
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Implementation of stratification in burn injured patients referred to a very helpful approach for surgeon distinguishing severity of problems as well as predicting the outcome and lead a surgeon to make an accurate decision and a guidance to deliver patient’s condition to his/her family. A stratification tools for prediction should be simple and applicable in clinical setting. It also feasible to be applied for clinical use, research purpose, and system audit. Amongst scoring systems in burn surgery, revised Baux score is the one. The study is aimed to run validation in our burn characteristics. Method. A study run to find out validation for revised Baux score, prior to its use for application in our setting. We run cohort study enrolled burn injured patient treated during period of January 2010 to December 2012, retrospectively. Total body surface area involved, age and inhalation injury referred to variables subjected to statistical analysis. Results. Out of 442 burn injured patient, there were 234 subjects included in the study. Statistical analysis using Hosmer and Lemeshow test addressed to evaluate calibration of scoring performance showed p value of p = 1 (> 0.05), and for its precision we found the performance of discrimination of r–Baux score showed the area under curve (AUC) of 0.87 (CI 95%; 0.825–0.915), showing a p value of <0.001, and sensitivity 77.9% and specificity 76.9%. Conclusion. On validation, revised Baux score provide a good performance and likely would provide a merit of its clinical application.
Effect of Preconditioning and Hypothermia in Ischemia–Reperfusion Injury to the Endothelial Cells of Blood Vessels in Oryctolagus cuniculus Ismet, Mohamad F.; Moenadjat, Yefta; Kekalih, Aria
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Ischemia/reperfusion injury (I/RI) remain a problem in post–hypoxia period, leading to remote organ injury. Studies showed that ischemic preconditioning (IPC) and hypothermia (HI) let destructive effect of ischemia to be minimized. The aim of study was to find out the impacts of interventions such as IPC and HI on morphology and function of the endothelial distal to ligation (ischemia) and contralateral vessel (I/RI). Method. An experimental study carried out by ligation the right common femoral artery of Oryctolagus cuniculus to induce ischemia. Endothelial cells distal to ligation and contralateral side was subjected to investigation. The effect of IPC and HI were investigated and compared to those in I/RI. Results. Morphological study showed significant difference scores between endothelial damage in ipsilateral vessels in interventional subjects with control, and intervention with I/RI group (p 0.05). Conclusion. Ischemia may lead to remote endothelial dysfunction; IPC and HI showed the efficacy to minimize the impact of reperfusion.
Co-Authors Adiningsih Sri Lestari Agi Satria Putranto Alma Thahir Pulungan Amendi Nasution Amir Shidik Amitya Kumara Angela BM Tulaar Anis Karuniawati ANIS KARUNIAWATI Anita Ratnawati Arthur Garson Aziza G. Icksan Badriul Hegar Badriul Hegar Bambang Supriyatno Benjamin Ngatio, Benjamin Bondan Harmani Boy Hidayat Budhi Antariksa Damayanti Rusli Sjarif Danny Rasjiid Garna Dewi Friska Dialika Dialika Elisna Syahruddin Elisna Syahruddin Faisal Yunus Feni Fitriani Harsono, Hasto Helena Turnip Hendriko Herqutanto Herqutanto Hidayat, Boy I Nyoman Murdana Ibrahim Basir Idqan Fahmi Ika Citra Susanti Iris Rengganis Isep Supriyana Ismet, Mohamad F. Iwan Dwiprahasto Jeo, Wifanto S. Jeo, Wifanto Saditya Johan, Anita Judith N. Anastasia Kamil, Radhita F. Kusnadi, Dana S. Luh K Wahyuni M. Sidik Maelissa Pramaningasih Maulanisa, Sinta C. Maulia Fitra Purnama Moretta Damayanti Muchtaruddin Mansyur Muhammad Ilyas Muhammad Sidik Mulyantara, Irwan Nuraini I Susanti Nury Nusdwinuringtyas Ova Emilia Pramaningasih, Maelissa Pratama, Dennis W. Purwito Adi, Nuri Putra, Muhammad Arza Putranto, Agi S. R. Muharam Raditya Pratama Rahayu, Tri Retno Asti Werdhani Reynaldo Reynaldo Reynaldo Reynaldo, Reynaldo Rini Andriani Risky Dwi Rahayu Rosa Tatun Roy Dwi Indra Rusli, Noer Triyanto S. Soemarko, Dewi Saunar, Rofi Y. Sawitri Darmiati Selly C Anggoro Siregar, Sun Parkuseg Sri Linuwih Susetyo Wardhani, Sri Linuwih Susetyo Sugiharto, Bobby Sulistomo, Astrid Sun Parkuseg Siregar Susanti, Nuraini I Susanti, Nuraini I Syntia Nusanti Syntia Nusanti Syska Widyawati Tirza Z Tamin Toar JM Lalisang Tresia Fransiska Ulianna Tambunan Tri Rahayu Vanto, Yoni Viscanita Viscanita W. Roestam, Ambar Wibowo, Suryo Wifanto Saditya Jeo Winata, Vera Yayi Suryo Prabandari Yefta Moenadjat Yoga Devaera Yundari, Yundari