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All Journal Tropical Medicine Journal Jurnal Ilmiah Farmasi Acta Interna : The Journal of Internal Medicine Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Simetris Medula JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Majalah Farmaseutik Indonesian Journal of Pharmacology and Therapy BKM Public Health and Community Medicine Jurnal Penyakit Dalam Indonesia

Rizka Humardewayanti Asdie

Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran, Kesehatan Masyarakat Dan Keperawatan Universitas Gadjah Mada/ RSUP Dr. Sardjito, Yogyakarta

Author-ID : 3661099

Biochemistry, Genetics & Molecular Biology Computer Science & IT Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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PROGNOSTIC FACTORS OF LEPTOSPIROSIS PATIENTS IN DR. SARDJITO GENERAL HOSPITAL, YOGYAKARTA, INDONESIA Kurniaatmaja, E.R, Kurniaatmaja, E.R; Priambodo, Doni; Humardewayanti, Rizka; Loeheri, Soebagjo
Acta Interna The Journal of Internal Medicine Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar

Background: Leptospirosis, an infectious disease that affects humans and animals, is a common zoonosis with a variety of clinical manifestations. Yogyakarta is one of the cities with a high incidence of leptospirosis. It is important to recognize the clinical features and prognostic factors of this disease. Severe disease can be fatal, although majority of cases are mild and self-limited.Â Objective: To determine the prognostic factors for leptospirosis that associated with mortality in patients with leptospirosis in Dr. Sardjito General Hospital, Yogyakarta.Â Methods: We conducted a retrospective study of data collected in our hospital between Jan 2010 until May 2011, from whom the diagnosis of leptospirosis was confirmed based on pertinent clinical and epidemiological data and positive serology.Â Result: Thirty two patients were included in this study, including 29 survivors (90.62%) and 3 non-survivors (9.38%). Of these 32 patients, 26 patients (81.25%) were admitted to the medical ward and 6 patients (18.75 %) were admitted to the ICU.Â Multivariate logistic regression demonstrated that three factors were independently associated with mortality: oliguria (OR 0.75; CI 0.541â1.04; p<0.05); urea nitrogen > 74.7 mmol/L (OR 0.813; CI 0.642-1.028; p<0.05), and neurological symptoms (altered mentation or seizure) (OR 30; CI 4.367â206.07; p<0.05)Â Conclusion: The mortality of leptospirosis remains high despite improvements in patients care. In order to improve the early treatment of high-risk patients, these 2 clinical and 1 laboratory criteria which are associated with mortality, can be used at the time of admission as prognostic factors.Â Â Keywords : Leptospirosis, prognostic factors, mortality

Apoptosis In Sepsis Humardewayanti, Rizka
Acta Interna The Journal of Internal Medicine Vol 2, No 1 (2012): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar

INTRODUCTIONÂ Â Â Â Â Â Â Â Â Â Â The word sepsis is derived from the Greek term for rotten or âto make putridâ. Sepsis, defined as the systemic host response to microorganisms in previously sterile tissues, is a syndrome related to severe infections and is characterized by end-organ dysfunction away from the primary site of infection. To meet the definition of sepsis, patients need to satisfy at least two of the Systemic Inflammatory Response Syndrome (SIRS) criteria in association with having a suspected or confirmed infection. The severity and mortality increase when this condition is complicated by predefined organ dysfunction (severe sepsis) and cardiovascular collapse (septic shock). The normal host response to infection is complex, aiming to both identify and control pathogen invasion and start immediate tissue repair. Both the cellular and humoral immune systems are activated, giving rise to anti-inflammatory and proinflammatory responses. Exacerbating these mechanisms can cause a chain of events that leads to sepsis, promoting massive liberation of mediators and the progression of multiple organ dysfunction1.Sepsis remains a critical problem with significant morbidity and mortality even in the modern era of critical care management. Despite intense efforts, sepsis remains a serious clinical problem and still associated with a high mortality rate. Septic shock and sequential multiple organ failure/dysfunction syndrome (MOF/MODS) correlate with poor outcome, and septic shock is the most common cause of death in intensive care units. A recent review by Angus et al estimated the 1995 incidence of sepsis in the United States to be 751,000 cases, resulting in 215,000 deaths. The average cost per case of sepsis was $22,100 with total costs of $16.7 billion nationally. A more recent analysis of hospital records indicates that the total number of patients who are dying is actually increasing. This study also confirmed the work of Angus et al that the incidence of sepsis is increasing and projected to continue to grow as the population ages. These studies concluded that âsevere sepsis is a common, expensive, and frequently fatal condition, with as many deaths annually as those from acute myocardial infarction2,3.The immunological cascade resulting in the sepsis response can be initiated by tissue injury, ischemia reperfusion injury, gram-positive organisms, and fungi as well as gram-negative organisms and their constituent endotoxin. The sepsis response may begin with an infectious nidus, which may either invade the bloodstream, leading to dissemination and positive blood cultures, or proliferate locally and release various microbial products into the bloodstream3.Multiple derangements exist in sepsis involving several different organs and systems, although controversies exist over their individual contribution to the disease process. Septic patients have substantial, life-threatening alterations in their coagulation system. Previously, it was believed that sepsis merely represented an exaggerated, hyperinflammatory response with patients dying from inflammation-induced organ injury. More recent data indicate that substantial heterogeneity exists in septic patientsâ inflammatory response, with some appearing immuno-stimulated, whereas others appear suppressed. Cellular changes continue the theme of heterogeneity. Some cells work too well such as neutrophils that remain activated for an extended time. Other cellular changes become accelerated in a detrimental fashion including lymphocyte apoptosis2.The role that apoptosis plays in sepsis syndromes and in the development of CARS and MODS has not been adequately explored, but there is rapidly developing evidence to suggest that increased apoptotic processes may play a determining role in the outcome to sepsis syndromes. In particular, increased apoptosis, particularly in lymphoid tissues and potentially in some parenchymal tissues from solid organs, may contribute to the sepsis-associated MODS3

SISTEM PENDUKUNG PENGAMBILAN KEPUTUSAN KLINIS DALAM PEMBERIAN TERAPI ANTIBIOTIK YANG RASIONAL Suharyanto, Suharyanto; Asdie, Rizka Humardewayanti
Simetris: Jurnal Teknik Mesin, Elektro dan Ilmu Komputer Vol 6, No 1 (2015): JURNAL SIMETRIS VOLUME 6 NO 1 TAHUN 2015
Publisher : Universitas Muria Kudus

ABSTRAK Pemilihan terapi antibiotik yang rasional pada penyakit infeksi akan memperbaiki simptom klinis secara lebih cepat, efisien dibandingkan dengan terapi yang tidak tepat atau tidak sesuai. Klinisi harus meningkatkan keahlian dalam penggunaan antibiotik yang rasional pada penyakit infeksi yang ringan atau berat dan pada penyakit yang disebabkan oleh virus. Terapi antibiotik yang rasional mencegah terjadinya resistensi antibiotik. Sistem pendukung pengambilan keputusan klinis (SPKK) akan meningkatkan penggunaan antibiotik yang rasional. Penelitian ini mengembangkan prototipe SPKK untuk mendukung pengambilan keputusan penggunaan antibiotik yang rasional. Desain penelitian ini menggunakan pendekatan action research. Pengembangan sistem dengan prototiping menggunakan rule based dengan format IF <gejala> THEN <terapi >. Pengujian system dilakukan dengan membandingkan output dari klinisi dan dari sistem. Hasil evaluasi system terdapat 50 data kuesioner yang diberikan pada klinisi dengan hasil yang sesuai dengan guideline adalah output dari klinisi 35 (70%) dan output system 49 (98%), X2=0,087, p=0,768. Pada hasil atas menunjukkan bahwa sistem memiliki performan yang baik. Kata kunci: diagnosis, rasional, terapi antibiotik, rule-based "IF THEN".

Vasopressin pada Manajemen Syok Septik Iswandi Darwis; Rizka Humardewayanti Asdie; Neema Putri Prameswari
Medula Vol 11 No 3 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i3.288

Sepsis is a systemic inflammatory response caused by an infection, which can involve multiple organs. Sepsis and multiple organ dysfunction syndrome (MODS) are the main causes of death in the intensive care unit of a hospital. In sepsis, septic shock, defined as sepsis-induced persistent hypotension despite adequate fluid resuscitation causing tissue hypoperfusion, can occur. Norepinephrine and dopamine are the vasopressors of choice for initial treatment septic shock, but the use of high-dose catecholamine vasopressors can cause adrenergic side effects that can increase mortality. Therefore, a septic shock patient with increased heart rate, it is necessary to use a vasopressor that does not cause adrenergic side effects. Vasopressin is a hormone secreted by the posterior pituitary. In hypotensive condition, vasopressin physiologically helps maintain blood pressure by acting as a potent vasoconstrictor. Vasopressin administration does not cause side effects caused by adrenergic stimulation such as increased tissue oxygen demand, decreased renal and mesenteric flow, increased pulmonary resistance and arrhythmias. This literature review also discusses the effects of vasopressin on blood pressure, the cardiovascular system, the immune system, the coagulation system, the respiratory system, the urinary system and the central nervous system in patients with septic shock.

Risk Factors Analysis of Typhoid Fever Occurence of Inpatient in Kebumen Public Hospital in 2013 Rina Hudayani; Hari Kusnanto; Rizka Humardewayanti; Trisno Agung Wibowo
Tropical Medicine Journal Vol 3, No 2 (2013): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

ABSTRACTIntroduction: Typhoid fever is a disease caused by infection of Salmonella typhoid and paratyphoid bacteria. There are 350-810 people who get this disease per 100.000 people and the percentage of death is 0.6-5%. Typhoid fever in Kebumen Regency always belongs to the big five diseases. The criteria are the number of in-patient in the hospital and the extraordinary occurrence for 4 years (from 2007 to 2010). This disease is related to unhealthy sanitation and bad individual hygiene practice.Objective: To analyze the risk factors of typhoid fever occurrence of inpatient in Kebumen Public Hospital in 2013.Methods : This research is an analytical observational research with control case study design. The sample subject was taken by using consecutive sampling method and there were 148 respondents, consisting of 74 case respondents and 74 control respondents. The data were analyzed by using McNemar (bivariate) test and conditional logistic regression (multivariate).Results : Most respondents are in the age of 15-20 years old (32.43%), female (70.27%), the graduates of Senior/Vocational High School (29.05%) and student/university student (34.46%). The results of multivariable analysis are the risk factor of eating non-homemade snack habit is high (p=0.000; OR=5.586; CI 95% 2.142-14.571) followed by the habit of washing hands before eating (p=0.003;OR=2.835; CI 95% 1.433-5.609). Water clean sources, facility for defecation, defecation habit in latrine, and typhoid fever history in family are not the risk factors of typhoid fever occurrence of in-patient in Kebumen Public Hospital.Conclusion : The risk to get typhoid fever in Kebumen Regency is higher on those whose habits of eating non-homemade snacks and not washing hand by using soap before eating. Therefore, the health officer should improve individual hygiene promotion and give information to society and those who manage food processing public place.Key Words: Risk factors,Typhoid fever, Kebumen.

PROGNOSTIC FACTORS OF LEPTOSPIROSIS PATIENTS IN DR. SARDJITO GENERAL HOSPITAL, YOGYAKARTA, INDONESIA Kurniaatmaja, E.R Kurniaatmaja, E.R; Doni Priambodo; Rizka Humardewayanti; Soebagjo Loeheri
Acta Interna The Journal of Internal Medicine Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Background: Leptospirosis, an infectious disease that affects humans and animals, is a common zoonosis with a variety of clinical manifestations. Yogyakarta is one of the cities with a high incidence of leptospirosis. It is important to recognize the clinical features and prognostic factors of this disease. Severe disease can be fatal, although majority of cases are mild and self-limited. Objective: To determine the prognostic factors for leptospirosis that associated with mortality in patients with leptospirosis in Dr. Sardjito General Hospital, Yogyakarta. Methods: We conducted a retrospective study of data collected in our hospital between Jan 2010 until May 2011, from whom the diagnosis of leptospirosis was confirmed based on pertinent clinical and epidemiological data and positive serology. Result: Thirty two patients were included in this study, including 29 survivors (90.62%) and 3 non-survivors (9.38%). Of these 32 patients, 26 patients (81.25%) were admitted to the medical ward and 6 patients (18.75 %) were admitted to the ICU. Multivariate logistic regression demonstrated that three factors were independently associated with mortality: oliguria (OR 0.75; CI 0.541–1.04; p<0.05); urea nitrogen > 74.7 mmol/L (OR 0.813; CI 0.642-1.028; p<0.05), and neurological symptoms (altered mentation or seizure) (OR 30; CI 4.367–206.07; p<0.05) Conclusion: The mortality of leptospirosis remains high despite improvements in patients care. In order to improve the early treatment of high-risk patients, these 2 clinical and 1 laboratory criteria which are associated with mortality, can be used at the time of admission as prognostic factors. Keywords : Leptospirosis, prognostic factors, mortality

Apoptosis In Sepsis Rizka Humardewayanti
Acta Interna The Journal of Internal Medicine Vol 2, No 1 (2012): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

INTRODUCTION The word sepsis is derived from the Greek term for rotten or “to make putrid”. Sepsis, defined as the systemic host response to microorganisms in previously sterile tissues, is a syndrome related to severe infections and is characterized by end-organ dysfunction away from the primary site of infection. To meet the definition of sepsis, patients need to satisfy at least two of the Systemic Inflammatory Response Syndrome (SIRS) criteria in association with having a suspected or confirmed infection. The severity and mortality increase when this condition is complicated by predefined organ dysfunction (severe sepsis) and cardiovascular collapse (septic shock). The normal host response to infection is complex, aiming to both identify and control pathogen invasion and start immediate tissue repair. Both the cellular and humoral immune systems are activated, giving rise to anti-inflammatory and proinflammatory responses. Exacerbating these mechanisms can cause a chain of events that leads to sepsis, promoting massive liberation of mediators and the progression of multiple organ dysfunction1.Sepsis remains a critical problem with significant morbidity and mortality even in the modern era of critical care management. Despite intense efforts, sepsis remains a serious clinical problem and still associated with a high mortality rate. Septic shock and sequential multiple organ failure/dysfunction syndrome (MOF/MODS) correlate with poor outcome, and septic shock is the most common cause of death in intensive care units. A recent review by Angus et al estimated the 1995 incidence of sepsis in the United States to be 751,000 cases, resulting in 215,000 deaths. The average cost per case of sepsis was $22,100 with total costs of $16.7 billion nationally. A more recent analysis of hospital records indicates that the total number of patients who are dying is actually increasing. This study also confirmed the work of Angus et al that the incidence of sepsis is increasing and projected to continue to grow as the population ages. These studies concluded that “severe sepsis is a common, expensive, and frequently fatal condition, with as many deaths annually as those from acute myocardial infarction2,3.The immunological cascade resulting in the sepsis response can be initiated by tissue injury, ischemia reperfusion injury, gram-positive organisms, and fungi as well as gram-negative organisms and their constituent endotoxin. The sepsis response may begin with an infectious nidus, which may either invade the bloodstream, leading to dissemination and positive blood cultures, or proliferate locally and release various microbial products into the bloodstream3.Multiple derangements exist in sepsis involving several different organs and systems, although controversies exist over their individual contribution to the disease process. Septic patients have substantial, life-threatening alterations in their coagulation system. Previously, it was believed that sepsis merely represented an exaggerated, hyperinflammatory response with patients dying from inflammation-induced organ injury. More recent data indicate that substantial heterogeneity exists in septic patients’ inflammatory response, with some appearing immuno-stimulated, whereas others appear suppressed. Cellular changes continue the theme of heterogeneity. Some cells work too well such as neutrophils that remain activated for an extended time. Other cellular changes become accelerated in a detrimental fashion including lymphocyte apoptosis2.The role that apoptosis plays in sepsis syndromes and in the development of CARS and MODS has not been adequately explored, but there is rapidly developing evidence to suggest that increased apoptotic processes may play a determining role in the outcome to sepsis syndromes. In particular, increased apoptosis, particularly in lymphoid tissues and potentially in some parenchymal tissues from solid organs, may contribute to the sepsis-associated MODS3

Changes in Anthropometry Measurement among Human Immunodefi ciency Virus/Acquired Immune Defi ciency Syndrome (HIV/AIDS) Patients Received Antiretroviral Treatment Adi Irawan; Doni Priambodo Wijisaksono; Rizka Humardewayanti; Yanri WIjayanti
Acta Interna The Journal of Internal Medicine Vol 4, No 2 (2014): The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

ABSTRACTBackground: Estimated nearly 38.6 million people infected by HIV and 2.8 million died in 2005. Evidence suggests the existence of a very important relationship between the output and improved nutritional statusin HIV/AIDS patients. Poor nutritional status in HIV/AIDS can be caused by several factors, namely the intake and absorption of inadequate nutrition, metabolic changes, hyper metabolism, or a combination of these, changes in the gastrointestinal tract as well as interactions between drugs and nutrients. Losing weight remains on the HAART (Highly Active Antiretroviral Therapies) era, but the problems are the side effects of HAART and lipodystrophy.Objective: The purpose of this study is to determine the provision of anti- retroviral effect on changes in anthropometric values people with HIV/AIDS. Method: The study is using the one group pre-posttest design (quasi-experimental), by assessing changes in anthropometric values in subjects with HIV before and after the administration of ARVs. Analysis of the data is computerized by a computer program Result: Obtained 30 samples of the study with anthropometric changes pre and post ARVs 6 months. Theweight was 51.4 ± 9.12 to 53.6 ± 8.68 with a p-value 0.001. Body Mass Index (BMI) was 19.98 ± 3.47 into 20.84 ± 3.35 with a p-value 0.001 and upper arm circumference 24.13 ± 3.62 into 24.95±3.48 with a p-value 0.003. The provision of antiretroviral drugs for 6 months infl uences the change in nutritional status of HIV patients are assessed by anthropometric measure. Signifi cant changes in the changes body weight, BMIand upper arm circumference. Changes in anthropometric values ARV Efavirenz group and non-Efavirenz meaningful change signifi cant in skinfold thickness obtained at the value of p 0.010.Conclusion: There were no signifi cant changes in anthropometric values compared to patients with early stage HIV and advanced stage after 6 months of antiretroviral therapy.Keywords: HIV, antiretroviral drugs, anthropometric, nutritional status

Th e Accuracy of Delta Neutrophil Index as a Marker of Sepsis Severity Level Compare to Serum Amyloid A Silvikarina Erfanti Dewi Halim; Rizka Humardewayanti Asdie; Doni Priambodo
Acta Interna The Journal of Internal Medicine Vol 9, No 1 (2019): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Background. Early diagnosis of infection before its progression to become organ dysfunction or circulation failure has an important clinical effect and critical patient outcome. Diagnostic modality used as a gold standard on diagnosing sepsis condition still relies on microbe culture. Microbial culture needed a long duration to grow bacteria in high numbers be identified. The upcoming alternative diagnostic modality used as a marker of sepsis severity level was Delta Neutrophil Index (DNI) and Serum Amyloid A (SAA). There were no references to compare the accuracy of DNI and SAA as a marker of sepsis severity level.Methods. 45 study subjects were patients with sepsis and severe sepsis or septic shock first known when first come to the ER or underwent treatment in the inpatient unit, ICU (Intensive Care Unit) or IMC (Intermediate Care) Sardjito’s Hospital that fulfilled the inclusion and exclusion criteria. The independent variable was DNI and the dependent variable was sepsis severity level. All of blood samples from septic patient undergo DNI and SAA test. Distributed data used the Kolmogorov-Smirnov test. DNI and SAA accuracy used sensitivity, specificity, positive predictive value, negative predictive value, like hood ratio and receiver-operating characteristics (ROC) curve.Results. The study consisted of 45 study subjects. The mean age was 52.98 years. The mean of SAA in this study was 54.39 ± 45.53 mg/L, while the mean of DNI in this study was 12.47 ± 8.79 %. Cut off point DNI 6.85% with value of sensitivity 93%, specificity 70%, positive predictive value (PPV) 79.31%, and negative predictive value (NPV) 87.5%, like hood ratio for a positive test result (LR+) (PLR) 14.28 and like hood ratio for a negative test result (LR-) (NLR) 3.3. Cut off for SAA 54.93 mg/L with value of sensitivity 60%, specificity 56%, positive predictive value (PPV) 52%, negative predictive value (NPV) 64%, like hood ratio for a positive test result (LR+) (PLR) 1.36 and likelihood ratio for a negative test result (LR-) (NLR) 0.71.Conclusions. DNI has better diagnostic accuracy value as a marker of sepsis severity level than SAA.Keywords. Sepsis, sepsis severity level, Delta Neutrophil Index (DNI), Serum Amyloid A (SAA)

Persistent lymphopenia in septic patients at Dr. Sardjito General Hospital, Yogyakarta Doni Priambodo; Rizka Humardewayanti Asdie; Yanri Wijayanti Subronto; Juvita Kurniawan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 4 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Sepsis triggers immune responseboth pro-inflammatory and anti-inflammatory. Lymphocytes play an important role in the regulation of the inflammatory response. The decrease in lymphocyte numbers due to continuous apoptosis by sepsiscan suppress the immune system and failure to resolve inflammation. Persistent lymphopenia is also associated with a poor prognosis of sepsis. Currently, there are limited studies about persistent lymphopenia in sepsis patients in low- and middle-income countries, including Indonesia. This study aimed to describe the sociodemographic, clinical, and laboratory patterns of sepsis patients with persistent lymphopenia. This was a descriptive study that analyzed patients’ medical records who were treated at the Department of Internal Medicine, Dr. Sardjito General Hospital, Yogyakarta from January 1st, 2016, to December 31th, 2017. Patients diagnosed with clinical sepsis and persistent lymphopenia were included in the study. The status of persistent lymphopenia was described as lymphocyte counts that remained low or lower (<1.62x103/L) on day 4± 24 h compared to the initial value at the time of sepsis diagnosis (day one). Information of patients’ individual and clinical characteristics, complete blood cell count profiles and culture results were included. The outcomes of interest were the survival status and length of stay of the patients. A total of 101 patients with sepsis and persistent lymphopenia were involved in this study. The average increase in lymphocyte numbers was 73.63 ± 426.86/µL. The main source of infection was pulmonary infection, with a mortality rate of 43.6% and a median survival of 19 days. The average length of stay was 13.1±6.8. Persistent lymphopenia in patients with sepsis has a high mortality. Further research is needed to determine the clinical ramifications of persistent lymphopenia.

Co-Authors Abu Tholib Aman Adi Irawan Agus Barmawi Anton Pratama Chairani, Farahdina Denia Yuni Wulandari Desty Gusti Sari Djoko Wahyono Djoko Wahyono Doni Priambodo Doni Priambodo Doni Priambodo Wijisaksono E.R Kurniaatmaja E.R Kurniaatmaja Elma Viorentina Sembiring Endang Estriningsih Estriningsih, Endang Faisal Heryono Farahdina Chairani Hanny Hafiar Hari Kusnanto Hemi Sinorita Hemi Sinorita Hemi Sinorita Hemi Sinorita Ika Puspita Sari Ika Puspita Sari Ika Puspita Sari Ika Puspitasari Ika Puspitasari Iswandi Darwis Juvita Kurniawan Maemonah, Maemonah Mayada Rakhmima Karizki Minar Paskah Lianti Manik Muhammad Luthfi Aziz Nanang Munif Yasin Neema Putri Prameswari Pebriati Sumarningsih Pebriati Sumarningsih Pratama, Anton Retnowulan, Heni Rina Hudayani Rizki Rahmawati Rosylianti Rosylianti Sari, Desty Gusti Silvikarina Erfanti Dewi Halim Soebagjo Loeheri Sumarningsih, Pebriati Titik Nuryastuti Titik Nuryastuti, Titik Titik Rahayu Titik Rahayu Tri Hartati Tri Hartati, Tri Trisno Agung Wibowo Wulandari, Denia Yuni Yanri WIjayanti Yanri Wijayanti Subronto Yuli Mawarti

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