Articles

Side effects of long-term antiepileptic drugs on renal tubules of Indonesian children Trihono, Partini Pudjiastuti; Grafianti, Deasy; Mangunatmadja, Irawan; Karyanti, Mulya Rahma
Paediatrica Indonesiana Vol 58 No 2 (2018): March 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (227.755 KB) | DOI: 10.14238/pi58.2.2018.84-9

Abstract

Background Long-term treatment with antiepileptic drugs such as valproic acid (VPA) and carbamazepine (CBZ) may disrupt renal tubular function. Urinary N-acetyl-beta-D-glucosaminidase (NAG) may reflect tubular function and may be useful in detecting early-stage tubular injury. To date, no study has investigated the toxic effect of VPA and CBZ on renal tubules using urinary NAG in Indonesian children. Objectives To determine the toxicity of long-term VPA and/or CBZ treatment on renal tubules in children with epilepsy by measuring urinary NAG index (iNAG). Methods This cross-sectional study was conducted from January to March 2015 at Cipto Mangunkusumo Hospital and Anakku Clinic Pondok Pinang, Jakarta. We included children aged 3 to 16 years with epilepsy on VPA (n=36), CBZ (n=14), or VPA-CBZ combination (n=14) therapy. We measured urinary levels of creatinine and NAG. The urinary NAG reference value was obtained from age-matched healthy controls (n=30). To eliminate diurnal variations in NAG, iNAG was calculated by dividing urinary NAG by urinary creatinine. A urinary iNAG of more than two standard deviations above the mean for healthy children was considered elevated. Results Mean urinary iNAG values for the control, VPA, CBZ, and combination groups were 3.01, 5.9, 4.07, and 6.9 U/g, respectively. All treated groups had higher mean urinary iNAG values compared to the control group. Urinary iNAG was increased in 11/36 children on VPA, 2/14 children on CBZ, and 9/14 children on combination therapy. Conclusion Long-term VPA use may impair renal tubular function, as shown by the increased urinary iNAG. Combination therapy increases damage in the renal tubules.
TOPIRAMATE AS AN ADJUNCTIVE THERAPY IN CHILDREN WITH INTRACTABLE EPILEPSY Pusponegoro, Hardiono D.; Handayani, Tri Lestari; Mangunatmadja, Irawan; Widodo, Dwi Putro; Suradi, Rulina
Paediatrica Indonesiana Vol 42 No 11-12 (2002): November 2002
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (315.257 KB) | DOI: 10.14238/pi42.6.2002.287-91

Abstract

Background Epilepsy is a chronic disease that requires antiepileptic drugs (AEDs). Only 60-70% of new patients could be controlled effectively by standard AEDs and this stimulates the search for new, more effective and well-tolerated AEDs.Objective To asses the efficacy and safety of topiramate, as an adjunctive therapy to standard AEDs for children with intractable epilepsy.Methods This was an open label, parallel group study. Forty children with at least 4 seizures during a 4-week baseline period were randomly assigned to topiramate (n=20) or control group (n=20). In the topiramate group, the drug was given in adjunct to AEDs for  2-week titration dosage continued with a 12-week stabilization period, while the control group received only AEDs adjusted to their clinical responses.Results Mean reduction from baseline in monthly seizures frequency was significantly greater in the topiramate group (88.6% vs. 25%; P=0.030). Other variable of efficacy was significantly different (e"50% reduction in seizures: 14/20 vs. 6 /20; P=0.049). Adverse effects of topiramate, such as decreased weight, paresthesia, somnolence, diarrhea, fever, aggressive reaction and flushing, were temporary and mild.Conclusion Results of this trial strongly suggested that topiramate is effective and well tolerated in reducing seizures of intractable epilepsy.
Clinical characteristics and electroencephalography features of intractable childhood epilepsy - A case series Mangunatmadja, Irawan; Harmoniati, Eva Devita
Paediatrica Indonesiana Vol 50 No 3 (2010): May 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi50.3.2010.133-8

Abstract

Background The majority of epilepsy patients have good prognosis, but lOAO% will develop intractable epilepsy. Early identification of patients v.ith risks of developing intractable epilepsy allows more intensive therapy to be performed.Objective To study clinical characteristics and electroencephalography (EEG) features of intractable childhood epilepsy.Methods We reviewed children \lith intractable epilepsy attending the Pediatric Neurology and Growth and Development Clinic in Child Health Department, Cipto Mangunkusumo Hospital from 2005􀁏2008. EEG examination was perfonned in epilepsy patients who had consumed two or more antiepileptic drugs for at least 18 months but still experienced seizure at least once per month. Data of clinical characteristics were collected from the medical records and information provided by the parents.Results There were 41 subjects. Age of onset between o􀁏 1 year old was found in 50% subjects, neurological impainnent in 80%, microcephaly in 50%, and abnonnal neuroimaging in 14 of 24 subjects. Seizure manifestations were mostly generalized tonic clonic, tonic, my oclonic, and complex partial seizures. AbnonnalEEG features were found in 88% subjects and the majority showed generalized sloMng of the background activity. Focal and multifocal epileptifonn activity was found in 31 % and 28% subjects, respectively. Epileptifonn activity was located mostly in the frontal and temporal lobe.Conclusions Most patients Mth intractable epilepsy haveage of onset before the age of 1 year. A substantialpoportionof them have neurological impairment, microcephaly,abnonnal neuroimaging, and abnormal EEG features. Seizure manifestation ismostlygeneralized seizure. Epileptiform activity in intractable childhood epilepsy is often found in the frontal and temporal lobe. 
Brainstem auditory evoked potentials in children with microcephaly Mangunatmadja, Irawan; Widodo, Dwi Putro; Pusponegoro, Hardiono D
Paediatrica Indonesiana Vol 43 No 1 (2003): January 2003
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (230.801 KB) | DOI: 10.14238/pi43.1.2003.28-30

Abstract

Background Hearing loss (HL) is commonly found in childrenwith microcephaly. The aim of this study was to reveal hearing lossand auditory brainstem pathways disorders in children with micro-cephaly and other handicaps.Methods There were 194 children who were referred for hearingevaluation. Subjects with history of congenital perinatal infection(TORCH) were excluded. Data were collected from the results ofBrainstem Auditory Evoked Potentials (BAEP) recordings, includ-ing sex, age, clinical manifestations, latency and interlatency be-tween waves I, III, V, and the hearing levels of each ear.Results Moderate to profound HL were found in fourteen ears(58%) of patients with microcephaly. Moderate to profound HL (28%)and endocochlear damage (15%) were found in the ears of pa-tients with microcephaly and delayed speech. Moderate to pro-found HL (39%) and endocochlear damage (11%) were detectedin the ears of patients with microcephaly and delayed develop-ment. Moderate to profound HL (21%) and endocochlear damage(16%) were found in the ears of microcephalic patients with bothdelayed speech and delayed development. Moderate to profoundHL (26%) and endocochlear damage (32%) were detected in theears of patients with microcephaly and cerebral palsy.Conclusion This study revealed the importance of early HL de-tection in microcephalic patients especially those with other handi-caps such as delayed speech, delayed development, and cere-bral palsy
RISK FACTORS FOR DELAYED SPEECH IN CHILDREN AGED 1-2 YEARS Tan, Sabrina; Mangunatmadja, Irawan; Wiguna, Tjhin
Paediatrica Indonesiana Vol 59 No 2 (2019): March 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (255.063 KB) | DOI: 10.14238/pi59.2.2019.55-62

Abstract

Background Speech delay is one of the most common developmental delays in children. To minimize the negative outcomes of speech delay, risk factors should be explored to help in early patient diagnosis. Objectives To assess for associations between delayed speech in children aged 1 to 2 years and possible risk factors including gender, gestational age, birth weight, asphyxia during birth, head circumference, anterior fontanelle closure, gross motor development, duration of breastfeeding, caregiver identity, number of siblings, exposure to gadgets and television, and social interaction. Methods Parents of children aged 1 to 2 years who were treated at Dr. Cipto Mangunkusumo Hospital, and Klinik Anakku, Pondok Pinang in Jakarta from January 2018 to March 2018 were interviewed. Data were processed with SPSS Statistics for Mac and analyzed by Chi-square test and logistic regression method. Results Of 126 subjects, 63 children had speech delay and 63 children had normal speech development. Multivariate analysis revealed that the significant risk factors for delayed speech were delayed gross motor development (OR 9.607; 95%CI 3.403 to 27.122; P<0.001), exclusive breastfeeding for less than 6 months (OR 3.278; 95%CI 1.244 to 8.637; P=0.016), and exposure to gadgets and television for more than 2 hours daily (OR 8.286; 95%CI 2.555 to 26.871; P<0.001). Conclusion Delayed gross motor development, exclusive breastfeeding for less than 6 months, media exposure for more than 2 hours daily, and poor social interaction are risk factors for delayed speech development in children.
Faktor yang Berhubungan dengan Hiperglikemia dan Luarannya pada Anak Sakit Kritis Rosary, Rosary; Chair, Imral; Amalia, Pustika; Firmansyah, Agus; Mangunatmadja, Irawan; Djer, Mulyadi M.
Sari Pediatri Vol 15, No 1 (2013)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp15.1.2013.32-8

Abstract

Latar belakang. Hiperglikemia pada sakit kritis berhubungan dengan luaran yang lebih buruk, seperti lama penggunaan ventilasi mekanik, dan obat vasoaktif lebih panjang, serta derajat disfungsi organ yang lebih berat.Tujuan. Mengetahui hubungan karakteristik subjek dengan hiperglikemia serta mengetahui perbedaan proporsi subjek yang mengalami hiperglikemia antara kelompok subjek yang memakai ventilasi mekanik, mendapat obat vasoaktif, serta dengan disfungsi organ berat, dibandingkan dengan kelompok subjek yang tidak.Metode. Studi analitik potong lintang dilakukan pada anak sakit kritis di Pediatric Intensive Care Unit (PICU) Rumah Sakit Cipto Mangunkusumo (RSCM) usia 1 bulan-18 tahun, dilakukan antara Maret-Juni 2011.Hasil. Didapatkan 87 subjek penelitian, 60 di antaranya laki-laki. Hiperglikemia ditemukan pada 25/87 (28,7%) subjek dengan median kadar glukosa darah 121 (37-443) mg/dL Hiperglikemia ditemukan lebih banyak pada laki-laki, usia >1-5 tahun, gizi kurang, dan pasca-bedah, tetapi tidak ditemukan hubungan yang bermakna. Subjek yang menggunakan ventilasi mekanik dan vasoaktif memiliki proporsi lebih besar mengalami hiperglikemia dibandingkan dengan subjek yang tidak, tetapi perbedaan ini juga tidak bermakna. Enam dari 10 subjek yang memiliki skor Pediatric Logistic Organ Dysfunction (PELOD) tinggi mengalami hiperglikemia. Proporsi ini lebih besar dibandingkan subjek dengan skor PELOD rendah, yaitu 19/77 subjek (p=0,03).Kesimpulan. Proporsi subjek yang mengalami hiperglikemia lebih besar pada anak dengan disfungsi organ berat daripada disfungsi organ ringan. Karakteristik subjek tidak berhubungan dengan hiperglikemia pada sakit kritis. Tidak terbukti adanya perbedaan proporsi subjek yang mengalami hiperglikemia pada anak sakit kritis yang menggunakan ventilasi mekanik dan obat vasoaktif dibandingkan dengan kelompok subjek yang tidak.
Angka Kejadian Koagulasi Intravaskular Diseminata pada Pneumonia Pudjiadi, Marissa Tania Stephanie; Said, Mardjanis; Mangunatmadja, Irawan; Satari, Hidra Irawan; Wulandari, H F; Andriastuti, Murti
Sari Pediatri Vol 14, No 1 (2012)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (178.752 KB) | DOI: 10.14238/sp14.1.2012.52-6

Abstract

Latar belakang. Pneumonia merupakan penyebab kematian utama pada bayi dan balita di negara berkembang. Sitokin pada pneumonia yang diproduksi akibat inflamasi paru secara berlebihan. Sehingga menyebabkan kaskade koagulasi sistemik teraktivasi yang berakhir pada trombosis sistemik yang akan menyebabkan keadaan kritis dan seringkali berakhir dengan kematian. Tujuan.Mengetahui profil koagulasi dan prevalensi koagulasi intravaskular diseminata (KID) pada pasien pneumonia yang dirawat inap.Metode. Studi deskriptif analitik dengan desain potong lintang dilakukan di ruang rawat Departemen Ilmu Kesehatan Anak RSCM antara 1 Februari 2010 sampai 28 Februari 2011.Hasil. Tiga puluh enam persen subjek penelitian mengalami trombositopenia, 13,4% mengalami pemanjangan protombine time (PT), dan 19,6% mengalami penurunan kadar fibrinogen. Didapatkan 83,5% subjek penelitian memiliki kadar D-dimer yang tinggi dan 64,9% di antaranya meningkat sangat tinggi. Kejadian KID 17,5% subjek dan seluruhnya mengalami perdarahan. Pada 88,2% pasien KID mengalami trombositopenia dengan rasio prevalens 32,5 (95% IK 6,70-157,57).Kesimpulan. Profil koagulasi pasien pneumonia yang dirawat di Departemen Ilmu Kesehatan Anak RSCM 36% mengalami trombositopenia, pemanjangan PT 13,4%, penurunan kadar fibrinogen 19,6%, dan peningkatan kadar D-dimer 83,5% . Koagulasi intravaskular diseminata terjadi 17,5% (17/97) pasien pneumonia yang dirawat.
Gambaran Fungsi Kognitif HIV Anak yang Telah Memperoleh Terapi Antiretrovirus Herlina, Herlina; Kurniati, Nia; Prawitasari, Titis; Soedjatmiko, Soedjatmiko; Hadinegoro, Sri Rezeki; Mangunatmadja, Irawan; Setyanto, Darmawan B.
Sari Pediatri Vol 18, No 2 (2016)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp18.2.2016.100-5

Abstract

Latar belakang. Pasien HIV anak berisiko tinggi mengalami gangguan neurokognitif akibat keterlibatan sistem saraf pusat (SSP). Pemberian antiretrovirus (ARV menurunkan viral load di SSP sehingga mencegah penurunan fungsi kognitif.Tujuan. Memberikan gambaran fungsi kognitif pasien HIV anak dalam terapi ARV.Metode. Studi potong lintang dilakukan terhadap pasien HIV anak berusia 5-15 tahun. Penilaian kognitif dilakukan dengan instrumen Wechsler intelligence scale for children IV (WISC IV) dilanjutkan dengan pemeriksaan elektroensefalografi untuk membuktikan kerusakan akibat keterlibatan SSP pada infeksi HIV.Hasil. Sembilan puluh pasien HIV anak (median usia 9 tahun) telah memperoleh ARV selama  1-124 bulan dengan median 69 bulan. Hasil rerata verbal, performance, dan full-scale IQ (FSIQ) berturut-turut adalah 88,66 (SB 15,69), 85,30 (SB 15,35), dan 85,73 (SB 15,61). Dua puluh tiga (25,6%) subjek memiliki verbal IQ abnormal, 34 (37,8%) performance scale abnormal, dan 32 (35,6%) FSIQ abnormal. Hasil EEG abnormal didapatkan pada 22 subjek (22,4%) dan tidak memiliki hubungan dengan stadium klinis, usia dan lama pemberian ARV, serta viral load. Stadium HIV menunjukkan hubungan bermakna dengan komponen verbal scale IQ dan FSIQ (p=0,042 dan p=0,044). Hasil IQ tidak memiliki hubungan dengan usia pemberian ARV, lama pemberian ARV, dan viral load.Kesimpulan. Pasien HIV anak yang telah mendapat terapi ARV selama 1-124 bulan memiliki rerata IQ abnormal pada verbal, performance, dan FSIQ meskipun jika dinyatakan dalam bentuk kategori, lebih dari 50% subjek memiliki IQ normal pada ketiga skala WISC. 
Profil Darah Tepi pada Anak dengan Infeksi Dengue Raditha, Citra; Tumbelaka, Alan Roland; Mangunatmadja, Irawan; Tambunan, Taralan; Advani, Najib; Roeslani, Rosalina
Sari Pediatri Vol 15, No 1 (2013)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (186.54 KB) | DOI: 10.14238/sp15.1.2013.23-6

Abstract

Latar belakang. Infeksi dengue merupakan infeksi Arbovirus tersering pada manusia. Insiden global dari infeksi ini telah meningkat secara dramatis dalam beberapa dekade terakhir. Perjalanan penyakit sulit diperkirakan, dan derajat penyakit bervariasi mulai dari yang bersifat asimtomatik sampai dengan syok.Tujuan. Mengetahui hubungan antara kombinasi parameter darah tepi dengan derajat infeksi dengue pada saat time of fever defervescence.Metode. Penelitian deskriptif analitik pada anak sepsis umur 1-18 tahun yang dirawat di Departemen. Ilmu Kesehatan Anak FKUI-RSUPN Cipto Mangunkusumo, RS Fatmawati, dan RS Harapan Kita. Penelitian dilakukan dari November 2010 – April 2011. Pemeriksaan darah tepi berupa trombosit, leukosit, hemoglobin, hematokrit, dan limfosit plasma biru dilakukan secara berkala tiap hari, dan pemeriksaan serologi hari ke-5 demam pada setiap subjek. Selanjutnya dilakukan analisis hubungan kombinasi parameter darah tepi dengan derajat infeksi dengue pada saat time of fever defervescence.Hasil. Terdapat 100 subyek penelitian, terdiri dari 50 DD, 30 DBD derajat I dan II, dan 20 SSD antara bulan November 2010-April 2011. Pada demam hari ke-3, terjadi penurunan jumlah trombosit, leukosit, serta peningkatan nilai hemoglobin, dan hematokrit. Jumlah limfosit plasma biru mengalami peningkatan sejak awal demam. Analisis diskriminan menemukan persamaan antara kombinasi trombosit, hematokrit, leukosit dengan derajat berat infeksi dengue pada saat time of fever defervescence yaitu y= -6,089 - 0,020 x trombosit (dalam 103) + 0,152 x hematokrit + 0,22 x leukosit (dalam 103). Prediksi diagnosis DD jika memiliki nilai diskriminasi -3,06047 hingga -0,20671, DBD derajat I-II jika nilai diskriminasi -0,25809 hingga 0,78855, dan SSD jika nilai diskriminasi 0,45226 hingga 2,80560.Kesimpulan. Penelitian ini menemukan hubungan antara kombinasi trombosit, hematokrit, leukosit dengan derajat berat infeksi dengue pada saat time of fever defervescence.
Pendekatan Klinis Berbagai Kasus Neurologi Anak yang Membutuhkan Pemeriksan Pencitraan Mangunatmadja, Irawan
Sari Pediatri Vol 5, No 2 (2003)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp5.2.2003.85-90

Abstract

Kelainan saraf pada bayi dan anak relatif sering ditemukan, hampir 20 – 30% pasienrawat inap maupun rawat jalan merupakan kasus neurologis.1 Pada umumnya anak dibawaoleh orang tua berobat akibat gangguan fungsional yang dialaminya, gangguanperkembangan, gangguan kesadaran, kelumpuhan ekstremitas, kelumpuhan saraf otak,kejang dan lain-lain. Anamnesis terarah tentang riwayat penyakit, perkembangan,pemeriksaan fisis pediatrik, pemeriksaan neurologik yang teliti akan sangat membantumenentukan diagnosis fungsional, gangguan anatomik, dan perkiraan etiologik kelainansaraf yang dihadapi.1 Untuk menegakkan diagnosis pasti diperlukan pemeriksaanpenunjang paling sederhana sampai yang paling canggih, seperti transiluminasi kepala,pemeriksaan darah tepi, cairan serebrospinalis, elektroneurofisiologi (elektroensefalografi,potensial cetusan, dan elektromiografi), pemeriksaan pencitraan, patologi anatomi danlain-lainnya.
Co-Authors A. C. Van Huffelen, A. C. Abdul Latief Agung Triono, Agung Agus Firmansyah Alan Roland Tumbelaka, Alan Roland Alifiani H. Putranti, Alifiani H. Aman Pulungan Antonius H. Pudjiadi, Antonius H. Antonius Pudjiadi, Antonius Arifin, Nahari Aryono Hendarto, Aryono Auliyanti, Fijri Bambang Tridjadja, Bambang Bambang Tridjaja, Bambang Budi, Lenny S. Citra Raditha, Citra Conny Tanjung, Conny Daisy Widiastuti, Daisy Darmawan B. Setyanto, Darmawan B. Dimyati, Yazid Dina Indah Mulyani, Dina Indah Dwi Putro Widodo, Dwi Putro Elisabeth Siti Herini Endang Windiastuti Eva Devita Harmoniati, Eva Devita Fatmawaty Fatmawaty, Fatmawaty Grafianti, Deasy H F Wulandari, H F Hafifah, Cut Nurul Hanrahan, Joanna Erin Hardiono D Pusponegoro, Hardiono D Hardiono D. Pusponegoro, Hardiono D. Hartono Gunardi Hasansulama, Wijana Herini, E S Herlina Herlina Hidra Irawan Satari, Hidra Irawan Hikari Ambara Sjakti, Hikari Ambara Himawan, Susanti I. Budiman, I. Idham Amir,, Idham Ifran, Evita Bermansyah Imral Chair, Imral Irene Yuniar, Irene Irma Rochima Puspita, Irma Rochima Jafar, Isman Jenny Bashiruddin Kurniawan, Kristian Lily Rundjan, Lily Malik, Safarina G. Mardjanis Said, Mardjanis Marissa Tania Stephanie Pudjiadi, Marissa Tania Stephanie Msy Rita Dewi MS, Msy Rita Dewi Mulya Rahma Karyanti, Mulya Rahma Mulyadi M. Djer Murti Andriastuti, Murti Muzal Kadim Najib Advani Nia Kurniati Noorshintaningsih, Dheeva Nur Hayati Pandelaki, Jacub Partini Pudjiastuti Trihono, Partini Pudjiastuti Pohan, Fathy Pustika Amalia Putranto, Fikri Mirza R. H. J. M Gooskens, R. H. J. M Rahmat, Dedy Rinawati Rohsiswatmo Rini Sekartini Rismala Dewi Ronny Suwento, Ronny Rosalina Roeslani, Rosalina Rosary Rosary, Rosary Rulina Suradi, Rulina Saptawati Bardosono Saputra, Hariadi Edi Setyanto, Darmawan Budi Setyo Handryastuti, Setyo Silitonga, Freddy Guntur Mangapul Soedjatmiko Soedjatmiko Soedjatmiko, Soedjatmiko,, Soedjatmiko, Soepardi Soedibyo Solek, Purboyo Sri Rezeki Hadinegoro, Sri Rezeki Sudigdo Sastroasmoro Sudjatmiko Sudjatmiko, Sudjatmiko Sudung O Pardede, Sudung O Sudung O. Pardede, Sudung O. Sukman Tulus Putra, Sukman Tulus Sundariningrum, Rina W Tan, Sabrina Taralan Tambunan Tatang M. Puspandjono, Tatang M. Teny Tjitra Sari, Teny Tjitra Tiansyah, Rizal Agus Titis Prawitasari, Titis Tjandradjani, Anna Tjhin Wiguna Tri Lestari Handayani, Tri Lestari Vimaladewi Lukito, Vimaladewi Widodo, Dwi P. Winny N Wishwadewa, Winny N Wulandari, Harjanti F Wulandari, Haryanti Fauziah Yeti Ramli, Yeti Zizlavsky, Semiramis