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Current management of children with acute otitis media: a feasibility survey for a pragmatic study Respati Wulansari Ranakusuma; Amanda R. McCullough; Elaine M. Beller; Christopher B. Del Mar; Eka Dian Safitri; Yupitri Pitoyo; Widyaningsih Widyaningsih
Paediatrica Indonesiana Vol 59 No 6 (2019): November 2019
Publisher : Indonesian Pediatric Society

Background Acute otitis media (AOM) is a common self-limiting infection where antibiotics confer limited benefit. Other treatments, such as anti-inflammatory agents have been proposed as an alternative to antibiotics, but no high-quality clinical trials have tested this. Objective To identify current AOM management practices among Indonesian clinicians. We also required this information for our proposed corticosteroids clinical trial for AOM. Methods This cross-sectional study surveyed a convenience sample of general practitioners (GPs), pediatricians, and Ear-Nose-Throat (ENT) specialists in Jakarta, Depok, and Bekasi. We addressed their current AOM management practices and willingness to participate in a future trial on corticosteroids. Results We distributed 2,694 questionnaires through conferences, primary care/hospital visits, and by mail-list group. Of 492 questionnaires received (response rate 18%), 352 were from eligible clinicians. Most clinicians diagnosed AOM by using an otoscope (64-91%). Tympanometry was used by a quarter of ENT specialists. Amoxicillin-clavulanate was the most common antibiotic for AOM, prescribed by pediatricians and ENT specialists, whilst most GPs prescribed amoxicillin. Clinical scenarios indicated most ENT specialists (88%) would prescribe antibiotics and most pediatricians (54%) would choose expectant observation by withholding antibiotics for mild AOM. Almost half of clinicians would consider using corticosteroids in a trial. Conclusion Most clinicians would prescribe antibiotics for mild AOM. However, slightly over half of pediatricians would solely choose expectant observation. Adequate numbers of potential participating clinicians, who would consider using corticosteroids, make our proposed corticosteroids trial for AOM feasible. We found gaps between clinical practice and evidence requiring further investigation to improve AOM management in Indonesia.

Labyrinthine fistula size as a prognostic factor for postoperative hearing deterioration Ratna Dwi Restuti; Harim Priyono; Ayu Astria Sriyana; Rangga Rayendra Saleh; Eka Dian Safitri
Oto Rhino Laryngologica Indonesiana Vol 51, No 2 (2021): VOLUME 51, NO. 2 JULY - DECEMBER 2021
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v51i2.497

ABSTRACTBackground: A labyrinthine fistula is an abnormal opening in the bony capsule of the inner ear, such as cochlea or semi-circular canals that may occur as a complication of chronic suppurative otitis media (CSOM) with cholesteatoma. Purpose: To find out the relation of the size of labyrinthine fistula as a prognostic factor of hearing deterioration after a complete cholesteatoma removal. Case report: Two cases of labyrinthine fistula in CSOM with cholesteatoma, along with preoperative and postoperative audiometry results. Clinical question: Does the labyrinthine fistula size in CSOM with cholesteatoma patients could serve as a prognostic factor in the postoperative hearing outcome? Review method: A structured, evidence-based literature search using Pubmed, Proquest and Cochrane to find studies of labyrinthine fistula as a complication of CSOM. The articles were selected based on eligibility criteria i.e. surgery procedure, labyrinthine fistula measurement, and postoperative evaluation of hearing function. The appraisal of each article used Oxford critical appraisal independently for prognostic study and systematic review. Result: Two studies met the inclusion criteria. One article used cohort retrospective method valid based on appraisal for prognostic studies. The other article used a systematic review method which had low validity. Conclusion: Fistula size is still debatable as a postoperative prognostic factor for hearing deterioration in CSOM with cholesteatoma. Larger sample size and better methods of study are necessary to resolve the clinical question.Keywords: chronic suppurative otitis media (CSOM), cholesteatoma, labyrinthine fistula, fistula sizeABSTRAKLatar belakang: Fistula labirin adalah terbukanya dinding tulang pada koklea atau kanalis semisirkularis yang merupakan suatu komplikasi dari otitis media supuratif kronik (OMSK) tipe bahaya. Tujuan: Untuk menjawab pertanyaan klinis terkait hubungan antara ukuran fistula labirin dengan prognosis penurunan pendengaran pasca operasi pengangkatan kolesteatoma. Laporan kasus: Dua kasus fistula labirin pada penderita OMSK tipe bahaya, disertai dengan hasil pemeriksaan audiometri pendengaran sebelum dan sesudah operasi. Pertanyaan klinis: Apakah ukuran fistula labirin pada kasus OMSK dengan kolesteatoma dapat menjadi faktor penentu prognosis untuk hasil pemeriksaan pendengaran pasca operasi? Telaah literatur: Pencarian literatur berbasis bukti menggunakan Pubmed, Proquest dan Cochrane terkait fistula labirin pada kasus OMSK. Kriteria inklusi studi berdasarkan teknik operasi, ukuran fistula dan evaluasi pendengaran pasca operasi. Metode Oxford critical appraisal digunakan untuk studi prognosis pada satu artikel, dan digunakan systematic review untuk artikel lainnya. Hasil: Dari pencarian literatur terdapat dua artikel yaitu studi kohort retrospektif, dan systematic review yang memenuhi kriteria inklusi. Hasil telaah literatur menunjukan bahwa study kohort retrospektif memiliki validitas cukup baik, sedangkan studi systematic review memiliki validitas yang kurang baik. Kedua artikel ini memiliki hasil yang berbeda dalam hubungan ukuran fistula labirin dengan prognosis penurunan pendengaran pasca operasi. Kesimpulan: Ukuran fistula sebagai faktor prognosis penurunan pendengaran pasca operasi pada kasus OMSK tipe bahaya masih memerlukan penelitian dengan sampel yang lebih banyak, dan metode yang lebih baik untuk dapat menjawab pertanyaan klinis.Kata kunci: otitis media supuratif kronik (OMSK), kolesteatoma, fistula labirin, ukuran fistula

Prognostic Factors for Refractory Chronic Rhinosinusitis in Patients Chronic Rhinosinusitis Concomitant Asthma : An Evidence Based Case Report Kartika Dwiyani; Eka Dian Safitri; Yupitri Pitoyo
Oto Rhino Laryngologica Indonesiana Vol 48, No 2 (2018): Volume 48, No. 2 July - December 2018
Publisher : PERHATI-KL

Background: In chronic rhinosinusitis (CRS) patients concomitant with asthma, more severe sinus disease has been reported and recurrence rate remains significant after optimal management. In this review, patients with CRS concomitant with asthma which had optimal management will be analyzed. Did several factors e.g. mucosal eosinophilia, high eosinophil count, high Lund MacKay score, severity of asthma, peripheral blood count and type of surgery, affect the recurrence of rhinosinusitis? Purpose: To investigate prognostic factors for the recurrence or refractory in CRS patients concomitant with asthma. Case Report: Female, 31 years old, suffered CRS with nasal polyp concomitant with asthma. She had recurrence of her sinus disease although she had already received optimal management. Methods: Using Medline, Cochrane database and Hand searching to search for the evidence. The evidence selected was appraised by at least two members of our group using Oxford Centre for Evidence-based Medicine (CEBM) worksheet. Result: Two valid prognostic articles were appraised for the validity, importance and applicability in our clinical scenario. Conclusion: In this evidence-based case report, the type of surgery could affect the olfactory function and endoscopic postoperative score in CRS patients concomitant with asthma. It was found that Extensive Endoscopic Sinus Surgery (EESS) contributed as a prognostic factor to improve olfactory Visual Analog Scale (VAS) score and endoscopic postoperative score. Latar belakang: Pada pasien rinosinusitis kronis (RSK) yang disertai dengan asma telah banyak dilaporkan gejala sinus yang lebih berat dan angka kekambuhan yang signifikan walaupun pasien telah mendapatkan tatalaksana optimal. Dalam laporan ini, akan dianalisis pasien RSK yang disertai asma, yang telah mendapat terapi optimal. Apakah faktor-faktor eosinofilia pada mukosa, tingginya hitung jumlah eosinofil, tingginya skor Lund-MacKay, derajat keparahan asma, hitung jenis darah perifer dan jenis operasi, berperan terhadap kekambuhan rinosinusitis? Tujuan: Mengetahui faktor prognostik yang mempengaruhi kekambuhan pada pasien RSK yang disertai asma. Laporan kasus: Pasien wanita 31 tahun, dengan diagnosis RSK dengan polip yang disertai asma. Pasien mengalami kekambuhan rinosinusitis walaupun telah mendapatkan terapi optimal. Metode: Pencarian bukti dilakukan melalui Medline, Cochrane, Hand searching. Artikel yang didapat ditelaah oleh setidaknya dua anggota kelompok dengan menggunakan lembar kerja yang diperoleh dari Oxford Centre for Evidence-based Medicine (CEBM). Hasil: Dua artikel prognosis yang didapat, ditelaah kritis untuk dinilai validitas, pentingnya, dan kemampuan untuk dapat diaplikasikan dalam skenario klinis. Kesimpulan: Pada laporan kasus berbasis bukti ini, jenis operasi dapat merupakan faktor prognostik dalam memperbaiki skor Visual Analog Scale (VAS) olfaktori dan skor endoskopi pasca operasi. Extensive endoscopic sinus surgery (EESS) memiliki kontribusi sebagai faktor prognostik dalam memperbaiki skor VAS olfaktori dan skor endoskopi pasca operasi.

Outcomes of Autologous Reconstruction in Comparison with Alloplastic in Microtia Patients Dini Widiarni Widodo; Irfan Irfan; Eka Dian Safitri; Mirta Hediyati Reksodiputro
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.178.258-64

Background: Microtia is a congenital abnormality of the auricle. One of the important comprehensive management of microtia is ear reconstruction. Reconstruction using an auricle framework from autologous material originating from the rib cartilages is still the gold standard. However, currently, some surgeons prefer alloplastic materials which are claimed to reduce morbidity and can be performed at a younger age. Objective: Report a case of a microtia patient who underwent autologous reconstruction followed by a literature search comparing the outcomes of autologous and alloplastic reconstruction. Case: An 11-year-old with grade 3 unilateral microtia who underwent autologous reconstruction surgery using materials from the rib cartilages. Later he complained of pain at the rib grafting site, more than at the surgical wound in the ear. Methods: A literature search based on the clinical question was done in PubMed, EBSCOhost, Cochrane Library, and by hand searching. Results: Three relevant articles that fit the clinical question were included. Autologous reconstruction causes fewer complications, while alloplastic reconstruction is better aesthetically. Further research is needed regarding the quality of life. Conclusion: Auricular reconstruction using autologous material remains the superior material of choice. Alloplastic framework can be an alternative choice with better aesthetic results but greater complication risk.

Labyrinthine fistula size as a prognostic factor for postoperative hearing deterioration Ratna Dwi Restuti; Harim Priyono; Ayu Astria Sriyana; Rangga Rayendra Saleh; Eka Dian Safitri
Oto Rhino Laryngologica Indonesiana Vol. 51 No. 2 (2021): VOLUME 51, NO. 2 JULY - DECEMBER 2021
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v51i2.497

ABSTRACTBackground: A labyrinthine fistula is an abnormal opening in the bony capsule of the inner ear, such as cochlea or semi-circular canals that may occur as a complication of chronic suppurative otitis media (CSOM) with cholesteatoma. Purpose: To find out the relation of the size of labyrinthine fistula as a prognostic factor of hearing deterioration after a complete cholesteatoma removal. Case report: Two cases of labyrinthine fistula in CSOM with cholesteatoma, along with preoperative and postoperative audiometry results. Clinical question: Does the labyrinthine fistula size in CSOM with cholesteatoma patients could serve as a prognostic factor in the postoperative hearing outcome? Review method: A structured, evidence-based literature search using Pubmed, Proquest and Cochrane to find studies of labyrinthine fistula as a complication of CSOM. The articles were selected based on eligibility criteria i.e. surgery procedure, labyrinthine fistula measurement, and postoperative evaluation of hearing function. The appraisal of each article used Oxford critical appraisal independently for prognostic study and systematic review. Result: Two studies met the inclusion criteria. One article used cohort retrospective method valid based on appraisal for prognostic studies. The other article used a systematic review method which had low validity. Conclusion: Fistula size is still debatable as a postoperative prognostic factor for hearing deterioration in CSOM with cholesteatoma. Larger sample size and better methods of study are necessary to resolve the clinical question.Keywords: chronic suppurative otitis media (CSOM), cholesteatoma, labyrinthine fistula, fistula sizeABSTRAKLatar belakang: Fistula labirin adalah terbukanya dinding tulang pada koklea atau kanalis semisirkularis yang merupakan suatu komplikasi dari otitis media supuratif kronik (OMSK) tipe bahaya. Tujuan: Untuk menjawab pertanyaan klinis terkait hubungan antara ukuran fistula labirin dengan prognosis penurunan pendengaran pasca operasi pengangkatan kolesteatoma. Laporan kasus: Dua kasus fistula labirin pada penderita OMSK tipe bahaya, disertai dengan hasil pemeriksaan audiometri pendengaran sebelum dan sesudah operasi. Pertanyaan klinis: Apakah ukuran fistula labirin pada kasus OMSK dengan kolesteatoma dapat menjadi faktor penentu prognosis untuk hasil pemeriksaan pendengaran pasca operasi? Telaah literatur: Pencarian literatur berbasis bukti menggunakan Pubmed, Proquest dan Cochrane terkait fistula labirin pada kasus OMSK. Kriteria inklusi studi berdasarkan teknik operasi, ukuran fistula dan evaluasi pendengaran pasca operasi. Metode Oxford critical appraisal digunakan untuk studi prognosis pada satu artikel, dan digunakan systematic review untuk artikel lainnya. Hasil: Dari pencarian literatur terdapat dua artikel yaitu studi kohort retrospektif, dan systematic review yang memenuhi kriteria inklusi. Hasil telaah literatur menunjukan bahwa study kohort retrospektif memiliki validitas cukup baik, sedangkan studi systematic review memiliki validitas yang kurang baik. Kedua artikel ini memiliki hasil yang berbeda dalam hubungan ukuran fistula labirin dengan prognosis penurunan pendengaran pasca operasi. Kesimpulan: Ukuran fistula sebagai faktor prognosis penurunan pendengaran pasca operasi pada kasus OMSK tipe bahaya masih memerlukan penelitian dengan sampel yang lebih banyak, dan metode yang lebih baik untuk dapat menjawab pertanyaan klinis.Kata kunci: otitis media supuratif kronik (OMSK), kolesteatoma, fistula labirin, ukuran fistula

Peran radioterapi lokoregional pada kasus karsinoma nasofaring dengan metastasis jauh: laporan serial kasus berbasis bukti Mayangsari, Ika Dewi; Rahman, Muhammad Ade; Adham, Marlinda; Prajogi, Gregorius Ben; Cahyanur, Rahmat; Safitri, Eka Dian
Oto Rhino Laryngologica Indonesiana Vol. 53 No. 2 (2023): VOLUME 53, NO. 2 JULY - DECEMBER 2023
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v53i2.638

Background: Nasopharyngeal carcinoma (NPC) is a highly metastatic head and neck cancer primarilytreated with platinum-based chemotherapy. The oligometastasis hypothesis proposed by Hellman andWeichselbaum suggested that controlling the primary tumor through locoregional radiotherapy couldsignificantly improve prolonged disease-free survival. Purpose: To evaluate the effectiveness of combining locoregional radiotherapy with chemotherapy for metastatic NPC. Case series report: The first case involved a 57-year-old male with NPC at T4N3M1 (lungs) with partial response to chemotherapy, who then underwent concurrent chemoradiotherapy. However, his condition deteriorated after completing chemoradiation. The second case featured a 56-year-old male with NPC at T4N3M1 (liver), exhibiting partial response to chemotherapy and remaining at a stable condition after concurrent chemoradiotherapy. Method: Using specific keywords based on clinical questions in the PubMed, Cochrane, EBSCOhost, and Proquest databases. Inclusion criteria, exclusion criteria, and critical appraisal were carried out to find relevant studies. Result: Eleven articles were appraised critically based on the Oxford Centre for Evidence-based Medicine (CEBM) worksheet and include the validity, importance, and applicability in clinical scenarios. Conclusion: Metastatic NPC patients had better overall survival outcomes when treated with locoregional radiotherapy and systemic chemotherapy. Predictive factors influencing survival included oligometastasis, locoregional radiotherapy, chemotherapy response, lactate dehydrogenase, C-reactive protein, EBV DNA, total chemotherapy administration, Karnofsky performance score, number of metastatic lesions, and liver metastases. Platinum-based chemotherapy combined with locoregional radiotherapy could be considered as a management approach for cases of oligometastatic NPC.Keywords: nasopharyngeal carcinoma, chemotherapy, metastasis, overall survival, radiotherapy

Round window sealing with steroid-soaked sponge in sudden sensorineural hearing loss Putranto, Fikri Mirza; Safitri, Eka Dian; Shafira, Ardys
Oto Rhino Laryngologica Indonesiana Vol. 54 No. 1 (2024): VOLUME 54, NO. 1 JANUARY - JUNE 2024
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v54i1.654

Background: A rescue treatment is needed in cases of Sudden Sensorineural Hearing Loss (SSNHL)which fail to obtain complete hearing restoration after conservative steroid therapy. In order to acquirebetter access of steroid to the cochlea, sealing the round window with a sponge soaked in steroid couldbe considered as an alternative delivery strategy. Purpose: To review the evidence about the impact ofround window sealing in SSNHL patients whose hearing failed to recover completely after treated withsystemic and/or intratympanic steroid. Cases: Seven patients with SSNHL, who had experienced either noor slight response to previous systemic and/or intratympanic steroid administration, underwent transcanalround window sealing with steroid-soaked sponge. Pure Tone Audiometry (PTA) results and symptoms(hearing loss, tinnitus, vertigo) were compared pre- and post-operatively. Five patients reported betterhearing and tinnitus symptom. Method: A scoping review was made by conducting literature searchingat Cochrane, Pubmed, and Google Scholar using keywords “sudden sensorineural hearing loss”, AND“round window sealing”, and their relevant synonymous terms, employing Boolean operators. Result: Atotal of 8 observational studies with 430 subjects met the inclusion criteria. Time measurement of hearingimprovement range from 6 days until 1 year. Most of the studies agreed that the procedure of sealingthe round window had a positive impact on hearing improvement. Conclusion: This study revealed thatround window sealing with steroid-soaked sponged could be considered as an alternative approach forpatients with SSNHL who failed in conservative therapy. Keywords: “round window sealing; sudden sensorineural hearing loss; transtympanic steroid”

Association between vitamin D deficiency and otitis media with effusion in children: a systematic review and meta-analysis Restuti, Ratna Dwi; Safitri, Eka Dian; Ranakusuma, Respati Wulansari; Sriyana, Ayu Astria; Priyono, Harim; Saleh, Rangga Rayendra; Marpaung, Dora A; Lazarus, Gilbert
Paediatrica Indonesiana Vol. 64 No. 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.419-29

Background Vitamin D plays a crucial role in the regulation of inflammation. However, its effect on the development of otitis media effusion (OME), an inflammatory disease of the middle ear without signs of infection, remains largely unknown. Objective To assess the association between vitamin D deficiency and OME in children by systematic review and meta-analysis of the literature. Methods Eligible studies retrieved from PubMed, ProQuest, Embase, Cochrane databases and trial registries published up to 30 October 2022 were included in this review. The risk of bias of the included articles was assessed with the JBI Critical Appraisal Checklist for observational studies. The certainty of evidence was assessed with the Grading of Recommendations Assessment, Development and Evaluation framework. Results We included eight studies (six case-control and two cross-sectional studies) involving 1,114 children, of which four studies were eligible for meta-analysis due to the significant clinical heterogeneity. We found that vitamin D deficiency (defined as vitamin D concentration of 20 ng/mL or less, i.e., ?50 nmol/L) might increase the odds of developing OME by 66.0% (n=514; OR 1.66; 95%CI 1.09 to 2.54; I2=20%), albeit with a very low certainty of evidence. Conclusion There is a very low quality of evidence indicating that vitamin D deficiency is associated with the development of OME in children. Further large, high-quality cohorts and adjusting for confounding factors are warranted to confirm our findings, ideally by exploring the dose-response relationship between vitamin D concentration and the development of OME.

Prognostic factors for medicamentous and dental treatment failure in odontogenic sinusitis Dwiyani, Kartika; Safitri, Eka Dian; Manalu, Josua
Oto Rhino Laryngologica Indonesiana Vol. 55 No. 1 (2025): VOLUME 55, NO. 1 JANUARY - JUNE 2025
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v55i1.698

Background: Odontogenic sinusitis refers to bacterial maxillary sinusitis caused by maxillary dental pathology, or complications from dental procedures. The therapeutic algorithm usually has two stages: conservative and surgical. If conservative therapy alone is successful in curing sinusitis, unnecessary sinus surgery can be avoided. But if conservative therapy fails, sinus surgery is usually required to remove the cause of the pathology. The effectiveness of conservative therapy varies in the range from 36 to 95%. Purpose: To investigate prognostic factors for medicamentous and dental treatment failure in odontogenic sinusitis. Case illustration: A 27 years old male with odontogenic sinusitis should undergo endoscopic sinus surgery although he had already received optimal conservative therapy. Clinical question: In patients with odontogenic sinusitis treated by conservative therapy, are smoking habits, high total Lund-Mackay score including osteomeatal complex (OMC) blockage, and history of dental procedure contribute as prognostic factors for medicamentosa and dental treatment failure? Method: Literature searching was performed through PubMed, Cochrane database and Hand-searching using keyword “odontogenic sinusitis”. Result: Three valid prognostic cohort articles were appraised for the validity, importance, and applicability in our clinical scenario. The precision prognostic factor is high total Lund-Mackay score with odd ratio (OR) 95%, and confidence interval (CI) 2.0, 1.04-3.79. Conclusion: High total Lund-Mackay score is an important prognostic factor for conservative therapy failure, so that the sinus surgery should be performed.

Identifikasi Kandungan Deksametason dalam Jamu Gemuk Badan pada Merek Jamu Kianpi Pil dan Jamu Gemuk Gunasehat dengan Metode KLT Permadi, Yulian Wahyu; Slamet, S; Safitri, Eka Dian
Prosiding University Research Colloquium Proceeding of The 7th University Research Colloquium 2018: Bidang MIPA dan Kesehatan
Publisher : Konsorsium Lembaga Penelitian dan Pengabdian kepada Masyarakat Perguruan Tinggi Muhammadiyah 'Aisyiyah (PTMA) Koordinator Wilayah Jawa Tengah - DIY

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

Obat tradisional menurut keputusan Peraturan Menteri Kesehatan RINo. 7 tahun 2012 Tentang Registrasi Obat Tradisional dilarangmengandung bahan kimia obat (BKO) baik berupa hasil isolasibahan alam atau senyawa sintetik berkhasiat obat. Pada penelitianini telah dilakukan identifikasi deksametason pada jamu gemukbadan dengan merek Kianpi Pil dan Jamu gemuk Guna Sehat.Identifikasi dilakukan dengan uji pendahuluan berupa ujiorganoleptis dan uji mikroskopik kemudian dilakukan ujikromatografi lapis Tipis (KLT). Uji organoleptis ditujukan untukmelihat tampilan sediaan dan uji mikroskopik untuk melihat keasliandari bahan simplisia serta kristal bahan kimia obat yangditambahkan kedalamnya. Identifikasi menggunakan metode KLTguna untuk melihat masih atau tidaknya kandungan deksametasondalam jamu tersebut. Hasil uji organoleptis menyatakan padaumumnya sampel memiliki bentuk sediaan serbuk dengan warna,rasa dan bau yang bervariasi. Hasil uji mikroskopik menyatakanterdapat beberapa fragmen-fragmen khas dari setiap bahan yangterdapat dalam komposisi dan terdapat kristal BKO dari keduasampel dan hasilnya selaras dengan hasil KLT. Pada KLT fase gerakyang digunakan berupa etil asetat : Toluen : Metanol (45:55:1).Hasil KLT terbentuk bercak noda pada kedua sampel yang sejajardengan baku pembanding (deksametason). Bercak noda memberikanwarna kuning jika dilihat secara visual dan warna ungu pada sinarUV 254 nm dan tidak berwarna pada sinar UV 366 nm dengan nilaiRf 0,25. Dari kedua sampel yang di uji disimpulkan bahwa positifmengandung bahan kimia obat berupa obat deksametason.

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