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Journal : Paediatrica Indonesiana

Challenges in diagnosing pediatric pericarditis and the etiology in remote areas during the COVID-19 pandemic: a socio-clinical dilemma: A Socio-Clinical Dilemma Liwan, Armand Setiady; Yantie, Ni Putu Veny Kartika; Gunawijaya, Eka
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.184-92

Abstract

Inflammation of the visceral and parietal surfaces of the pericardium is defined as pericarditis. It can evolve to excessive production of pericardial effusion if the speed of fluid accumulation is faster than the absorption. Acute pericarditis is rare in children but it can lead to circulatory collapse and death. It accounts for <0.2% of the emergency visits of children without prior heart diseases in tertiary pediatric emergency settings. The etiology of acute pericarditis varies depending on geography, and the most common etiology in children are bacterial infection, viral pericarditis, inflammatory or connective tissue diseases, malignancies, metabolic diseases, and post-cardiac surgery. Idiopathic pericarditis is presumed to have viral or post-viral etiology. It accounts for 37-68% of admissions in children with pericardial effusions or acute pericarditis.
The efficacy of audiovisual distraction as an anxiety-minimizing technique during echocardiography in preschool children Yantie, Ni Putu Veny Kartika; Gunawijaya, Eka; Windiani, I Gusti Ayu Trisna; Maharini, Kadek
Paediatrica Indonesiana Vol. 63 No. 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.328-34

Abstract

Background Echocardiography procedures can cause fear and anxiety in children, especially at preschool age. Audiovisual distraction is a simple, harmless, and low-cost technique that does not interfere with the procedure. Objective To assess the effect of audiovisual distraction on the anxiety levels of children aged 2-5 years during echocardiography. Methods This quasi-experimental study included children aged 2-5 years who were admitted for echocardiography. Patients with hearing or visual impairment, Down syndrome, autism, or attention-deficit/hyperactivity disorder were excluded. We administered anxiety-reducing intervention in the form of cartoon audiovisual media shown on a ceiling-mounted television during the echocardiography procedure. Anxiety levels were assessed using the Visual Analogue Scale - Anxiety (VAS-A) before and after the intervention was given. We compared the subjects’ pre- and post-procedure VAS-A scores and heart rates. Results Of the 43 subjects who underwent echocardiography during the study period, the mean age was 3.2 (SD 0.9) years, with an equal sex distribution. Most subjects had a history of repeated echocardiography procedures and hospitalizations. Thirty-nine (90.6%) of subjects demonstrated anxiety during the echocardiography procedure. There was a significant mean difference of 11.9 (SD 13.2) bpm (95%CI 7.8 to 15.9 bpm, p<0.001) in heart rate pre- vs. post-intervention. Median pre- and post-intervention VAS-A scores were 5 (range 0-10) and 1 (range 0-4), respectively (P=0.001). Post-intervention, almost all (97.7%) subjects had no or mild anxiety. Conclusion Audiovisual content presented on television serves as an effective distraction method to reduce children's anxiety during echocardiography.