مجله دانشکده پزشکی اصفهان
پیاپی 614 (هفته دوم اردیبهشت 1400)

One of the most common cardiac arrhythmias after coronary artery bypass graft surgery is atrial fibrillation, and its occurrence is associated with an increase in the length of hospitalization morbidity and postoperative mortality. Recently, the role of oxidative stress in the pathophysiology of this arrhythmia has been raised. Current research was done to assess the role of prescribing vitamin C in preventing this arrhythmia.

In this clinical trial study, 140 patients who underwent coronary artery bypass graft surgery in Booali hospital, Qazvin, Iran, in the years 2016 to 2017 were randomly divided into two equal case and control groups. The case group received 1 g of vitamin C per day from 24 hours prior to 48 hours after surgery, and the control group received placebo at same time. Finally, data were analyzed using SPSS software, and incidence of postoperative atrial fibrillation was compared between the two groups.

Of 140 studied patients, 4 cases (5.7%) of the case group and 11 cases (15.71%) of control group had atrial fibrillation, and the difference between the two groups was significant (P = 0.028).

Our study showed that administration of oral vitamin C can effectively reduce the incidence of atrial fibrillation after coronary artery bypass graft surgery.

Due to the conflicting results in the relationship between mitral valve prolapse (MVP) and quality of life (QOL) in children, and the evidence of reduced QOL in adult patients with heart disease, the present study aimed to investigate the possible effect of MVP on QOL in children.

This cross-sectional study was performed on 120 children referred to Amir-Kabir hospital in Arak, Iran, in 2020. First, echocardiography was performed to diagnose MVP in children, and then the children were divided into two groups with and without MVP. Then, the pediatrics QOL questionnaire (Peds QL) was completed in two forms of self-assessment by the child and parent reporting.

According to the self-assessment questionnaire of children, the average dimension of physical function in children with MVP was 72.53 ± 12.34, which was significantly lower than healthy children (P = 0.021). Moreover, according to the questionnaire reported by parents, the mean score of the emotional dimension of children with MVP was 58.18 ± 13.09, which was significantly lower than healthy children (P = 0.007).

Based on our results, children’s QOL is generally not affected by MVP, and only the physical function dimension in children and the emotional function dimension from the parent’s perspective was lower than healthy children. Therefore, it is important to pay attention to the factors affecting the reduction of physical function in children with MVP.

Retroperitoneal hematomas, as a rare but significant quantity in patients with history of recent operation, should be suspected in all patients who demonstrate signs of hypovolemia without apparent blood loss. Here, we have presented a rare case of postpartum hematoma to aware about this diagnosis in similar cases.

Case Report:

A 24-year-old gravid 1 woman with term pregnancy had tachycardia and oliguria after delivery with large episiotomy extended up to right fornix. After volume resuscitation, a tense tender swelling in the upper part and posterior lateral of vagina in vaginal exam was suspicious to retroperitoneal hematoma, and emergent laparotomy confirmed the diagnosis.

Post-vaginal delivery laceration extending from posterior vaginal wall to uterosacral ligament and rarely to para-vesical space can be a life-threatening emergency and a cause of maternal mortality. Careful examination and repair of extended episiotomy or laceration is the key factor to prevent retroperitoneal hematoma.