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Jarcho-Levin syndrome a very rare anomaly is described for a variety of clinical phenotypes consisting of short-trunk dwarfism associated with rib and vertebral anomalies. The patient is two months old infant with spondylocostal dysostosis and bilateral direct recurrent inguinal hernia. He was successfully operated by a new method and after 36 months follow up he did not have any problem.

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Background and purpose: Although some studies have demonstrated the effect of magnesium sulphate on reducing the postoperative pain, some others have refuted this and showed that it has limited or no effect. In this study, the researchers investigated the effects of pre- and intraoperative magnesium sulphate administration on the postoperative pain and opioid consumption. Materials and methods: In a randomized double blind placebo controlled clinical trial, thirty-two patients with the age range of 15-74 undergoing inguinal surgery in Imam Khomeini Hospital in Sari were nonrandomly divided into two equal groups. The patients in the magnesium sulphate group received magnesium sulphate 50 mg/kg/h IV, 15 minutes before until one hour during the surgery, whereas patients in the control group received the same volume of normal saline 20cc (infusion with similar volume) over the same time. The data were analyzed using SPSS version 16. Results: Postoperative pain was significantly lower in magnesium sulphate group in comparison to control group. At 0, 2, 6, 12 and 24 hrs after the operation, the mean VAS for control and case groups were 8.50 ± 0.894, 7.06 ± 1.94, (P=0.012), 8.31 ± 1.07, 6.63 ± 1.360 (P=0.001), 8.06± 1.124, 4.75± 1.125 (P=0.001), 7.31 ± 1.45, 4.06 ±0.85 (P=0.001), 6.69 ±1.40, 0.63 ± 1.02 (P=0.001), respectively. Conclusion: Intraoperative magnesium sulphate infusion in inguinal surgery considerably decreases postoperative pain in the first 24 hours after operation. (Clinical Trials Registry Number: IRCT138809282883N1)

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Background and purpose: Surgical site infections are infections of the tissues,organs,or spaces exposed by surgeons during performance of an invasive procedure,and the development of SSIs is related to the degree of microbial contamination of wound during surgery,duration of the procedure,and host factors.Inguinal hernioplasty is one of the most common surgical operations. The use of prophylactic antibiotic in Lichtenstein hernioplasty is controversial. Hence this study done to evaluate the prophylactic antibiotic effect in reducing the post operative wound infection in Lichtenstein hernioplasty. Materials and methods: This is an interventional double-blind randomized trial on 282 patients under going, Unilateral primary elective inguinal hernioplasty with Lichtenstein method. Using polypropylene mesh. They were randomized to receive 1gr/1v cephalotin (keflin) or equal volume of placebo 30min before incision. Patients were evaluated 1week, 2weeks and 12weeks after surgery by an independent surgeon or resident. Wound infection was defined according to the criteria of centers for Disease control and recorded. Results were assessed using chi-square and t-test as appropriate. Results: We included 282 patients in this study between March 2010 and october 2011. The total number of wound infection was 13 (4.7%), 4(2.8%) in antibiotic group and 9(6.4%) in placebo group (p= 0.29). There was 1 deep infection only in placebo group. Statistical analysis showed no significant difference in two groups. Conclusion: The results show that, in Lichtenstein hernioplasty, routine use of prophylactic antibiotic is not indicated, as it does not significantly reduce the post operative surgical site infection rates.