ABSTRACT
BACKGROUND: In developing countries, most inguinal hernia repairs are performed using Bassini or Shouldice techniques resulting in higher recurrence rates than with mesh placement. Our study aimed to evaluate the postoperative course and quality of life of patients undergoing inguinal hernia repair with a polyester mosquito net meshes during non-governmental organization health campaigns in Cameroon. METHODS: Patients were prospectively included from January to November 2013. Meshes were made from a polyester non-impregnated mosquito net purchased at a local market in Yaounde and sterilized on site. RESULTS: The total cost of a mesh was 0.21 USD. Among the 41 patients included in the study, 33 (80.5%) were men, 30 (72%) were farmers and the median age was 52 (21-80) years. The time between the onset of symptoms and surgery was 24 (3-240) months. Eleven (26.8%) patients had a previous history of hernia repair: 4 (9.7%) had been operated on the contralateral side and 7 (17.1%) had a recurrence. No intraoperative event related to the meshes was recorded. Three patients (7.2%) had a postoperative uninfected scrotal seroma, and 1 patient (2.4%) experienced a superficial skin infection that was treated using local care and oral antibiotics. No allergic rejection or deep infection was observed. CONCLUSIONS: Meshes made from sterilized mosquito nets are safe and effective and provide a cost-effective alternative to commercially available meshes in countries with limited resources especially during non-governmental organization health campaigns.
Subject(s)
Hernia, Inguinal/surgery , Herniorrhaphy/methods , Mosquito Nets/statistics & numerical data , Patient Safety/statistics & numerical data , Surgical Mesh , Cameroon , Cohort Studies , Developing Countries , Feasibility Studies , Female , Hernia, Inguinal/diagnosis , Humans , Male , Mosquito Nets/economics , Polyesters , Poverty , Prospective Studies , Treatment Outcome , Wound Healing/physiologyABSTRACT
We study a one-dimensional model of gravitational instability in an Einstein-de Sitter universe. Scaling in both space and time results in an autonomous set of coupled Poisson-Vlasov equations for both the field and phase space density, and the N-body problem. Using dynamical simulation, we find direct evidence of hierarchical clustering. A multifractal analysis reveals a bifractal geometry similar to that observed in the distribution of galaxies. To demonstrate the role of scaling, we compare the system to other one-dimensional models recently employed to study structure formation. Finally we show that the model yields an estimate of the time of galaxy formation of the correct order.
ABSTRACT
The aim of this paper is to present an original usage of genetic algorithms as a robust search space sampler in application to 3-D medical image elastic registration. An overview of the standard steps of a registration algorithm is given. We focus on the genetic algorithms use and particularly on the problem of extraction of the optimal solution among the final genetic population. We provide an original encoding scheme relying on a structural approach of point matching and then point out the need for a local optimization process. We then illustrate the algorithm with a concrete registration example and assert the results with a direct multivolume rendering tool. Finally, the algorithm is applied on the vanderbilt medical image database to assert the robustness and in order to compare it with other techniques.
