iosr-JDMS   Volume-1 ~ Issue-2

Abstract: An omphalocele is a congenital defect that affects the development of the abdominal wall in the umbilical region, resulting in a hernial-type sac of variable size. Here we describe a case report of a isolated omphalocele in which bowel loops were the only content .
Key words: bowel loops ,omphalocele

[1] D'Andrea F, Brongo S, Grella E, Grella R, Nicoletti G. Hepatic omphalocele in an adult: a case report. Scand J Plast Reconstr Surg Hand Surg 2004; 38:236-9.
[2] 2. Shraga Blazer, MD, Etan Z. Zimmer, MD, Ayala Gover, MD and Moshe Bronshtein, MD. Omphalocele Fetal Omphalocele Detected Early in Pregnancy: Associated Anomalies and Outcome. 2004 Radiology , 232 , 191-195
[3] Grosfeld JL, Weber TR. Congenital abdominal wall defects: gastroschisis and omphalocele. Curr Probl Surg 1982; 19:157-213.
[4] Sadler TW. Digestive system. In: Sadler TW, eds. Langman's medical embryology. 6th ed. Baltimore, Md: Williams & Wilkins, 1990; 237-260
[5] Cyr DR, Mack LA, Schoenecker SA, et al. Bowel migration in the normal fetus: US detection. Radiology 1986; 161:119-121
[6] Kurkchubasche AG. The fetus with an abdominal wall defect. Med Health R I 2001; 84:159-61.
[7] van Eijck FC, Hoogeveen YL, van Weel C, Rieu PN, Wijnen RM. Minor and giant omphalocele: long-term outcomes and quality oflife. J Pediatr Surg 2009; 44:1355-9.
[8] Tan KB, Tan KH, Chew SK, Yeo GS. Gastroschisis and omphalocele in Singapore: a ten-year series from 1993 to 2002. Singapore Med J 2008; 49:31-6.
[9] Hasan Y . Malkawi ,MD* ,Hussein S. Qublam MD* ,Ahmad . Omphalocoel containing bowel , liver and spleen: a case report. JRMS June 2005;12(1):35-37
[10] How HY,harris BJ ,Pietrantoni M, et al. Is vaginal delivery preferable to elective caesarean deliveryin foetuses with a known ventral wall defect. Am J obstel Gynecol 2000; 182: 1527-1534.

Abstract: The spectrum of odontogenic fibroma, fibromyxoma/ myxofibroma and myxoma represents a histogenetically related but behaviourally distinct heterogenous group of benign mesenchymal neoplasms. The terminologies myxofibromas/ fibromyxomas have been used histologically in the literature in a contradictory way either synonymously to myxomas or to designate simple odontogenic fibromas/ fibromas undergoing myxomatous degeneration. This article is shedding light on the importance of these disputed terminologies and emphasizes on the required distinctions pertaining to the clinical relevance of the same along with a case-report of a clinically soft to fibrous lesion with a histological diagnosis of peripheral odontogenic myxofibroma in a 33years old male patient.
Key Words: Fibroma, Fibromyxoma, Myxofibroma, Myxoma, Odontogenic, Terminologies.

[1] Pindborg JJ, Kramer IR, Torloni H. Histological typing of Odontogenic tumors, jaw cysts and allied lesions. International histological classification of tumors No.5. Geneva: World Health Organization; 1971. p. 30-1
[2] Neville BW, Damn DD, Allen CM, Bouquot EJ. In: Oral and maxillofacial Pathology. 3rd Edition. Saunders Elsevier; 2009.
[3] Martelli-Junior H, Mesquita RA, de Paula Am, Pego SP, Souza LN. Peripheral odontogenic fibroma (WHO type) of the newborn: a case report. Int J Paediatr Dent. 2006 Sep; 16(5):376-9.
[4] Brannon RB. Central odontogenic fibroma, myxoma (odontogenic myxoma, fibromyxoma), and central odontogenic granular cell tumor. Oral Maxillofac Surg Clin North Am. 2004; 16: 359-74.
[5] Lombardi T, Lock C, Samson J, Odel EW. S100, alpha-smooth muscle actin and cytokeratin-19 immunohistochemistry in odontogenic and soft tissue myxomas. J Clin Pathol 1995; 48(8):759-762.
[6] Barnes, L. (2001) Tumours and tumour-like lesions of the soft tissues. In: Barnes, L. (ed). Surgical Pathology of the Head and Neck, 2nd edition, pp. 952–954. New York: BC Decker.
[7] A. Buchner, E.W. Odell. Odontogenic myxoma / Myxofibroma. Pathology & Genetics Head and Neck Tumours. Edited by Leon Barnes, John W. Eveson, Peter Reichart, David Sidransky. pp 316.
[8] Anil Govindrao Ghom. Teeth Anomalies.Anil Govindrao Ghom (ed).Text book of Oral Medicine, 2nd edition.New Delhi, Jaypee Brothers 2010:260.
[9] Rajendran R, Sivapathasundaram Shafer's Textbook of Oral Pathology. 6th edition. Elsevier; 2009.
[10] Ramraj PN, Shah SP. Peripheral myxoma of maxilla. A case report. Indian J Dent Res. 2003; 14(1):67-9.

Abstract: Objective: (1) To assess the knowledge, attitude and practices of hypertensive patients. (2) To assess the risk factors and associated co-morbidities in them.
Material and Methods: A cross-sectional study was conducted at Shivaji Nagar urban slum which is a field practice area of Department of Preventive and Social Medicine, of TN Medical College Mumbai. Hypertensive patients above 40 years of age were included in this study. The information was gathered by personal interview using semi-structured proforma.
Results: Out of 340 subjects 176 (51. 76% ) were males. Majority of subjects 43.82% belonged to joint family and 64.11% subjects were from III, IV, V socioeconomic class. 39.7% patients were unemployed and unskilled. 131 (38.52%) patients had the family history of Hypertension. majority of the patients 117 (34.41%) had Smokeless tobacco addiction, followed by Cigarettes smoking 45 (13.23%). Alcohol consumption and smokeless tobacco chewing both in 43 (12.64%) patients. 90 (26.47%) patients had Diabetes Mellitus along with Hypertension followed by Anaemia 68 (20%) and Osteoarthritis / Osteoporosis 51 (15 %). 221 (65%) hypertensive patients had BMI equal to or more than 25 Kg/ m2. Poor knowledge, attitude and practices were in 83.42%, 69.11%, 73.24% patients respectively. Mean systolic BP, Diastolic BP, Body mass index and weight was 145.58 mm of Hg, 92 mm of Hg, 25.09 Kg/ m2 and 67.8 Kg respectively.
Conclusion: Most of the patients had associated co-morbidities. Poor practices regarding hypertension is the main reason for higher Blood pressure, Body mass Index. Poor practices were because of lack of awareness about hypertension. There is need for encouraging health services including health education regarding risk factors.
Keywords: Co-morbidities, Hypertension, KAP, Risk factors, Urban slum

[1] WHO Expert Committee. Primary prevention of essential Hypertension. WHO. Tech Rep Ser.686. Geneva. 1983
[2] Stamler J. Blood pressure and high blood pressure: Aspects of risk. Hypertension 1991; 18 (Suppl.): 05-1, 107
[3] Flack JM, Nearton, Grimm R Jr, et al. Blood pressure and mortality among men with prior myocardial infarction: Multiple risk factor intervention trial research group. Circulation. 1995: 92; 2437-2445.
[4] Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: Global burden of disease study. Lancet, 1997; 349(15): 1269-1442.
[5] RB Gaurav et al. "Biochemical profile of hypertensive individuals in an urban community", Bombay Hospital Journal 2001, Vol:55 (12); page-663-668.
[6] National high blood pressure education program working group. Arch Intern Med. 1993; 153: 186-208.
[7] Agarwal H, Bawja S, Haldiya KR, Mathur A. Prevalence of hypertension in elderly population of desert region of Rajasthan. Journal of the Indian Academy of Geriatrics. 2005; 1: 14-17.
[8] Teo GS, Indris MN Prevalence of hypertension among Chinese elderly and its relationship to behavioural and nutritional factors. Medical Journal of Malaysia 1996 Mar; 51(1): 33-40.
[9] Ana V. Diez-Roux, Mary E. Northridge, Alfredo Morabi, Mary T Bassett Steven Shea. Prevalence and social correlates of cardio vascular disease risk factors in Harlem. American Journal of Public Health. 1999 Mar; 89(3): 302-307.
[10] Ericus C, Gilberts AM, Marinus JC, Arnold WJ, Diederick E Grobbee. Hypertension and determinants of blood pressure with special reference to socio-economic status in a rural south Indian community. Journal of Epidemiology and community health. 1994; 48: 258-261.

Abstract: Objective:The purpose of this in vitro study was to test the pH changes that occurred over a period of 7 days using calcium hydroxide, Metapex and Ledermix & Calcium hydroxide combination and to compare the effect of contamination in a simulated periapical environment. The materials were filled in extracted premolar roots, which were suspended in individual vials containing distilled water at a pH of 7.4. Digital pH-meter was used to measure the pH of different groups at half an hr, 1 hr, 4 hr, 1 day, 2 days 3 days & 7 days after immersion of the specimens. The mean pH was found for all groups and statistical analysis was carried out using repeated Measure ANOVA. Combination of medicaments did affect the pH of calcium hydroxide significantly. Calcium hydroxide was found to significantly raise the pH of the surrounding medium with and without contamination of root canals compared to combination medicaments. Therefore calcium hydroxide is an effective choice in< clinical practice where seepage of pus into the root canal between appointments.
Keywords: Calcium hydroxide, Combination, Contamination, Intracanal medicaments, pH , Periapical

[1]. Zmener O, Pameijer CH, Banegas G. An in vitro study of the pH of three calcium hydroxide dressing materials. Endod Dent Traumatol 2007; 23: 21-25.
[2]. Anderson M, Seow WK. The pH of endodontic medicaments used in pediatric dentistry. Effects of dyadic combination. J Clin
Pediatr Dent 1990; 15: 42-45.
[3]. Larsen MJ, Horsted-Bindsle P. A laboratory study evaluating the release of hydroxyl ions from various calcium hydroxide products
in narrow root canal like tubes. Int Endod J 2000; 3: 238-42.
[4]. Horning GT, Kessler JR. A comparison of three different root canal sealers when used to obdurate moisture contaminated root canal
system. J Endod 1995; 21: 354-57.
[5]. Beltes PG, Pissiotis E, Koulaouzidou, Kortsaris AH. In vitro release of hydroxyl ions from six types of calcium hydroxide non
setting pastes. J Endod 1997; 23: 413-15.
[6]. Robert GH, Liewehr FR, Buxton TB, Mcpherson JC. Apical diffusion of calcium hydroxide in an in vitro model. J Endod 2004; 31:
57-60.
[7]. Fava LRG, Saunders WP. Calcium hydroxide pastes classification and clinical indications. Int Endod J 1999; 32: 257-282.
[8]. Kwon TY, Fujishima T, Imai Y. FT-Raman spectroscopy of calcium hydroxide medicament in root canals. Int Endod J 2004; 37: 489-93.
[9]. Simon ST, Bhat KS, Francis R. Effect of four vehicles on the pH of calcium hydroxide and the release of calcium ion. Oral Surg
Oral med Oral Pathol Oral Radiol Endod 1995; 80: 459-64.
[10]. Amanda Law, Harold Messer. An evidence based analysis of the antibacterial effectiveness of intracanal medicaments. J Endod
2004; 30: 689-94.

Abstract: The anterior tibial artery terminated into medial tarsal and lateral tarsal branches. Dorsalis pedis artery was very thin arising as a branch from medial tarsal artery. The first and second dorsal metatarsal arteries were seen arising from lateral tarsal artery. Arcuate artery was absent. Knowledge of vascular anatomy of foot is essential for arterial reconstruction flap surgeries of the foot. This can avoid amputation of foot in cases of arterial trauma like thromboangitis obliterans, industrial automobile accidents, diabetes and severe ischaemia of lower limb.
Key Words – Anterior tibial artery, Arcuate artery, Dorsalis pedis artery, Medial Tarsal artery, Lateral Tarsal artery.

[1]. EMEI – Saeed et al - Anatomical study of the Dorsalis pedis artery and its surgical importance in reconstructive surgeries – Allexandria Bulletin pg- 557 to 571
[2]. VijayaLakshmi S, Gunapriya Raghunat, Varsha Shenoy Anatomical study of dorsalis pedis artery and its clinical correlations
- – Journal of clinical and diagnostic research 2011 April, Vol – 5 (2) : 287 – 290
[3]. Sadler T. W (1985) in Langman's Medical Embryology 5th edition Wiliam and Wilkins; 68-69
[4]. Williams, Peter, Bannister, LawrenceH.; Berry Martin M.; Collins; Patricia, Mary Dyson; Dussek, Julien E.; Feruson,
Mark W.J.; Gray's Anatomy, The Anatomical Basis Of Medicine and Surgery, 38th edition, Ch-10, Pg 1572 -1574.
[5]. Keith L. Moore, Arthur F. Dalley Clinically Oriented Anatomy 5th edition, Ch - 5 Pg- 670 – 671.
[6]. Vishram Singh Anatomy Of Abdomen & Lower Limb, Elservier, Ch – 27, Pg- 422-427.
[7]. Brearley S, Simms MH, Shearman CP. Peripheral pulse palpation: an unreliable physical sign. Ann R Coll Surg Eng 1992; 169-71.
[8]. Gross DE, de Trafford JC, Roberts VC et al. Raise ankle/brachial index in insulin treated diabetic patients. Diabet Med
1989;6:576-8.

Abstract: Present communication describes a case of a young female patient suffering from pulmonary tuberculosis associated with delayed diagnosis of adenocarcinoma of lung. Timely diagnosis requires a high index of suspicion and knowledge of the spectrum of clinical and radiologic features. This case report emphasizes the importance of diagnostic evaluation like thoracic computed tomography scan (CT) and CT guided fine needle aspiration cytology (FNAC) which if used without much delay, may lead to accurate diagnosis of the fatal disease without undue delay.
Keywords- adenocarcinoma of lung, CT guided fine needle aspiration cytology, pulmonary tuberculosis

[1]. Subramanian J, Govindan R. Lung cancer in never smokers: a review. Journal of Clinical Oncology 2007;25 (5): 561–70.
[2]. Pelosi G, Sonzogni A, Veronesi G, et al. Pathologic and molecular features of screening low-dose computed tomography (LDCT)-
detected lung cancer: A baseline and 2-year repeat study. Lung Cancer. 2008;62:202-14.
[3]. Gangopadhyay M, Chakrabarti I, Ghosh N, Giri A. Computed tomography guided fine needle aspiration cytology of mass esions of
lung: Our experience. Indian J Med Pediatr Oncol 2011;32:192-6 Lee HY, Han J, Lee KS, Koo JH, Jeong SY, Kim BT, Cho YS, Shim YM, Kim J, Kim K, Choi YS. Lung adenocarcinoma as a solitary pulmonary nodule: prognostic determinants of CT, PET, and histopathologic findings. Lung Cancer 2009;66(3):379-85.
[4]. Lee HY, Han J, Lee KS, Koo JH, Jeong SY, Kim BT, Cho YS, Shim YM, Kim J, Kim K, Choi YS. Lung adenocarcinoma as a solitary pulmonary nodule: prognostic determinants of CT, PET, and histopathologic findings. Lung Cancer 2009;66(3):379-85.
[5]. Gould MK, Fletcher J, Iannettoni MD, et al. Evaluation of patients with pulmonary nodules: when is it lung cancer?: ACCP
evidence-based clinical practice guidelines (2nd ed). Chest 2007;132(3):108-30.

Abstract: On one side of India, we have multi-specialty hospitals which satisfy the healthcare needs of people with specialized and speedy treatments. On the other side, a large part of the population in India resides in rural areas where basic medical facility is sometimes unavailable. People in the rural areas do not get proper treatment due to the non availability of required number of registered medical practitioners. This paper presents the architecture of Context Aware Health Monitoring System developed for connecting Primary Healthcare Centres in the rural areas with the sophisticated hospitals in the urban areas of India through mobile communication and IT infrastructure. The system aims to provide affordable, efficient and sustainable healthcare service by leveraging mobile communication and information technology. The system monitors and delivers patient's physiological readings to the hospitals and provides an alert mechanism triggered by the patient's vital signs which is linked to a medical practitioner's mobile device.
Keywords (11bold) – Telemedicines, Secure key, sensors, Mobile application.

[1]. Rash, M.C. Privacy concerns hinder electronic medical records. The Business Journal of the Greater Triad Area (Apr. 4, 2005).
[2]. Lin X, Lu R, Shen X, Nemoto Y, Kato N.SAGE: a strong privacy preserving scheme against global eavesdropping for ehealth
systems. IEEE Journal of Selected Areas of Communications.
[3]. Ou, C.-M. and Ou, C. R., "A High-Level 3G Wireless PKI Solution for Secure Healthcare Communications", EuroPKI 2006,
Lecture Notes in Computer Science 4043, Springer-Verlag, 2006, pp. 254-256.
[4]. Yuhai Zhang, Yongyong Xu, Lei Shang, etc.An investigation into health informatics and related standards in China.
International Journal of Medical Informatics[J]. 2007(76),614–620.

Abstract: Objective:A prospective, controlled trial was conducted to assess the outcome of early physical therapy intervention on preterm low birth weight infants during the first six months of life. A cohort of 100 preterm low birth weight infants who got admitted in neonatal intensive care unit (NICU) and referral newborn unit (RNB) of Raja Muthiah Medical College and hospital (RMMC&H) were included prospectively. Infants who received< regular early physiotherapy intervention were assigned as interventional group (EI) & infants who were advised but did not turn up for early intervention as comparison group (NEI) .The Amiel-Tison neurologic examination and Denver developmental screening test (DDST) were used and results were compared. Results: Better performance of infants in EI group in neurologic and developmental outcome. Conclusion: The data suggest significant benefit of the use of EI program over NEI in the neurodevelopmental outcome of preterm LBW infants at 6 months of corrected age.
Keywords: Preterm low birth weight infants, Early Intervention, Developmental outcome

[1]. Costello D, Friedman H, Minich N, Siner B, Taylor G, Schuchlter M, Hack M. Improved neurodevelopmental outcomes for
extremely low birth weight infants in 2000-2002. Pediatrics 2007;119: 37-45.
[2]. Escobar G, Littenberg B, Petitti DB Outcome among surviving very low birth weight infants: a Meta analysis .Arch Dis Child
Feb1991; 66: 204 - 211.
[3]. C. F. Martínez-Cruz, A. Poblano, L. A. Fernández-Car-rocera, R. Jiménez-Quiróz and N. Tuyú-Torres, "Association between
Intelligence Quotient Scores and Extremely Low-Birth Weight in School-Age Children," Archives of Medical Research, Vol. 37,
No. 5, 2006, pp. 639-645.
[4]. Bernbaum, J. C. & Batshaw, M. L (1997). Ch 7. Born too soon, born too small. In Children with disabilities: A medical primer.
(Eds.). Baltimore: Paul H. Brooks
[5]. Subramanian S. K.N., Yoon H., & Toral, J.C. (2002). Extremely low birth weight infant. Emedicine Journal, 10, (3),
[6]. Perlman, J.M. (2001). Neurobehavioral deficits in premature graduates of intensive Care -potential medical and neonatal
environmental risk factors. (Review Article). Pediatrics, 108, 1339-1348
[7]. T. Kanda, M. Yuge, Y. Yamori, J. Suzuki and H. Fukase, "Early Physiotherapy in the Treatment of Spastic Diplegia," Developmental Medicine and Child Neurology, Vol. 26, No. 4, 1984, pp. 438-444.
[8]. A. Poblano, "Early Identification and Treatment of Infants with Neurologic Damage (in Spanish)," Editors de Textos Mexicanos,
México City, 2003.
[9]. M.K.C Nair , Neurodevelopmental follow up- "Module on Early Stimulation," Editors Tanmay R.Amladi, 2004
[10]. Hack, M. & Sanaroff, A. (1999). Outcomes of children of extremely low birth weight and gestational age in the 1990‟s. Early
Human Development, 53, 193-218.

Abstract: The introduction of quality assurance and medical audit has been an important development in general practice. The present study describes the pros and cons of implementing Medical Audit in Nizam's
l Sciences, a tertiary care hospital in India, by conducting opinion survey among the faculty members of the institute through a structured questionnaire. The study reveals that majority of doctors were interested in implementing system of Medical Audit through a Medical Audit Committee membered by internal staff with periodical reviews and reforms in policies and guidelines for auditing. The study also revealed that a few proportion of doctors were reluctant to adopt the new system adhering to the traditional thinking and felt medical audit can be a tool of criticism. Keywords: Quality assurance, Medical audit, Quality Health Care
Keywords: Co-morbidities, Hypertension, KAP, Risk factors, Urban slum

[1] Lawrence M. What is medical audit? In: Lawrence M, Schfield T, editors. Medical Audit in Primary Health Care. New York:
Oxford University Press; 1993.
[2] Fraser R, Lackani M, Baker R. Evidence-Based Clinical Audit. 1st ed. Oxford: Butterworth- Heinemann; 1998.
[3] Marinker M. Principles in Medical Audit and General Practice. London: BMJ Publishing Group; 1990.
[4]RCGP. Information sheet module10. Clinical Audit in General Practice. 2002 Jan. Available from: URL: www.gpnetwork.net.au/eduseru/10- keyiss.htm/.
[5] Sheldon MG. Audit in General Practice. Practice Update. 1989; 5:1052.
[6]RCGP. Information sheet No.17. Clinical Audit in General Practice. 2002 Feb. Available from: URL: www.gpnetwork.net.au/eduseru/1- backgr.htm/.
[7] Webb S, Dowell A, Heywood P. Survey of general practice audit in Leeds. BMJ 1991; 302: 390-392.
[8] Black N, Thompson E. Obstacles to medical audit: British doctors speak. Soc Sci Med 1993; 36: 849-856.
[9] Morrison J, Sullivan F. Audit: teaching medical students in general practice. Med Educ 1993; 27: 495-502.
[10] Newton J, Hutchinson A, Steen N, et al. Educational potential of medical audit: observations from a study of small group setting
standards. Qual Health Care 1992; 1: 256-259.

Abstract: Gingival fibromatosis is a heterogeneous group of enlargement characterized by progressive increase in submucosal connective tissue elements. Many Cases are iatrogenic and some are inherited or idiopathic. Idiopathic gingival fibromatosis, is a benign slow growing proliferation of the gingival tissue, i genetically heterogeneous. This condition is usually part of a syndrome or rarely an isolated disorder. Aggressive Periodontitis, another genetically transmitted disorder of the periodontium, typically result in severe rapid destruction of the tooth supporting apparatus. Gingival overgrowth as a clinical characteristic of Idiopathic gingival fibromatosis causes many dental complications which worsens patient's adaptation in daily emotional, social and functional requirements. Here we present a rare case of a nonsyndromic idiopathic gingival fibromatosis associated with generalized aggressive periodontitis in a 23 year old female. The diagnosis was made based on history, Clinical examination, radiographic findings and histopathology. Gingivectomy was carried out in all four quadrants under local anesthesia. No recurrence was observed during 2 years follow up and patient showed remarkable esthetic and functional improvement.
Keywords: Aggressive Periodontitis, Gingival fibromatosis, Gingivectomy, Idiopathic gingival fibromatosis, Syndrome.

[1]. Neville, Damm, Allen, Bouquot. Periodontal diseases, oral and maxillofacial pathology, 2nd Ed. (Elsevier saunders 2004) P.148-50
[2]. Pappachan B, Narayan JV, Nayak A. Idiopathic gingival fibromatosis; A neglected case, Indian J. Radiol imaging, 12(3) 2002 P
335 – 338 .
[3]. J.A.Regezi and J.J Sciuba. "connective tissue lesions," in oral pathology: clinical pathologic correlations, (W.B. Saunders, Philadelphia , Pa, USA, 1999 ) P.179 – 183.
[4]. F.cekmez , O.Pirgon and I.A. Tanju . Idiopathic gingival hyperplasia, in International Journal of Biomedical science. 5(2), 2009, P
198- 200.
[5]. Carranza FA , Hogan EL. "Gingival enlargement" in Clinical Periodontology , M.G. Newman , H.H. Takei and F.A. Carranza , 9th
Ed.(Saunders , Philadelphia, pa, USA, 2002 ) P279 – 296.
[6]. T.c. Hart , D pallos, D.W. Bowden , J.Bolyard, M.J. Pettenati , and J.R cortelli. Genetic linkage of hereditary gingival fibromatosis
to chromosome 2p21, American journal of human genetics. 62(4),1998; P 876 – 883.
[7]. T.C. Hart D. pallos , L.Bozzo et al , "Evidence of genetic heterogeneity for hereditary gingival fibromatosis", Journal of Dental
research , 79(10), 2000 P 1758 – 1764 .
[8]. Bozzo L, de Almeida, c. Scully and M.J. Aldred, "Hereditary gingival fibromatosis. Report of an extensive four generation
pedigree". Oral surgery, oral medicine, oral pathology, 78(4), 1994. P 452 – 454.
[9]. H.Martelli Jr. D.P. Lemos, C.O.Silva, E. Graner, and R.D. Coletta, "Hereditary gingival fibromatosis: report of a five generation
family using cellular proliferation analysis". J. of periodontology, 76(12), 2005; P 2299 – 2305.
[10]. Xiao S, Bu L , Zhu L, Zheng G, Yang M , Qian M et al, "A new locus for hereditary gingival fibromatosis (GINGF2 ) maps to 5q13 – q22", Genomics, 74 (2) 2001; P 180 – 5.

Abstract: Background: The relevance of empirical evidence in healthcare decision making is well acknowledged. Within any setting constrained by a lean resource base, stronger premium should be placed on evidence which informs policy; as ever so often in such climes, multiplicity of healthcare needs outstrip available resources. Thus, the outstanding challenge is how to best serve the most compelling needs of the teeming populace by a fair balance of evidence and resource outlay within the complex imperatives of the overarching socio-cultural context. Familiar poor development indices underscore most developing countries; peculiarities also exist with respect to national priorities, resource base, available technologies and infrastructure, philosophies and cultures, and penchant for adaptation. Nigeria is one such complex society, trying to address healthcare needs of her citizens while concurrently addressing competing needs from other sectors by a very delicate balancing act. This study aims to provide an overview of the state and turnover of Comparative Effectiveness Research (CER) in Nigeria between the years 1975 and 2009, and the extent to which key health problems are addressed within study imperatives.
Keywords: comparative effectiveness research, healthcare, Nigeria

[1]. Golub RM, Fontanarosa PB. Comparative Effectiveness Research Relative Successes. JAMA. 2012;307(15):1543-645.
[2]. Docteur E, Berenson R. How Will Comparative Effectiveness Research Affect Quality of Health Care? Timely Analysis of
Immediate Health Policy Issues 2010.
[3]. Herrick LM, Locke GR, Zinsmeister AR, Talley NJ. Challenges and Lessons Learned in Conducting Comparative-Effectiveness
Trials. The American Journal of Gastroenterology 2012;107:644-9.
[4]. Daniel T, Leonard MA. Comparative Effectiveness and Real-World Evidence. Am J Managed Care 2010;16( 6):410-1.
[5]. Alemayehu D, Ali R, Alvir JMJ, Cappelleri JC, Cziraky MJ, Jones B, et al. Examination of Data, Analytical Issues and Proposed
Methods for Conducting Comparative Effectiveness Research Using "Real-World Data". JMCP. 2011 Suppl 17(9a):S2-S37.
[6]. US CBO. Research on the Comparative Effectiveness of Medical Treatments: Issues and Options for an Expanded Federal Role.
Washington D C. U. S. A. 2007 p. 1-35
[7]. IOM. Initial National Priorities for Comparative Effectiveness Research. Institute of Medicine (IOM): National Academy Press,
Washington DC; 2009.
[8]. Willke RJ, Mullins CD. "Ten Commandments" for Conducting Comparative Effectiveness Research Using "Real -World Data.
JMCP 2001;Suppl 17(9-a ):S10-S3.
[9]. Oxman AD, Lavis JN, Fretheim A, Lewin S. Support Tools for Evidence-Informed Health Policy Making (STP) 17: Dealing with
Insufficient Research Evidence. Health Research Policy and Systems 2009;7(Suppl 1):S17.
[10]. Manchikanti L, Falco FE, Boswell MV, Hirsch JA. Facts, Fallacies, and Politics of Comparative Effectiveness Research: Part I.
Basic Considerations. Pain Physician 2010;13:E23-E54.