Impact of distractors in item analysis of multiple choice questions

Background: Item analysis is a quality assurance of examining the performance of the individual test items that measures the validity and reliability of exams. This study was performed to evaluate the quality of the test items with respect to their performance on difficulty index (DFI), Discriminatory index (DI) and assessment of functional and non-functional distractors (FD and NFD).Methods: This study was performed on the summative examination undertaken by 113 students. The analyses include 120 one best answers (OBAs) and 360 distractors.Results: Out of the 360 distractors, 85 distractors were chosen by less than 5% with the distractor efficiency of 23.6%. About 47 (13%) items had no NFDs while 51 (14%), 30 (8.3%), and 4 (1.1%) items contained 1, 2, and 3 NFDs respectively. Majority of the items showed excellent difficulty index (50.4%, n=42) and fair discrimination (37%, n=33). The questions with excellent difficulty index and discriminatory index showed statistical significance with 1NFD and 2 NFD (p=0.03).Conclusions: The post evaluation of item performance in any exam in one of the quality assurance method of identifying the best performing item for quality question bank. The distractor efficiency gives information on the overall quality of item.

Musculoskeletal Complications and Surgical Needs of Patients with Haemophilia

Background: Musculoskeletal problems in haemophiliaoccur due to delayed therapy or lack of detection, leading to joint damage and other complications Orthopaedic surgery is one option to improve deformity of haemophilic patients caused by repeated bleeding. Materials and Methods:This study includes 85 patients in which all musculoskeletal survey was done . Observation and Results: Surgery was recommended in 51 (60%) patients (37 severe haemophilia, 12 moderate and 2 mild). Minor surgery was most common in younger patients, while major surgeries increased proportionately with patient age. Conclusion: Insufficient use of factor replacement and lack of regular supply of factor are major cause for joint damage and other musculoskeletal problems in haemophilic patient.This study is beneficial for assessment of the grade of musculoskeletal problem and identification of the surgical needs of the haemophilic patients.

Anticholinesterase, Antioxidant and Nitric Oxide Scavenging Activity of the Aqueous Extract of Some Medicinal Plants.

Aims: Enhancement of cholinergic activity and reduction of oxidative stress by scavenging free radicals such as nitric oxide are well recognized therapeutic approaches in several pathological conditions. We evaluated the anticholinesterase, antioxidant and nitric oxide scavenging activity of the aqueous extracts of Ocimum basilicum, Curcuma longa and Solanum nigrum. Study Design: Experimental. Place and Duration of Study: Delhi Institute of Pharmaceutical Sciences & Research, Delhi University, New Delhi, India between January 2008 and December 2008. Methodology: The aqueous extracts of the rhizome of Curcuma longa, berries of Solanum nigrum and seeds of Ocimum basilicum were authenticated by HPTLC fingerprinting. The anticholinesterase activity of these extracts was estimated spectrophotometrically as described by Ellman in 1961 and IC50 was calculated. Total antioxidant capacity of extracts was also estimated spectrophotometrically based on the reduction of molybdenum (Mo) (VI) to Mo(V) by the sample and the subsequent formation of a green phosphate/Mo(V) complex at acidic pH. Ascorbic acid was used as standard. Estimation of nitric oxide scavenging activity of extracts was based on the diazotization reaction. Results: The anticholinesterase activity (IC50) was observed at the concentrations of 2.73 ± 0.09, 3.38 ± 0.05 and 3.88 ± 0.11 gram/l for Solanum nigrum, Curcuma longa, and Ocimum basilicum respectively. At these concentrations, maximum antioxidant capacity equivalent to 4.36 ± 0.14 mM of ascorbic acid was shown by Curcuma longa, followed by Solanum nigrum, and Ocimum basilicum. Curcuma longa showed the maximum nitric oxide scavenging activity equivalent to 29.78 ± 1.28 mM of sodium nitrite followed by Solanum nigrum and Ocimum basilicum. Conclusion: Plant derived pharmacological agents may provide an attractive therapeutic option in future for several pathological conditions especially the neurodegenerative diseases due to their anticholinesterase, antioxidant and nitric oxide scavenging properties.

Topically applied standardized aqueous extract of Curcuma longa Linn. suppresses endotoxin-induced uveal inflammation in rats.

Aqueous extract of C. longa when administered 4 h after induction of E. coli lipopolysaccharide-induced uveitis in rats showed significantly suppressed inflammation with a significantly lower mean clinical grade, histopathological grade and aqueous humor (AH) protein level compared to vehicle treated group. Although, prednisolone group showed significantly lower clinical grade, histopathological grades and AH protein levels compared to C. longa group, TNF-α levels did not differ significantly. Moreover, when the aqueous extract was administered starting from 3 days before induction of uveitis, the mean clinical and histopathological grade as well as AH protein and TNF-α levels were comparable to C. longa group when treatment was administered 4 h after induction of uveitis. It is concluded that topically applied standardized aqueous extract of C. longa suppresses endotoxin-induced uveitis in rats by reducing TNF-α activity.

Glaucomatous neurodegeneration An eye on tumor necrosis factor-alpha.

Glaucoma, a neurodegenerative disease, is currently being treated by modulation of one of its primary risk factors, the elevated intraocular pressure. Newer therapies that can provide direct neuroprotection to retinal ganglion cells are being extensively investigated. Tumor necrosis factor-α, a cytokine, has been recognized to play an important role in pro and antiapoptotic cellular events. In this paper we review the relevant literature to understand (1) The association of increased expression of tumor necrosis factor-α with glaucomatous neurodegeneraion, (2) Modulation of tumor necrosis factor-α expression by exposure to various risk factors of glaucoma, (3) Downstream cellular signaling mechanisms following interaction of tumor necrosis factor-α with its receptors and (4) Role of tumor necrosis factor-α as a possible target for therapeutic intervention in glaucoma. Literature was reviewed using PubMed search engine with relevant key words and a total of 82 English language papers published from 1990 to 2010 are included in this review.

Current concepts in the pathophysiology of glaucoma.

Glaucoma, the second leading cause of blindness, is characterized by changes in the optic disc and visual field defects. The elevated intraocular pressure was considered the prime factor responsible for the glaucomatous optic neuropathy involving death of retinal ganglion cells and their axons. Extensive investigations into the pathophysiology of glaucoma now reveal the role of multiple factors in the development of retinal ganglion cell death. A better understanding of the pathophysiological mechanisms involved in the onset and progression of glaucomatous optic neuropathy is crucial in the development of better therapeutic options. This review is an effort to summarize the current concepts in the pathophysiology of glaucoma so that newer therapeutic targets can be recognized.The literature available in the National Medical Library and online Pubmed search engine was used for literature review.