Comparative histomorphologic study of basement membrane side staining and additional epithelial side staining of the anterior lens capsule with Trypan Blue.

PURPOSE: To compare the histomorphologic changes on the anterior lens capsule by both epithelial and basement membrane side staining to those of only basement membrane side staining of the anterior lens capsule with Trypan Blue (TB). METHODS: A cross-sectional study was done on 72 samples from patients who underwent cataract surgery between April 2021 and September 2022. After capsulorhexis of the TB-stained capsule, it was made into two halves externally and one half labeled as controls (sample A). The other half was immediately stained further with TB on the epithelial side and was taken as cases (sample B). Samples were analyzed for lens epithelial cells and basement membrane changes. RESULTS: The loss of intactness of lens epithelial cells, partial or complete detachment of lens epithelial cells, degeneration of lens epithelial cells, and basement edema were significantly higher in cases compared to controls, whereas intactness of the basement membrane did not show any statistical significance between the two groups. There was a statistically significant decrease in cell density in cases compared to controls. CONCLUSION: Staining the epithelial side of the capsular bag with TB is more detrimental to lens epithelial cells and paves the way for a further study of staining the capsular bag before intra-ocular lens implantation to reduce the incidence of posterior capsule opacification.

Item analysis and optimizing multiple-choice questions for a viable question bank in ophthalmology: A cross-sectional study.

Purpose: Multiple-choice questions (MCQs) are useful in assessing student performance, covering a wide range of topics in an objective way. Its reliability and validity depend upon how well it is constructed. Defective Item detected by item analysis must be looked for item writing flaws and optimized. The aim of this study was to evaluate the MCQs for difficulty levels, discriminating power with functional distractors by item analysis, analyze poor items for writing flaws, and optimize. Methods: This was a prospective cross-sectional study involving 120 MBBS students writing formative assessment in Ophthalmology. It comprised 40 single response MCQs as a part of 3-h paper for 20 marks. Items were categorized according to their difficulty index, discrimination index, and distractor efficiency with simple proportions, mean, standard deviation, and correlation. The defective items were analyzed for proper construction and optimized. Results: The mean score of the study group was 13.525 ± 2.617. Mean difficulty index, discrimination index, and distractor efficiency were 53.22, 0.26, and 78.32, respectively. Among 40 MCQs, twenty-five MCQs did not have non-functioning distractor; 7 had one, 5 had two, and 3 had three. Of the 20 defective items, 17 were optimized and added to the question bank, two were added without modification, and one was dropped. Conclusion: Item analysis is a valuable tool in detecting poor MCQs, and optimizing them is a critical step. The defective items identified should be optimized and not dropped so that the content area covered by the defective item is not kept of the assessment.

Primary mucinous carcinoma of buccal mucosa: a rare case report.

Minor salivary gland tumors of oral cavity are very rarely encountered in day-to-day practice. Mucinous adenocarcinoma is very rare, and is commonly seen in elderly males. Palate and buccal mucosa is the commonest site. Wide local excision is the treatment. Histology shows tumor cells floating in pools of mucin, compartmentalized by fibrous tissue. Metastasis is a close mimicker, however with an evidence of negative scan and minor salivary gland proliferation in adjacent tissue diagnosis can be made. Mucin stains and immunohistochemistry can be used to support the diagnosis in problematic cases. We are presenting a rare case of mucinous adenocarcinoma-cheek in a 54-year-old male who came with gradually progressive swelling in the left buccal mucosa since 3 months and after wide excision, no evidence of recurrence was noted in 1 year and 3 months of follow up period.

Uncommon manifestations of Endocervical Malignant Mixed Mullerian Tumor with Incidental Bilateral Fallopian Tube Carcinoma.

A 43-year-old perimenopausal lady presented with bleeding per vagina and lower abdominal pain. On evaluation, she had cervical polyp, which expelled spontaneously during the per speculum examination. Histopathology revealed malignant mixed Mullerian tumor. Extended hysterectomy with salphingo oophorectomy was carried out, which showed bilateral fallopian tube carcinoma and leiomyoma uterus. The patient was treated with carboplatin regime and found to be disease-free for 1 year. This case presented because of a rare combination of the lesions.