Relations of the Number of Functioning Distractors With the Item Difficulty Index and the Item Discrimination Power in the Multiple Choice Questions.

Background Multiple choice questions (MCQ) are used nowadays in summative assessments for certification of courses, in a competitive examination, and for recruitment. A single-best-answer stem-type MCQ is one of the formats most commonly used for this purpose; it contains a question and options from which the examinee needs to select the correct answer. Item analysis is used for the determination of the quality, validity, and reliability of the MCQ. Item difficulty index, item discrimination power, and distractor effectiveness are critical for the quality of the MCQs. Aim This study was conducted to estimate the effect of distractor effectiveness on the item difficulty index and item discriminating power. Method A test paper consisting of 200 single-best-answer stem-type MCQs with four options responded to by 400 medical undergraduates was analyzed for item difficulty index, item discriminating power, and distractor effectiveness with established item analysis formulas. The effect of distractor effectiveness on item difficulty index and item discriminating power was statistically analyzed using Epi-Info 7TM software. Result The mean item difficulty index, item discriminating power, and distractor effectiveness were 57.75% ± 28.65%, 0.4388 ± 0.36, and 84.17%, respectively (p<0.05). The item difficulty index was higher for items with single-functioning distractors in comparison to items with three-functioning distractors. Item discriminating power was higher in items with three functioning distractors in comparison to items with one and two functioning distractors. Conclusion Two or three functioning distractors show an appropriate item difficulty index and item discriminating power. In addition, item discriminating power is lower for the easy MCQs. Two to three distractors are appropriate to construct a quality MCQ.

Nasal NK/T Cell Lymphoma Presenting with Perforation of Palate: A Case Report and Review of Literature.

Nasal Natural Killer (NK)/T cell lymphoma, commonly mentioned in the literature as Lethal Midline Granuloma (LMG) is an unusual pathology of the oro-maxillo-facial region characterized by aggressive and progressive destruction of the face, nose, palate and pharynx. This disease is now classified as a T-cell lymphoma based on modern cytogenetics, immunologic and molecular studies. However, it is mentioned in various literatures by various names. Here, we present one such clinically diagnosed, histopathologically and immunologically confirmed case of LMG, designated as NK/T cell lymphoma in a 56-year-old male. The uncommon presentation of NK/T cell lymphomas should be kept as a differential diagnosis for management of patients.

In-silico analysis of heat shock protein 47 for identifying the novel therapeutic agents in the management of oral submucous fibrosis.

BACKGROUND: Heat shock proteins-47 (HSP47) is a collagen specific molecular chaperone, involved in the processing and/or secretion of procollagen. It seems to be regularly upregulated in various fibrotic or collagen disorders. Hence, this protein can be a potential target for the treatment of various fibrotic diseases including oral submucous fibrosis (OSF), which is a collagen metabolic disorder of oral cavity and whose etiopathogeneic mechanism and therapeutic protocols are still not well documented. AIM: The aim of this study is to identify the novel therapeutic agents using in-silico methods for the management of OSF. OBJECTIVES: The objectives of this study are to identify the binding sites of HSP47 on the collagen molecule and to identify the lead compound with anti-HSP47 activity from the library of natural compounds, using in-silico methodology. MATERIALS AND METHODS: The web-based and tool based in-silico analysis of the HSP47 and collagen molecules are used in this study. The crystal structure of collagen and HSP47 were retrieved from Protein Data Bank website. The binding site identification and the docking studies are done using Molegro Virtual Docker offline tool. RESULTS: Out of the 104 Natural compounds, six ligands are found to possess best binding affinity to the binding amino acid residues. Silymarin binds with the 4AU2A receptor and the energy value are found to be -178.193 with four Hbonds. The other best five natural compounds are hesperidin, ginkgolides, withanolides, resveratrol, and gingerol. Our findings provide the basis for the in-vitro validation of the above specified compounds, which can possibly act as "lead" molecules in designing the drugs for OSF. CONCLUSION: HSP47 can be a potential candidate to target, in order to control the production of abundance collagen in OSF. Hence, the binding sites of HSP47 with collagen are identified and some natural compounds with a potential to bind with these binding receptors are also recognized. These natural compounds might act as anti-HSP47 lead molecules in designing novel therapeutic agents for OSF, which are so far unavailable.

Drug induced erythema multiforme: two case series with review of literature.

Erythema Multiforme, (EM) an uncommon, acute inflammatory reactive mucocutaneous disorder and primary allergies confined to the oral mucosa. However the subsequent attacks can produce more severe forms of EM involving the skin. Manifestations of EM are varied and present a diagnostic dilemma because infections (particularly herpes simplex and mycoplasma pneumoniae) and drugs seem to predispose towards development of EM. We report two cases of EM in which drugs (Dioclofenac sodium & Amoxycilline) seems to be precipitating factor. In addition, the article reviews various aspects of EM as relevant to dental practice and highlight the associated potential etiologic agents, pathogenic mechanisms and therapies.