Item analysis is the process of collecting, summarizing and using information from students’ responses to assess the quality of test items. Difficulty index (P) and Discrimination index (D) are two parameters which help evaluate the standard of MCQ questions used in an examination, with abnormal values indicating poor quality. In this study, 120 test items of 12 Type A MCQ tests of Foundation 1 multi-disciplinary summative assessment from M2 / 2003 to M2 / 2006 cohorts of International Medical University were selected and their P-scores in percent and D-scores were estimated using Microsoft Office Excel. The relationship between the item difficulty index and discrimination index for each test item was determined by Pearson correlation analysis using SPSS 11.5. Mean difficulty index scores of the individual summative tests were in the range of 64% to 89%. One-third of total test items crossed the difficulty index of 80% indicating that those items were easy for the students. Sixty seven percent of the test items showed acceptable (> 0.2) discrimination index. Forty five out of 120 test items showed excellent discrimination index. Discrimination index correlated poorly with difficulty index (r = -0.325). In conclusion, a consistent level of test difficulty and discrimination indices was maintained from 2003 to 2006 in all the twelve summative type A MCQ tests.
Pre-eclampsia or pregnancy induced hypertension (PIH) affects 6-8% of all pregnancies. Although the underlying mechanism of PIH is still unknown, it is widely believed that the placenta plays an important role. It was thought that an ischemic placenta due to poor perfusion can precipitate the signs and symptoms of PIH. This study aims to investigate the possible role of Type 1(AT1) and Type 2 (AT2) angiotensin II receptor subtypes in the mechanism of PIH. AT1 receptor stimulation causes vasoconstriction and AT2 receptor stimulation causes vasodilatation. Investigating the interactions of these two receptors in the placenta provides an insight as to the balance that may exist between AT1 and AT2 receptors in normal pregnancy. Any disruption to the balance might cause a disruption of the blood flow in the placenta, leading to PIH. Placentas were collected from 11 PIH patients and 11 normal patients. Immunohistochemistry techniques were performed on the placental tissue to determine the distribution of AT1 and AT2 receptors in the placental tissue qualitatively and quantitatively. It was observed that in normal patients, the balance between AT1 and AT2 receptors is that the level of AT2 receptors is higher than the level of AT1 receptors. However in the PIH patient, it was observed that the normal balance was disrupted. In PIH patients the level of AT1 receptors was observed to be higher than the level of AT2 receptors. This study suggests that disruption of the balance between AT1 and AT2 receptors observed in PIH placentas might cause a decrease in blood flow to the placenta, causing it to be poorly perfused. This may cause placental ischemia which may lead to PIH.
Euphorbia hirta is widely used in traditional remedies and has been used cross-culturally for generations against maladies such as asthma, skin ailments and hypertension. Previous studies have demonstrated that Euphorbia hirta has antibacterial activity, and have also indicated certain antimolluscidal, antimalarial and anti-inflammatory properties, the latter of which have been suggested to be more pronounced than those of the rheumatological drug, etanercept. To date, no studies have identified the anatomical effects of this herb on the organs of test animals. This study aimed to identify the effects of Euphorbia hirta on the ultrastructure of the murine liver, kidney and aorta. A total of 32 adult male Sprague-Dawley rats were divided into four groups; three groups were fed with aqueous extracts of Euphorbia hirta at doses of 1, 10 and 50 mg/kg, respectively, every alternate day for 50 days, while one group served as a control. The animals were later sacrificed and the liver, kidney and aorta harvested for examination by electron microscopy. The aorta showed no ultrastructural changes across the groups. Renal and hepatic tissue from the treated groups demonstrated dose-dependent injuries, which showed architectural damage beginning in the nuclei and spreading outwards. Taking into consideration the properties of Euphorbia hirta that have been described in previous studies, in addition to the results from the present study, it appears that the herb may exhibit similar effects to those of the quinolone group of antibiotics. Further in-depth investigations are required into the potential effects of Euphorbia hirta, deleterious and otherwise.