Background and Purpose: Triple Negative Breast Cancer (TNBC) is defined by a lack of expression of the steroid hormone receptors (oestrogen and progesterone), and the human epidermal growth factor receptor-2 (HER-2). It is characterized by distinct molecular, histological and clinical features. It is a high risk breast cancer that lacks the benefit of a specific therapy.Our study was aimed at pathologically illustrating triple-negative breast carcinoma and at evaluating the expression of the Epidermal Growth Factor Receptor (EGFR) ,cytokeratin 5/6 (CK 5/6) and Ki-67 among triple-negative breast cancer cases. Further, we aimed to probe whether triple-negative phenotype could be a surrogate marker for the basal phenotype and to correlate the expression of the basal markers (CK 5/6 and EGFR) with the clinico-pathological prognostic parameters. Methods:The expression of EGFR, CK 5/6 and Ki-67 were studied by immunohistochemistry (IHC) in 50 triple-negative breast cancer cases.Statistical Analysis: A statistical analysis was implemented by using the SPSS version 20.0. The Chi-square test was conducted to assess the relationship between the immunohistochemical markers and other variables. The Fischer exact test was used when the expected cell counts were less than 5. Results:The women with triple-negative breast cancer were younger, with the adverse pathological characteristics of a high tumour grade, tumour necrosis, frequent nodal metastases and high proliferation. 37 (74%) of the 50 triple-negative breast carcinomas showed the expression of the basal markers (EGFR and /or CK 5/6). We observed a statistically significant association between the basal marker expression and the presence of tumour necrosis.

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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.

Rhinosporidiosis is a granulomatous disorder caused by Rhinosporidium seeberi. It frequently involves the nasopharynx and occasionally affects the skin. We hereby report a case of 46–year-old male who presented with multiple cutaneous plaque-like lesions with nasal obstruction. On examination, multiple cutaneous lesions were found to be present on malar aspect, infraorbital and supraorbital region, right shoulder and over the back near the tip of scapula. Oral cavity revealed a polypoidal lesion, in the base of the tongue. Excision biopsy confirmed the lesions as disseminated cutaneous rhinosporidiosis. The patient was treated with excision and dapsone therapy. After 1 year of therapy, the patient has disease-free survival. We report this rare case of rhinosporidiosis with disseminated cutaneous involvement.