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Ever since its inception 100 years back, multiple choice items have been widely used as a method of assessment. It has certain inherent limitations such as inability to test higher cognitive skills, element of guesswork while answering, and issues related with marking schemes. Various marking schemes have been proposed in the past but they are not balanced, skewed, and complex, which are based on mathematical calculations which are typically not within the grasp of medical personnel. Type X questions has many advantages being easy to construct, can test multiple concepts/application/facets of a topic, cognitive skill of various level of hierarchy can be tested, and unlike Type K items, they are free from complicated coding. In spite of these advantages, they are not in common use due to complicated marking schemes. This is the reason we explored the aspects of methods of evaluation of multiple correct options multiple choice questions and came up with the simple, practically applicable, nonstringent but logical scoring system for the same. The rationale of the illustrated marking scheme is that it takes into consideration the distracter recognition ability of the examinee rather than relying on the ability only to select the correct response. Thus, examinee's true knowledge is tested, and he is rewarded accordingly for selecting a correct answer and omitting a distracter. The scheme also penalizes for not recognizing a distracter thus controlling guessing behavior. It is emphasized that if the illustrated scoring scheme is adopted, then Type X questions would come in common practice.

Objectives:To assess pharmacotherapeutics (PT) knowledge of second professional medical undergraduates.Materials and Methods:It is a questionnaire-based cross-sectional study. The questionnaire was designed to objectively assess the current level of knowledge of PT acquired by the second MBBS students in a medical college in India. Thirty Type-A multiple choice questions (MCQs) related with the PT of common and important medical conditions and some emergency conditions were administered to 125 participants. Grading of knowledge was also done as poor, average, and good both subjectively and objectively. Descriptive statistics were used to analyze responses. Association of PT knowledge with respect to mode of admission in a medical college was analyzed with Chi-square test.Results:MCQs related with PT of nonemergency conditions were responded correctly by 9.8–77.7% of participants. MCQs related with PT of some emergency conditions were responded correctly by 17–66.1% of participants. No statistically significant association was observed in PT knowledge with respect to mode of admission.Conclusion:Gross deficiency in the PT knowledge can potentially and adversely affect future rational prescribing skills. PT knowledge about common medical conditions should be emphasized during undergraduate training program.

Background: Blood pressure (BP) measurement is the most common investigation performed nearly on all patients’ for diagnosis and treatment of hypertension. Accuracy of the measurement device is crucial for timely diagnosis.However, sphygmomanometer requires medical expertise whereas automated oscillometric device needs only careful observations in measuring BP.Aims and Objectives: The objective of the present study is to determinethe comparative accuracy of mercury sphygmomanometer and automated oscillometric device of measuring BP and the limit of agreement between the two devices.Materials and Methods: A cross-sectional study designed and carried out at MGM Medical College, Indore among 438 normal individuals. Age, weight, height, body mass index, history and BP were recorded. An average of three recording of BP measurement by both the devices was used.Results: Out of a total, 52.3% were male and 47.7% were female. Average SBP (130.78±17.31 mmHg) and DBP (86.96±10.26 mmHg) measured by automated instrument were significantly elevated than SBP (126.32±13.47 mmHg) and DBP (81.70±8.63 mmHg) by mercury sphygmomanometer while the mean differences in SBP and DBP (5.16±4.40 and 5.57±3.30 mmHg) were statistically significant (p=0.000). Hypertension reported in more patients with automated (79.0%) compared to sphygmomanometer (76.0%). Bland-Altman plots indicated a positive linear trend for BP readings between two instruments. Differences were more in SBP reading than DBP within three categories. Measurement of agreement indicated strong statistically significant (p=0.000) mutual agreement between the rate of judging hypertension by two apparatuses. The coefficient of determination for SBP (R2=0.95) and DBP (R2=0.87) were very high when manual readings compared to automated.Conclusion: Present research suggests that BP readings obtained by automated and sphygmomanometer is comparable however as compared to mercury sphygmomanometer ocillometric device gives slightly higher readings of SBP. Looking towards the simplicity of measurement and freedom from environmental toxicity automated ocillometricdevice may be recommended as a primary tool for early detection and management of high BP.Asian Journal of Medical Sciences Vol.9(5) 2018 17-24

Background & Aims: ABO blood group antigens are well known genetic risk factors for various diseases. These antigens were reported as a non-modifiable risk factor for the development of hypertension independent of conventional modifiable risk factors. These findings were based on populations with pre-existing hypertension; however, such a relationship was rarely evaluated in normal healthy subjects. Materials & Methods:This cross-sectional study consisted of 400 healthy adolescents (203 males and 197 females) aged 17 to 25 years. The slide agglutination method was used for the determination of ABO blood typing. A standardized mercury sphygmomanometer was used for recording BP. Pulse Pressure (PP) and Mean Arterial Pressure (MAP) were also calculated. JNC-8 guidelines were used for calculation of the prevalence of elevated BP across ABO groups. ANOVA test was used to compare BP values in ABO blood groups. Chi-square correlation was used to assess frequency distribution of ABO blood groups among hypertensive and normal subjects.Results: Blood group B was most prevalent (35.2%) in our study. The highest average values of SBP DBP, PP, and MAP were recorded in blood group AB. The observed differences in the mean values of BP indices across ABO blood groups were statistically insignificant.Maximum subjects with elevated blood pressure were found in blood group A (n=12;10.81%) but no significant association was observed between ABO blood groups and elevated blood pressure. Conclusion:Tendencies for developing elevated BP levels have no significant association with ABO blood groups in young healthy subjects of any gender.