Diabetes Mellitus and its Laboratory Diagnosis

Diabetes mellitus is a group of metabolic disorder characterized by hyperglycemia either due to deficiency of insulin production or resistance of organs to the effect of normal amount of insulin or both.1 In healthy individuals after taking meals, according to the blood glucose concentration appropriate amount of insulin is produced by the pancreas and this insulin transports glucose from blood into the cells. In diabetic individual, either little or no insulin is produced by the pancreas, or the cells do not give appropriate response to the produced insulin. This insulin dysfunction leads to decreased synthesis and increased degradation of glycogen, protein and fat in the body, ultimately causing hyperglycemia and overflow of glucose into urine.2 Characteristic symptoms of diabetes are thirst, polyuria, weight loss and blurring of vision. Most severe form is characterized by ketoacidosis or non ketotic hyperosmolar coma, ultimately leading to stupor, coma and death. Chronic hyperglycemia develops pathological and functional changes characterized by retinopathy, nephropathy and neuropathy. Risk of cardiovascular, peripheral vascular and cerebrovascular diseases is also common in chronic state.3 Diabete

Seroprevalence of Rubella IgG in Pregnant Females

Objective: To find out the seropositivity of IgG rubella in pregnant women in Pakistan, to assess the prevalence of infection and to estimate the requirement of vaccination.Patients and Methods: In this retrospective cross sectional study total 730 females who visited Salma Kafeel Fertility Clinic (Rawalpindi) for antenatal checkup were inducted. Their age range was 18-45 years. The study was carried out from 2011-2016. ELISA serological testing was used to check the seroprevalence of Rubella IgG.Results: In total the 730 subjects were included in the study and divided in four groups according to their ages. The results were as follows: group 1(18-20yrs) 100% positive, group 2 (21-30yrs) 90.5% positive, group 3 (31-40yrs) 93.5% positive and lastly group 4 (>40yrs) 95%positive. Overall 92.32 % seropositivity was seen while 7.70% were found at risk of developing infection.Conclusion: There is a high prevalence of Rubella in females of child bearing age in Pakistan. This is alarming as it can result in high risk of CRS in newborns and fetal death. Therefore, women planning to become pregnant, who do not have natural immunity to rubella should be vaccinated at least 4 weeks prior to conception

Difficulty Index, Discrimination Index and Distractor Efficiency in Multiple Choice Questions

Objective: Our first objective was to evaluate the quality of MCQs by analyzing difficulty index, discrimination index and distractor efficiency. Our second objective was to find out the association of MCQs having good difficulty and discrimination indices with distractor efficiency.Methodology: This cross-sectional study was conducted at department of Pathology, Islamabad medical and dental college. Midterm paper comprising of total 65 MCQs was assessed for difficulty index (DIF), discrimination index (DI) and distractor efficiency (DE). Data was entered in Microsoft Excel 2010 and SPSS 21. Quantitative variables were expressed as mean±SD. Qualitative variables were written as number and percentage. Independent t-test was applied to find out the association of DIF and DI with DE.Results: According to DIF, out of total 65, 53(81%) MCQs were in acceptable category, only 1(2%) MCQ was too difficult and 11(17%) were too easy. Regarding DI, total 34(62%) MCQs showed excellent discrimination tendency to distinguish low and high performer students. While 15(23%), 5(8%) and 11(17%) MCQs demonstrated good, acceptable and poor discrimination ability respectively. Out of total 260 distractors, 72% were functional and only 28% were non-functional. Total 16(25%) MCQs had zero non-functional distractor (NFDs), while 30(46%) and 16(25%) MCQs had 1 and 2 NFDs respectively. Only 3(5%) MCQs were with 3 or more NFDs. DE was significantly more (100%) in 1 difficult item as compared to 11 easy items in which DE was less (36.33%). However, DE in MCQs having poor and good DI was almost same.Conclusion: In this paper of Pathology, large number of MCQs have acceptable level of DIF (81%) and DI (83%). Distractor efficiency related to presence of zero or 1 NFD is 71%. Through item analysis, standardized MCQs having average DIF, high discrimination power with large number of functioning distractors can be developed. Thus it is an effective way to improve the validity of examination and to efficiently assess the student performance