Delayed primary closure is a sound incision management technique that should be utilized for dirty abdominal incisions. It significantly lowers the rate of superficial SSI as well as fascial dehiscence and reduces the mean CIH time and hospitalization. The short-term cosmetic appearance is superior.

This study demonstrates that poor sanitation and inadequate environmental conditions are the main determining factors that predispose the population to intestinal parasites. Mass deworming programs are recommended for school children, as this population is easily accessible.

Background: Multiple Choice Question (MCQ) based assessments are ubiquitous now, yet the emphasis on training of teachers in preparing good MCQs is inadequate. There are very few studies reporting use of item analysis of MCQs in medical education from India. Hence, we present this simple psychometric analysis of MCQs. Methods: An item analysis was performed on an internal assessment test paper with 50 MCQs faced by 158 final year undergraduate students (6th and 7th semester) in Community Medicine during the year 2011. The following indicators of item analysis were derived; 1. Response rate for each item, 2. Facility Value (FV), 3. Discrimination index (DI), 4. Distractor efficiency and 5. Cronbach"s alpha(α). Microsoft Office Excel was used for analysis. Results & Discussion: The mean score (±2 SD) of the students was 27.2/50 (15.8-38.6), and 54% of the items had a response rate of more than 95%. Out of 50 items on the test, 19 and 22 items were in the acceptable range of FV and DI respectively. Only 12 items were in acceptable range of both. 36% distractors achieved a below optimal response rate (<5%). Cronbach"s alpha was 0.66. Conclusion: The analysis helped us detect the technical flaws in the single paper scrutinized. Reporting of matrix of the items falling in different ranges of FV and DI was found to be more informative, as it would help improve the quality of the items in our bank.

IntroductionHepatic hydatid disease can be successfully treated by a variety of modalities.Case PresentationWe report a case of a 60 year old male with giant hepatic hydatid disease who presented with a huge cystic mass in the upper abdomen. Diagnosis was confirmed by serology, ultrasonography and CT scan. The patient was treated successfully by open minimally invasive surgery with minimum breaching of the peritoneal cavity using a laparoscopic trocar to evacuate the cyst.ConclusionThe use of a laparoscopic trocar through a small abdominal incision in selected patients with hepatic hydatid disease with subfascial extension can be a safe, minimally-invasive option of treatment