https://www.selleckchem.com/products/pmx-53.html 05). The differences of two groups in the incidence of adverse reactions had no statistical significance (P>0.05). Serum IL-6 level and TNF-a level of observation group were significantly lower than those of control group and before the treatment, and the differences had statistical significance (P>0.05). The application of omeprazole in treatment of PU patients with positive HP for four weeks can significantly improve PU cure rate and HP eradication rate, relieve clinical symptoms and reduce inflammatory response, so it deserves to be promoted clinically. The application of omeprazole in treatment of PU patients with positive HP for four weeks can significantly improve PU cure rate and HP eradication rate, relieve clinical symptoms and reduce inflammatory response, so it deserves to be promoted clinically. Multiple Choice Questions (MCQs) can sample broad domains of knowledge efficiently and reliably. The MCQs of lower order C1(Cognitive Level1=Recall of knowledge) do not fulfill this purpose and those of higher cognitive order C2 (Cognitive Level2=Interpret) &C3(Cognitive Level3=Analyze) are better at assessing the problem solving capabilities of the student. Every good educational activity must be supported by quality examination to complete the objectives of a curriculum. The objective of the study was to evaluate MCQs presently being used in internal examinations of medical colleges in Lahore. Papers consisting of MCQs from Orthopedics other specialties were collected in June 2019 from different medical colleges of Lahore and reviewed by a senior medical teacher without blinding and without his knowing the scores the students had been awarded before. Question statement, clinical scenarios, options and other mistakes were assessed in each item on predetermined criteria. Cognitive level of the item waction can be improved. Mistakes in spellings, grammar and conceptual mediocrity is common in both groups. To determi