ABSTRACT
Introduction: Hypothyroidism, a risk factor for atherosclerotic cardiovascular disease has been seen to be associated with hyperhomocysteinemia. The plasma levels of homocysteine and its relationship with hypothyroidism was assessed. Material and Methods: A total of 120 patients aged 20 – 60 years comprising of 60 hypothyroid and 60 euthyroid controls were assessed for the study. Evaluation of plasma homocystein was done using human homocysteine ELISA my BioSource. FT3, FT4 and TSH were also evaluated by enzyme linked immunosorbent assay (ELISA) technique using stat fax-2100. Result: In our study, we have found the values of FT3 in the subjects as 1.21+ 0.89pg/ml lower than controls values of 1.92+0.66pg/ml, values of FT4 in subjects as 0.60+0.53ng/dl as compared to control group value of 1.40+0.30ng/dl, values of TSH as 2.07+1.19µiU/ml higher than the control group of 0.48+1.67µiU/ml. The mean values of plasma homocysteine (Hcy) for subjects was 34.50+10.01µmol/L higher than the control group with 9.30+2.11µmol/L. Conclusion: Our study findings suggest that patients with hypothyroidism also have a high plasma homocysteine known to pose cardiovascular complications.

ABSTRACT
Introduction: Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Approximately one in six people have experienced infertility at some stage in their lives. In Tanzania, the prevalence of infertility is 16%. Most couples suffer from this condition silently without knowing what to do. FEMM (Fertility Education and Medical Management) has come to bring back hope and happiness in these patients. Case series: Here we present four cases of women with subfertility who have suffered for more than five years without being able to conceive. Very interesting they all conceived within two to four months after using the FEMM approach. Currently, they are all pregnant at different gestation ages. Conclusion: Women who are not ovulating cannot conceive. Many times the answers to infertility are hiding in plain sight within the patterns of a woman's menstrual cycle. Failure to ovulate is the first sign of an underlying health condition in a woman followed by irregular cycles. Observing characteristics of cervical mucus is a simple and non-expensive biomarker any woman can tell you about. Fertility awareness together with medical management helped these women to conceive.

ABSTRACT
Work related stress is the adverse reaction as a result of excessive work pressure. As new diseases such as Corona virus, Ebola, Lassa fever, Monkey pox, etc evolves each day, so technology and new skills to tackle such diseases are required. In addition to clinical nursing care, the need to learn and practice how to use modern equipment in patients’ care to combat such diseases imposes more stress on the nurses. The world population is also on the increase, hence the need for healthcare services is also increasing. Contrarily, there are (six) 6 million global nurses’ shortage presently. The recent Covid 19 pandemic is also putting on more stress on the nursing workforce forcing many nurses to leave their job as a result of work-related stress. The study aimed at investigating key interventions that will reduce work relate and enhances nurses work performance.

ABSTRACT
Objective: To assess ocular findings among patients with leprosy and ex-leprosy at Nazareth Leprosy Center. Methodology: An analytical cross sectional study was conducted at Nazareth Leprosy Center in Morogoro region, from June to December 2021.All patients with leprosy and ex-leprosy patients who were available at Nazareth during the study period were interviewed and examined. A total of 88 participants were enrolled in the study and their socio-demographics, clinical history and ocular examination findings were analysed. Results: There were 53 (60.2%) males and 38 (43.2%) of participants were between the age of 54 to 70 years with a median age 64 years. Majority, 66 (75%), were unemployed and 46.6% had no formal education. Participants with multibacillary type of leprosy were 72.7% and forty three (48.9%) resided at the leprosarium Center. Ocular findings were present in 69% of study participants. Cataract was the most common (45.5%), 15.6% had lagophthalmos, 9.1% had keratitis and 9% uveitis. There were 19 (21.6%) patients who were blind with the best corrected visual acuity of less than 3/60 in the better eye. Conclusion: Patients with leprosy and ex-leprosy have significant prevalence of ocular pathologies which affects their vision. Patients with low socio-economic status and Multibacillary type of leprosy are more affected. Cataract is the most common cause of visual impairment, however other sight threatening conditions like lagophthalmos, exposure keratitis and uveitis are also common.

ABSTRACT
Background: Piriformis syndrome is a neuromuscular disorder where the sciatic nerve is compressed or irritated by the inflammation of piriformis muscle representing pain, tingling and numbness in the buttock region and in the course of sciatic nerve. Piriformis syndrome can be painful, but it is very rarely alarming and needs surgical interventions. It can be managed effectively by conservative means such as NSAIDS, analgesics and physiotherapy interventions like stretching, electro therapeutic modalities, myofascial release, thermo therapies, etc. The purpose of this study is to compare the effect of sciatic nerve gliding exercise with hip abductor strengthening exercises versus piriformis stretching exercises in software professionals who are sitting for prolong hours in office and diagnosed with piriformis syndrome. Materials & Methods: 30 patients with piriformis syndrome, reporting at the OPD of Physiotherapy Department were evaluated according to the inclusion and exclusion criteria and were divided into Group A (experimental) N=15, Group B (control) N=15 randomly. Their baseline data with respect to age, sex, pain in VAS, hip internal rotation range by goniometer, and disability evaluation by MODQ were taken on day 1 of the treatment and day 15 of the treatment. Data analysis was done by Mann Whitney ‘u’ test for subjective data and unpaired ‘t’ test for objective data analysis with 95%confidence interval. Results: The patients treated with sciatic nerve sliding exercise and abductor strengthening (Group A) showed statistically significant decrease in pain (p=0.00), increase in range of motion for hip internal rotation (p=0.00) and decrease in disability level according to MODQ (p=0.00) after 15 days of interventions as compared to Group B who were treated by piriformis stretching exercises. Conclusion: This study has shown significant improvement in the experimental group (group A) in respect to pain relief, hip internal rotation range of motion, and .......

ABSTRACT
Pesticides are integral to modern agriculture and public health but pose significant risks to human and environmental health. This study investigates the impact of selected pesticides on male reproductive health via inhalation in an improvised chamber. Male Wistar rats were assigned to groups and exposed to individual pesticides and a combined mixture to determine lethal doses. Tissue samples from 54 rats were analyzed histologically and biochemically for effects on testes and epididymides, with measured serum testosterone and GSH levels. Sniper consistently showed the highest significant decrease in GSH levels across all exposure levels (p < 0.05). A significant dose-dependent relationship was observed in the recovery groups from 25% to 75% exposure (p < 0.05). Pesticide exposure led to a substantial decrease in serum testosterone levels in male Wistar rats at 25% (all pesticides, p < 0.05), 50% (DD Force, Sniper, Kerosene, Combined, p < 0.05), and 75% (DD Force, Industrial Camphor, Edible Camphor, Kerosene, p < 0.01) concentrations. Escalating damage in testicular and epididymal structures, with a more pronounced severity at higher exposure levels, including epithelial degeneration, Sertoli cell vacuolation, seminiferous tubule derangement, and ductal atrophy. Increased exposure to high doses of pesticides induces oxidative stress in male Wistar rats which could potentiate decreased testosterone levels and adversely impact the histological architecture of the testes and epididymides. Pesticide detoxifications are somewhat evident following withdrawal from the environmental insults. Significant and persistent damage occurred at higher levels, suggestive of substantial reproductive toxicity following exposure.

ABSTRACT
Background: Indeed, AKI is a common complication in ICU patients, and it is associated with an increase in morbidity and mortality as well as healthcare costs. Recognizing AKI risk factors in LMIC settings is important for intervention approaches. Objectives: The objectives of this study are as follows: To determine the incidence of AKI based on RIFLE criteria among the critically ill patients in a tertiary care hospital in Bangladesh and to analyze the impact of the presence of comorbidities on the development of AKI in these patients. Methods: This prospective observational study was carried out at the ICU of Community Based Medical College in Bangladesh from January to December 2023. The target subjects were adult patients who were admitted to the ICU for a period of 24 to 48 hours. Patients with AKI were categorized using RIFLE criteria based on serum creatinine and urine output. For the univariate and multivariate logistic regression, demographic data, comorbidities, and clinical characteristics were collected. Results: In the present study of 22 patients with a mean age of 42.16 years and 63.6% of male patients, 86.4 percent of the patients had AKI according to both serum creatinine and urine output criteria. Sepsis/septic shock ([OR] 2. 2, [CI] 0. 8–5. 8) and cardiac etiology ([OR] 2. 7, [CI] 1. 0–7.1) were significant predictors of AKI. The study revealed that respiratory disease [OR. = 3.56, 95% confidence interval (CI): 0.33–38.78] and hematologic malignancy [OR. = 4.20, 95% CI: 0.40–43.82] were the comorbid conditions most closely associated with AKI. Conclusions: This research shows a very high prevalence rate of AKI among the clients in critical conditions in Bangladesh. Sepsis, cardiac dysfunction, respiratory disease, and hematologic malignancies emerged as significant factors. The results are therefore informative for programs aimed at improving AKI awareness, early detection activities, and prevention efforts in low-resource settings.