This study was conducted to evaluate cellular proliferation of germinal and non-germinal elements of seminiferous tubules following continuous Day 1 to Day 17 exposure of methotrexate (12.5 microgram) in male rats. There was significant decrease in the diameter of seminiferous tubules (P < 0.10) followed by increase of interstitial space (P < 0.01). The size of various stages of primary, secondary spermatocytes, and spermatids was altered significantly compared to controls. Vacuolization/decondensation of "chromatin-mass" in spermatocytes changed from rounded to oval. The size of the Sertoli and Leydig cells were reduced significantly. Basement membrane at some places seems to be disrupted and thin in experimental testis. Methotrexate induced cytotoxicity on the proliferation of cellular contents of seminiferous tubules elucidating the mechanism of dose-dependent drug induced testicular damage during spermatogenesis.

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This study reveals 1 year's experience of the introduction of thyroid function tests (TFT) in B P Koirala Institute of Health Sciences (BPKIHS), a Medical University situated in eastern Nepal. These were performed on theadvice of doctors working in this region. The rational TFT advice by the medical practitioners was evaluated according to how closely the advice was in line with the algorithms recommended in the textbooks. Only about 14% of the TFT advice followed some rational strategy. A retrospective analysis showed that rational TFT advice could have reduced the cost of a TFT investigation to 43.11% without altering the patient management and disease outcome. Continuing medical education (CME) lectures arranged for a limited number of doctors were found to improve the quality of the subsequentTFT advising pattern. This emphasizes the importance of CME while introducing a costly laboratory test panel (e.g.TFT, lipid profile) needing a strategic approach.

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