## 4 Discussion
\begin{table}
\begin{tabular}{l c c c c} \hline \hline  & \multicolumn{4}{c}{**TREATED GROUPS**} \\
**PARAMETERS** & **DM** & **DM+A** & **DM+cART** & **DM+A+cART** \\ \hline Fasting glucose & \(\uparrow\) * & \(\uparrow\) * & \(\uparrow\) * & \(\uparrow\) * \\
**Testis morphometry** & & & & & \\ Testis weight & \(\downarrow\) & \(\downarrow\) * & \(\downarrow\) & \(\downarrow\) \\ Testis volume & \(\downarrow\) & \(\downarrow\) * & \(\downarrow\) & \(\downarrow\) \\ Testis size & \(\downarrow\) & \(\downarrow\) * & \(\downarrow\) & \(\downarrow\) \\
**Testicular component area fractions** & & & & \\
**(AF)** & & & & \\ Epithelial AF & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) \\ Lumen AF & \(\downarrow\) * & \(\uparrow\) & \(\downarrow\) * & \(\downarrow\) \\ Interstitial space AF & \(\uparrow\) * & \(\uparrow\) * & \(\uparrow\) * & \(\uparrow\)* \\ Connective tissue AF & \(\uparrow\) * & \(\uparrow\) * & \(\uparrow\) * & \(\uparrow\)* \\
**Tubule morphometry** & & & & \\ Tubule area & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) \\ Tubule diameter & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) \\ Epithelial height & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) \\ Lumen diameter & \(\downarrow\) * & \(\uparrow\) & \(\downarrow\) * & \(\uparrow\) \\
**Spermatogenic cell count** & & & & \\ Spermat & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) * & \(\uparrow\)* \\ Spermat & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\)* \\ Round spermatids & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\)* \\ Elongated spermatids & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\)* \\
**Testicular somatic cells** & & & & \\ Sertoli cell count & & \(\downarrow\) & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) \\ Leydig cell nuclear & -Diameter & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\)* & \(\downarrow\)* \\  & -Volume & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\)* & \(\downarrow\)* \\
**Histopathological evaluation** & & & & \\ Johnsen’s score & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) * \\ Lifting of epithelium & VSC & \(\downarrow\) & \(\uparrow\) & \(\uparrow\) \\ Epithelial sloughing & \(\uparrow\) & \(\uparrow\) * & VSC & \(\uparrow\)* \\ Karyolysis & VSC & \(\uparrow\) * & \(\uparrow\) * & VSC \\
**Connective tissue** & & & & \\ Seminiferous tubule basement & & & & \\ membrane thickness & & & & \\ Testicular capsule thickness & \(\downarrow\) & \(\uparrow\) * & \(\uparrow\) * & \(\uparrow\) * \\ Collagen & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\)* \\ Reticulin & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\)* & \(\downarrow\)* \\ Elastin & \(\downarrow\) * & \(\downarrow\) * & \(\downarrow\)* & \(\downarrow\)* \\
**Reproductive hormones** & & & & & \\ Luteinizing hormone & & & & & \\ follicle stimulating hormone & & & & \\ Tostostoreome & & & & \\ Inhibition B & & & & \\
**Androgen receptor (AR)** & & & & \\ Sertoli cell AR & & & & \\ Leydig cell AR & & & & \\ \hline \hline \end{tabular}  
* Significantly different compared to the control group. \(\uparrow\) = increase; \(\downarrow\) = decrease. Key: VSC, value same as the control group; DM, diabetes; DM+A, diabetes and alcohol; DM+cART, diabetes and combination antiretroviral therapy; DM+A+cART, diabetes and alcohol and combination antiretroviral therapy.  
\end{table} 
Table 4: Summary of the study’s results. they are intricately connected and can occur simultaneously in an individual [10; 11; 12; 13]. Such a conundrum might elicit severe testicular dysfunction. The present report highlights the impact of diabetes, alcohol, and cART interactions on the male reproductive capacity and male fertility. Morphometry and histopathology are widely used tools to determine perturbations in the testis structure and function [19; 37] and were utilized in the present study.