## 3 Results
### Testicular Capsule Thickness  
The testicular capsule, also referred to as the tunica albuginea, is composed of mostly collagen fibers braced with a network of myoid cells (Figure 3). The thickness of the capsule was significantly increased in the DM+A and DM+A+cART treated groups in comparison with the control group (\(p\) = 0.0002 and \(p\) = 0.0055, respectively). The DM and DM+cART treated groups showed an insignificant (\(p\) > 0.05) decrease and increase in the capsule thickness, respectively, compared to the control griyo, but the capsule thickness increased significantly (\(p\) = 0.0002) in the DM+cART group relative to the DM group (Figure 2).  
\begin{table}
\begin{tabular}{l l l l l} \hline \hline
**Animal Groups** & **Control** & **DM** & **DM+A** & **DM+cART** & **DM+A+cART** \\ \hline [PERSON]’s score & & & & & \\ Histological changes & 8.81 & 8.44 \({}^{\text{a}}\) & 4.04 \({}^{\text{a}}\) & 8.61 & 8.62 \\ Lifting of the & & & & & \\ epithelium & 0.04 & 0.04 & 0.00 & 0.13 & 0.58 \({}^{\text{c}}\) \\ Epithelial sloughing & 0.00 & 0.08 & 0.63 \({}^{\text{ad}}\) & 0.00 & 0.29 \({}^{\text{ad}}\) \\ Karyolysis & 0.00 & 0.00 & 0.25 \({}^{\text{abe}}\) & 0.25 \({}^{\text{abe}}\) & 0.00 \\ \hline \hline \end{tabular}  
* In the same row, different superscripts \({}^{\text{a}}\), \({}^{\text{b}}\), \({}^{\text{d}}\), and \({}^{\text{c}}\) represent significant differences (\(p\) < 0.05) as analyzed by [PERSON]’s multiple comparison test: \({}^{\text{a}}\) significantly different compared to the control group, \({}^{\text{b}}\) significantly different compared to DM+A, \({}^{\text{c}}\) significantly different compared to DM+A, \({}^{\text{d}}\) significantly different compared to DM+A+cART, and \({}^{\text{e}}\) significantly different compared to DM+A+cART. Key: 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 3: Median Johnsen’s scores and histological changes observed in animal groups.  
Figure 2: Representative photomicrographs of an H&E-stained testicular section. Testis of the control group (image **(A)**) showed a normal oval-shaped seminiferous tubule (ST) separated by a layer of interstitial connective tissue (thick arrow). Changes in the normal testicular morphology were observed in animals from the treated groups. Image **(B)** (DM group) shows an increased interstitial space (double arrow), image **(C)** (DM+A group) shows extensive tubular atrophy and germinal epithelium derangement (arrowheads), image **(D)** (DM+cART group) shows lifting of the epithelium (thin arrow), and image **(E)** (DM+A+cART group) shows epithelial sloughing (arrowheads). Images **(F-J)** are magnified views of the square area indicated in images **(A-E)**. As demonstrated in the image, **(F)** is the germinal epithelium (double arrow) consisting of a discretely arranged series of spermatogenic cells and a lumen (asterisk), **(G)** shows germ cell pyknosis (thin arrow), H shows a ghost cell (thick arrow) and widened intercellular space (arrowhead), **(I)** shows karyolysis (thin arrow), and **(J)** shows sloughed germ cells in the lumen (asterisk) and germ cells of increased size (arrowheads), DM, diabetes; DM+A, diabetes and alcohol; DM+cART, diabetes and combination antiretroviral therapy; DM+A+cART, diabetes and alcohol and combination antiretroviral therapy. The left and right panels are \(\times 100\) and \(\times 400\) magnifications with scale bars of \(200\) μm and \(50\) μm respectively.