BACKGROUND:Diagnostic imaging is an integral aspect of care that is often insufficient, if not altogether absent, in rural and remote regions of low to middle income countries (LMICs) such as Tanzania. The introduction of ultrasound can significantly impact treatment in these countries due to its portability, low cost, safety, and usefulness in various medical assessments. This study reviews the implementation of a four-week ultrasound course administered annually from 2013–2016 in a healthcare professional school in Mwanza, Tanzania by first-year allopathic US medical students. METHODS:Participants (n=582, over 4 years) were recruited from the Tandabui Institute of Health Sciences and Technology to take the ultrasound course. Subjects were predominantly clinical officer students, but other participants included other healthcare professional students, practicing healthcare professionals, and school employees. Data collected includes pre-course examination scores, post-course examination scores, course quiz scores, demographic surveys, and post-course feedback surveys. Data was analyzed using two-tailed t-tests and the single factor analysis of variance (ANOVA). RESULTS:For all participants who completed both the pre- and post-course examinations (n=229, 39.1％ of the total recruited), there was a significant mean improvement in their ultrasound knowledge of 42.5％, P<0.01. CONCLUSION:Our data suggests that trained first-year medical students can effectively teach a point of care ultrasound course to healthcare professional students within four weeks in Tanzania. Future investigation into the level of long-term knowledge retention, impact of ultrasound training on knowledge of human anatomy and diagnostic capabilities, and how expansion of an ultrasound curriculum has impacted access to care in rural Tanzania is warranted.

Thyroid hormones exert a major control over many vital functions of the human body and thus have an important role in maintaining homeostasis. Therefore, the hypothyroid state is associated with a wide spectrum of symptoms affecting almost all bodily functions. Among the major organs affected, nervous system and body metabolism are severely affected. Facial appearance, including ocular changes, is a characteristic of the hypothyroid state. The most prominent ocular features of hypothyroidism include loss of eyelashes and eyebrows, especially on the temporal side, puffiness of the eyelids, ocular irritation and ocular protrusion. Mild drooping of the eyelids is also seen in some patients due to loss of sympathetic tone; however the occurrence of complete bilateral ptosis is rare in the setting of hypothyroidism. Our patient, who presented with sudden onset bilateral ptosis, had no manifestations of diseases involving the ocular structure, cranial nerves or central nervous system primarily; the cause may be attributed to severe hypothyroidism considering the dramatic response to thyroxine replacement therapy.
Hypothyroidism ; Thyroxine ; Myokymia