Asian Journal of Research in Medical and Pharmaceutical Sciences

Haloperidol as a Novel Augmentation Strategy in Treatment-Resistant Depression: A Clinical Practice Perspective with Case Series

2026-09-24T10:50:54+00:00

Treatment-resistant depression (TRD) remains a major clinical challenge when adequate antidepressant trials fail to achieve remission. This clinical practice perspective examines low-dose haloperidol as a potential augmentation strategy in carefully selected, treatment-refractory affective presentations. The manuscript combines an integrative theoretical review of dopaminergic dysregulation with an observational case series of three inpatients with severe treatment-refractory depression, including bipolar and unipolar presentations. Clinical outcomes were evaluated through psychiatric assessment and symptom-severity measures, with attention to depressive symptoms, suicidal ideation, anxiety, psychomotor activity, sleep, and neurological adverse effects. Following the introduction of low-dose haloperidol alongside existing treatment, all three patients showed clinically meaningful short-term improvement, including resolution or reduction of suicidal ideation, mood stabilisation, reduced anxiety, improved sleep, and greater psychomotor or social engagement. At three-month follow-up, two patients remained clinically stable on the augmented regimen, while one patient required haloperidol dose reduction because of mild parkinsonian symptoms, which subsequently resolved. Interpretation is limited by the small uncontrolled sample, concomitant medications, inpatient therapeutic milieu, selection bias, and brief follow-up. The findings therefore do not establish efficacy or causality. Rather, they support a preliminary clinical-neurobiological hypothesis that warrants systematic evaluation in controlled studies with rigorous neurological monitoring and longer-term safety assessment in future research.

Utilization, Correlates and Predictors of Contraceptive Use among Married Women in Amassoma, Bayelsa State, Nigeria

2026-09-28T13:06:48+00:00

Background: Nigeria's national modern contraceptive prevalence rate among married women remains low, at roughly 12% to 20%, with wide sub-national variation, and a recurring explanation is that awareness of contraceptives does not reliably translate into use. This study determined the prevalence and pattern of contraceptive use among married women in Amassoma, Bayelsa State, Nigeria, and tested whether knowledge of contraceptives and socio-demographic factors (age, education, occupation and parity) are associated with, and independently predictive of, use.

Methods: A descriptive cross-sectional study was conducted in 2024 among 400 married women using a structured, interviewer-administered questionnaire (100% response rate). Prevalence and pattern of use were summarised as frequencies and percentages. Five bivariate hypotheses linking knowledge, age, education, occupation and parity to contraceptive use were tested using the Chi-square test of association, and a multivariable binary logistic regression model, adjusted for age, education, parity and knowledge, was fitted to identify independent correlates of use. Significance was set at p<0.05, and key distributions are presented as pie and bar charts.

Results: Of the 400 respondents, 281 (70.3%) were current contraceptive users. Among users, implants were by far the most commonly used method (65.1%), followed by pills (11.0%), withdrawal (7.5%), calendar/rhythm method (5.0%), condoms (4.3%), lactational amenorrhoea method (3.9%) and injections (3.2%). More than one-third of users (37.7%) had used their current method for about five years, while 28.1% had started within the past year. Contraceptive use was significantly associated with knowledge of contraceptives (X²=52.261, p<0.001), age (X²=25.145, p<0.001), education (X²=15.575, p=0.004), occupation (X²=15.993, p=0.007) and parity (X²=15.828, p=0.003) at the bivariate level. In the adjusted logistic regression model, knowledge of contraceptives remained a strong, independent predictor of use (adjusted odds ratio [aOR]=6.53, 95% CI: 3.39-12.60, p<0.001), and women aged 31-36 years had significantly higher odds of use than the youngest reference group (aOR=3.14, 95% CI: 1.16-8.47, p=0.024). Education, occupation and parity did not retain independent significance after adjustment.

Conclusion: Contraceptive utilisation among married women in Amassoma is considerably higher than national and several sub-national averages, driven substantially by a strong preference for implants. All five hypothesised correlates were supported at the bivariate level, but knowledge of contraceptives emerged as the dominant, independent driver of use even after accounting for socio-demographic factors, indicating that closing the knowledge gap is likely to be the single most impactful lever for improving contraceptive uptake in this community.

Hyperbaric Oxygen Therapy in Non-Healing Wounds: A Critical Narrative Review of Mechanisms, Clinical Applications and Outcomes

2026-09-21T14:03:27+00:00

Non-healing wounds impose a substantial and rising clinical and economic burden, and hyperbaric oxygen therapy remains one of the most contested adjuncts in their management. Half a century of mechanistic work has established that intermittent hyperoxia raises dissolved plasma oxygen far above the physiological range, generates a controlled oxidative stress, activates hypoxia-inducible factor signalling, mobilises vasculogenic progenitor cells and augments oxidative bacterial killing. Translation of that biology into reproducible clinical benefit has, however, been inconsistent. This critical narrative review examines why mechanistic plausibility and clinical performance have diverged, and defines the conditions under which the therapy can be defended. Peer-reviewed literature was identified through structured searching of biomedical databases and open scholarly indexes, supplemented by backward and forward citation tracking, publisher records and retraction notices, with bibliographic details and digital object identifiers verified individually. The synthesis is organised around mechanisms, the randomised and observational evidence in diabetes-related foot ulceration, the evidence position in late radiation tissue injury, venous leg ulceration, necrotising soft tissue infection, compromised flaps and rare refractory wounds, and the determinants of patient selection, dose, safety and cost. Randomised trials in diabetes-related foot ulceration diverge sharply, and this divergence tracks systematically with baseline perfusion, ulcer severity, comparator design and per-protocol treatment exposure rather than with chance alone. Aggregated syntheses reproduce these differences and have additionally been contaminated by several retracted meta-analyses, an underappreciated threat to the integrity of the pooled estimates now entering guidelines. The evidence is strongest for ischaemic, severe-grade ulceration in patients with measurable oxygen responsiveness and weakest for well-perfused, non-ischaemic wounds. Prospective, physiologically stratified randomised trials with adequate treatment exposure and standardised endpoints are the principal unmet requirement. Until such trials are reported, hyperbaric oxygen therapy is best regarded as a selectively indicated adjunct rather than a general treatment for wounds that fail to heal.