Asian Journal of Research in Medical and Pharmaceutical Sciences

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

Timi Fiekumo Buseri — 2026-09-28

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.

Distribution of Sorbic Acid Tube Precipitation and Leukocyte Adherence Inhibition Results in Two Clinically Selected Patient Cohorts: A Retrospective Descriptive Study

Celso Eduardo Olivier — 2026-10-09

Background: Hypersensitivity has been reported in association with sorbic acid and sorbate salts in susceptible individuals.

Objective: This retrospective descriptive analysis characterised the distribution of Tube Titration of Precipitins (TTP) and Leukocyte Adherence Inhibition Test (LAIT) responses to sorbic acid among patients with allergic multimorbidity and polysensitisation.

Methods: Two clinically selected outpatient cohorts (100 patients each) were identified from electronic medical records. Humoral immunoreactivity was assessed by TTP with sorbic acid solution in one cohort, while the other underwent an ex vivo sorbic acid challenge monitored by LAIT to examine cellular immunoreactivity. The cohorts were independent and lacked healthy controls, disease controls, and an independent diagnostic reference standard.

Results: All TTP observations were positive. The mean titre was 1:220, the median was 1:128, the mode was 1:128 and occurred 30 times, and the standard deviation was 1:167. LAI values extended from 0% to 98%; the mean was 29.4%, the median 25%, the standard deviation 28.6%, and the mode 0%, which occurred 29 times.

Conclusion: These clinically selected cohorts showed wide distributions of humoral and cellular immunoreactivity to sorbic acid. The data do not determine sensitivity, specificity, diagnostic utility, or immune endotypes. Accordingly, the findings are descriptive and hypothesis-generating and require prospective confirmation using appropriate controls and an independent diagnostic reference standard.

Prospective Evaluation of a Structured Management Protocol for Adhesive Small Bowel Obstruction: Gastrografin and Initial Severity Stratification

Mehdi Karami — 2026-10-15

Background: Adhesive small bowel obstruction (ASBO) is a frequent surgical emergency, and identifying patients who require early operative intervention remains challenging.

Aim: This study evaluated outcomes under a structured management protocol incorporating initial severity stratification and selective Gastrografin use.

Methods: A prospective, single-centre observational study included 32 patients aged ≥14 years with imaging-confirmed ASBO managed between January 2022 and December 2024. Patients underwent clinical, laboratory and radiological assessment, followed by nasogastric decompression and fluid resuscitation. Gastrografin was administered selectively to patients without severity criteria who did not improve with initial management.

Results: Medical treatment alone resolved obstruction in 5 of 32 patients (15.6%). Seven patients underwent a Gastrografin challenge, of whom four (57.1%) avoided surgery. Overall, nine patients (28.1%) were managed conservatively, while 23 (71.9%) underwent laparotomy. Bowel resection was performed in eight of 23 operated patients (34.8%). All eight resections occurred among the 15 patients with a positive initial severity profile; none occurred among the 17 patients without such criteria (Fisher's exact test, p<0.001). Complications were recorded in five of 30 evaluable patients (16.7%). Median hospital stay was 4.5 days after conservative management and 6.5 days after surgery (p=0.053).

Conclusion: The structured protocol permitted non-operative resolution in a subset of patients. Initial severity criteria were associated with bowel resection, although the small sample and non-random allocation limit interpretation.

Neuropathological Changes Induced by Microplastics Associated with Sachet Water in Wistar Rats: Implications for Human Neurological Health

Victor C. Chibueze — 2026-10-16

Background: The widespread consumption of sachet water in Nigeria has raised concerns about microplastic contamination and associated health risks, particularly after environmental exposure during storage. Although microplastics have been associated with oxidative stress and neurotoxicity, limited data exist on the neurological effects of ingestion through drinking water.

Aim: This study investigated the neurotoxic effects of microplastic-contaminated sachet water in Wistar rats.

Study Design: A controlled in vivo experimental study involving twenty male Wistar rats randomly assigned to five groups.

Place and Duration of Study: The study was conducted in Enugu State, Nigeria. Experimental exposure lasted 30 days following a two-week acclimatisation period.

Methodology: Two sachet water brands (AX and NM) were categorised into sunlight-exposed and unexposed groups. Twenty male Wistar rats were randomly assigned to five groups and orally exposed to the water samples for 30 days. Physicochemical analysis and Fourier transform infrared (FTIR) spectroscopy were performed. Brain tissues were analysed for neurotransmitters, oxidative stress markers, and histopathological changes. Data were analysed using one-way ANOVA (p < 0.05).

Results: FTIR analysis revealed spectral features potentially associated with polymeric materials in the investigated water samples, including the control. Significant overall differences were observed in glutamate, glutamate decarboxylase activity, dopamine, gamma-aminobutyric acid, norepinephrine, reduced glutathione, glutathione peroxidase, malondialdehyde, and catalase. The sunlight-exposed NM group exhibited the highest mean glutamate and dopamine concentrations and the lowest mean reduced glutathione and catalase values. Histopathological examination revealed alterations including gliosis and mononuclear cell infiltration in exposed groups.

Conclusions: Chronic consumption of sunlight-exposed sachet water was associated with oxidative stress, neurochemical imbalance, and structural brain changes in Wistar rats, highlighting potential neurological risks and the need for improved packaging, storage, and regulation.

Comparative Assessment of Phostoxin-Induced Biochemical and Histopathological Renal Toxicity in Male and Female Wistar Rats

Etu Esther Ifeyinwa — 2026-10-17

Background: Phostoxin, an aluminium phosphide–based pesticide, is widely used as a fumigant but poses significant health risks due to its potential to cause oxidative and organ toxicity.

Aim: This study conducted a comparative assessment of phostoxin-induced biochemical and histopathological renal toxicity in male and female Wistar rats.

Methods: Thirty-six Wistar rats were assigned to three groups (n = 12 per group). Treatment groups were exposed to phostoxin for 30 and 60 days, while control rats were maintained under normal air conditions. Serum levels of sodium (Na⁺), potassium (K⁺), chloride (Cl⁻), bicarbonate (HCO₃⁻), urea, and creatinine were analysed using standard biochemical methods. Renal tissues were processed for histopathological evaluation using haematoxylin and eosin staining.

Results: Phostoxin exposure caused a significant (p < 0.05) elevation in serum sodium and chloride levels and a corresponding decline in potassium levels compared with controls. Bicarbonate levels decreased slightly but not significantly. Urea and creatinine concentrations increased markedly (p < 0.05) after prolonged exposure, indicating impaired renal function. Histopathological analysis revealed mild haemorrhage, glomerular infiltration, and vacuolar degeneration after 30 days, whereas 60-day exposure resulted in glomerular distortion, tubular necrosis, and extensive vacuolation.

Conclusion: These findings indicate that chronic inhalation of Phostoxin induces significant biochemical and histological alterations in the kidneys of both male and female rats, reflecting dose- and duration-dependent nephrotoxicity.

Comparative Effects of Atracurium and Rocuronium on Perioperative Blood Glucose in Non-Diabetic Patients Undergoing Appendectomy under General Anesthesia

Hayder Hasan Khudhiar — 2026-10-17

Aims: To compare perioperative capillary blood glucose levels between non-diabetic patients receiving atracurium or rocuronium during general anaesthesia for appendectomy.

Study Design: A prospective, randomised, two-group clinical study.

Place and Duration of Study: The study was conducted in Najaf, Iraq, from October 2025 to January 2026.

Methodology: Thirty non-diabetic patients undergoing appendectomy under general anaesthesia were allocated into two equal groups. Group A received atracurium (0.5 mg/kg; n = 15), while Group B received rocuronium (0.6 mg/kg; n = 15). Capillary blood glucose was measured at three time points: 10 minutes before induction, 10–15 minutes after induction, and 10 minutes after surgery. Data were analysed using GraphPad Prism 9.0. A two-way repeated-measures ANOVA with Geisser–Greenhouse correction was performed, followed by Šídák’s multiple comparisons test. Results were expressed as mean ± standard error of the mean (SEM), with statistical significance set at P < 0.05.

Results: Preoperative blood glucose concentrations were comparable between the atracurium and rocuronium groups (92.40 vs 90.27 mg/dL; adjusted P = 0.3109). Intraoperative glucose concentrations were higher in the atracurium group (115.00 vs 105.47 mg/dL; adjusted P < 0.0001). This difference persisted postoperatively (113.33 vs 107.60 mg/dL; adjusted P < 0.0001). Repeated-measures ANOVA demonstrated a significant interaction between treatment group and measurement time (P < 0.0001).

Conclusion: Intraoperative and postoperative blood glucose concentrations were significantly higher in the atracurium group than in the rocuronium group. Repeated-measures analysis demonstrated a significant interaction between neuromuscular blocking agent and measurement time. However, the small sample size and potential clinical confounding factors limit causal interpretation. Further controlled studies are required to confirm these findings and determine their clinical significance.

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

Ketan Vagholkar — 2026-09-21

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.

Exercise Echocardiography in the Diagnostic Work-up of Unexplained Dyspnoea: A Critical Narrative Review of Physiological Targets, Diagnostic Performance and Unresolved Controversies

Malki Mohamed — 2026-10-23

Background: Chronic exertional dyspnoea frequently remains unexplained after clinical assessment, natriuretic peptide measurement and resting echocardiography. Many underlying cardiovascular abnormalities, particularly heart failure with preserved ejection fraction and exercise pulmonary hypertension, become apparent only during physiological stress. Exercise echocardiography is non-invasive, widely available and free of ionising radiation, but its diagnostic role outside ischaemia testing remains contested.

Purpose and Scope: This critical narrative review evaluates the evidence supporting exercise echocardiography in adults with chronic exertional dyspnoea that remains unexplained after first-line evaluation. It examines test conduct and feasibility, the diastolic stress test, pulmonary vascular and right ventricular responses, ischaemic, valvular and dynamic obstructive causes, and multiparametric approaches incorporating lung ultrasound, cardiopulmonary exercise testing and artificial intelligence.

Methods: Literature was identified through structured searches of bibliographic databases and scholarly indexes, supplemented by citation tracking and professional-society guidance. Evidence was appraised with attention to patient spectrum, reference standards, feasibility reporting and outcome relevance, and synthesised thematically.

Principal Findings: Invasive studies consistently show that exercise unmasks haemodynamic abnormalities that resting tests miss. Exercise-derived echocardiographic abnormalities, including elevated filling-pressure surrogates, exercise pulmonary hypertension and exercise-induced pulmonary congestion, carry consistent prognostic information. The diagnostic accuracy of individual markers, especially the ratio of early mitral inflow to early diastolic annular velocity, is considerably less secure: validation studies conflict, largely because of differences in patient spectrum, reference standards and measurement timing. Tricuspid regurgitation signals are frequently unobtainable at peak exercise, and the incremental value of stress testing over probability scores appears modest in several invasive validation cohorts. Left atrial mechanics, systolic reserve, cardiac output-indexed pulmonary pressures and lung ultrasound show promise but require external validation.

Unresolved Questions: Consensus is lacking on the reference standard, age- and sex-specific normal responses, optimal protocols and the effect of test-guided management on patient outcomes.

Implications and Conclusion: Exercise echocardiography is best regarded as a question-driven, multiparametric physiological test integrated with pre-test probability and, where available, gas-exchange measurement, rather than as a single-parameter rule-in or rule-out tool. Prospective multicentre studies with invasive reference standards and outcome-oriented diagnostic trials are needed before stronger recommendations can be justified.

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

Giovanna Azevedo Rodrigues — 2026-09-24

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.