Asian Journal of Medicine and Health

Effectiveness of Nurse-led Family Planning Counseling Program: A Systematic Review

Evidence Ngozi Otobo — 2026-04-03

Background: Family planning counseling is a key component of reproductive health services that enables individuals and couples to make informed decisions regarding the number, spacing, and timing of their children. Nurses play a critical role in delivering family planning education and counseling due to their accessibility and continuous interaction with patients. However, evidence on the effectiveness of nurse-led counseling programs remains dispersed across different settings and study designs.

Objective: This systematic review aimed to evaluate the effectiveness of nurse-led family planning counseling programs in improving contraceptive knowledge, attitudes, intention to use contraception, and contraceptive uptake among women of reproductive age.

Methods: This review followed PRISMA 2020 guidelines and was prospectively registered in PROSPERO (CRD420261346636). A comprehensive search was conducted in PubMed, Scopus, and Web of Science, supplemented by manual reference screening. Studies were included if they examined nurse-led counseling interventions with measurable family planning outcomes. After screening, ten studies met the inclusion criteria and were synthesized narratively due to heterogeneity.

Results: Nurse-led counseling interventions significantly improved contraceptive knowledge, attitudes, and intention to use contraception. Several studies also reported increased uptake of modern contraceptive methods. However, knowledge gains did not consistently translate into contraceptive use due to sociocultural barriers, partner influence, misconceptions, and health system limitations.

Conclusion: Nurse-led family planning counseling improves reproductive health knowledge and supports informed contraceptive decision-making. Strengthening nurse training, enhancing counseling quality, and integrating counseling into routine services may improve contraceptive uptake. Further research is needed to evaluate long-term effectiveness across diverse settings.

A Systematic Review of Factors Affecting Uptake of Contraception amongst Adolescents in Nigeria

Obinna Tobechukwu Okonyia — 2026-04-17

Background: Adolescent contraceptive uptake remains a major public health concern in Nigeria, where high rates of unintended pregnancy contribute to adverse health, educational, and socioeconomic outcomes. Despite widespread awareness of contraceptive methods, utilization among adolescents remains low, suggesting the influence of multiple interacting factors.

Objective: This study aimed to systematically review the factors affecting contraceptive uptake among adolescents in Nigeria.

Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered with PROSPERO (CRD420261364491). Electronic databases including PubMed, Scopus, Web of Science, CINAHL, and Google Scholar were searched for studies published between 2000 and 2025. Eligible studies included observational and mixed-methods research focusing on adolescents aged 10–19 years in Nigeria. Data extraction and quality assessment were performed independently by two reviewers. Due to heterogeneity across studies, findings were synthesized narratively.

Results: Fifteen studies met the inclusion criteria. Although awareness of contraceptive methods was consistently high, utilization remained low across studies. Key individual determinants included age, educational level, knowledge gaps, and fear of side effects. Interpersonal factors such as partner approval, parental communication, and peer influence significantly shaped contraceptive behaviour. Sociocultural and religious norms, stigma, and gender inequalities were identified as major barriers, particularly among unmarried adolescents. Socioeconomic disparities and rural residence further limited access to services. Health system challenges, including lack of adolescent-friendly services, provider bias, confidentiality concerns, and commodity stock-outs, also reduced utilization. Conversely, exposure to family planning information through mass media was consistently reported as a facilitator of contraceptive uptake.

Conclusion: Contraceptive uptake among adolescents in Nigeria is influenced by interconnected factors operating at multiple levels. Addressing these challenges requires comprehensive, culturally sensitive interventions and strengthened adolescent-friendly health services to improve utilization and reproductive health outcomes.

The Impact of Clinical Factors on Health-related Quality of Life in Adult Patients with Asthma

Raed Abdullah Alharbi — 2026-04-01

Background: Several clinical factors, such as: depression, obesity, and diabetes, have been linked to asthma in different ways, affecting health-related quality of life (HRQoL) in patients with asthma.

Aim: Asthma is a long-term lung illness that causes a variety of respiratory difficulties that significantly affect an adult patient's quality of life in terms of physical and mental health as well as activity limitation. Additionally, a variety of related factors can exacerbate asthma. Clinical factors, such as: depression, obesity, and diabetes, are among the most significant categories of these factors. Thus, the purpose of this study is to examine how these clinical characteristics affect health-related quality of life.

Methodology: The Behavioural Risk Factor Surveillance System in the United States provided open-source data for this investigation. It is a telephone-based health survey that gathers information from Americans. The Statistical Analysis System (9.4 version) was used for various descriptive, inferential, and predictive analysis techniques in order to achieve the study's goal.

Results: 42,875 of the 461,436 patients in the BRFSS 2014 data are current adult asthma patients. Of these asthmatic patients, 14,095 suffer from depression, and asthmatic patients 14,749 are obese. Among these asthmatic individuals, 7,392 have diabetes. Each clinical factor and measures of health-related quality of life were statistically significantly correlated, according to all p-values of various analyses.

Conclusions: The results of this study show that adult asthma patients with these clinical factors are more likely to have poor health-related quality of life than adult asthma patients without these clinical factors.

Lifestyle Changes of Type 2 Diabetes Subjects Expressing CDKN2A in Some Tribes in Nigeria

Obi, Chidinma Doris — 2026-04-03

Background: Type 2 diabetes (T2D) is characterised by pancreatic beta-cell dysfunction and insulin resistance resulting from the interaction of genetic and environmental factors. The cyclin-dependent kinase inhibitor 2A (CDKN/2A) gene locus has been implicated in T2D susceptibility through genome-wide association studies (GWHAS). However, the molecular mechanisms underlying this association remain elusive. The CDKN2A gene locus is associated with an increased risk of developing T2D. Variants in the CDKN2A gene have been linked to impaired insulin secretion and an increased risk of T2D.

Aim: The study aims to evaluate lifestyle changes among type 2 diabetes subjects expressing the CDKN2A gene in some tribes in Nigeria.

Methods: This is a cross-sectional study involving 120 female and male participants from the Ijaw, Ogoni, Ikwerre, and Igbo tribes, aged 34-84, attending diabetic clinics at two tertiary hospitals. The Transcript Variants of the CDKN2A gene and biochemical: fasting blood sugar HBA1C, c-peptide, insulin, cystatin C, leptin and homa IR in type 2 markers in type 2 diabetics mellitus subjects from selected ethnic groups. Well-structured questionnaires were randomly administered to the 120 subjects. The gene transcript variants of CDKN2A present in T2DM were assessed and quantified with PCR. Biochemical prognostic markers were determined: Fasting Blood Glucose, HbA1C, Insulin, C-peptide, Leptin, Cystatin C, and HOMA-IR for T2D using immunoassays. The data were analysed using GraphPad Prism (version 8.0.2), with ANOVA, Chi-Square Tests, and Pearson’s correlation; P-values less than 0.005 were considered statistically significant.

Results: The results revealed significant associations (p < 0.05) between all examined lifestyle factors and T2D among individuals carrying the CDKN2A gene. The study indicates that HOMA-IR levels are elevated in T2D (P=0.044) following a special diet, suggesting potential difficulties in glycaemic control despite dietary changes. Furthermore, in patients with Type 2 diabetes not on a special diet, CDKN2A CT values are significantly higher (p=0.019), possibly indicating a role for dietary interventions in gene expression. Additionally, BMI levels were higher in smokers compared to non-smokers among type 2 diabetic subjects, highlighting a potential impact of smoking on metabolic health (p=0.042). A significant association was observed between HbA1c and Leptin (p=0.003), whilst CDKN2A levels were associated with insulin and FBS (p=0.003). Other variables demonstrated that TRNA is significantly associated with C-peptide (p=0.001). Significant correlations were noted between HbA1c, FBS, insulin, and HDL-1R in CDKN2A gene carriers with T2D who engaged in regular exercise. A notable association was also identified among those not on a special diet. Regular exercise has been shown to improve glycaemic control and reduce HbA1c levels in type 2 diabetes (T2D). Based on this research, age does not appear to play a significant role in glycaemic control and insulin resistance as long as proper interventions such as appropriate medication, regular exercise, and abstinence from smoking and alcohol are employed. The study further indicates that a special diet does not influence Type 2 diabetic subjects who do not adhere to other lifestyle modifications. Additionally, it notes that exercise reduces the risk of early expression of the CDKN2A gene, which predisposes to Type 2 Diabetes, by a factor of 3 compared with non-exercisers.

Conclusion: This knowledge can inform the development of novel biomarkers for early detection and monitoring of T2D. Furthermore, targeting specific genes and pathways involved in T2D pathogenesis may lead to more effective therapeutic strategies.

Effects of Patient Behaviour and Work Experience in Needle Stick Injuries among Healthcare Practitioners in Tertiary Hospitals, Rivers State, Nigeria

Precious Friday Amadi — 2026-04-04

Introduction: The behaviour of patients plays a vital role in reducing the risk of needle-stick injuries. Uncooperative or agitated patients can make it challenging for healthcare workers to administer procedures safely, more difficult when the healthcare worker does not have enough experience to handle such. Hence, this study investigated the effects of patient behaviour and work experience in needle stick injuries among healthcare practitioners in tertiary hospitals, Rivers State.

Materials and Methods: The study adopted descriptive correlational survey design with a population of 4,100 healthcare workers in the three functional tertiary health institutions in Rivers state (University of Port Harcourt Teaching Hospital, Rivers State University Teaching Hospital and Madonna University Teaching Hospital). A sample size of 879 was predicted using Cochran formula and a multi-stage sampling procedure. Pearson Products Moment Correlation was used to obtain a Reliability coefficient value of 0.82. Instrument for data collection was a structured questionnaire titled “Predictors of Needle-stick Injuries among Healthcare Workers Questionnaire” (PNIHWQ) and analyzed using statistical tools such as mean, percentage, frequency, standard deviation and logistic regression at 0.05 level of significance.

Findings: The result of the study showed that, 7% of years of work experience predict needle-stick injury among healthcare workers in tertiary health institutions. The result indicated that years of work experience is about 7 times more likely to predict needle-stick injury among healthcare workers. The extent to which patient behaviour constituted a predictor of needle-stick injuries among healthcare workers in tertiary health institutions, Rivers State was high as the grand mean of 2.71 and 0.79 was greater than the criterion mean of 2.50. In addition, patient behaviour significantly predict needle-stick injuries among healthcare workers (F-value = 30.148, p<0.05).

Conclusion: It was concluded that needle-stick injury was predicted to a high extent by years of work experience and patient behaviour. the study recommended among others, that the managers of health institutions should establish safety inspection teams to evaluate adherence to safety protocols at all stages of medical practices to reduce incidence of NSI.

Bacteriological Profile of Peritoneal Fluid in Patients with Appendiceal Peritonitis at Tra Vinh General Hospital

Ho Y Bang — 2026-04-06

Background: Appendiceal perforation–related peritonitis is a severe complication associated with a high risk of sepsis and mortality. Identification of causative pathogens and their antimicrobial susceptibility patterns plays a crucial role in guiding effective treatment. Previous studies have reported that common pathogens include Escherichia coli, Klebsiella spp., and Pseudomonas spp., with an increasing trend of antimicrobial resistance. However, local data in Tra Vinh Province remain limited.

Aims: This study was conducted to provide regional bacteriological evidence to support the rational selection of empirical antibiotics.

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: The study was conducted on 158 patients diagnosed with appendiceal peritonitis who underwent surgical treatment at Tra Vinh General Hospital from January 2024 to July 2024.

Methodology: Peritoneal fluid specimens were collected intraoperatively and subjected to bacterial culture and identification. Antimicrobial susceptibility was determined using standard antibiotic susceptibility testing methods.

Results: A total of 158 cases were included, with a mean age of 49.23 ± 16.23 years (range: 15–90 years). The study population consisted of 49.4% males (n=78) and 50.6% females (n=80), with a male-to-female ratio of 0.9:1. The overall culture positivity rate was 77.8%. The most frequently isolated pathogen was Escherichia coli, accounting for 61.4% (97 cases), followed by Klebsiella pneumoniae at 4.4% (7 cases) and Pseudomonas aeruginosa at 2.5% (4 cases). Extended-spectrum beta-lactamase (ESBL)-producing strains were predominantly Escherichia coli (52.6%, 51/97 cases) and Klebsiella pneumoniae (14.8%, 1/7 cases), exhibiting high resistance rates to most tested antibiotics. In contrast, non-ESBL-producing strains remained susceptible or intermediately susceptible to several antibiotics. Most Pseudomonas aeruginosa isolates were sensitive to multiple antibiotics, with resistance observed only to ciprofloxacin in 50% of cases.

Conclusion: Escherichia coli was identified as the predominant pathogen in appendiceal peritonitis, with a high proportion of ESBL-producing and multidrug-resistant strains. Non-ESBL-producing organisms and Pseudomonas aeruginosa generally retained susceptibility to several antimicrobial agents. These findings underscore the importance of bacterial culture and antimicrobial susceptibility testing in optimizing antibiotic therapy for appendiceal peritonitis.

Comparative Study of T2DM Knowledge, Adherence and Socio-demographic Predictors at University Medical Centres in Rivers State, Nigeria

Okey-Omunakwe Chinyere — 2026-04-25

Type 2 diabetes mellitus (T2DM) involves hyperglycemia from insulin resistance, inadequate insulin secretion, and excess glucagon. Nigeria faces the highest diabetes prevalence in Africa, with T2DM dominating cases, particularly in the south-south region, including Rivers State. This study aimed at investigating the level of knowledge about T2DM among patients attending different university medical centres in Rivers State. This comparative study at Rivers State University Medical Centre (RSUMC) and Ignatius Ajuru University of Education Medical Centre (IAUEMC) in Port Harcourt assessed T2DM knowledge, treatment adherence, and socio-demographic predictors among 560 adult patients using a quasi-experimental pre-test-post-test design with questionnaires, clinical measurements, and laboratory tests like HbA1c. Patients at both centres showed substantial T2DM knowledge (grand means 3.12 RSUMC, 3.09 IAUEMC), good adherence (2.93 RSUMC, 2.98 IAUEMC), and similar socio-demographic influences (2.89 both), with no significant inter-centre differences. Medication adherence exceeded self-care practices like exercise and monitoring, while low income and insurance gaps hindered outcomes. Facility-based education fosters knowledge, but targeted interventions, such as self-care enhancement, insurance expansion, and support mechanisms, are needed to optimise glycemic control and align with ADA/WHO guidelines in resource-limited settings.

Hamstring Flexibility as a Predictor of Musculoskeletal Wellbeing in University Students: A Cross Sectional Study

Subhashchandra Rai — 2026-04-28

Background: Sedentary academic lifestyles common in university settings, yet the specific contribution of hamstring flexibility to broader musculoskeletal health in this population has not been adequately examined.

Objectives: This study aimed to measure hamstring flexibility using two clinically validated tools, establish the pint prevalence to hamstring tightness among undergraduate students, and determine whether hamstring flexibility independently predicts musculoskeletal wellbeing outcomes.

Methods: A cross-sectional observational design was employed among undergraduate students affiliated to university in South India. Hamstring flexibility was evaluated using the Sit-and-Reach test (SRT) and the Active Knee Extension (AKE) test. Musculoskeletal outcomes were quantified through various validated instruments. Multiple linear regression modelling identified independent predictor of a composite Musculoskeletal Wellbeing Score (MWS).

Results: Hamstring tightness was detected in 126 participants (60.0%). Female students recorded substantially higher SRT scores than males, whereas males showed greater bilateral AKE angles reflecting more pronounced tightness. All musculoskeletal outcome measures worsened in a graded manner across flexibility categories (P<0.001 to 0.003). In the regression model SRT score emerged as the strongest independent predictor (β = -0.36; p <0.001); daily sitting time and physical activity level also contributed significantly.

Conclusion: Hamstring flexibility is a significant and independent predictor of musculoskeletal wellbeing in university students. The 60% prevalence of tightness in this cohort warrants structured institutional screening. Both the SRT and AKE test provide reliable, complementary assessments suitable for university health appraisals, and modifiable behavioural factors like prolonged sitting and physical inactivity should be addressed alongside flexibility training.

The Impact of Socioeconomic Factors on Health Related Quality of Life in Adult Patients with Asthma

Raed Abdullah Alharbi — 2026-04-28

Background: Asthma patients' health-related quality of life (HRQoL) is impacted by a number of socioeconomic factors, including stress, income levels, and educational levels, which have been connected to asthma in various ways. Asthma is a chronic lung disease that results in a range of respiratory issues that have a substantial impact on an adult patient's quality of life in terms of their physical and mental well-being as well as their ability to engage in certain activities. Asthma can also be made worse by several linked issues. Among the most important categories of these issues are socioeconomic factors, including stress, income levels, and educational levels.

Aim: This study aims to investigate the impact of these socioeconomic factors on health-related quality of life.

Methodology: Publicly open-source data from the United States Behavioural Risk Factor Surveillance System was used in this research. It is a telephone-based health survey that gathers information from US citizens. The Statistical Analysis System (9.4 version) was used for various descriptive, inferential, and predictive analysis techniques in order to achieve the aim of this research.

Results: Of the 461,436 individuals in the BRFSS 2014 data, 42,875 are current adult asthma patients. However, of these asthmatic patients, 650 have elevated stress levels, 20,605 have low incomes, and 21,692 have low levels of education. Each socioeconomic factor and measures of health-related quality of life were statistically significantly correlated, according to all p-values of various analyses.

Conclusions: According to the study's findings, adult asthma patients with these socioeconomic factors are more likely than those without them to have a lower health-related quality of life.