Greater Mekong Subregion Medical Journal

Psychotropic Drugs and ASEAN Road Safety: The Need for New Legal Framework

Arnon Jumlongkul — 2024-09-01

Background: Currently, ASEAN has policies but no uniform legislation controlling driving under the influence of psychotropic drugs. Numerous road safety concepts and theories may be used to improve road safety in ASEAN. However, member nations continue to under apply these principles.

Objective: The goals of this study are to investigate international theories and concepts for promoting road safety, the ASEAN concept of driving under the influence, global traffic strategies for dealing with driving while intoxicated, and to suggest the appropriate ASEAN-specific policies that can effectively prevent drugged driving.

Materials and method: A qualitative documentary research was conducted for this study. The scope of this study also includes global concepts and theories to promote road safety, concept of driving under the influences in ASEAN, concept of harmonizing road safety laws, international traffic strategies to dealing with impaired driving issues, and human rights and drug testing.

Results: In accordance with the United Nations’ five pillars of road safety, ASEAN has focused on driving under the influence. ASEAN has no additional guidelines for controlling psychotropic drug use among drivers. In the case of cross-border driving, it is difficult for most individuals to know what blood alcohol concentration or drug levels are permitted for drivers in the country into which they are traveling. All human rights and drug testing issues must be addressed as part of ASEAN’s implementation of the concept of drug testing among road users.

Conclusion: This article suggests that ASEAN should develop a clear policy to promote the prevention of drug-impaired driving and the consequences of such driving among ASEAN drivers. The prospective ASEAN Agreement for the Protection of Driving Under the Influence of Psychotropic Drugs and its Work Plan should be proposed. The ASEAN should support instruments for measuring alcohol and psychotropic drugs at border crossings in each country. Finally, ASEAN should monitor each country, particularly during physical examination and drug testing procedures at checkpoints, traffic accident scenes, and while driving.

A Comparative Study of Efficacy of Calamine Lotion versus Topical Corticosteroid in Intertrigo Treatment

Kwanhatai Kultawanich — 2024-09-01

Background: Intertrigo is an inflammatory dermatitis caused by moisture, friction, and lack of ventilation. Topical corticosteroid has been used for intertrigo treatment with concerning of infection and side effects.

Objective: The objective of this study was to compare the efficacy between calamine lotion and topical corticosteroid by clinical and instrumental evaluation for the treatment of intertrigo.

Materials and Method: In this randomized split-side open-label prospective trial, thirty-three patients with intertrigo enrolled at the Dermatology Clinic of Phramongkutklao Hospital, were randomly assigned to apply two types of topical treatments twice daily for 15 days on separated side (left and right) of the body. The degree of erythema was evaluated by instrumental and clinical using mexameter (erythema index) and visual analogue scale (VAS) at baseline and at 15 days. Subject-completed visual analogue scale was carried out by patients to evaluate the pruritus.

Results: All 33 patients showed significant improvement of erythema along with pruritus intensity from baseline for both groups (p < 0.001). However, there was no significant difference in the erythema index, erythema intensity and pruritus degree between topical corticosteroid and calamine lotion (p > 0.05). Mild skin irritation was described in only 1 case (3%) on the calamine lotion side.

Conclusion: Our results suggest that calamine lotion can be as effective as conventional topical corticosteroid in the treatment of intertrigo, so it would be considered an alternative option to avoid corticosteroid used.

Association between Psychological Conditions and Obesity in Elderly

Warongporn Rattanabun — 2024-09-01

Background: Obesity has been related to psychological disorders such as depression and has been shown to be a key contributor to morbidity and to adversely affect working ability and quality of life.

Objective: The purpose of this study was to explore the association between body mass index (BMI) and depression amongst elderly people.

Materials and Method: This was a cross-sectional analytic study. Participants were living in Suphan Buri Province, Thailand. Data, including demographic information, body composition record, The Thai geriatric depression scale: TGDS-15 assessment was used to measure levels of depression from 34 elderly people. Obesity and normal weight were defined as body mass index ≥ 25 and 18.5-22.9 kg/m2, respectively.

Results: The association between depression and obesity were explored, controlling for age and BMI. After adjustments, a higher level of depression was found in obese elderly (compared with normal weight elderly) but not statistically significant between group. However, no significant association between depression and BMI. The positive associations between depression with BMI, weight, and the percentage of body fat, after controlling for potential confounders.

Conclusion: The present study found a positive association between depression in this obese elderly group. Future research should continue to explore the complex nature of obesity and develop more appropriate assessments and interventions to confirm these findings.

Successful Management of a Foramen Magnum Meningioma that Presented as Recurrent Aspiration Pneumonia and was Associated with COVID-19 Pneumonia with Obstructive Sleep Apnea: A Case Report.

Kriangsak Champawong — 2024-09-01

Foramen magnum meningiomas (FMMs) are rare and challenging tumors. We report a case of foramen magnum meningioma in a 49-year-old female who presented with obstructive sleep apnea and suffered from recurrent aspiration pneumonia. She tested positive for COVID-19. A magnetic resonance image (MRI) revealed a ventral foramen magnum mass lesion that measured 33 mm in diameter, causing a significant pressure effect on the medulla oblongata. After her pneumonia improved, a far lateral retrocondylar approach provided a safe surgical plane for the total excision of this tumor. The pathologic analysis revealed a WHO-grade-I meningioma. Rarely, FMM-compressed medulla oblongata can present with obstructive sleep apnea and recurrent aspiration pneumonia. We successfully removed the entire FMM, resolving her obstructive sleep apnea and recurrent aspiration pneumonia.

Physical and Chemical properties of Medical Lubricant Made from Rice Starch

Sittiporn Punyanitya — 2024-09-01

Background: Gel lubricants belong to pharmaceuticals that are included in the cost of diagnostics. This material is pharmaceutical product in gel form that has been synthesized for medical or veterinary use. It is a lubricant for various body parts for surgery, physical examination, or as a reduced friction agent between the body and medical equipment. Normally, this product must be imported from foreign contries billions baht per year.

Objective: This research aims to produce medical lubricant gel from rice starch, a Thai agricultural raw material that helps reduce the problem of importation from abroad.

Materials and Method: The main raw material is pure rice starch, pharmaceutical grade added in different amounts of 37%, 54%, 63%, 70%, and 80% by weight mixed with additives. These additives are sodium hydroxide, carboxyl-methyl cellulose, sucrose, glycerin, and methylparaben. The method of combining the solution with the solution determines the physicochemical characteristics of commercial lubricant gel, compared with the gel samples of this research by using the SEM-EDS technique, pH analysis, and the FTIR technique.

Results: The results showed that the acidity and alkalinity of the two commercial gels compared to the sample gel. The pH is in the range between can be used according to ISO 13485: 2003 in the same range, pH 6-7. The morphology of the commercial gel found that the lubricant gel from the rice starch was uniformly distributed in the structure of the gel. The viscosity of the commercial lubricant gel is 2,991 ± 60.92 cP. This value is near the viscosity of gel 80 wt% of rice starch was 2,936 ± 18.52 cP. The chemical composition of the commercial gels consists of the carbon and oxygen function groups. However, the FTIR technique found amounts of synthetic substances such as sulfur, chloride, nitrogen, and zinc, which may irritate to skin. Meanwhile, the rice gel of this research found that there are carbon compounds, oxygen, and sodium, which are more than 95% organic compounds, and therefore 100% safe.

Conclusion: The study of lubricating gel made from rice starch by finding the physical, chemical, and biological properties. This project found that rice lubricant gel contains 80% of rice starch by weight. It is the best ingredient which has the same safety and lubrication performance as a commercial gel. Therefore, lubricant gel from rice starch can replace the gel ordered from abroad.

Video Creative Musical Based Tutorial as a Media to Enhance Students Socioemotional Well-Being

Djohan Djohan — 2024-09-01

Background: The concept of independence in learning has been widely recognized as a fundamental aspect of national education. It presents new problems and paradigms that are believed to require a significant amount of time to fully develop students’ ability to think critically and autonomously, both for their own benefit and for the betterment of society.

Objective: To study effect of creative music learning with video tutorials on emotional well-being of primary school music students.

Materials and Method: We measure student self-efficacy through musically creative video training. Immersive, adaptable, and culturally-rooted sounds excite kids. With more digital media, kids can cope with globalization. Communication boosts learning and engagement. This channel helps kids learn at home. E-learning is beneficial for remote COVID-19 learners. Media-based distance learning is self-paced and instructor-free. Teachers, parents, and students must work together at home and school. Without academics, distance education employs technology, information, and media. In video tutorials, audiovisual elements can enhance teacher-student online learning. The lack of creativity among primary school music teachers has negatively impacted this. This study employs art-based mixed-methods research. Using a quasi-experimental approach, questionnaires collect quantitative data. Additionally, we use focus group summaries as secondary qualitative data.

Results: The treatment group had a self-efficacy score of 0.49, with an average of 0.91, compared to the control group’s 0.95, with an average of 0.85. A 2-tailed significance value of 0.05 or above demonstrates that creative music learning through video lessons affects the experimental group. The focus group discussions with students’ parents and teachers showed that multimedia made the video tutorial learning approach more successful and enjoyable.

Conclusion: Creative and engaging online music learning resources may improve and broaden the paradigm. Creative music learning with video tutorials may be a viable alternative and increase primary school music students’ emotional well-being.