Special Journal of the Medical Academy and other Life Sciences.

Development of alcohol drinking behavior modification program in Village health volunteers at Traph-Anant, Chonburi, Thailand

Suwicha Navakul — 2025-05-02

Background: Alcohol consumption poses a significant public health challenge in Thailand, particularly in culturally permissive environments like Chonburi Province. Village health volunteers (VHVs), as frontline public health agents, often face difficulties in both addressing and personally managing alcohol consumption behaviors. This study aimed to develop an evidence-based behavior modification program tailored to the context of VHVs in Traph-Anant Village to reduce alcohol consumption and promote healthier lifestyles.

Methods and Materials: A mixed-methods approach was used. Qualitative data were collected through in-depth interviews and focus group discussions with VHVs to explore patterns, motivations, and cultural influences on alcohol use. Quantitative surveys assessed attitudes, self-efficacy, and alcohol-related behaviors. The program design was informed by health promotion theories and behavior change models such as the Health Belief Model and Stages of Change. Expert evaluation and community stakeholder input validated the program's feasibility and relevance.

Results: Findings indicated that most VHVs consumed alcohol frequently, especially in the evenings or during cultural events. Key drinking triggers included social obligations, stress relief, and cultural norms. A majority believed alcohol enhanced appetite and sleep. The final behavior modification model included components such as refusal skill training, community alcohol-free event policies, leadership role modeling, and environmental control strategies (e.g., time/place limitations for drinking). Expert review confirmed the program as culturally appropriate, practical, and adaptable.

Conclusion: The developed behavior modification program offers a practical framework to support VHVs in reducing alcohol consumption. It highlights the need for integrated, community-level strategies that respect cultural traditions while promoting behavioral change. Implementation of this model could serve as a blueprint for similar rural health volunteer initiatives across Thailand and other culturally rich settings.

A Comparative Analysis of Contributing Factors and Management Approaches for Type 2 Diabetes Mellitus in the Elderly: Evidence-Based Perspectives from Malaysia and Russia

Mira Tarmizi — 2025-05-03

Background: Type 2 diabetes mellitus (T2DM) is a growing global concern, especially in aging populations. As over 95% of all diabetes cases are classified as type 2, addressing this issue among the elderly is critical for public health planning. Malaysia and Russia, two countries with differing healthcare infrastructures and socio-cultural contexts, face increasing T2DM prevalence among their senior populations. This study aims to explore regional disparities and similarities in contributing factors and management approaches to provide evidence-based guidance for improving elderly care.

Methods and Materials: This comparative study utilized a comprehensive literature review from databases such as PubMed, ScienceDirect, WHO, and national health registries from 2010 onwards. Epidemiological data, dietary and physical activity trends, socioeconomic influences, and genetic predispositions were analyzed. National management guidelines for T2DM in both Malaysia and Russia were also critically reviewed, including the Malaysian Clinical Practice Guidelines and the Russian National Diabetes Algorithms.

Results: Findings revealed that Malaysia exhibits a higher T2DM prevalence in the elderly due to urban lifestyle changes, poor dietary habits, and physical inactivity. Russia, while having a slower increase in prevalence, shows notable disparities in rural healthcare access and higher incidence among older women. Socioeconomic barriers and genetic predispositions play key roles in both regions. Malaysia emphasizes subsidized care and national registries, while Russia relies heavily on universal healthcare and medication access. Both countries face challenges in lifestyle modification adherence and equitable healthcare delivery.

Conclusion: T2DM in elderly populations requires context-specific management strategies. While Malaysia must address urban-rural disparities and promote healthier lifestyles, Russia should focus on enhancing accessibility and preventive education. Cross-country insights underscore the importance of tailored, equitable, and proactive approaches in managing T2DM among aging populations globally.

Comparative Analysis of Mental Health Challenges in Malaysian Youth and Older Adults

Farah Roslan — 2025-05-03

Background: Mental health is a growing public health concern in Malaysia, with youth and older adults facing distinct challenges. Young people are increasingly affected by academic pressure, social media influence, and cultural stigma. At the same time, older adults experience mental health issues such as loneliness, depression, and anxiety, often driven by life transitions and social isolation. This study aims to compare mental health stressors in these two groups and propose tailored strategies to address their needs.

Methods and Materials: A qualitative review and comparative analysis were conducted using data from national surveys, scholarly journals, and reports by the Ministry of Health and the World Health Organization. The study identifies key psychosocial and cultural contributors to mental health conditions in youth and the elderly. Case studies, population statistics, and mental health service accessibility data were analyzed to understand demographic-specific challenges and inform cross-generational support strategies.

Results: Youth in Malaysia are especially vulnerable to anxiety and depression due to academic expectations, peer pressure, and the negative effects of social media. Meanwhile, older adults face increasing risks of depression and loneliness due to family changes, retirement, and insufficient community support. Cultural stigmas around mental health persist in both demographics, hindering open dialogue and timely intervention. The disparity in mental health service accessibility across rural and urban regions further exacerbates the issue.

Conclusion: Mental health challenges in Malaysia require demographic-specific interventions. Schools and digital platforms must integrate mental health education and counseling services for youth. Community-based engagement programs and stronger social support systems are vital for older adults. Promoting intergenerational dialogue and reducing stigma across all age groups can create a more inclusive mental health framework, improving overall societal well-being.

Red blood cell (RBC) arteriovenous gap as a marker of hemotransfusion in massive and fulminant hemorrhage with the formation of Multiple Organ Dysfunction Syndrome (MODS). Case report

Ilie Vasiliev — 2025-05-03

Background: Massive and fulminant hemorrhage frequently leads to critical states such as hemorrhagic shock and Multiple Organ Dysfunction Syndrome (MODS). Early diagnostic and therapeutic decision-making, particularly regarding hemotransfusion, remains a challenge when classical venous indicators do not reflect the severity of hypoxia. This study proposes the arteriovenous red blood cell (RBC) gap and pCO₂ arteriovenous (AV) gap as novel biomarkers for evaluating tissue hypoxia and guiding red blood cell transfusion, especially in cases with visual blood loss exceeding 3 liters.

Materials and Methods: This case-based investigation evaluated the diagnostic utility of the RBC arteriovenous gap and the pCO₂ AV gap (>6 mmHg) as markers of Microcirculatory-Mitochondrial Distress Syndrome (MMDS), a precursor of MODS. Analysis included sequential arterial and venous blood gas measurements, lactate monitoring, and oxygenation indices in a patient presenting with severe hemorrhage and signs of MODS. The microcirculatory-mitochondrial recruitment strategy was applied, involving volemic resuscitation, oxygenation correction, and targeted hemotransfusion.

Results: Initial measurements revealed a pCO₂ AV gap of 49.7 mmHg, confirming severe tissue hypoxia and MMDS. This gap decreased to 10.2 mmHg following the recruitment strategy, coinciding with the normalization of pH (6.9 → 7.4), improved oxygenation (SO₂ 51% → 98%), and decreased lactate levels (8.2 → 1.8 mmol/L). Despite a normal venous hematocrit (VHct 36%) and hemoglobin (VtHb 12.3 g/dL), arterial samples showed critical reductions (AHct <12%), justifying RBC transfusion. This AV discrepancy provided a reliable medico-legal basis for intervention, which traditional venous markers alone would not have supported.

Conclusion: The RBC and pCO₂ AV gaps are effective, underutilized markers for detecting MMDS and guiding hemotransfusion in cases of massive hemorrhage. They reflect systemic hypoxia more accurately than isolated venous parameters. The application of microcirculatory-mitochondrial recruitment strategies improves patient outcomes and supports metabolic recovery, offering a low-tech yet life-saving intervention approach. These findings propose a paradigm shift in intensive care resuscitation strategies and transfusion criteria in critical care.

The Effects of Air Pollution on Respiratory Health in Lagos state, Nigeria.

Abijah Yisa — 2025-05-03

Background: Lagos State, Nigeria, is experiencing worsening air quality due to rapid urbanisation, industrial emissions, and heavy vehicular traffic. This environmental challenge has significant implications for public health, particularly respiratory health. Despite the scale of the problem, limited localised research exists on the direct health impacts of air pollution on Lagos residents.

Materials and Methods: A cross-sectional, exploratory study was conducted using surveys, hospital record reviews, and ambient air quality monitoring across urban and peri-urban areas in Lagos, including Epe and the University of Lagos community. Data were collected on pollutant levels (PM2.5, PM10, NO₂, SO₂, and O₃), self-reported respiratory symptoms, and health outcomes. Supplementary interviews with healthcare workers and environmental officials provided contextual insights.

Results: Findings reveal a high prevalence of respiratory illnesses, including asthma, bronchitis, and COPD, among populations exposed to poor air quality. Strong correlations were observed between elevated pollutant concentrations and increased hospital admissions, especially during high-traffic periods. Children, the elderly, and individuals with pre-existing conditions were disproportionately affected. The study also identified gaps in community awareness and limited enforcement of environmental regulations.

Conclusion: Air pollution in Lagos significantly compromises respiratory health, contributing to acute and chronic conditions. Urgent policy interventions, public awareness campaigns, and investments in clean technologies are needed to reduce exposure and improve air quality. The study provides critical local evidence to inform health policy and environmental regulation in urban Nigeria.