Efficacy and safety of “Yahom” as a traditional Thai herbal therapy: a systematic review

Yahom is a traditional Thai medicine used to treat syncope and abdominal discomfort.This study aimed to systematically review all available evidence which purports to support these claims.The systematic review accorded with the Cochrane Collaboration framework and PRISMA reporting. Databases including MEDLINE, Excerpta Medica Database (EMBASE), Cochrane library database, and Google Scholar were searched by keywords, Yahom and Ya-hom. Pharmacological and toxicity data from non-animal and animal studies were included.Twenty-four articles: 2 on in vitro cell lines or bacteria, 3 in vitro cell-free, 5 in vitro animal, 13 in vivo and 1 human mainly reported (A) Cardiovascular effects (i) transient hypotension (0.2-0.8g/kg, intravenous injection (i.v.)), increased cerebral blood flow (2g/kg, single oral) and vascular dilatation/relaxation (ii) elevated blood pressure (BP) (0.2-0.8g/kg, i.v. or 2-4g/kg oral) and vasocontraction. Single Yahom doses (3g) given to healthy volunteers had no effect on cutaneous blood flow, ECG or systolic BP although marginally increased diastolic BP was claimed. (B) Yahom (2-4g/kg) completely inhibited gastric acid secretion evoked by gastric secretagogues. (C) Toxicity: Chronic oral doses of selected Yahoms to rodents (0.001-1g/kg) supports its status as generally regarded as safe.Most studies supported declared objectives relating to perceived Yahom actions, but lacked background demonstrating clinical efficacy, and mechanistic data that would validate conclusions. Our study suggests that research into traditional medicinal herbs needs underpinning by appropriate clinical interventions and pharmacovigilance, thereby optimising efficacy and minimizing toxicity by combining traditional wisdom and modern testing

Opportunistic screening and health promotion for type 2 diabetes: an expanding public health role for the community pharmacist

BackgroundEarly detection to identify people at risk of diabetes is an important approach to prevent or delay type 2 diabetes. This study aimed to implement the Diabetes Prevention Program in community pharmacy using a diabetes risk prediction tool.MethodsThe program was conducted in seven pharmacies in Bangkok, Thailand. Participants were the pharmacy's clients aged ≥35 years without the history of diabetes. A validated risk prediction tool was used to assess individuals' diabetes risk. Educational information was offered to all participants. Those with a high risk score (≥9 out of 17) were offered a self-check of fasting capillary blood glucose (CBG). A referral was made for those with CBG ≥126 mg/dl.ResultsDuring a 3-month service, 397 individuals participated in the program. Nearly half of the participants (49.4%) were at a high risk of diabetes (risk score: ≥9). Ninety five (48.5%) of these high risk individuals undertook fasting CBG. Elevated fasting CBG (≥126 mg/dl) was found in 12 persons (12.7%). Overall, two patients with diabetes were identified during the provision of the program.ConclusionsThe Diabetes Prevention Program in community pharmacies uncovered half of the clients who were at risk of diabetes and provided an opportunity for participants to learn more about the prevention of diabetes. © 201