Background: Eyelid surgery is one of the top five aesthetic procedures. It is performed to improve both appearance and function, but intraoperative bleeding leads to adverse events which perturb patients. The objective of this study was to demonstrate the efficacy of TXA combined with epinephrine in decreasing intraoperative blood loss and postoperative inflammation. Methods: This prospective randomized control trial was performed on the 30 eyelids of 15 patients who underwent upper blepharoplasty. One of each patient’s eyes was randomly assigned to the TXA group, and the other eye was in the control group. Eyes in the TXA group were given 2% lidocaine with epinephrine (1:100000) mixed with TXA (50 mg/ml) in 1:1 mixture subcutaneously as a local anesthetic. The eyes in the control group received 2% lidocaine with epinephrine (1:100000) diluted with normal saline in 1:1 mixture. Intraoperative blood loss and postoperative swelling were compared between the two groups. Results: Intraoperative blood loss was significantly higher in the TXA group [4.86 (1.83) ml] than it was in the control group [2.53 (1.49) ml] (p < 0.001). There was no statistically significant difference between the two groups in operative time (p = 0.645), pain score (p = 0.498), lid crease (p = 0.548), or MRD1 (p = 0.626). On postoperative day 7, there was no difference in lid crease (p = 0.879), MRD1 (p = 0.463), pain score (p = 0.934), or ecchymosis (p = 0.976) between two groups. Conclusions: TXA in lidocaine with epinephrine was found to increase intraoperative bleeding compared to lidocaine with epinephrine alone, but there was no difference in postoperative swelling or ecchymosis. TXA combined with lidocaine and epinephrine injected subcutaneously should be avoided until additional relevant data are obtained. Further drug interaction study is needed. Level of Evidence II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Sahastara (SHT) remedy is a Thai traditional medicine described in the Thai National List of Essential Medicine (NLEM) for the relief of muscle pain. The purpose of this study was to investigate the efficacy and safety of SHT remedy extract capsule for treating primary OA. A phase 2, double-blind, randomized, and controlled trial study was used to determine the clinical efficacy and safety of SHT in comparison with diclofenac for the treatment of knee OA. The outcome of reduce pain was measured from VAS, 100 meter time walk, and the WOMAC score of day 14 and day 28 which should reduce significantly when compared with day 0 and should be equal with or better than diclofenac. Blood pressure and blood chemistry values at day 14 and day 28 did not change when compared with day 0. The results found that SHT remedy ethanolic extract capsule can reduce all OA knee scores at day 14 and day 28 significantly when compared with day 0 and also no significant difference with diclofenac ( ). The SHT also showed safety values on blood pressure and blood chemistry. The SHT was observed that it had no serious side effect. The results of this study are the first report of using the SHT ethanolic extract capsule in the treatment of primary osteoarthritis of the knee. It can be recommended as an anti-inflammatory herbal drug for reducing pain in knee osteoarthritis patients.

Rang Chuet is a traditional Thai medicinal plant widely used for detoxification, although the name is applied to several botanically distinct species. This study investigated the ethnopharmacological basis and potential molecular mechanisms underlying this practice by integrating practitioner knowledge, botanical authentication, phytochemical profiling, and molecular docking. Structured interviews were conducted with 30 experienced traditional medicine practitioners from five regions of Thailand to document the therapeutic use and preparation of Rang Chuet. Botanical identification confirmed three species marketed under this name: Crotalaria spectabilis Roth, Curcuma rangjued Saensouk & Boonma, and Thunbergia laurifolia Lindl. Most practitioners used Rang Chuet primarily for detoxification, with C. spectabilis and T. laurifolia being the predominant species. LC–MS/MS analysis identified fifteen phytochemicals, including compounds common to both species, such as apigenin, quercetin, and caffeic acid, together with species-specific constituents including rosmarinic acid and α-spinasterol in T. laurifolia. Molecular docking suggested that selected phytochemicals may interact with xenobiotic-sensing receptors, with α-spinasterol showing favorable binding to the Pregnane X Receptor (PXR) and apigenin and catechin to the Aryl Hydrocarbon Receptor (AhR). However, C. spectabilis is a recognised source of hepatotoxic pyrrolizidine alkaloids, and because molecular docking cannot distinguish agonist from antagonist activity or establish functional receptor activation, these predicted interactions should not be interpreted as evidence of detoxification efficacy or safety. These findings provide a scientific framework linking traditional knowledge, botanical diversity, phytochemical composition, and potential receptor-mediated mechanisms, and highlight the public health risk of botanical substitution under the shared vernacular name “Rang Chuet.” These findings are hypothesis-generating and warrant future functional and toxicological validation, particularly regarding C. spectabilis.