Correspondence Address:
Viroj Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok
Thailand

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Sir,

The recent publication on leech therapy is very interesting.  [1] Lone et al. said that "It can be used effectively for the management of various disorders specially skin and musculoskeletal disorders where western medical treatment is of less value." [1] Indeed, this kind of animal therapy has been widely used and there are some reports confirming on its effectiveness. [2] To use this technique, there are also some issues to be addressed. First, the quality control of this therapeutic approach should be set. There must be standard operational procedure for controlling of the practice. The standardization of the therapeutic center and practice is needed. [1] In addition, this therapy should be considered as a procedure to be controlled. This therapy is an actual manipulation on hemostasis of the patient. [3] The closed monitoring of the coagulation system is needed. The use of point-of-care testing tool for monitoring of coagulation is suggested. [4]

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