Dangers of Using Bee Propolis and Foeniculum Vulgare Before Browplasty.

Several medicinal herbs have been associated with coagulopathy. They can be readily purchased at a local herb store without prescription or expert opinion based on scientific evidence. This is probably why patients do not disclose using these herbs to health care providers even on direct questioning. Here, we focus on two commonly used herbs in our community, bee propolis, and Foeniculum vulgare, also known as fennel seeds, as our patient ingested them before a scheduled browplasty. The significance of this anecdote is the concomitant ingestion of fennel seeds and bee propolis. Arguably, their consumption resulted in excessive intraoperative and postoperative bleeding in a previously healthy subject. This complication is undesirable in any aesthetic surgery, as it affects wound healing and the final cosmetic outcome. We hope that such bioactive herbs are warned against and that their risks are known to patients and physicians alike.

Role of immunohistochemical cyclo-oxygenase-2 (COX-2) and osteocalcin in differentiating between osteoblastomas and osteosarcomas

Background/Aims: Differential diagnosis between aggressive osteoblastoma and low grade osteosarcoma may be very diffi cult or even impossible on a small biopsy. This study was designed to assess the usefulness of immunoexpression of COX-2 and osteocalcin in the differential diagnosis of the two tumour types. Methods: Immunostaining of COX 2 and osteocalcin were studied in 9 osteoblastomas and 30 osteosarcomas. Results: All osteoblastomas and 11/20 (55%) high-grade osteosarcomas showed COX-2 immunoreactivity. All low grade osteosarcomas were COX-2 negative. COX-2 was signifi cantly higher (p<0.002) in osteoblastomas 9/9 (100%) than in osteosarcomas 13/30 (43%) and in aggressive osteoblastomas versus low grade osteosarcomas (p<0.01). Osteocalcin was found in tumour cells of all osteosarcomas and osteoblastomas and in the osteoid matrix of 84% of osteosarcomas and 78% of osteoblastomas. Strong osteocalcin was signifi cantly higher (p<0.02) in osteoblastomas (78%) than in osteosarcomas (27%). Conclusion: COX-2 is a valuable marker in distinction between osteosarcoma and osteoblastoma. Negative COX-2 could confi rm the diagnosis of low grade osteosarcoma versus aggressive osteoblastoma. Intensity and distribution of osteocalcin may indicate the degree of osteoblastic differentiation.