Honey as an alternative fixative for oral tissue:An evaluation of processed and unprocessed honey

Abstract

Background:Fixation is the most imperative step in the practice of diagnostic histopathology, which is intimately linked to 10% formalin. As a result of increasing concerns about the potential carcinogenicity of the formaldehyde, attempt to find safer alternatives is necessary. Honey has been shown to possess antimicrobial, antiviral and antimutagenic properties. Many studies have reported that honey possesses dehydrating and preserving effects also.Aims and Objectives:To study the fixative properties of processed and unprocessed honey in oral tissues followed by comparision with formalin.Materials and Methods:The study group comprised 12 different tissues. Each tissue was cut into 3 segments and were immediately fixed in bottles containing 10% unprocessed honey, 10% processed honey and 10% formalin, respectively, for 24 h at room temperature. After fixation, tissues were processed using the routine standard processing protocol followed by hematoxylin and eosin staining. Data were statistically analyzed using descriptive statistics such as mean, standard deviation and percentage. Kruskal–Wallis test followed by post hoc Dunn's multiple comparisons test and Chi-square test or Fisher's exact test for small sample size. A P < 0.05 was considered as significant. Data analysis was done by using software Minitab v14.0.Results:When all the stained sections were assessed for the parameters, there was no statistically significant difference between tissues fixed in processed and unprocessed honey compared to formalin (P = 0.004). The tissue morphology and staining adequacy for diagnosis in honey fixed tissue was at par with formalin fixed tissue. Hence, our results suggest that both processed honey and unprocessed honey can be used as a safe alternative for formalin.

Natural substitutes for formalin: A boon to histopathology!!

“…[ 6 ] In the presence of water, formaldehyde reacts with hydrochloric acid to form bischloromethyl ether which is a known carcinogen for humans. [ 7 ]…”

“…also found strong evidence that supports genotoxic and cytotoxic mode of action for the carcinogenesis of inhaled formaldehyde. [ 7 ]…”

Comparison of Fixative Properties of Honey with Ethanol in Oral Cytological Smears

“…[7,8] Many different studies have already been done to compare honey as fixative in histopatholgy in comparison to formalin, which has provided convincing and appreciable results. [9][10][11] In honey fixed smears one could very clearly appreciate all cellular details such as nuclear, cytoplasmic staining, cellular morphology, clarity and uniformity of the staining which are almost equivalent to ethanol fixed smears. Present study in concordance with Singh A, et al [4] showed that cellularity and cell morphology were well preserved in honey which provides adequate cytological material for diagnosis.…”

A comparative study on the efficacy of honey and ethanol as cytological fixatives

“…Ethanol is classified by the International Agency for Research on Cancer (IARC) as causing cancer in humans following ingestion. 4 Skin exposure from spillages of ethanol can cause burning and stinging. Eye exposure to ethanol can also cause burning and stinging.…”

“…Almost all of the slides reported scanty cellularity and were not suitable for diagnosis. Later the sample smeared on to the slide was dried for 1-2minutes and then put into the newer fixative (diluted honey) 4 . These smears were then checked for cellularity, which were adequate for diagnosis or reporting.…”