Efficacy of Honey and Local Anaesthetics as Tissue Fixatives

Malavika; Jebisha; Mahalingam Bhuvaneswari; Sathish Muthukumar; Sreeja; Harini Priya A H

Malavika Undergraduate Student, Department of Oral and Maxillofacial Pathology, Chettinad Dental College and Research Institute, Kancheepuram, Kelambakkam, Chennai Tamil Nadu, India.
Jebisha Postgraduate Student, Department of Oral and Maxillofacial Pathology, Chettinad Dental College and Research Institute, Kancheepuram, Kelambakkam, Chennai Tamil Nadu, India.
Mahalingam Bhuvaneswari Senior Lecturer, Department of Oral and Maxillofacial Pathology, Chettinad Dental College and Research Institute, Kancheepuram, Kelambakkam, Chennai Tamil Nadu, India
Sathish Muthukumar Professor, Department of Oral and Maxillofacial Pathology, Chettinad Dental College and Research Institute, Kancheepuram, Kelambakkam, Chennai Tamil Nadu, India.
Sreeja Professor, Department of Oral and Maxillofacial Pathology, Chettinad Dental College and Research Institute, Kancheepuram, Kelambakkam, Chennai Tamil Nadu, India.
Harini Priya A H Associate Professor, Department of Oral Pathology, Manipal University, Malaysia.

Keywords: Fixative, Formalin, Honey, Local Anaesthesia

Abstract

Introduction: Fixatives are crucial in the preparation of tissue for pathological diagnosis. The gold standard for tissue specimen fixation is formalin. Since formalin is costly, carcinogenic, and difficult to get, there is interest in finding a viable replacement. In addition to being a dehydrator, honey also contains antibacterial and antioxidant qualities. The risks associated with local anaesthetics (LA), which are accessible in any clinic, are negligible. The purpose of this study was to evaluate the efficacy of using honey and a local anaesthetic solution in place of formalin as a fixative for tissue processing.
Aim: To analyse the staining parameters of honey and local anaesthetic with formalin as tissue fixatives for traditional hematoxylin and eosin staining (H&E) procedures
Methodology: All the tissue samples were extracted from animals (goat tongue). The collected tissue samples were divided into the following three groups: Group A- tissues fixed in neutral buffered formalin (standard) (n = 20), Group B- tissues fixed in processed honey solution (n = 20), and Group C- tissues fixed in local anaesthetic solution (n = 20). Each tissue was fixed in an appropriate volume of solution for 24 hours, followed by standard procedures. After being cut into sections and coated with hematoxylin and eosin, tissues were studied to identify their quality and other characteristics.
Results: 100% of formalin-fixed, 79% of honey-fixed, and 80% of local anaesthesia-fixed tissue sections were acceptable. In all three fixatives, there were statistically significant variations in intracellular staining, cell differentiation, staining uniformity, clarity, and tissue architecture. From statistical analysis, significant differences were found in all three fixatives on cytoplasmic staining, cell morphology, clarity of staining, uniformity of staining, and tissue architecture.
Conclusion: Although there was a mild variation in staining quality, honey and local anaesthetics can be safely used as an alternate emergency fixative.

How to cite this article:
Malavika, Jebisha, Bhuvaneswari M, Muthukumar S, Sreeja, Priya A H H. Efficacy of Honey and Local Anaesthetics as Tissue Fixatives. Chettinad Health City Med J. 2024;13(1):66-74.

DOI: https://doi.org/10.24321/2278.2044.202412

References

Patil S, Rao RS, Ganavi BS, Majumdar B. Natural sweeteners as fixatives in histopathology: a longitudinal study. J Nat Sci Biol Med. 2015;6(1):67-70. [PubMed][Google Scholar]

Rajanikanth M, Ravi PA, Sreenath G, Jk SB, Ndvn S. Transit fixatives: an innovative study. J Clin Diagn Res. 2015 Mar;9(3):ZM01-3. [PubMed] [Google Scholar]

Thamilselvan S, Don KR, Sherlin HJ, Jayaraj G, Santhanam A. Honey as a natural alternative for formalin fixative - a systematic review. J Evol Med Dent Sci. 2021;10(6):369-74. [Google Scholar]

Bhattacharyya A, Gupta B, Singh A, Sah K, Gupta V. Probing natural substitute for formalin: comparing honey, sugar, and jaggery syrup as fixatives. Natl J Maxillofac Surg. 2018;9(1):14-21. [PubMed] [Google Scholar]

Kasetty S, Dwivedi D, Ragavendra TR, Kallianpur S, Gupta S, Prabhakar N. Comparison of efficacy of local anesthetic solution, distilled water and normal saline as emergency fixatives. J Oral Maxillofac Pathol. 2018;22(2):283. [PubMed] [Google Scholar]

Lam-Ubol A, Kitrueangphatchara K, Putthanuparp T, Arayakhun R, Kwanthong R, Choonhawarakorn K. Nonformalin fixative agents: a comparative study of fixative efficacy and histomorphology. Int J Surg Pathol. 2018 Dec;26(8):701-6. [PubMed] [Google Scholar]

Muddana K, Muppala JN, Dorankula SP, Maloth AK, Kulkarni PG, Thadudari D. Honey and olive oil as biofriendly substitutes for formalin and xylene in routine histopathology. Indian J Dent Res. 2017;28(3):286-90. [PubMed] [Google Scholar]

Patil S, Premalatha BR, Rao RS, Ganavi BS. Revelation in the field of tissue preservation – a preliminary study on natural formalin substitutes. J Int Oral Health. 2013;5(1):31-8. [PubMed] [Google Scholar]

Sinha N, Nayak MT, Sunitha JD, Dawar G, Rallan N, Gupta S. Comparitive efficacies of a natural fixative with a conventional fixative. J Oral Maxillofac Pathol. 2017;21(3):458. [PubMed] [Google Scholar]

Chittemsetti S, Nallamala S, Sravya T, Guttikonda VR, Manchikatla PK, Kondamari S. Natural substitutes for formalin: a boon to histopathology!! J Oral Maxillofac Pathol. 2018;22(1):143. [PubMed] [Google Scholar]

Majumdar B, Rao RS, Patil S. Tissue preservation with natural fixatives: an immunohistochemical evaluation. World J Dent. 2016;7(2): 87-91. [Google Scholar]

Sabarinath B, Sivapathasundharam B, Sathyakumar M. Fixative properties of honey in comparison with formalin. J Histotechnol. 2014;37(1):21-5. [Google Scholar]

Lalwani V, Surekha R, Vanishree M, Koneru A, Hunasgi S, Ravikumar S. Honey as an alternative fixative for oral tissue: an evaluation of processed and unprocessed honey. J Oral Maxillofac Pathol. 2015;19(3):342-7. [PubMed] [Google Scholar]

Pandiar D, Baranwal HC, Kumar S, Ganesan V, Sonkar PK, Chattopadhyay K. Use of jaggery and honey as adjunctive cytological fixatives to ethanol for oral smears. J Oral Maxillofac Pathol. 2017;21(2):317. [PubMed] [Google Scholar]