Use of jaggery and honey as adjunctive cytological fixatives to ethanol for oral smears.

BACKGROUND: Ethanol has satisfactorily been used as cyto-fixative. Owing to its limitations, pathologists have always searched for new fixatives. The present study was conducted to evaluate the efficacy of two natural sweeteners as cyto-fixatives. An attempt has also been made to understand the underlying mechanism by which these fixatives fix the oral mucosal cells.

MATERIALS AND METHODS: Three smears were collected from 25 healthy volunteers. One smear was fixed in ethanol and the other two in 20% aqueous honey solution and 30% aqueous jaggery solution for 15-30 min followed by Papanicolaou staining. Slides were evaluated for nuclear staining, cytoplasmic staining, cell morphology, clarity of staining and uniformity of staining randomly irrespective of the fixatives. Chi-square test and Bonferroni post hoc test were done using SPSS software. P < 0.05 was considered to be statistically significant. In addition, cytological fixatives were analyzed for the pH and amount of reducing sugars.

RESULTS: It was found that for all the characteristics studied, no statistically significant difference was seen between the three fixatives. The pH of the both tested fixatives remained acidic even after 1 week. The amount of reducing sugars in 20% aqueous honey solution and 30% aqueous jaggery solution was 19.3 g/100 mL and 2.07 g/100 mL, respectively.

CONCLUSION: Both the test fixatives gave results equivalent to ethanol and thus can be used as alternative fixatives for oral smears. It is proposed that 20% aqueous honey and 30% aqueous jaggery fix the oral smears satisfactorily in a mechanism akin to ethanol by coagulating and denaturing proteins.