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.