Natural substitutes for formalin: A boon to histopathology!!

INTRODUCTION: In routine tissue processing, formalin has been proved as efficient as fixative since inception and hazards associated with it are of major safety and health concern. AIM: The aim of this study is to compare the efficacy of natural fixatives such as jaggery and Khandsari over formalin. MATERIALS AND METHODS: Ninety normal tissue specimen collected during minor oral surgical procedures were included in this study. Thirty specimen each were fixed in 30% jaggery (Group-A), 30% Khandsari (Group-B) and 10% formalin (Group-C). The slides obtained after tissue processing were analyzed for the quality of fixation. The tissue sections were assessed for cellular outline, cytoplasmic details, nuclear details, staining quality and overall morphology. Each criterion was rated on a scale of 1–4. (one for poor and four for excellent). The study was double-blinded and subjected to the Kruskal–Wallis ANOVA and Chi-square test. RESULTS: The cellular outline is excellent in 90% (Group-C) followed by 36.67% (Group-B) of specimens. With respect to cytoplasmic staining 83.33% (Group-C) of tissues showed excellent results followed by 60% (Group-B), 33.33% (Group-A). Nuclear details are excellent in 86.67% (Group-C) followed by 83.33% (Group-B), 36.67% (Group-A) of specimens. With respect to staining quality 93.33% (Group-C) followed by 50% (Group-B), 26.67% (Group-A). Overall morphology is excellent in 90% (Group-C) followed by 46.67% (Group-B). CONCLUSION: In the present study, Khandsari was on par with formalin and our effort of using Khandsari and jaggery for tissue fixation in human oral tissues yielded good results.