Probing natural substitute for formalin: Comparing honey, sugar, and jaggery syrup as fixatives

BACKGROUND: Since its discovery in 1859, formalin has been considered as the “gold standard” in tissue fixation. As formalin is highly toxic and carcinogenic, the quest for its substitute has started recently. Literature search reveals very sparse studies on natural substitute for formalin. Here, it is an attempt to explore eco-friendly, economical, and readily available natural substance for formalin substitute. AIM: The aim of our study was to evaluate the efficacy of natural fixatives such as honey, sugar, jaggery, and water in comparison to the standard fixative used like formalin. MATERIALS AND METHODS: Fresh goat tissues (tongue) were fixed separately with buffered 10% formalin (positive control), honey, sugar syrup, jaggery syrup, and distilled water (negative control). 24 h fixation was done at room temperature followed by conventional processing and routine H and E staining. The stained sections were assessed for cytoplasmic and nuclear detail by three pathologists under light microscope and were graded accordingly. RESULTS: The results showed statistically significant differences between jaggery with other natural fixatives for both nuclear details and cytoplasmic staining. CONCLUSION: The preservation of tissue by honey, sugar, and jaggery syrup was comparable to that of formalin. Among the three natural fixatives, jaggery syrup excelled. Hence, it can be considered as an equally effective formalin substitute.