C-reactive protein/albumin ratio greater than 7.1 is a good candidate to be used as an inflammation biomarker to predict perforation in appendicitis.

OBJECTIVE: We aimed at identifying novel biomarkers to predict perforation in patients with acute appendicitis. PATIENTS AND METHODS: Medical records of patients who underwent appendectomy due to acute appendicitis were reviewed. Complete blood count and biochemistry panel results of these patients were analyzed. This study included 58 patients, 42 (72.4%) male and 16 (27.6%) female. The mean age of the patients was 33.8±14.1 years (range: 18-75). 49 (84.5%) patients had non-perforated acute appendicitis. Perforated acute appendicitis was observed in 9 (15.5%) patients. RESULTS: Patients with perforated appendicitis had higher appendiceal diameter, C-reactive protein (CRP) level, CRP/albumin and monocyte/lymphocyte (M/L) compared to patients with non-perforated appendicitis. Moreover, patients with perforated appendicitis had lower lymphocyte count than those with no perforation. Sensitivity rates of appendiceal diameter, CRP level, CRP/Albumin and M/L for perforated appendicitis were similar (89%). However, the most specific biomarker for perforation was CRP/albumin (87.8%), followed by CRP (85.7%), M/L (63.3%) and appendiceal diameter (57.1%). Patients with CRP/albumin>7.1, CRP>32.7 mg/L, M/L>0.44 and appendiceal diameter>9.8 mm were most likely to have appendiceal perforation. CONCLUSIONS: We suggest that CRP/albumin, CRP, M/L, appendiceal diameter and lymphocyte count can be used to predict perforation in patients with acute appendicitis. However, the most specific inflammation biomarker indicating perforated acute appendicitis is CRP/Albumin>7.1.

Knowledge and attitude regarding bisphosphonates and related osteonecrosis among Turkish dentist: A cross sectional study.

BACKGROUND AND AIMS: Bisphosphonates (BPs), the antiresorptive drugs, can cause osteonecrosis of the jaws. Having adequate knowledge about BPs and bisphosphonate-related osteonecrosis of the jaw (BRONJ) is very important to prevent complications. In this study, we aimed to determine the level of knowledge of dentists about BPs and BRONJ in Turkey and also aimed to share the results with health authorities to plan new education strategies. MATERIALS AND METHODS: A questionnaire consisting of 20 questions and two parts was used to determine the knowledge level, attitude, and training needs of the dentists. Answers to all questions were analyzed with descriptive statistics, and using Pearson Chi-square and Kruskal-Wallis tests. P values <0.05 were considered statistically significant. RESULTS: A total of 620 general and specialist dentists working in three different sectors and four different cities agreed to participate in the study. Statistically, more knowledge about BPs and BRONJ was observed in dentists who have less than 10 years of experience than those who have over 10 years, specialist dentists than general dentists, and those who working in university hospitals than in other sectors. In general, the rate of those who know BPs is 16.8%, the rate of those who know BRONJ is 20.2%. CONCLUSIONS: Although the use of BPs increases day by day, the awareness of BPs and BRONJ among the dentists is insufficient. However, periodically organizing postgraduate training programs on this subject will increase the awareness and level of knowledge.

Protective effects of vortioxetine in predator scent stress model of post-traumatic stress disorder in rats: role on neuroplasticity and apoptosis.

Post-traumatic stress disorder (PTSD) can be observed after a traumatic event. The effect of an antidepressant vortioxetine (Vrx) against PTSD is unknown. The aim of this study was to investigate the possible protective effect of Vrx in the predator scent-induced PTSD rat model. The rats were exposed to dirty cat litter for 10 min and the protocol was repeated 1 week later with clean cat litter as a trauma reminder. The rats received Vrx (10 mg/kg/p.o.) or saline (1 ml/kg/p.o.) during 7 days between two exposure sessions. Novel object recognition test, hole board test, and elevated plus maze were performed. The b-cell lymphoma (bcl-2)/bcl-2-associated X protein (bax) ratio, brain-derived neurotrophic factor (BDNF), caspase-3 and -9 expressions were detected using Western blotting in the amygdaloid complex, hippocampus, and frontal cortex. Our results indicate that increased freezing time and anxiety index in the stress-induced group is decreased with Vrx application. Vrx treatment improved deteriorated recognition memory in the stress-induced group. Decreased bcl-2/bax ratio and BDNF level and increased caspase-3 and -9 expressions in the stress group, improved with Vrx in the amygdala, and hippocampus. Decreased bcl-2/bax ratio and increased casp-3 and -9 expressions in the stress group are ameliorated with Vrx in frontal cortex. The level of BDNF was increased with Vrx in the frontal cortex. Increased damage scores in the amygdaloid complex, hippocampal CA3, and frontal cortex in the stress group ameliorated with Vrx treatment. Our results show that if vortioxetine is administered immediately after trauma, it reduces anxiety, cognitive and neuronal impairment and may be protective against the development of PTSD.

Classification of BCI Users Based on Cognition.

Brain-Computer Interfaces (BCI) are systems originally developed to assist paralyzed patients allowing for commands to the computer with brain activities. This study aims to examine cognitive state with an objective, easy-to-use, and easy-to-interpret method utilizing Brain-Computer Interface systems. Seventy healthy participants completed six tasks using a Brain-Computer Interface system and participants' pupil dilation, blink rate, and Galvanic Skin Response (GSR) data were collected simultaneously. Participants filled Nasa-TLX forms following each task and task performances of participants were also measured. Cognitive state clusters were created from the data collected using the K-means method. Taking these clusters and task performances into account, the general cognitive state of each participant was classified as low risk or high risk. Logistic Regression, Decision Tree, and Neural Networks were also used to classify the same data in order to measure the consistency of this classification with other techniques and the method provided a consistency between 87.1% and 100% with other techniques.

Beneficial Therapeutic Effects of Sildenafil on Bone Healing in Animals Treated with Bisphosphonate.

OBJECTIVES: The purpose of the present study was to evaluate the effects of sildenafil on mandibular fracture healing in animals treated with zoledronic acid by using histologic, histomorphometric, immunohistochemical, and radiodensitometric methods. MATERIALS AND METHODS: A total of 36 Sprague-Dawley rats (3 months old) were used. All animals were treated intraperitoneally with 0.1 mg/kg zoledronate three times per week, for a total of 8 weeks. Postoperatively, the animals were divided into two groups: zoledronate group (Z), which had no treatment applied (n = 18), and zoledronate + sildenafil (ZS), which were treated daily with 10 mg/kg sildenafil (n = 18). Each group was divided into two subgroups and the animals were sacrificed at the end of week 1 (Z1 and ZS1, n = 9) and week 4 (Z4 and ZS4, n = 9) after the operation. Histologic, histomorphometric, immunohistochemical analysis, and radiodensitometry were performed on the test subjects. RESULTS: Sildenafil-treated groups showed a significant increase in fracture healing scores. This result was supported by the densitometric, histologic, histomorphometric, and immunohistochemical findings. CONCLUSIONS: Sildenafil may have positive effects on accelerating and improving fracture healing, and it may be used as a supporting factor in bone healing in patients treated with bisphosphonate (BP) to prevent negative effects of BP's.

Is it possible to change of the duration of consolidation period in the distraction osteogenesis with the repetition of extracorporeal shock waves?

BACKGROUND: In this study we examined the effects of two different repeated Extracorporeal Shock Waves (ESW) on the consolidation period of the distraction osteogenesis (DO) of the rabbit mandible using stereological, radiological and immunohistochemical methods. MATERIAL AND METHODS: DO was performed unilaterally in the mandible of 18 New Zealand rabbits (six months old, weighing between 2.5-3 kg). In the consolidation period, rabbits were divided into three groups randomly after the distraction period. The distraction zone of the mandible was received no treatment as controls (E0*2). Group 2 (E 500*2) received ESWT (twice 500 impulses at 14 kV and 0.19 mJ/mm2 energy) in the first and fourth days of the consolidation. Group 3 (E1000*2) treated with ESWT (twice 1000 impulses at 14 kV and 0.19 mJ/mm2 energy) in the first and fourth days of the consolidation period. After the sacrification, radiologically bone mineral density, new bone formation, new fibrous tissue and new vessel formation were analyzed by stereological. RESULTS: It was found a statistically significant difference between the study groups and control group in the bone mineral density measurements and the highest value was in the E1000*2 group. In the stereological analysis, new bone formation was highest in the E1000*2 group and there was a significant difference compared to the other groups (E0*2 and E500*2) (p=0.000). The lowest connective tissue volume was found in the E500*2 and there was a significant difference compared to the other groups (E0*2 and E1000*2) (p=0.000). The volume of the new vessel was highest in the E500*2 and lowest in the E0*2 group. It was found statistically significant difference between the values of the study and control groups. CONCLUSIONS: Interestingly, we found that repetition of the 1000 impulses ESWT accelerated the consolidation, 500 impulses ESWT extended consolidation period of the DO.

Tacrolimus-Eluting Suture Inhibits Neointimal Hyperplasia: An Experimental In Vivo Study in Rats.

OBJECTIVE/BACKGROUND: Neointimal hyperplasia (NIH) remains one of the leading causes of graft failure after vascular anastomoses. Cytotoxic drugs, such as rapamycin and tacrolimus, have been shown to inhibit the development of NIH. In this study, the aim was to test the impact of a sustained releasing tacrolimus-chitosan-eluting suture on the development of NIH in a rat model. METHODS: After tacrolimus-chitosan coating of a 7/0 polyvinylidene difluoride (PVDF) Trofilen® suture, the tacrolimus concentration on the coated suture and in vitro release trials were performed spectrophotometrically. Twelve Wistar rats were included. After midline laparotomy, a 7-8 mm longitudinal aortotomy in the infrarenal aorta was made and then closed by a bare 7/0 PVDF (group C, n = 6) and a 7/0 tacrolimus-chitosan coated PVDF suture (0.65 µg/cm tacrolimus [0.9 wt%] + 1.82 µg/cm chitosan [2.28 wt%]) (group T, n = 6). After 1 month, rats were sacrificed and aortotomy sites were examined histologically by ratio of intimal area (including neointima) and immunohistochemically by α-smooth muscle actin (ASMA) and proliferating cell nuclear antigen (PCNA) immunostaining. The PCNA positive cells were indexed to total cell number and expressed as percentage. RESULTS: In vitro tacrolimus release tests for a 7/0 tacrolimus-chitosan coated PVDF suture were confirmed for 1 month without an initial burst release. Endothelialisation over the aortotomy line occurred in both groups. The area of neointima was significantly reduced in group T compared with group C (ratio 0.22 ± 0.12 vs. 0.42 ± 0.11; p = .017) 1 month post-operatively. Likewise, the percentage of PCNA immunostaining significantly decreased in group C compared with group T (3.83 ± 2.85% vs. 11.17 ± 7.78%; p = .026). The cells constituting NIH were positive for ASMA immunostaining. CONCLUSIONS: Tacrolimus-chitosan-eluting suture is shown to be an effective way to reduce NIH without interfering with normal endothelialisation.

Sedative-analgesic activity of remifentanil and effects of preoperative anxiety on perceived pain in outpatient mandibular third molar surgery.

The aim of this study was to assess the sedative-analgesic activity of different doses of remifentanil and effects of preoperative anxiety on intraoperative pain levels in patients attending a dental clinic. The patients (n=60) were divided into two groups according to the remifentanil infusion dose given: group R1: 0.05µg/kg/min; group R2: 0.1µg/kg/min. The following were evaluated: haemodynamic parameters, State-Trait Anxiety Inventory (STAI) TX-I score, pain level due to local anaesthesia injection, time to reach a Ramsay Sedation Scale (RSS) score of 3, amount of bolus dose, total drug consumption, recovery period, patient and surgeon satisfaction, and complications. The patient satisfaction score on a visual analogue scale (VAS) was 90 in group R1 and 100 in group R2 (P=0.008); the surgeon satisfaction score was 80 in group R1 and 90 in group R2 (P=0.004). The time to reach an RSS score of 3 and the amount of bolus dose were significantly lower in group R2 than in group R1. High levels of anxiety did not affect intraoperative pain levels. In conclusion, high doses of remifentanil can safely be used for various same-day dental surgery interventions.

The CHESS score: a simple tool for early prediction of shunt dependency after aneurysmal subarachnoid hemorrhage.

BACKGROUND AND PURPOSE: Acute hydrocephalus is an early and common complication of aneurysmal subarachnoid hemorrhage (SAH). However, considerably fewer patients develop chronic hydrocephalus requiring shunt placement. Our aim was to develop a risk score for early identification of patients with shunt dependency after SAH. METHODS: Two hundred and forty-two SAH individuals who were treated in our institution between January 2008 and December 2013 and survived the initial impact were retrospectively analyzed. Clinical parameters within 72 h after the ictus were correlated with shunt dependency. Independent predictors were summarized into a new risk score which was validated in a subsequent SAH cohort treated between January and December 2014. RESULTS: Seventy-five patients (31%) underwent shunt placement. Of 23 evaluated variables, only the following five showed independent associations with shunt dependency and were subsequently used to establish the Chronic Hydrocephalus Ensuing from SAH Score (CHESS, 0-8 points): Hunt and Hess grade ≥IV (1 point), location of the ruptured aneurysm in the posterior circulation (1 point), acute hydrocephalus (4 points), the presence of intraventricular hemorrhage (1 point) and early cerebral infarction on follow-up computed tomography scan (1 point). The CHESS showed strong correlation with shunt dependency (P = 0.0007) and could be successfully validated in both internal SAH cohorts tested. Patients scoring ≥6 CHESS points had significantly higher risk of shunt dependency (P < 0.0001) than other patients. CONCLUSION: The CHESS may become a valuable diagnostic tool for early estimation of shunt dependency after SAH. Further evaluation and external validation will be required in prospective studies.

Relation between Endothelial Nitric Oxide Synthase Genotypes and Oxidative Stress Markers in Larynx Cancer.

Nitric oxide synthase (eNOS/NOS3) is responsible for the endothelial synthesis of nitric oxide (NO(•)). G894T polymorphism leads to the amino acid substitution from Glu298Asp that causes lower NOS3 activity and basal NO(•) production in NOS3 894T (298Asp) allele carriers compared with the GG homozygotes. NO(•) acts as an antioxidant protecting against Fenton's reaction which generates highly reactive hydroxyl radicals. Allelic variation of NOS3 may influence an individual's risk of laryngeal cancer (LC). In the current study we have examined the possible relationship between NOS3 G894T genotypes and various systemic oxidative damage markers such as protein carbonyl, advanced oxidation protein products, Cu, Zn-superoxide dismutase, thiol group fractions, and lipid hydroperoxides in LC patients. Genotyping was carried out by PCR-RFLP. In LC patients with TT genotype, Cu, Zn-superoxide dismutase activities and nonprotein thiol levels were significantly higher than the controls. In patients with GT and GG genotype, high levels of lipid hydroperoxides showed statistical significance when compared to controls. Our results indicate a potential relationship among G894T polymorphism of NOS3, and impaired redox homeostasis. Further studies are required to determine the role of NOS3 gene polymorphism and impaired plasma redox homeostasis.

Analyses of 1100 supernumerary teeth in a nonsyndromic Turkish population: A retrospective multicenter study.

PURPOSE: The aim of this study was to analyze the clinical and radiological features of supernumerary teeth (ST), record the related complications, and discuss different forms of treatment. MATERIALS AND METHODS: A total of 111,293 patients were examined over a 3-year period. The patients' ages and genders, in addition to the number, morphology, location, position, shape, developmental stage, and eruption status of ST and associated complications, were recorded. RESULTS: Among the 111,293 patients, there were 851 (0.76%) patients with 1100 ST. Of these patients, 478 (56.2%) were males, and 373 (43.8%) were females, with a mean age of 22.71. Most of the 1100 ST were located in the maxilla, 437 (39.72%) were a conical shape, with 82.81% of these including a fully developed tooth. A mesiodens was the most common type of supernumerary tooth (n=284, 33.37%), followed by distomolars (n=204, 23.97%) and parapremolars (n=146, 17.16%). Among the 1100 ST, 422 (38.36%) were associated with complications. CONCLUSIONS: No previous studies in the literature have examined in detail so many cases with ST. The demographic profile of the patients with ST presented herein provides useful additional epidemiological information.

Complex and compound odontomas: Analysis of 69 cases and a rare case of erupted compound odontoma.

OBJECTIVE: The purpose of this study was to analyze clinic and radiologic features of the 69 odontoma cases and present a rare case of erupted compound odontoma in the oral cavity. MATERIAL AND METHODS: The 69 cases were analyzed with regard to the following parameters: age, gender, location, associated unerupted teeth, missing teeth, radiological and histopathological features and treatment protocols. RESULTS: Of the 69 cases, 49 were compound odontoma and 20 were complex odontoma. There was a female predilection for both compound and complex odontomas. Compound odontoma occurred more often in the anterior region of the jaws; complex lesions occurred more often at the posterior mandible. The most common clinical manifestations were the retention of permanent teeth. CONCLUSION: Compound odontomas rarely erupt into the mouth. The presented case is the 13 th case of erupted compound odontoma reported in the literature. The treatment of choice is surgical removal of the odontoma. In the case of odontomas associated to impacted teeth, the teeth should be preserved in wait of spontaneous eruption, or alternatively fenestration followed by orthodontic traction is indicated. Regular follow-up period is crucial to evaluate the prognosis of these teeth.

St. John's wort may ameliorate 2,4,6-trinitrobenzenesulfonic acid colitis off rats through the induction of pregnane X receptors and/or P-glycoproteins.

It is reported that deficiencies of the pregnane X receptor (PXR) and P-glycoprotein (P-gp), the latter of which is encoded by the MDR1 gene, are important factors in the pathogenesis of inflammatory bowel disease (IBD). It is also known that the activation of PXR is protective of IBD due to the mutual repression between PXR and nuclear factor kappa B (NF-κB) expression and because NF-κB was reported to play a pivotal role in the pathogenesis of ulcerative colitis. The goal of this study was to investigate whether St. John's wort (SJW) and spironolactone (SPL), both known to have strong inducing effects on cytochrome P 450 (CYP) enzymes as well as PXR and P-gp, have ameliorating effects on 2,4,6-trinitrobenzenesulfonic acid (TNBS) colitis of rats through induction of PXR and/or P-gp. Wistar albino rats (250 - 300 g) were divided into control and TNBS-colitis groups. Each group was then divided into a) control (saline), b) SJW (300 mg/kg p.o. bid), and c) SPL (80 mg/kg p.o.) groups. Drugs were given for 7 days. Both treatments ameliorated the clinical hallmarks of colitis, as determined by body weight loss and assessment of diarrhea, colon length, and bowel histology. Plasma levels of NF-κB, tumour necrosis factor-alpha (TNF-α) and tissue myeloperoxidase (MPO) activity, as well as the oxidative stress markers that increased during colitis, decreased significantly after both treatments. The PXR and P-gp expression in the intestinal tissues was diminished in the colitis group but increased after drug treatments. Both drugs appeared to have significant antioxidant and anti-inflammatory effects and ameliorated the TNBS colitis of the rats, most likely through their PXR- and P-gp-inducing properties.

Is topical corticosteroid necessary in traumatic hyphema?

PURPOSE: To compare the outcomes in the management of traumatic hyphema treated with topical corticosteroid plus supportive therapy versus only supportive therapy. PATIENTS AND METHODS: In this retrospective study, 206 patients were divided into two groups; group I, 98 eyes were treated with topical corticosteroid 12 × 1 and supportive therapy including bed rest, keeping the head elevated (45 degrees), and hydration. In group II, 108 eyes were treated with only supportive therapy. Hyphema size, initial and final visual acuities and intraocular pressure, time to hyphema clearance, and incidence of rebleeding were evaluated. RESULTS: The time needed for hyphema resorption in the two groups were 60.25 ± 33.9 and 62.3 ± 28.9 hours respectively (P=0.62). There was no significant difference in rebleeding rate between the topical corticosteroid group (4.01%) and non-steroid group (6.48%) (P=0.67). The initial and final visual acuities were similar in the two groups (P=0.86). In Groups I and II, the average intraocular pressures were 19.7 ± 8.01 and 14.2 ± 10.2 mmHg respectively. The difference between the two groups was statistically significant (P=0.04). CONCLUSION: Patients who were treated with topical corticosteroids were no less likely to experience a rebleed or a poor visual outcome than those treated with supportive therapy alone. Supportive therapy alone may be convenient and cost-effective management strategy in uncomplicated traumatic hyphema.

The effect of zoledronic acid on growth plates and high turnover bones.

OBJECTIVES: Bisphosphonates have preventive effect on bone resorption caused by osteoclasts.We aimed to investigate the histopathological effects of zoledronic acid (ZA) on the jaw and long bones and growth plates of rats. METHODS: Thirty-six 12 week-old female Sprague-Dawley rats were divided into the control (C, n=18) and ZA groups (Z, n=18). Z group animals were administered 0.1 mg/kg saline-diluted ZA intraperitoneally three times per week for 8 weeks. C group animals were administered the same amount of saline simultaneously. At the end of 11th week, half the subjects from either the control group (C1) and ZA group (Z1) were sacrificed. At the end of 14th week, the remaining half from both groups were also sacrificed (C2 and Z2). In all animals, no dental procedures were performed; the posterior and anterior mandible and the knee joint including distal femur and proximal tibia were histopathologically investigated. RESULTS: Histological examination revealed that inflammation and necrosis were limited to the posterior mandible of the Z1 and Z2 groups, while the anterior mandible and knee joint including distal femur and proximal tibia remained unaffected however the development of the growth plate of the proximal tibia was found to be arrested in animals of the Z1 and Z2groups. CONCLUSION: Due to it is inhibitory effect over growth plate and inflammatory and necrotic effect over high turnover bones, zoledronic acid should be administered cautiously, especially in pediatric patients who are still in their growth and development stages (Fig. 6, Ref. 34).

Spontaneous resolution of paraparesis because of acute spontaneous thoracolumbar epidural hematoma.

BACKGROUND: Symptomatic spontaneous spinal epidural hematoma(SSEH) is an uncommon cause of cord compression that commonly is considered an indication for emergent surgical decompression. We aimed to investigate a patient with a SSEH that completely resolved clinically and radiographically, without surgical treatment. The patient presented three days after the sudden onset of back pain, numbness, and weakness. Magnetic Resonance Imaging (MRI) revealed a posterior thoracolumbar epidural hematoma extending from the level of T10 to L2 with significant cord compression. Decompression was recommended but he refused surgery and was managed conservatively. One month later weakness totally recovered and hematoma was absent on MRI.

Spontaneous resolution of paraparesis because of acute spontaneous thoracolumbar epidural hematoma.

Symptomatic spontaneous spinal epidural hematoma(SSEH) is an uncommon cause of cord compression that commonly is considered as an indication for emergent surgical decompression. We aimed to investigate a patient with a SSEH that completely resolved clinically and radiographically, without surgical treatment. The patient presented three days after the sudden onset of back pain, numbness, and weakness. Magnetic Resonance Imaging (MRI) revealed a posterior thoracolumbar epidural hematoma extending from the level of T10 to L2 with significant cord compression. Decompression was recommended but he refused surgery and was managed conservatively. One month later, weakness totally recovered and hematoma was absent on MRI.

Complete endovascular occlusion of a cranial dural fistula using a venous "to the point" approach.

BACKGROUND AND OBJECT: Cranial dural arteriovenous fistulas are commonly treated using an endovascular method. In comparison to intracerebral arteriovenous malformations, it is important to reach the venous part of these malformations to maintain a complete occlusion. Therefore, often the venous side is totally occluded using coils and∕or glue. PATIENT AND METHODS: We describe a patient with an initially Type IIab (Cognard classification) left occipital cranial fistula. The patient suffered from an intense pulsate tinnitus. Therefore, the first embolization was performed using an approach via the dilated left middle meningeal artery using Onyx. The shunt of the fistula was reduced significantly but total occlusion was impossible. Therefore, the venous approach was used. Over a guiding catheter in the sigmoid sinus, the venous side of the fistula could be reached with a microcatheter. This part of the fistula was then completely occluded using coated and bare coils, without occluding the adjacent sinus. Control angiography of all previous feeders showed a complete occlusion of the fistula (used classification: Cognard). RESULTS: The fistula was entirely occluded. The patient's outcome was excellent. The patient did not develop any symptoms and no complication occurred due to the treatment. CONCLUSIONS: Direct occlusion of the venous part of an arteriovenous cranial fistula can be an option before an occlusion of the sinus has to be performed. This approach can lead to reduction of risk during the endovascular procedure and risk reduction in long-term follow-up.

Honey as a substitute for formalin?

Formalin has long been the standard fixative for clinical routines worldwide. After the Formaldehyde Standard became law in the US in 1987, as a result of increasing concerns about the potential carcinogenicity of formaldehyde, attempts have been made to find safer alternatives. Alcoholic formalin is a useful fixative, because in addition to fixation, dehydration also is begun. For centuries, honey has been known to be an antibacterial agent with the potential to preserve compounds without harmful effects on its users. We compared the effects of honey fixation with other routine fixatives using conventional histochemical and immunohistochemical staining methods. Our results demonstrated that tissues fixed in either honey or alcoholic formalin and 10% neutral buffered formalin (NBF) have similar histomorphology. Honey fixation showed minor histomorphological differences among the various tissues; however, it did not influence affect correct diagnostic conclusions. Our results suggested that honey can be used as a safe alternative to formalin in histopathology.