Liver diseases characterized by inflammation or tissue damage affect the optimal functioning and increase the morbidity and mortality of the affected individual. Liver diseases are a largely neglected health issue and recent reports indicate that they affect over 10% of the world population, with the highest burden in low and middle income countries that have minimal medical resources. To complicate matters the currently available pharmacological therapies are not optimal and when used for extended periods of time impart systemic toxicity. Diet can modify pathophysiological processes, including those of hepatotoxins, and studies have shown that some dietary constituents can afford heptoprotection. Emblica officinalis Gaertn or Phyllanthus emblica Linn, commonly known as the Indian gooseberry in English or amla in Hindi, is one of the most important medicinal and dietary plants in the Indian subcontinent. The fruits are of dietary and medicinal use and have wide applications in both traditional and folk systems of medicine. Scientific studies have shown amla to be effective in preventing/ameliorating the toxic effects of hepatotoxic agents like ethanol, paracetamol, carbon tetrachloride, heavy metals, ochratoxins, hexachlorocyclohexane, antitubercular drugs and hepatotoxicity resulting from iron overload. Amla is also reported to impart beneficial effects on liver function and to mitigate hyperlipidemia and metabolic syndrome. Amla possesses protective effects against chemical-induced hepatocarcinogenesis in animal models of study. Additionally, the phytochemicals quercetin, gallic acid, corilagin and ellagic acid are also reported to protect against the cytotoxic effects of paracetamol, microcystins, galactosamine and lipopolysaccharide. The hepatoprotective actions of amla appear to be mediated by its free radical scavenging, antioxidant, anti-inflammatory and modulation of the xenobiotic detoxification process and lipid metabolism.

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Background: This study was planned to evaluate the efficacy of topical application of an Aloe vera-based cream (AVC) for the prevention of ionizing radiation (X ray)-induced dermatitis in head and neck cancer patients requiring therapeutic radiation treatment (>62 Gy). Methods: From July 2012 to December 2012, a total of 60 head and neck cancer patients requiring curative radiotherapy (RT) of more than 66 Gy were prospectively enrolled and treated with AVC or a comparator Johnson’s Baby Oil (JBO). Acute skin reaction was monitored and classified according to the Radiation Therapy Oncology Group (RTOG) four-point rating scale on a weekly basis. Results: The results indicate that there was a statistically significant delay in the incidence (p = 0.04) of dermatitis at week three in the AVC application group. Application of AVC reduced the incidence of Grade 1, 2, and 3 dermatitis at subsequent time points, while Grade 4 dermatitis was not seen in either cohort. The other most important observation was that the continued application of AVC two weeks after the completion of RT was effective in reducing the average grade of dermatitis and was statistically significant (p < 0.02). Conclusions: Prophylactic use of an AVC-based cream is thus effective in delaying radiation dermatitis in head and neck cancer.

Background: The primary objective of this study was to ascertain the benefit of Vicco turmeric Ayurvedic cream (VTC; Vicco Laboratories, Mumbai, India) sandalwood oil and turmeric-based cream in preventing radiodermatitis in women undergoing curative radiotherapy for their breast cancer. Methods and Materials: The study was an investigator-blinded randomized study with Johnsons Baby Oil (JBO; Johnson & Johnson Ltd., Baddi, India) as a comparator, administered daily from the start of radiation therapy for 5 weeks in women receiving breast radiation therapy, 50 Gy in 2 Gy fractions daily for 5 weeks. The endpoints were to ascertain the delay in the appearance and the degree of severity of dermatitis throughout the study period in accordance to the Therapy Oncology Group (RTOG) score. Results: The results indicated that the topical application of VTC delayed and mitigated the radiodermatitis. When compared to the Johnson’s Baby Oil, a significant decrease (p = 0.025) in the incidence of grade 1 was seen at week two, and also in grade 2 and 3 at week 3 (p = 0.003) and week 4 (p = 0.02), respectively, in the VTC cohort. A concomitant decrease in the average severity was also observed at week 2 (p = 0.02), week 3 (p = 0.05) and week 4 (p = 0.03). Conclusions: The results indicate that VTC cream significantly reduces radiation dermatitis when applied to the breast during and after radiation therapy. The result of this study indicates the beneficial effects. Double blind randomized control studies are required to further confirm the beneficial effects of VTC in mitigating radiodermatitis is people undergoing radiation treatment for their cancer.

Radiation-induced mucositis is a dose-limiting factor in the effective treatment of head and neck (H & N) cancers. The objective of this study was to understand the efficacy of honey in mitigating radiation-induced mucositis and whether it would interfere with tumor control. This was a single-blinded, randomized, controlled study and was carried out in patients with H & N cancer requiring curative radiotherapy (>62 Gy (Gray)). The patients meeting the inclusion criteria were randomly assigned to receive either honey (n = 25) or povidone-iodine (active comparator) (n = 25) during radiotherapy. Oral mucositis was assessed using the RTOG (Radiation Therapy Oncology Group) grading system before the start, during, and at the end of the treatment by an investigator unaware of the treatment. The results indicate that when compared with the active comparator, honey reduced the radiation-induced oral mucositis, decreased the incidence of intolerable mucositis, treatment breaks, loss of treatment days (p < 0.0001 and < 0.0003) and did not affect the radiation-induced tumor response. The clinical observations indicate that honey mitigates the radiation-induced mucositis and does not interfere with tumor cell killing.