Low level nitrogen laser therapy in pulmonary tuberculosis

Area of Science:

• Medical Microbiology
• Laser Physics
• Pulmonology

Background:

• Tuberculosis (TB) remains a global health challenge, with millions of new cases and deaths annually.
• Multi-drug resistant tuberculosis (MDR-TB) presents a significant treatment challenge due to high mortality rates.
• A substantial proportion of MDR-TB cases are concentrated in India, China, and the Russian Federation.

Purpose of the Study:

• To determine the prevalence of drug resistance in Mycobacterium tuberculosis isolates in Central India.
• To evaluate the in-vitro efficacy of N2 laser against M. tuberculosis.
• To assess the therapeutic impact of intra-cavitary N2 laser irradiation on pulmonary TB patients unresponsive to chemotherapy.

Main Methods:

• Drug sensitivity testing was performed on 567 M. tuberculosis isolates using the proportion method.
• In-vitro N2 laser efficacy was assessed by exposing M. tuberculosis cultures on LJ plates to laser irradiation for 10 minutes.
• Intra-cavitary laser therapy involved introducing a fiber into the lung cavity for 10 minutes of N2 laser irradiation.

Main Results:

• Only 12.8% of M. tuberculosis isolates were sensitive to all anti-TB drugs; 21.5% exhibited resistance to Rifampicin, meeting the definition of MDR-TB.
• In-vitro studies confirmed a bactericidal effect of N2 laser on M. tuberculosis.
• In a clinical trial, 90% of 96 patients showed improvement, with 60% exhibiting improved X-rays and 75% becoming Acid-fast bacilli smear-negative within 4-15 days.

Conclusions:

• Intra-cavitary N2 laser therapy is a highly effective adjunct to conventional chemotherapy for treating pulmonary tuberculosis.
• The study highlights the potential of N2 laser as an innovative therapeutic modality for challenging TB cases.