Mesodiencephalic modulation in the treatment of XDR TB patients with concomitant type II diabetes mellitus

Abstract

Background: The progressive course of extensively drug resistant (XDR) TB accompanied by type II diabetes mellitus (DM) is associated with the development of a chronic pathology with gradual degradation of neuroendocrine centres and reduced function of the hypothalamic-pituitary system.

Aim: To evaluate effectiveness of mesodiencephalic modulation (MDM) in the treatment of XDR TB/DM patients.

Materials and methods: A prospective study of 87 XDR TB/DM patients was conducted in 2018-2020. Group 1 included 48 patients with progressive pulmonary TB (extensive destructive changes with bacterioexcretion). They received standard TB treatment along with MDM (2 courses, 12 procedures in each, at a two-week interval). Group 2 (control) included 39 patients with similar conditions. They only received standard TB treatment. Treatment effectiveness was evaluated by sputum conversion, cavity closure, and normalization of blood sugar levels, glycated hemoglobin, reduced levels of acute-phase proteins (APPs) (haptoglobin, fibrinogen, etc.)

Results: Treatment effectiveness was evaluated at the end of the intensive phase. Sputum conversion was registered in 94.6% of group 1, and 59% of group 2 (p1-2 < 0,05). Cavity closure was twice faster in group 1 with minimal residual changes. APPs normalized. Adverse events (polyneuropathy) and residual changes were minimized in group 1 vs group 2.

Conclusion: We established that mobilization of APPs responsible for early reactions to infection in patients with XDR TB/DM became less pronounced. In group 1 APPs and clinical presentations decreased faster; adverse events due to chemotherapy or DM reduced to minimum.