Tuberculosis of the lymph nodes is comparatively prevalent in India, and poses many problems in treatment, particularly due to the unpredictability of the response of the nodes to chemotherapy. Enlargement of the glands and growth of new glands during antituberculosis treatment (ATT) is not uncommon, with development of abscesses and sinuses undesirable side effects. The nodes may persist after the prescribed chemotherapeutic regimen, and may even reappear after surgical excision. The helium nein (HeNe) laser has been shown to be effective in wound healing, although the exact action mechanism and pathways are not yet completely clear. The authors decided to try HeNe laser therapy delivered subcutaneously over affected lymph nodes in patients who were experiencing problems despite existing chemotherapeutic regimens. A series of ten representative case reports is presented which demonstrate that HeNe laser therapy is an effective method for helping the physician deal with problematic tuberculous lymph nodes, either as a stand-alone therapy or as an adjunctive therapy concomitant with ATT. From the success in this limited series of patients, the authors conclude that further trials are definitely warranted, perhaps involving double-blind and crossover elements, to demonstrate the efficacy of HeNe laser therapy in a controlled trial environment.
A double-blind controlled study is presented on the amino acid analysis of levels of a selected group of 26 free amino acids (FAA) in CO2 laser generated standardized burn wounds on the bilateral dorsum in the ddy mouse model. Four groups of ddy white mice (male, 5 weeks old, average weight 20 g), 6 animals per group, were anaesthetized with ether. The hair on the bilateral dorsum of all animals was carefully removed with a depilatory cream, and in three of the groups standardized burn injuries were inflicted using the defocused beam of the CO2 laser (25 W, continuous wave, 1.45 cm diameter spot, 0.99 sec/shot). The injuries were made bilaterally 1 cm laterally from the dorsal midline, 1.5 cm caudally from the line drawn between the base of the ears. The 4th group was the unburned control group for assessing base FAA levels. In experimental group A (LLLT group), the centre of the right hand burn injury was irradiated daily on days 0, 1, 2, 3, 4, and 5 with an 830 nm GaAlAs diode laser system (60 mW continuous wave). The left hand injury was unirradiated. The laser was held 1 mm from the surface of the wound, giving a spot size of approximately 0.03 cm2, 20 sec per exposure per day, energy density per exposure of 40 J/cm2. Group B (sham irradiation group) was handled in exactly the same way, but a non-emitting probe was used. Group C (unirradiated burned controls) was not handled at all. The animals were killed (ether overdose) on post-burn day 10. The size of the burn injury and the degree of wound healing were measured macroscopically on days 2, 5 and 7 and 10. The LLLT group A demonstrated better wound healing than groups B and C, between which there was no difference. On days 0, 1, 3, 5, 7 and 10, sample tissue was collected from both burned sites in the burned animals and from the unburned controls and subjected to automated AA analysis. The unburned controls were used as standards. On day 7 specimens were taken from the burn wounds in groups A, B and C and routinely processed for histological assessment with haematoxylin and eosin and elastica van Giesen’s stains. Automated AA analysis in general revealed higher levels of total FAA in group A, with no statistical difference between groups B and C. When looked at individually as spider graphs, the 26 AA isolated in this study at fell into 6 typical patterns. At day 10 histology revealed more advanced wound healing between the LLLT group and groups B and C, between which there was no difference. although the present study was only designed to isolate patterns in FAA associated with healing burns, the authors conclude that 830 nm diode LLLT certainly appears to accelerate wound healing, and there is a higher level of those FAA associated with protein synthesis.
Clinically, Low Level Laser Therapy - LLLT has been used successfully in the treatment of chronic pain but many have questioned the scientific basis for its use. Many studies have been poorly designed or poorly controlled. A double-blind, placebo-controlled, random-allocation study was designed to analyse the effect of second daily infrared (IR) laser (820 nm, 25 mW) and visible red laser (670 nm, 10 mw) at 1 J/cm2 and 5 J/cm2 on chronic pain. Forty-one consenting subjects with chronic pain conditions exhibiting myofascial trigger points in the neck and upper trunk region underwent five treatment sessions over a two week period. To assess progress, pain scores were measured using visual analogue scales before and after each treatment. The incidence of side effects was recorded. AII groups demonstrated significant reductions in pain over the duration of the study with those groups which received infrared (820 nm) laser at 1 J/cm2 and 5 J/cm2. demonstrating the most significant effects (p ‹ 0.001). Only those subjects who had active laser treatment experienced side effects. Results indicated that responses to LLLT at the parameters used in this study are subject to placebo and may be dependent on power output, dose and/or wavelength.
The nitrogen(N2) laser is used in our institute and country for treating tuberculous lung cavities and nonhealing wounds. Septicaemias and systemic bacterial infections being more important emergencies, data on the safety of intravenous (iv) nitrogen laser usage in the experimental animal model becomes a prerequisite for its trial in human subjects The test group of rabbits received iv nitrogen laser (power output = 2.5 mW ) through an intravenously-placed quartz fibre. After ten sittings of ten minutes each on alternate days, routine haematological parameters and histological studies on vital organs were carried out. Antibody response to typhoid vaccine, delayed hypersensitivity response to tuberculin antigen in BCG sensitized rabbits and the periodic complement levels were compared to the matched nonirradiated controls. Immunomodulatory response was not observed after iv laser irradiation. There was in addition no haematohistopathology and the iv nitrogen laser appeared to be a safe modality in the experimental rabbit model.
The purpose of this randomized, double-blind study was to examine the effect of GaAs laser therapy for tendinitis and myofascial pain in a sample from the general population of Åkersberga in the northern part of Greater Stockholm. 176 patients (of an original group of 200) completed the scheduled course of treatment. The patients were assigned randomly to either a laser group (92 patients, of whom 74 had tendinitis, completed the study) or a placebo group (84 patients, of whom 68 had tendinitis, completed the study). All 176 patients received six treatments during a period of 3-4 weeks. Their pain was estimated objectively using a pain threshold meter, and subjectively with a visual analogue scale before, at the end of, and four weeks after the end of treatment. Laser therapy had a significant, positive effect compared with placebo measured from the first assessment to the third assessment, four weeks after the end of treatment. Laser treatment was most effective on acute tendinitis.