Dr. Divya Ravikumar is an MBBS graduate from Azerbaijan Medical University with extensive clinical exposure across cardiology, cardiothoracic surgery, general surgery, internal medicine, emergency medicine, pediatrics, and other specialties. She has completed clinical attachments at leading hospitals in Dubai and has actively participated in medical research, contributing to multiple case reports, systematic reviews, and original research publications. Her academic interests include cardiovascular medicine, cardiothoracic surgery, emergency care, and evidence-based medicine. She has received awards for scientific presentations and actively participates in student scientific and surgical organizations. With strong clinical reasoning, communication, research, and teamwork skills, she is committed to continuous learning and delivering patient-centered care.

Title: Adjunctive Collapse Therapy Accelerates Cavitary Healing in Drug-Resistant Destructive Pulmonary Tuberculosis: A Prospective Comparative Study  Background: The global burden of drug-resistant tuberculosis (DR-TB) remains a profound public health challenge. Patients with drug-resistant destructive pulmonary tuberculosis (DR-DPTB) frequently suffer from persistent cavitary lesions, delayed sputum conversion, and prolonged infectiousness, complicating medical management. Collapse therapy—utilizing artificial pneumothorax or pneumoperitoneum to mechanically reduce lung volume and oxygen tension—has recently regained attention as a potential adjunctive intervention to promote reparative fibrosis and cavity healing in these complex cases. Methods: A prospective, single-center, comparative study was conducted involving 152 patients diagnosed with DR-DPTB at a specialized tuberculosis dispensary in Baku, Azerbaijan. Patients were divided into two cohorts: Group I (n=68) received individualized anti-tuberculosis chemotherapy combined with adjunctive collapse therapy, and Group II (n=84) received individualized chemotherapy alone. The primary clinical endpoints were sustained sputum smear conversion and radiological closure of pulmonary cavitary lesions, evaluated over a six-month treatment period. Results: At the six-month follow-up, sputum conversion rates were numerically higher in the collapse therapy group (73.5%) compared to the chemotherapy-only group (66.7%), though this did not reach statistical significance. However, radiological evaluation demonstrated a substantial, statistically significant improvement in cavity closure among patients receiving collapse therapy (58.8%) versus the control group (23.8%, p<0.0001). Furthermore, the adjunctive therapy was well-tolerated, with no serious procedure-related complications or instances of respiratory insufficiency reported. Conclusions: Collapse therapy is a safe, feasible, and highly effective adjunctive intervention for selected patients with DR-DPTB. By significantly accelerating the radiological closure of persistent pulmonary cavities, incorporating collapse therapy into individualized treatment regimens may substantially improve clinical outcomes, reduce bacillary burden, and mitigate ongoing transmission risks in high-burden settings.