USE OF 90Sr - BETA EMITTER AS AN ANTIFUNGAL AGENT-AN INNOVATIVEDIMENSION IN THERAPEUTIC NUCLEAR MEDICINE

摘要

Onychomycosis is defined as the infection of nail by fungus and represents up to 30% ofrndiagnosed superficial fungal infection. It induces a serious public health problem both in developedrnand developing countries. Clinical impression indicates that there is a high prevalence of superficialrnmycoses (dermatophytosis) in Bangladesh. In treating onychomycosis, the therapeutic limitations ofrnconventional antimycotic agents (in respect of low cure rates, high relapse rate, inherent side effects,rnlong duration of treatment and high expense) have provided clear incentives to explore alternativerntherapy procedures. Sr90 has been used for treatment of onychomycosis in the present study. The studyrnpopulation was 330 randomly allocated patients divided into three groups: Group – A (n =110)rnreceived griseofulvin; Group – B (n=110) received beta radiation and Group – C (n=110) receivedrncombined beta radiation and griseofulvin. At the end of the follow up period (6 months afterrndiscontinuation of treatment) mycological cure rate was achieved 41 (42.70%), 36 (38.70%) and 65rn(66.33%) in Group-A, Group-B and Group-C respectively. The mycological cure rate was highlyrnsignificant (P=0.000). Percentage of clinical cure rate was similar as mycological cure rate andrnequally significant (P=0.000). Recurrence rate of the disease was highest in griseofulvin-inducedrnpatients 21 (21.88%) and in beta radiation exposed patients was 14 (15.06%). This rate was least inrncombination therapy group of griseofulvin and beta radiation 4 (4.08%). Cure rate in Group – C isrnsignificantly higher than Group – A and B as well (P=0.000). It can be concluded that the proposedrnnew beta radiation treatment modality using Sr-90 for onychomycosis exhibited a low risk- benefitrnratio. From the observations of the present study it may be considered worthy to comment that inrnGroup – C can be considered as the more acceptable procedure for management of onychomycosis inrna developing country like Bangladesh.