Adoption of IWGDF guidance on prevention and management of foot problems in diabetes for local use in Iran by ADAPTE methodology: a step toward best practice.

Purpose: Adoption of international working group on the diabetic foot (IWGDF) guidance on prevention and management of foot problems in patients with diabetes was the study aim. Methods: The ADAPTE process consisted of three main phases of set-up, adoption, and finalization with overall 24 steps was used. In set- up phase, organizing committee by a multidisciplinary approach was established. In adoption phase, comprehensive search in databases and guideline resources was done. According to the inclusion criteria, the 2015IWGDF guidance was selected for adoption process. Quality, currency, content and consistency of the guidance were assessed. Also, consensus on different level of agreement for each recommendation were reported. On finalization phase, the adopted version was reviewed by the guidance developer and the final guidance for local use in Iran was disseminated. Results: The 2015 IWGDF guidance with 77 recommendations was adopted after screening of 1760 documents retrieved from Jan. 2006 to Nov. 2016. An organizing committee was established according to a multidisciplinary approach including 73 members with endocrinology, orthopedic & vascular surgery, dermatology, infectious diseases, physical medicine and rehabilitation specialties, general practitioners and nurses. This guidance obtained a good quality in all six domains of AGREE II instrument (Score ≥ 80%), good currency, content, and consistency. Also, during the third round of Delphi, the consensus on the agreement level of each recommendation were greater than 80% and 77 recommendations of the original guidance were kept in the adopted version. Conclusion: The 2015 IWGDF guidance with 77 recommendations adopted for local use in different health care settings of Iran. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-022-01121-0.

Iron status in diffuse telogen hair loss among women.

The relationship between iron body status and different types of hair loss has been investigated in a number of studies, however, with relatively discrepant findings. Therefore we conducted an analytical case-control study to assess whether diffuse telogen hair loss in women of childbearing age (15 to 45 years old) is associated with iron deficiency. Using the analytical case-control methodology, we studied 30 consecutive women with documented diffuse telogen hair loss in comparison with 30 women without hair loss. Study subjects had no history of nutritional supplement intake or chronic underlying diseases, and had normal thyroid function and inflammatory profiles. Biochemical investigations were performed in all study women. The mean ferritin level and trasferrin saturation was statistically significantly lower in patients with diffuse telogen hair loss than in subjects without hair loss (16.3+/-12.6 vs. 60.3+/-50.1, ng/mL; P<0.0001 and 20.3+/-9.7 vs. 28.3+/-11.8 percent; P=0.006, respectively). Also, total iron binding capacity was significantly higher in patients than in control group (367.8+/-58.2 vs. 319.2+/-60.1 microg/dL; P=0.004). Of nine patients with iron deficiency anemia (Hb <12 g/dL), eight patients had telogen hair loss (odds ratio: 10.5, 95%CI: 1.2-90.7; P=0.013). Odds ratio (95% confidence interval) for diffuse telogen hair loss was 21.0 (4.2-105.0) at serum ferritin levels < or =30 ng/mL. Women with iron deficiency status are at a risk of telogen hair loss. The important role of serum ferritin in hair loss is becoming more evident. In women without systemic inflammation or other underlying disorders, serum ferritin levels below or equal to 30 ng/mL are strongly associated with telogen hair loss.

The relationship between Video Display Terminals (VDTs) usage and dermatologic manifestations: a cross sectional study.

BACKGROUND: Recently, it has been observed that Video Display Terminals (VDTs) usage for long periods can cause some dermatological manifestations on the face. An analytical cross-sectional study was designed in order to determine this relationship. METHODS: In this study, 600 office workers were chosen randomly from an organization in Tehran (Iran). The subjects were then divided into two groups based on their exposure to VDTs. 306 workers were considered exposure negative (non VDT user) who worked less than 7 hours a week with VDTs. The remainders 294 were exposure-positive, who worked 7 hours or more with VDTs. The frequency of dermatologic manifestations was compared in these two groups. RESULTS: In the exposure-positive and exposure-negative groups, the frequency of these dermatologic manifestations were 27 and 5 respectively. After statistical analysis, a P.value of < 0.05 was obtained indicating a statistically significant difference between these two groups for dermatological manifestations. CONCLUSION: According to our study, there is a relationship between dermatologic manifestations on the face and exposure to VDTs.

Identification of hitherto undefined B-cell epitopes by antibodies in the sera of vitiligo patients using phage-display Peptide library.

A random 12 mers phage library was used to screen a pool of immunoglobulin fractions obtained from vitiligo patients. Subsequent to panning experiments, a panel of affinity selected phage from vitiligo patients were obtained. This panel was tested using an ELISA for their reactivity with pooled sera from patients and normal controls. Among the 16 randomly selected clones, two of clones showed distinct positive reactivity with the patient's sera compared with controls. The peptides displayed by these phages expressed the following amino acid sequences: SHMPLANQYQWA and NHVQAWEQFWDS. Thus, screening with phagedisplayed random peptide library of vitiligo sera can reveal peptide sequences that mimic vitiligo-related self-antigen.