Medical Journal of the Islamic Republic of Iran最新文献

{"title":"MiR-20b Tissue Expression Level Displays the Diagnostic Value in Papillary Thyroid Carcinoma.","authors":"Maryam Honardoost, Zohreh Maghsoomi, Arman Karimi Behnagh, Nazanin Hosseinkhan, Fereshte Abdolmaleki, Mahshid Panahi, Mohammad E Khamseh","doi":"10.47176/mjiri.37.101","DOIUrl":"https://doi.org/10.47176/mjiri.37.101","url":null,"abstract":"<p><strong>Background: </strong>Detection of cancer in patients with thyroid nodules requires sensitive and specific diagnostic modalities that are accurate and inexpensive. This study aimed to identify a potential microRNA(miRNA) panel to detect papillary thyroid carcinoma (PTC).</p><p><strong>Methods: </strong>Following a comprehensive literature review as well as miRNA target predictor databases, Real-time PCR was used to quantify the expression of candidate miRNAs in 59 tissue specimens from 30 patients with PTC and 29 patients with benign nodules. A receiver operating characteristic (ROC) curve analysis was used to assess the accuracy of miRNA expression levels compared to the pathology report as the gold standard. Based on prediction results, four miRNAs, including miR-9, miR-20b, miR-221, and miR-222, were selected to evaluate their expression level in Iranian thyroid samples.</p><p><strong>Results: </strong>A significant difference between the tissue expression level of miR-20b, miR-9, miR-222, and miR-221 was detected in the PTC group compared with non-PTC (<i>P</i> < 0.05). The area under the curves for the included miRs were 1, 0.98, 0.99, 0.98, and 1, respectively.</p><p><strong>Conclusion: </strong>Our results confirmed deregulations of miR-20b as well as miR-222, miR-221, and miR-9 in PTC and, therefore, could be used as a helpful miRNA panel to differentiate PTC from benign nodules, which results in the more efficient clinical management of PTC patients.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Rate of the Use of Persian Traditional Medicine Services in Tehran.","authors":"Dariush Taherkhani, Ali Davati, Reza Majdzadeh, Elham Eemaratkar","doi":"10.47176/mjiri.37.100","DOIUrl":"https://doi.org/10.47176/mjiri.37.100","url":null,"abstract":"<p><strong>Background: </strong>Despite all the advancements and publicity made in regard to classical medicine, every day more and more people are interested in complementary medicine. This study was designed and conducted to determine the relative frequency of the use of Persian traditional medicine services by the people of Tehran.</p><p><strong>Methods: </strong>This cross-sectional study was conducted using the telephone survey method in Tehran. A total of 1824 samples were included in the study based on Cochran's formula. At first, by searching databases, including Google Scholar, PubMed, Embase, and internal sources, including the Iran Medex database, numerous medical texts and articles were reviewed in the field of using traditional medicine services. Then, interview guide questions were designed and asked over the phone. Finally, the data were extracted and subjected to quantitative analysis. Frequency and percentage of relative frequency were used to describe the study data.</p><p><strong>Results: </strong>In the study, 62% (n = 1131) of the participants were women, and 60.5% (n = 1103) of the participants have turned to modern medicine for treatment and have also used traditional medical treatments. Also, 43.5% (n = 864) of the participants have used herbal medicines and their products; 43% (n = 616) of the participants have used Persian traditional medicine treatments as self-treatment based on their personal information; and only 46.5% (n = 666) have evaluated the therapeutic effect of Persian traditional medicine methods as \"good.\"</p><p><strong>Conclusion: </strong>The results of the study indicate the need for more emphasis on Persian traditional medicine alongside modern medicine, more organization and supervision of traditional medicine service providers in the country, and the creation of coherent and integrated management in this field.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Time to Report the Side Effects after AstraZeneca and Sinopharm Vaccinations in Users of the COVID-19 Symptom Study App: A Survey in South Iran.","authors":"Marjan Zare, Alireza Mirahmadizadeh, Masoumeh Khosravi, Mohammadreza Karimi, Seyedeh Leila Dehghani","doi":"10.47176/mjiri.37.99","DOIUrl":"https://doi.org/10.47176/mjiri.37.99","url":null,"abstract":"<p><strong>Background: </strong>Concerns about the side effects of SARS-CoV-2 vaccines have been raised nationwide. We aimed to compare the time to report the side effects of the Oxford-AstraZeneca and Sinopharm COVID-19 vaccines.</p><p><strong>Methods: </strong>Information on side effects of AstraZeneca and Sinopharm COVID-19 vaccines was obtained from the COVID-19 Symptom Study App affiliated with Shiraz University of Medical Science during 2021. A COX regression model with an adjusted Hazard Ratio and 95% Confidence Interval; HR (95% C.I) was reported at the significance level of < 0.05.</p><p><strong>Results: </strong>4478 and 5555 participants received the AstraZeneca and Sinopharm vaccines, respectively; more age, history of SARS-CoV-2 infection, first vaccine dose, hypertension, and hypertension with cardiovascular disease were seen in the AstraZeneca group (<i>P</i> < 0.05 for all). However, the AstraZeneca group had lower immune deficiency and time to report the side effects (<i>P</i> < 0.05 for both). There was significantly less time to pain HR(95% C.I.); 0.50 (0.47-0.52), vertigo 0.65 (0.61-0.69), weakness 0.41 (0.38-0.44), headache 0.43 (0.39-0.74), anorexia 0.31 (0.28-0.34), nausea 0.56 (0.51-0.62), severer allergy 0.71 (0.63-0.81), general inflammation 0.27 (0.23-0.31), fever > 38oC 0.12 (0.1-0.15), eye inflammation 0.45 (0.39-0.52), diarrhea 0.85 (0.73-0.99), blurred vision 0.73 (0.61-0.86), injection site redness 0.32 (0.26-0.39), fatigue/paleness 0.53 (0.50-0.57), joint pain 0.55 (0.41-0.73), auxiliary gland inflation 0.59 (0.43-0.80), convulsions 0.30 (0.17-0.52), and severe side effects 0.3 (0.27-0.33) in the AstraZeneca group; However, skin rash 0.77 (0.57-1.05) and hospitalization 0.72 (0.21-2.55) were the same.</p><p><strong>Conclusion: </strong>Sinopharm COVID-19 vaccine recipients reported longer times to report vaccine-related side effects than AstraZeneca; due to the lack of adverse effects like hospitalization, vaccination should continue to control the pandemic; more real-population studies are needed on the long-term effects of vaccination against COVID-19.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Social Mobility and Quality-of-Life Index in Women of Rasht: A Population-Based Study in the Iranian Context.","authors":"Asiyeh Namazi, Hassan Rafiey, Mirtaher Mousavi, Ameneh Setareh Forouzan, Gholamreza Ghaedamini Harouni","doi":"10.47176/mjiri.37.98","DOIUrl":"https://doi.org/10.47176/mjiri.37.98","url":null,"abstract":"<p><strong>Background: </strong>Life course research has shown that socioeconomic conditions in childhood have a profound impact on adult health. However, little is known about the different health effects of social mobility. This study was conducted to answer whether the intergenerational social mobility of women in Rasht is related to their quality of life index.</p><p><strong>Methods: </strong>This cross-sectional survey conducted in 2020-2021, in which the researcher created a social mobility questionnaire, was used to study the association between social mobility and the quality of life index of women aged 30-65 in Rasht. The current socioeconomic status of 784 married women in this city was compared to the previous socioeconomic status of their parents. Also, Ferrans and Power's quality of life index questionnaire was used. Data analysis was done using t-test and ANOVA.</p><p><strong>Results: </strong>The mean (SD) score for the overall quality of life index was 21.60 (4.23) of 30. The majority of participants had immobility (350 of them or 44.6%). There was no statistically significant correlation between women's intergenerational mobility and their quality-of-life index (<i>P</i> = 0.734). Still, there was a statistically significant difference between the average score of the quality of life in the socioeconomic groups of the participants.</p><p><strong>Conclusion: </strong>Findings show that the women in Rasht did not have opportunities to promote their status or could not take advantage of these possibilities. Although our results did not show evidence for the effects of social mobility on quality of life, some scholars' findings support the idea of the impact (negative or positive) of intergenerational upward mobility on well-being.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CBC Differences between Survived and Deceased COVID-19 Patients: A Cohort Study.","authors":"Mahboobeh Freidoon, Narjes Soleimanifar, Naghmeh Sayadi, Hanieh Mojtahedi, Sara Assadiasl","doi":"10.47176/mjiri.37.97","DOIUrl":"https://doi.org/10.47176/mjiri.37.97","url":null,"abstract":"<p><p>The Coronavirus disease 2019 (COVID-19) pandemic showed the importance of simple, low-cost, and accessible tests for patient triage. Complete Blood Count (CBC) can be considered a good option for predicting the prognosis of COVID-19 and daily follow-up of hospitalized patients. CBC tests of 100 COVID-19 patients admitted to the general ward or intensive care unit (ICU) were monitored for ten days. Routine laboratory tests were also performed. In addition, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated at the time of admission. The WBC count of the ICU-admitted patients was significantly lower than in the non-ICU-admitted group (<i>P</i> = 0.008). The mean lymphocyte percentage of deceased patients was significantly lower than in the survived patients (<i>P</i> = 0.041), whereas the mean neutrophil percentage of the former group was higher than the latter ( <i>P</i> = 0.012). Moreover, the mean monocyte percentage of the survivors was significantly more than that of non-survivors (<i>P</i> = 0.003). However, there was no significant difference in mean platelet counts, hemoglobin levels, and red blood cell count between the studied groups. A lower WBC, lymphocyte percentage, and monocyte percentage, in addition to a higher neutrophil percentage, may indicate a poor prognosis in moderate to severe COVID-19 patients.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic Inequality in Screen Time, Phone, and Tablet Use among Iranian Adolescents: Results of A National Study.","authors":"Ghobad Moradi, Bakhtiar Piroozi, Farideh Mostafavi, Daem Roshani, Ebrahim Ghaderi, Seyyedeh Pouya Morovati","doi":"10.47176/mjiri.37.96","DOIUrl":"https://doi.org/10.47176/mjiri.37.96","url":null,"abstract":"<p><strong>Background: </strong>Excessive screen time has been associated with a variety of negative health outcomes. We aimed to evaluate screen time and phone and tablet use in Iranian adolescents and their relation to the socioeconomic status of adolescents' families in 2018.</p><p><strong>Methods: </strong>This descriptive-analytical study was carried out on 10-12-year-old adolescents from Kurdistan, Fars, and Markazi provinces. Cluster sampling was used for sampling. Data were collected by completing demographic questionnaires, calculating the BMI of adolescents and phone and tablet use, screen time, and socioeconomic status of the families. We used linear and logistic regression to estimate the final model. The concentration index was used to measure inequality and the Oaxaca decomposition to examine the different determinants of the inequality.</p><p><strong>Results: </strong>1590 adolescents (52.58% boys) were enrolled in our study. Screen time activities were significantly higher in boys, older adolescents, higher BMIs, more educated mothers, and 35< year-old fathers (<i>P</i> < 0.05). The use of mobile phones and tablets was significantly higher among boys, ten-year-olds, families with four or fewer members, higher BMIs, adolescents with higher levels of parental education, and more educated mothers (<i>P</i> < 0.05). In addition, the concentration index for screen time activities (C = 0.083) and phone and tablet use (C = 0.536) showed that screen time and phone and tablet use activities were higher in adolescents with high socioeconomic status.</p><p><strong>Conclusion: </strong>Screen time, phone and tablet use were higher in adolescents with high socioeconomic status. Also, many other factors like gender, age, BMI, parents' education and age can affect screen time, phone and tablet use in adolescents.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scoping Review of Adopted Information Extraction Methods for RCTs.","authors":"Azadeh Aletaha, Leila Nemati-Anaraki, AbbasAli Keshtkar, Shahram Sedghi, Abdalsamad Keramatfar, Anna Korolyova","doi":"10.47176/mjiri.37.95","DOIUrl":"https://doi.org/10.47176/mjiri.37.95","url":null,"abstract":"<p><strong>Background: </strong>Randomized controlled trials (RCTs) provide the strongest evidence for therapeutic interventions and their effects on groups of subjects. However, the large amount of unstructured information in these trials makes it challenging and time-consuming to make decisions and identify important concepts and valid evidence. This study aims to explore methods for automating or semi-automating information extraction from reports of RCT studies.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed, ACM Digital Library, and Web of Science to identify relevant articles published between January 1, 2010, and 2022. We focused on published Natural Language Processing (NLP), machine learning, and deep learning methods that automate or semi-automate key elements of information extraction in the context of RCTs.</p><p><strong>Results: </strong>A total of 26 publications were included, which discussed the automatic extraction of key characteristics of RCTs using various PICO frameworks (PIBOSO and PECODR). Among these publications, 14 (53.8%) extracted key characteristics based on PICO, PIBOSO, and PECODR, while 12 (46.1%) discussed information extraction methods in RCT studies. Common approaches mentioned included word/phrase matching, machine learning algorithms such as binary classification using the Naïve Bayes algorithm and powerful BERT network for feature extraction, support vector machine for data classification, conditional random field, non-machine-dependent automation, and machine learning or deep learning approaches.</p><p><strong>Conclusion: </strong>The lack of publicly available software and limited access to existing software makes it difficult to determine the most powerful information extraction system. However, deep learning models like Transformers and BERT language models have shown better performance in natural language processing.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Affecting the Good Governance in Teaching Hospitals: A Narrative Review.","authors":"Ali Javani, Akhtar Jamali, Nader Gholi Ghoorchian","doi":"10.47176/mjiri.37.94","DOIUrl":"https://doi.org/10.47176/mjiri.37.94","url":null,"abstract":"<p><strong>Background: </strong>One of the indicators of development in different countries is the efficiency of the health care system. Hospitals and health centers have a very important role in the sustainability of society as w well as its economic growth and development. Meanwhile, one of the important development indicators of hospitals is good governance. This study was aimed to determine the factors affecting good governance in teaching hospitals.</p><p><strong>Methods: </strong>This study was a scoping review of Iranian databases, including IranDoc, ISD, Magiran and International databases such as Science Direct, ISI, PubMed and Scopus to meet the good governance factors in teaching hospitals. There were no time limitations to data collection. the keywords governance, good governance, hospital governance, and good governance in hospitals, teaching hospitals, hospital management, hospital leadership, and their synonyms were used in the search strategy. The content analysis method was used to analyze selected studies.</p><p><strong>Results: </strong>The findings showed that the characteristics of effective governance in teaching hospitals can be considered as follow: efficiency, managing conflict of interests, facilitated operation, managed and under control activities, integration, and synergy, achieving the desired consequences, creating an atmosphere that is rewarding and for each member.</p><p><strong>Conclusion: </strong>Based on the results regarding the good governance model in teaching hospitals, it is recommended that on the basis of the nature of service, the mission and value of teaching hospitals have to be clearly redefined. On the other hand, the methods based on which we treat patients should be seriously redefined and we should pay more attention to the patient's values because the patients feel that we are practicing and testing them.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thought Believability and Anxious Feelings about COVID-19: A Case-Control Study in Northeastern Iran.","authors":"Abbas Ghodrati Torbati, Atefeh Shirinzadeh Feizabadi, Mohammad Reza Askari, Anahita Zandi, Mohammad Sarmadi","doi":"10.47176/mjiri.37.93","DOIUrl":"https://doi.org/10.47176/mjiri.37.93","url":null,"abstract":"<p><strong>Background: </strong>Believability and thoughts are considered as the pillars of behaviors over time, and anxious feelings are a risk factor for mental disorders, especially during the coronavirus disease (COVID-19) pandemic. This study aimed to explore the thought believability and anxious feelings of COVID-19 among infected and healthy families.</p><p><strong>Methods: </strong>In this hospital-based matched case-control study, health surveillance files of COVID-19 patients were collected from January to June 2021 and were analyzed statistically. In this study, two questionnaires of demographic characteristics and the Believability of Anxious Feelings and Thoughts (BAFT) were used. Data were analyzed using the One-way ANOVA.</p><p><strong>Results: </strong>Of 600 participants, 300 (50%) were PCR-confirmed and 300 (50%) were non-infected. Overall, 163 (54.33%) of infected people were male, 146 (48.67%) single, and 156 (52.00%) government employees. The results showed that the mean scores of physical anxiety (PA) and negative evaluation (NE) in the case group is significantly higher than the control group (<i>P</i> = 0.001); while emotional regulation (ER) in the control group was significantly higher than the case group (<i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>Having high believability to the risks of COVID-19 may be a predictor of preventive behaviors in individuals. Worrying about COVID-19 can increase the perceived risk of a pandemic in societies and consequence, increase the general public health.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tocilizumab in ICU-admitted COVID-19 Patients: A Retrospective Study.","authors":"Zeinab Siami, Mojtaba Hedayat Yaghoobi, Parsa Karimi","doi":"10.47176/mjiri.37.92","DOIUrl":"https://doi.org/10.47176/mjiri.37.92","url":null,"abstract":"<p><strong>Background: </strong>Severe and critically-ill COVID-19 patients are characterized by a severe inflammatory response. Pharmacologic inhibition of acute-phase inflammatory pathways such as IL-6 receptor inhibitor, Tocilizumab (TCZ) may improve patient outcomes in these cases. Consequently, the therapeutic benefit of TCZ was evaluated in this study.</p><p><strong>Methods: </strong>We evaluated intravenous tocilizumab in severe and critically ill adult COVID-19 patients who met pre-defined stringent CRS criteria. A single-center, prospective, observational cohort study was carried out among consecutive adult (≥18 years of age) in-patients with COVID-19 between March 20, 2020 and March 20, 2021. In total, 354 patients were included in our study. Mortality and time to hospital discharge were compared between patients who received tocilizumab treatment (n = 177) and those who did not (n = 177).</p><p><strong>Results: </strong>A total of 354 patients were analyzed whereas 177 patients were included in each group. In those receiving TCZ, all-cause mortality was significantly reduced, corresponding to an adjusted hazard ratio (HR) of 0.57, (95% confidence interval (CI): 0.43-0.76; <i>P</i> < 0.001). Furthermore, time to discharge was significantly improved in the TCZ group (HR: 1.66; 95%CI: 1.17-2.36, <i>P</i> = 0.004). Invasive mechanical ventilation was not statistically different among the study groups after adjusting for confounding variables (HR: 1.38; 95%CI: 0.89-2.14; <i>P</i> = 0.139). Dosing frequency was independent of survival status (<i>P</i> = 0.676).</p><p><strong>Conclusion: </strong>The use of TCZ in ICU-hospitalized patients resulted in improved patient survival and reduced duration of hospitalization. Further studies are needed to confirm the efficacy of TCZ in severe and critical COVID-19 cases.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}