---

Abstract Background & aim: Infection with resistant microorganisms in intensive care units (ICUs) is more prevalent than other parts of the hospital. The aim of this study was to determine the relationship between the daily dose of the antibiotic resistance and patterns of microorganisms isolated from patients with nosocomial infections. Methods: This cross-sectional study was conducted in a period of 9 months in three wards of ICU, internal medicine, neurosurgery of Namazi Hospital of Shiraz. The World Health Organization definition was used for determining the daily Dose. The sensitivity test of microorganisms to antibiotics was determined by E-test. The collected data were analyzed with Pearson test. Results: The highest incidences of nosocomial infection were observed in intensive care medicine and surgery, respectively. The total amount of consumed antibiotics were seen in intensive care of surgery, internal medicine and neurosurgery were 100.29 DDD/100 bed days. Uses of cephalosporins, especially third generation cephalosporins show the highest amount. The resistance rate of gram-negative bacteria such as Acinetobacter, Pseudomonas and Enterobacter to ceftriaxone were100, 100 and 82.4% respectively. Conclusion: The results of study showed that there was a relationship between antibiotic consumption and resistance of microorganisms. Although other variables than the antibiotic consumption causing antibiotic resistance should not be ignored. Key words: Defined daily dose, Intensive care unit, Antibiotics, Antibiotic resistance, Nosocomial infection

---

Abstract Background & aim: Infection with resistant microorganisms in intensive care units (ICUs) is more prevalent than other parts of the hospital. The aim of this study was to determine the relationship between the daily dose of the antibiotic resistance and patterns of microorganisms isolated from patients with nosocomial infections. Methods: This cross-sectional study was conducted in a period of 9 months in three wards of ICU, internal medicine, neurosurgery of Namazi Hospital of Shiraz. The World Health Organization definition was used for determining the daily Dose. The sensitivity test of microorganisms to antibiotics was determined by E-test. The collected data were analyzed with Pearson test. Results: The highest incidences of nosocomial infection were observed in intensive care medicine and surgery, respectively. The total amount of consumed antibiotics were seen in intensive care of surgery, internal medicine and neurosurgery were 100.29 DDD/100 bed days. Uses of cephalosporins, especially third generation cephalosporins show the highest amount. The resistance rate of gram-negative bacteria such as Acinetobacter, Pseudomonas and Enterobacter to ceftriaxone were100, 100 and 82.4% respectively. Conclusion: The results of study showed that there was a relationship between antibiotic consumption and resistance of microorganisms. Although other variables than the antibiotic consumption causing antibiotic resistance should not be ignored. Key words: Defined daily dose, Intensive care unit, Antibiotics, Antibiotic resistance, Nosocomial infection

---

Abstract
Background and Aim: Multiple sclerosis (MS) is an autoimmune, inflammatory, chronic and progressive disease of central nervous system in which myelin sheath and axons of nerve cells in the brain and spinal cord destroyed by immune system. The change in concentration of cytokines is the major physiological symptom of the disease; whereas physical activity and exercise is an important non-pharmacological method in maintain homeostasis of physiological symptom in MS disease. The aim of this study was to determine the effect of eight weeks of exercise training combined with Q₁₀ supplementation on serum TNF-α and IL-10 in patients with multiple sclerosis.
 
Methods: In the present experimental research, twenty eight MS patients (EDSS=3-5) were selected by using available sampling method and randomly divided into three experimental groups (combined exercise training + Q₁₀ supplementation, combined exercise training + placebo & Q₁₀ supplementation) and one control group (5 female and 2 male in each group). Two groups of three experimental groups performed a combined exercise program include two sessions of endurance training (%50-60 max HR at beginning to end)  and one session of resistance training (%50-60 1RM at beginning to end) three sessions per week. 200 mg of CoQ₁₀ supplement was prescription per day. Blood samples (after 10 hours fasting) were collected 24 hours before the first and 24 hours after the last session of exercise for evaluation of serum levels of IL-10 and TNF-α. Data were analyzed with Shapiro - Wilk and analysis of covariance at a significance level of P<0.05.
 
Results: The results of covariance analysis showed that there was no significant difference between the serum levels of IL-10 and TNF-α in all three experimental groups compared to the control group. Also, the results of t-test showed that there was no significant difference between the data of serum levels of IL-10 and TNF-α in the post-test compared to the pre-test (P≥0/05). 
 
Conclusion: Combined exercise training with coenzyme Q₁₀ supplementation cannot lead to changes in concentration of IL-10 and TNF-α in patient with MS. Therefore, it is necessary to change the duration and severity of this type of training as well as dose of supplementation.
 
Multiple sclerosis,