Background: Oral suspension of cotrimoxazole is one of the best oral antibacterial, which consists of sulphamethoxazole and trimethoprim. These two constituents must he mixed well, in order to have better therapeutic effect and physical stability. Stale suspension has no crystal growth and is flocculate and thixotropic .To achieve these requirements, polymers such as (Na.C.M.C. LV. Na.C.M.C. HV and P.V.P) have been used.Methods: After preparation of flocculated suspension, assessment were carried out on factors such as: F, n, pH, microscopic observations, viscosity and accelerated tests.Findings: At first stage of preparation, large slumps were observed because the particles were not wetted properly. This problem was overcome by polymers.Na.C.M.C and P.V.P neither of them alone could protect crystal growth, but blend of these two polymers were effective. Effect of pH was not significant. Discussion: By using flocculating agents (polymers) in our suspension flocs settled rapidly, and by shaking redistributed uniformly, but suspension does not have suitable appearance. Uneven distribution of particles in suspension cause crystal growth, this shortcoming could be treated by using mixture of S.C.M.C and P.V.P These polymers adsorbed well on the surface of particles and Cover their porosity.

Context: Cotrimoxazole is one of the antibiotics commonly used to treat urinary tract infections. The widespread use of this drug has led to increased resistance to cotrimoxazole among urinary tract pathogens. This study aimed to investigate the cotrimoxazole resistance pattern of uropathogenic bacteria by a systematic review and meta-analysis method. Evidence Acquisition: Several databases including PubMed, Web of Science, Scopus, Google Scholar, Iran Medex, Magiran, IranDoc, MedLib, and SID were searched. From a total of 171 papers published from different regions of Iran from 1992 to May 2015, 67 were included in this study. To assess the quality of the study, the STROBE (strengthening the reporting of observational studies in epidemiology) checklist was employed. The I2 index was used to determine heterogeneity and a random effects model to analyze the data. Results: The results showed that the prevalence of urinary tract infection was several times higher in women than in men. The most common pathogens causing urinary tract infections were E. coli 64%, Klebsiella 12%, Staphylococcus 10%, and Enterobacter (6%). The prevalence of cotrimoxazole resistance was as follows: E. coli 62% (95%CI: 60-65), Klebsiella 54% (95% CI: 45-62), Staphylococcus 55% (95% CI: 47-63), and Enterobacter 52% (95% CI: 33-70). Cotrimoxazole resistance in different studies varied from 22% in Arak to 88% in Ahvaz. Conclusions: Gram-negative bacilli, particularly Escherichia coli, were the most common bacteria causing urinary tract infections. The majority of strains were resistant to cotrimoxazole. According to the findings, cotrimoxazole is not recommended as the firstline drug for the treatment of urinary tract infections in Iran.

Milk thistle plants including medicinal plants useful that its extract has antioxidant and liver protection. The aim of this study was to investigate the effect of different levels of Milk thistle herb and antibiotics Cotrimoxazole on blood metabolites of Ross broilers. In this experiment, milk thistle herb in three levels 0, 0.3 and 3 percent and antibiotics Cotrimoxazole in two levels 0 and 2 kg with 3 repeat were considered. Blood metabolites were measured at 42 days of age. Metabolites include glucose, cholesterol, prothrombin time (PT), uric acid, creatinine and bilirubin. Data to evaluate the effect of factors under study using the general linear model (GLM) and SAS statistical software were analyzed. Antibiotic cotrimoxazole was a significant effect on blood glucose (p<0.05). Milk thistle effect was a significant on blood cholesterol (p<0.05) and Cotrimoxazole antibiotic effect on blood cholesterol was a very significant (p<0.01). Milk thistle effect on uric acid and creatinine levels was a significant (p<0.05). The different levels of Milk thistle was very significant on bilirubin in the blood (p<0.01). Different between mean of Milk thistle and antibiotic cotrimoxazole for prothrombin time (PT) was significant (p<0.05). Use of the Milk thistle levels reduced the liver problems, because the amounts of liver enzymes secreted in the blood was decreased. Level 3% Milk thistle have maximum protective effect on the liver.

Cutaneous nocardiosis is an acute or chronic infectious disease caused by a gram positive, aerobic bacterium. This disease may be limited to the skin or my manifest as a systemic disease. In cutaneous disease, skin lesions usually occur on the sites of trauma and present as cellulitis, pustules, abscess and pyoderma. The most common cause of cutaneous nocardiosis is Nocardia brasiliensis. Herein, we report a young male patient who has lost his right hanet) after an accident. Cutaneous nocardiosis developed near the amputation stamp. The patient completely cured after treatment with cotrimoxazole.      

Human brucellosis, continues to be a major public health problem worldwide and Iran is considered as one the endemic polluted regions of brucellosis. A number of treatment modalities have been recommended for the treatment of brucellosis. Each children under 12 years and affected with brucellosis who had reported at the children outpatient department or were admitted in the ward between 1368 and 1379 and treated with a combination of cotrimoxazole and Gentamycin. Out of 101 cases, 100 revealed an improvement or altogether disappearance of, clinical signs likewise, the wrights and 2ME titers showed a decline following one weeks of treatment. 100 patients showed a decrease in the titers of Wright and 2ME 6 weeks after treatment. Only one of the cases had persistence of symptoms and rising titers 6 weeks after the treatment. An assessment revealed later that the mother had provided her child with medicines less than that recommended by the physician and for a period shorter than the recommended duration. On completion of the treatment, the patient regained full recovery without any relapses. In conclusion, our treatment protocol proved to be. hundred percent effective.

Background: Toxoplasmosis is an opportunistic infection that affects solid organ transplant (SOT) recipients. The parasite transmission may be occurred from a Toxoplasma-seropositive donor to a Toxoplasma-seronegative recipient by organ transplantation. Objectives: In this study, a nested PCR was carried out using different primers targeting the B1, SAG4, and MAG1 genes to assess Toxoplasma infection in pediatric heart transplantation at Shahid Rajaei Heart Center in Tehran. Methods: Blood samples were collected from 46 pediatric heart transplant patients aged 1-17 years referring to Rajaei Cardiovascular Medical and Research Center from 2018-2019. All patients were on oral administration of Trimethoprim-sulfamethoxazole (cotrimoxazole). Blood samples were collected, and peripheral blood mononuclear cell (PBMC) isolation using the Ficoll gradient method was performed. DNA was extracted from PBMC, and nested PCR was carried out. Serologic tests were performed using ELISA to determine IgG and IgM anti-Toxoplasma gondii antibodies. Results: The results of serologic tests showed that all 46 patients had negative anti-T. gondii IgM antibody. Furthermore, 6 (13. 05%) and 3 (6. 5 %) out of the 46 patients were positive for IgG T. gondii antibody before and after transplantation, respectively. All 46 patients were evaluated using PCR using B1, MAG-1, and SAG-4 genes, and PCR results were negative. Conclusions: In general, due to the negative results of Toxoplasma with PCR using B1 and bradyzoite-specific genes (SAG-4 and MAG-1), it is possible that the results obtained in this study are because of prophylaxis with cotrimoxazole.

Background and Aim: Urinary tract infection is one of the most common childhood diseases. The results of studies investigating discontinuation or continuation of antibiotics in children with recurrent urinary tract infections and urinary reflux are controversial. Therefore, this study was conducted to compare prophylactic antibiotic treatment twice a week versus every night in the recurrence of urinary tract infections in children. Methods: This clinical trial was conducted using non-random simple sampling. Group A was given a single daily dose of cephalexin 10 mg/kg and group B was given cotrimoxazole at a dose of 5 mg/kg. Both groups were followed for ten months. Recurrences of urinary tract infections were compared between the two groups. Results: The mean age of the participants was 3. 53±, 2. 04 years. Most of the subjects were female (n=37, 61. 7%). Urinary reflux was unilateral in 65% of the cases (n=39) and bilateral in the rest. There was no significant difference in age distribution, sex, and type of reflux between groups A and B. The frequency of recurrent urinary tract infection was 8. 3% in group A and 6. 7% in group B indicating no significant difference (p = 0. 500). Conclusion: The results of this study showed that the frequency of recurrence of urinary tract infections in children who received prophylactic antibiotic treatment twice a week was not significantly different compared to the group of children who received continuous antibiotic prophylaxis.