TMSS Medical College Journal

Background: Tuberculosis is a common disease in Bangladesh so dose the nontuberculous mycobacteria (NTM) infection but the pathogenic role of the nontuberculous mycobacteria is yet to be answered but with development of diagnostics modalities and as well as changing trend of disease like Crohn’s disease(CD) in Bangladesh the use of immunomodulator has also increased. There is also gape of knowledge regarding the effect of conventional anti tubercular medication on nontuberula mycobacteria. So we need to find whether the anti Tubercular medication as well as immunomodulator like azathioprine has any role in presence of notuberculous mycobacteria(NTM) in patient; got anti TB drugs or getting azathioprine. Objective: Objective of this study is to assess the Effect of Conventional Anti Tubercular Drugs and Azathioprine on Nontuberculous Mycobacteria in Patients of Crohn's Disease. Materials and Methods: This Study was carried out in the department of Gastroenterology, BSMMU, Bangladesh. Period of study was from January 2016 to September 20017. 34 diagnosed case of Crohn’s disease was included in this study. Biopsy for PCR to detect NTM was collected from ulcer in CD patients. ITS primer was used to detect NTM. Results: Total 34 Crohn's diseases (CD) patient were included in this study. Among them 15 had history of conventional anti tb drugs intake before diagnosis of CD. In this anti TB medication group only 39.3 % were positive for NTM (OR 0.32 with P value0.219). Among the CD patients 14 patients were taking azathioprine and this azathioprine group had only 35.7% NTM positive ( OR 0.28 and P value 0.173). It appears none of these were significant. Conclusion: Use of anti TB or the azathioprine has no significant effect on the presence of NTM but the whether the bacteria is present during the Anti Tubercular drug therapy or not yet to be find out and the other immunomodulator can affect the bacteria in which manner need to be discover.

Inflammatory bowel diseases (IBD) are chronic inflammatory disorders of the gastrointestinal tract marked by episodes of relapse and remission. There are two identified subtypes of the disease, ulcerative colitis (UC) and Crohn’s Disease (CD), which differ in patterns of involvement which differ in patterns of involvement. However the exact etiology has still to be found hence come various hypothesis including one involving the gut microbiota The main bacterial populations in the human intestinal microbiota (>90%) is part of two phyla: the Firmicutes and the Bacteroidetes; the remainders belong to rarer phyla such as Proteobacteria (containing genuses such as Escherichia and Helicobacter) and Actinobacteria as well as viruses, protists, and fungi'~. The composition of the fecal microbiota may temporally vary following exposure to different types of foods, medications, or physical environments, and also from changes in transit time, as microbial composition in the lumen varies from caecum to rectum’.