OBJECTIVE : To compare the outcome of treatment with silymarin or N-acetyl cysteine in patients taking anti-tuberculous drugs for tuberculosis at Tertiary Care Hospital, Karachi.

SAMPLE SELECTION : Patients presenting with tuberculosis previously not on anti-tuberculous drugs, between 40-80 years of age, both genders will be included .Patients with history of alcohol use,Discontinuation of drug due to other adverse effects except hepatotoxicity ,Inadequate date of laboratory testing at baseline or 2 to 4 weeks after treatment initiation, Cases with human immunodeficiency virus (HIV) co-infection, viral hepatitis, or suspected mal absorption (e.g., gastrointestinal disease or diarrhea) ,Chronic liver disease, COPD, asthma, myocardial infarction, chronic kidney disease and stroke will be excluded

Inclusion Criteria:

• Patients presenting with tuberculosis and previously not on any anti-tuberculous drugs, between 40-80 years of age
• either gender.

Exclusion Criteria:

• History of malignancy.
• Patients with history of seropositive, seronegative, connective tissue disorder or vasculitis, congestive cardiac failure.
• Patients with history of alcohol use.
• Discontinuation of drug due to other adverse effects except hepatotoxicity.
• Inadequate date of laboratory testing at baseline or 2 to 4 weeks after treatment initiation.
• Cases with human immunodeficiency virus (HIV) co-infection, viral hepatitis, or suspected mal absorption (e.g., gastrointestinal disease or diarrhea).
• Chronic liver disease, COPD, asthma, myocardial infarction, chronic kidney disease and stroke.