NOMORE A DOCTOR’S DILEMMA

NOMORE A DOCTOR’S DILEMMA
A RESEARCH REPORT ON INTESTINAL TUBERCLOSIS NOMORE A DOCTOR’S DILEMMA BY: LT. COL. DR. AMJAD AZIZ

Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph.+92614543786
ABOUT ME Lt. Col. Dr. AMJAD AZIZ MBBS MCPS (Internal Medicine) 1975 EMPLOYMENT HISTORY As Medical Specialist (Last Hospital) Combined Military Hospital Multan Medical Director: AZIZ HOSPITAL since 1990 Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Experience in Ultrasonology Research Interests & Activities
Since 1985 Research Interests & Activities Early diagnosis of Intestinal T.B in adults & children with ultrasonography since 1987. Role of testosterone in End Stage chronic Heart Failure since Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

WHY ? Diagnosis of Intestinal TB is considered a Doctor’s Dilemma.
Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

LONG LIST OF TESTS ESR Monteux Test Gene Xpert ADA PCR / Tissue Barium Meal Follow Through/ Barium Enema Colonoscopy / Gastroscopy Laparoscopy / Biopsy Histopathology Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

SYMPTOMS Pain Abdomen / Epigastria Amblical / Lower Abdominal Anorexia / Nausea / Eructation Vomiting Diarshoe / Constipation Bleeding / per rectum Fever Distention Vague ill Health & Wt. Loss Fatigue Disinterest in any activity around / school / studies / play etc. Obstruction / Partial or Complete Accompanied TB glands/Pul TB Pelvic TB and Dysmenorrheal / infertility Ascites / Localized / Generalized Psychosis Rt. iliac Mess (Advanced Stages). Depression / withdrawn / other psychological presentations Palour & Anemia Delayed gastric emptying Gola / Gas / Gurgling Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

PIT FALLS APD Ch. Amoebiasis Worms
(in Diagnosis) APD Ch. Amoebiasis Worms Labeled as Psychiatric Problem e.g Hysteria Dyspepsia Dysentery Mucus Colitis AC or Chronic Appendicitis IBS Constipation Malingerer Avoiding of School (children) Blamed to be eating Junk Food Typhoid Carriers Crohn’s Disease Report By: Lt. Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

After 06 Months Treatment
Patient Name : Manzoor Age : 36Yrs Sex : Male Date: Symptoms Before Treatment After 06 Months Treatment Yes No Duration Remarks Aziz Cotton Cloud Sign Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM/Other Disease √ 01 Year Gained 10kg wt. Brief History: This 36 years old male patient presented with above mentioned complaints of 01 year duration with ESR 30mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 10kg weight, HB 12.5gm, & ESR 18mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Razia Age : 25 Yrs Sex: Female Date:10-3-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ More than a Year -do- Gained 8kg weight. Brief History: This 25 years old female patient presented with above mentioned complaints of more than a year duration with ESR 35mmHg.He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 8kg weight, HB 12gm, & ESR 20mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Asia Age : 28 Yrs Sex : Female Date:07-6-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 08 Months Gained 10kg weight. Brief History: This 28 years old female patient presented with above mentioned complaints of 08 months duration with ESR 40mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 10kg weight, HB 12.5gm, & ESR 19mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Tahir Abbas Age : 17 Yrs Sex : Male Date: 27-4-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 14 Mnths Gained 9kg weight Brief History: This 17 years old male patient presented with above mentioned complaints of 14 months duration with ESR 30mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 9kg weight, HB 13gm, & ESR 16mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Aqeel Ahmad Age: 26Yrs Sex: Male Date:25-3-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 09 Mnths Gained 12kg weight Brief History: This 26 years old male patient presented with above mentioned complaints of 9 months duration with ESR 34mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 12kg weight, HB 12.7gm, & ESR 16mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Dilawar Age: 12 Yrs Sex: Male Date: 20-5-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 01 Year Gained 10kg Weight Brief History: This 12 years old male patient presented with above mentioned complaints of 01 year duration with ESR 30mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 10kg weight, HB 12.6gm, & ESR 20mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: M. Yasir Age: 14 Yrs Sex: Male Date: 14-3-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 07 Mnths Gained 11kg weight Brief History: This 14 years old male patient presented with above mentioned complaints of 07 months duration with ESR 35mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 11kg weight, HB 13gm, & ESR 16mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Manzoor Ahmad Age: 50 Yrs Sex: Male Date: 31-5-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 11/2 Years Gained 8kg weight Brief History: This 50 years old male patient presented with above mentioned complaints of 11/2 year duration with ESR 40mmHg.He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 8kg weight, HB 11.9gm, & ESR 24mmHg.On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Akhtar Age: 15 Yrs Sex: Male Date: 07-2-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 10 Mnths Gained 12kg Weight Brief History: This 15 years old male patient presented with above mentioned complaints of 10 months duration with ESR 33mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 12kg weight, HB 13.1gm, & ESR 19mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: M. Daud Age: 17 Yrs Sex: Male Date:28-4-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 15 Months Gained 9kg Weight Brief History: This 17 years old male patient presented with above mentioned complaints of 15 months duration with ESR 32mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 9kg weight, HB 12gm, & ESR 19mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: M. Noman Age: 13 Yrs Sex: Male Date: 10-5-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 01 Year Gained 8kg Weight Brief History: This 13 years old male patient presented with above mentioned complaints of 01 year duration with ESR 34mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 08kg weight, HB 12.7gm, & ESR 20mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Zubair Ahmad Age: 40 Sex : Male Date: 17-3-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 03 Years Gained 8kg Weight Brief History: This 40 years old male patient presented with above mentioned complaints of 03 years duration with ESR 39mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 08kg weight, HB 12.5gm, & ESR 21mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Jamshaid Age: 6 Yrs Sex: Male Date: 26-6-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Ague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 6 Months Gained 10kg Weight Brief History: This 06 years old male patient presented with above mentioned complaints of 06 months duration with ESR 30mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 10kg weight, HB 12.5gm, & ESR 18mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Ghulam Abbas Age: 48 Yrs Sex: Male Date: 01-5-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 10 Years Gained 10kg Weight Brief History: This 48 years old male patient presented with above mentioned complaints of 10 year duration with ESR 42mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 10kg weight, HB 12.7gm, & ESR 19mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Waqas Age: 18Yrs Sex: Male Date: 14-3-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 10 Months Gained 8kg Weight Brief History: This 18 years old male patient presented with above mentioned complaints of 10 months duration with ESR 35mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 8kg weight, HB 13.5gm, & ESR 17mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Zeeshan Age: 20 Yrs Sex: Male Date: 23-5-2015
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 03 Years Gained 10kg Weight Brief History: This 20 years old male patient presented with above mentioned complaints of 03 year duration with ESR 36mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 10kg weight, HB 12.4gm, & ESR 19mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Samiya Bibi Age: 13Yrs Sex: Female Date: 04-4-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 01 Year Gained 11kg Weight Brief History: This 13 years old female patient presented with above mentioned complaints of 01 year duration with ESR 36mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 11kg weight, HB 13.2gm, & ESR 19mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Punu Age: 25 Yrs Sex: Male Date: 05-6-2014

After 6 months Treatment
Patient Name: Ali Age: 12 Yrs Sex: Male Date: Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ More Than a year -do- Gained 10kg Weight Brief History: This 12 years old male patient presented with above mentioned complaints of more than a year duration with ESR 33mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 10kg weight, HB 12.9gm, & ESR 19mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Hudeba Age: 11 Yrs Sex: Female Date:30-5-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 08 Months Gained 12kg Weight Brief History: This 11 years old female patient presented with above mentioned complaints of 08 months duration with ESR 35mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 12kg weight, HB 12.8gm, & ESR 19mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Akram Age: 40 Yrs Sex: Male Date:10-6-2014

Patient Name: Bushra Age: 8 Yrs Sex: Female Date:15-4-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 11/2 Year Gained 11.5kg Weight Brief History: This 8 years old female patient presented with above mentioned complaints of 11/2 years duration with ESR 36mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 11.5kg weight, HB 13gm, & ESR 17mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: IMRAN Age: 20 Yrs Sex: Male Date:08-3-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 15 Months Gained 8.5kg weight Brief History: This 20 years old male patient presented with above mentioned complaints of 15 months duration with ESR 40mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 8.5kg weight, HB 13.2gm, & ESR 22mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: KAINAT Age: 15 Yrs Sex: Female Date:05-1-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 11/2 Year Gained 11kg weight Brief History: This 15 years old female patient presented with above mentioned complaints of 11/2 Year duration with ESR 39mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 11kg weight, HB 12.6gm, & ESR 20mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: KANEEZ Age: 50 Yrs Sex: Female Date:10-4-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Headache Gas Backache Delayed Empty √ 2 Years Gained 7.8kg Weight Brief History: This 50 years old female patient presented with above mentioned complaints of 02 Years duration with ESR 45mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 7.8kg weight, HB 12.3gm, & ESR 21mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: MAFIA Age: 50 Yrs Sex: Female Date:18-7-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB Arthralys √ 2 Years Gained 9kg Weight Brief History: This 50 years old male patient presented with above mentioned complaints of 02 Years duration with ESR 43mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 9kg weight, HB 12.9gm, & ESR 20mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: Mrs. FALAK Age: 31 Yrs Sex: Female Date:31-7-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 03 Years Gained 12.5kg Weight Brief History: This 31 years old female patient presented with above mentioned complaints of 03 Years duration with ESR 40mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 12.5kg weight, HB 13.3gm, & ESR 19mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: MUZAMIL Age: 12 Yrs Sex: Male Date:15-3-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 10 Months Gained 10kg Weight Brief History: This 12 years old male patient presented with above mentioned complaints of 10 months duration with ESR 37mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 10kg weight, HB 12.9gm, & ESR 19mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: NAVEED Age: 12 Yrs Sex: Male Date:18-3-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 01 Year Gained 9kg Weight Brief History: This 12 years old male patient presented with above mentioned complaints of 01 Year duration with ESR 38mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 9kg weight, HB 13gm, & ESR 21mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: PARVEZ Age: 20 Yrs Sex: Male Date:11-5-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 14 Months Gained 8.5kg Weight Brief History: This 20 years old male patient presented with above mentioned complaints of 14 months duration with ESR 41mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 8.5kg weight, HB 12.4gm, & ESR 20mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: SADIA Age: 17 Yrs Sex: Female Date:30-6-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 6 Months Gained 8kg Weight Brief History: This 17 years old female patient presented with above mentioned complaints of 06 months duration with ESR 37mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 8kg weight, HB 13.2gm, & ESR 18mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: SHAHAB Age: 11 Yrs Sex: Male Date:15-7-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 05 Years Gained 12kg Weight Brief History: This 11 years old male patient presented with above mentioned complaints of 05 Years duration with ESR 40mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 12kg weight, HB 13.4gm, & ESR 17mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

Patient Name: SHAHID Age: 17 Yrs Sex: Male Date:20-4-2014
Symptoms Before Treatment After 6 months Treatment Aziz Cotton Cloud Sign Yes No Duration Remarks Pain Abdomen Vomiting Diarrhea Fever Wt. Loss Fatigue Abdomen Swelling Vague ill Health Anorexia Gola Formation Doughy Abdomen Palour Glands (Lymph) Pul. TB Any other TB DM / Other Disease √ 01 Year Gained 10kg Weight Brief History: This 17 years old male patient presented with above mentioned complaints of 01 Year duration with ESR 38mmHg. He had typical cotton clouds sign suggestive of kochs abdomen. Treated for six months. He is completely asymptomatic, gained 10kg weight, HB 12.6gm, & ESR 20mmHg. On USG, Cotton Cloud Sign still persists at the end of six months of treatment. Report By: Lt.Col.Dr. Amjad Aziz Aziz Hospital Multan Ph

NOMORE A DOCTOR’S DILEMMA

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NOMORE A DOCTOR’S DILEMMA

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