59   years old male pateint 
presented with back pain and  generalzed wekaness 
he  sought medical  advice    for many doctors 
  he received   manay treatement  for discopathy 
and he    sought medical advce  by dr imad  talahma and   he  found  to have MALTIYA    
before one month 
he  sought medical advice   at   seha and  he  found to have FMF 

HE  HAS  CREATININE   2   MG/DL FOR THE LAST  20 YEARS 

HE SOUGHT MEDICAL ADVICE   AND 


CREATININE    1.7
CREATININE 1.9
URINE ANALYSIS  SHOWED   NEAGTIVE
BUT ANOTHER  ONE  SHOWED HEMATURIA 
CREATININE  15/2   2.33


PLAN 
RTC AFTER  10 DAYS 
DO  ANA    C3 C 4   ESR 
NBALGISC 
CONTOINIUE   DOXAL   AND  RIFAMPIN 
HOLD  FOR GENTAMYCINA ND   STEREPTOMYCIN 

