301 ANNALS VOL 21, ISSUE 4, OCT. – DEC. 2015 DEVELOPMENT OF MDR TB IN SHORT DURATION IN A PATIENT RECEIVING TREATMENT FOR SIMPLE TB: A CASE REPORT Muhammad Kashif Munir, 1 Sana Rehman, 2 Rizwan Iqbal, 3 Saqib Saeed 4 Abstract Multidrug resistant (MDR) tuberculosis (TB) is beco- ming more cumbersome especially in developing cou- ntries. Already supportive infrastructures are weak as compared to disease burden. Numerous diagnostic techniques for early diagnosis of TB and MDR TB have brought incremental improvements however; the technical intricacies of these assays and their reliance on enthusiastic laboratory infrastructure have restricted their implementation, particularly in low – resource and high – burden settings. Recently introduced Gene- Munir M.K. 1 Research Officer Pakistan Medical Research Council TB Research Centre King Edward Medical University, Lahore Rehman S. 2 Research Officer Pakistan Medical Research Council TB Research Centre King Edward Medical University, Lahore Iqbal R. 3 Director Research Pakistan Medical Research Council TB Research Centre King Edward Medical University, Lahore Saeed M.S. 4 Chairman Dept of TB and Chest Medicine KEMU / Mayo Hospital, Lahore Xpert MTB / RIF assay simultaneously detects the presence of MTB, and its susceptibility to the impor- tant first – line drug rifampicin. Aim of this report is to understand the role of physician in prompt diagnosis and its control in spread of MDR TB and conversion of normal TB to MDR TB using available resources. Watchfulness of physician is an important factor in treating TB patients and early diagnosis of MDR TB using available resources. A good skilled team work is necessary to locate such cases in early stages and pro- mpt treatment can save many lives and ultimately ser- ve as a big barrier in spreading primary MDR TB. Keywords: MDR TB, Tuberculosis, Prompt Diagno- sis, GeneXpert. Introduction Multidrug resistant (MDR) tuberculosis (TB) has bec- ome common especially in developing countries al- ready suffering from fewer infrastructures compared to the disease burden. By increasing the drug resistance TB patients around the world, prompt, accurate and appropriate diagnosis and treatment of various presen- tations of disease require special attention. 1 About one third of the global population is infected with Myco- bacterium tuberculosis (MTB) main cause of TB and at risk of developing MDR TB. 2 Multi drug resistant (MDR) TB is the disease caused by the strain of MTB complex which is resistant to at least isoniazid and rifampicin with or without resistance to any other first Case Report