Yousaf - Progressive genetic muscular dystrophy (Oman) Update on June 26, 2013

Name: YOUSAF KHALID NASSER AL HINAI     
Sex: Male
Country: Oman
Age: 10
Diagnoses: Progressive genetic muscular dystrophy, a hypochromic microcytic anemia
Admission Date: 2011-07-16
Days Admitted to the Hospital: 34

Yousaf has had a slightly abnormal walking gait and posture for the past 5 years. Early on during this time period, his family wasn't too concerned but eventually the symptoms got worse and additionally included weakness in the legs which caused walking difficulties. Yousef's family took him to a local hospital for treatment about two years after the onset of the disease. The creatase result was higher than normal. He received a muscle biopsy, the result showed he had progressive muscular dystrophy. He didn't received special medications. He could stand by himself, but the gait was abnormal obviously. Both heels couldn't touch the floor. He, also, had muscle weakness in both arms. He had difficulty with raising his arm or holding an object. The laboratory test showed he had hypochromic microcytic anemia.

During the admissions examination we discovered that Yousaf has abnormal posture and a spinal deformity. Bp; 101/63 63mmHg, Hr: 86/min. Temperature:36.1 degree, height:140cm. Weight:35Kg. There was mild muscle atrophy in the shoulders and pelvic region. The shoulders were "wing-like." There was mild contracture deformity in the ankle joints, and the right foot was more severe. Both feet had strephenopodia. The Gower's sign was positive. Yousaf had difficulty walking and stood on the tips of his toes. During the nervous system examination, Yousaf was alert, and he was in good spirits. His speech was clear. His memory, calculation abilities and orientation were normal. Both pupils were equal in size and round, the diameter was 3.0mms. Both eyeballs could move freely and flexibly and the pupils were sensitive to light stimulus. The eye closing ability was strong. The tongue was centered in the oral cavity and the teeth were shown without deflection. There was no air leakage when he expanded his cheeks. The soft palate could be raised symmetrically and strongly. The muscle strength of both triceps was level 4-, the muscle strength of the upper limbs' proximal-end and distal-end was level 3, and the holding power was level 3. The muscle strength of the left lower limb was between level 2 and level 3; the muscle strength of the right lower limb was level 1+. The muscle tone of all four limbs was slightly low. The triceps reflex, the radial periosteal reflex and bilateral biceps reflex of the upper limbs were not elicited. The bilateral palm jaw reflex was negative, the bilateral Hoffmann's sign and Rossolimo's sign were negative. The bilateral Babinski's sign was suspect. The deep, shallow, and fine sensations were normal through loose measure. Yousaf could finish the finger-nose-test, digital opposition test and rapid rotation test almost normally. He had difficulty with the heel-knee-shin test.

We initially gave Yousaf a complete examination and then he received treatment to improve the blood circulation in order to increase the blood supply to the damaged neurons, start the repair of muscle and regeneration of muscle cells. He also received treatment to activate stem cells in the vivo, to nourish the nerves and enhance the immunity. This was combined with daily physical rehabilitation training.

After the completion of the stem cell treatment for 1 month, The patient's condition has improved. The Height: 142cm, weight: 36kg. The muscle strength of the upper limbs had increased by one level and reached level 4+. The grasping power had increased by 1 level and reached level 4. The muscle strength of the lower limbs increased by 1 level and reached between level 2 and level 3. The muscle volume of the shoulders had increased. When Yousaf is standing, with some assistance, the right foot can now touch the floor. The abdominal reflexes are more sensitive than before. The anemia has been healed.
 

Second round treatment:
Admission Date: 2013-03-05
Days Admitted to the Hospital: 98

The patient received treatment 2 years ago and received significant improvement after 1 month treatment. The muscle strength has increased obviously. The disease progressed gradually in the recent year. The muscle strength has been reduced obviously and only left 1-2 level muscle strength.

Admission PE: There was mild muscle atrophy in the shoulders and pelvic region. The shoulders were "wing-like." There was mild contracture deformity in the ankle joints, and the right foot was more severe. Both feet had strephenopodia and couldn't wear shoes normally. Yousaf had difficulty with sitting up, standing or walking. During the nervous system examination, Yousaf was alert, and he was in good spirits. His speech was clear. His memory, calculation abilities and orientation were normal. Both pupils were equal in size and round, the diameter was 3.0mms. Both eyeballs could move freely and flexibly and the pupils were sensitive to light stimulus. The eye closing ability was strong. The tongue was centered in the oral cavity and the teeth were shown without deflection. There was no air leakage when he expanded his cheeks. The soft palate could be raised symmetrically and strongly. The muscle strength of both triceps was level 4-, the muscle strength of the upper limbs' proximal-end and distal-end was level 3, and the holding power was level 3. The muscle strength of the left lower limb was between level 2 and level 3; the muscle strength of the right lower limb was level 1+. The muscle tone of all four limbs was slightly low. The triceps reflex, the radial periosteal reflex and bilateral biceps reflex of the upper limbs were not elicited. The bilateral palm jaw reflex was negative, the bilateral Hoffmann's sign and Rossolimo's sign were negative. The bilateral Babinski's sign was suspect. The deep, shallow, and fine sensations were normal through loose measure. Yousaf could finish the finger-nose-test, digital opposition test and rapid rotation test almost normally. He had difficulty with the heel-knee-shin test.

We initially gave Yousaf a complete examination and then he received treatment to improve the blood circulation in order to increase the blood supply to the damaged neurons, start the repair of muscle and regeneration of muscle cells. He also received treatment to nourish the nerves and enhance the immunity. This was combined with daily physical rehabilitation training.

After the completion of the stem cell treatment, the muscle strength of the upper limbs had increased by one level and reached level 4+. The dexterity of wrist and fingers has increased. The muscle strength of bicipital muscle of arms had reached level 3. The muscle strength of both upper limbs' far-end has reached level 3+. The control ability of forearms is better than before. The muscle volume of both regio scapularis has increased than before. Lordosis is alleviated obviously. The gap between the trunk and the bed surface is alleviated obviously. The muscle strength of both lower limbs has reached level 2+. Bilateral knees joints can be lift bed surface. The strephenopodia is alleviated obviously. The left foot can touch the floor tightly. The right foot still has some introversion, but can wear shoes normally. Both legs can stretch from flexion position. The self-actuated control ability in curtsey position is improved obviously. The tendon reflex is normal. Bilateral abdominal reflexes are more sensitive. At present, the patient is able to do the following actions by himself, wash his hair, twist body, drink water from a cup, switch faucet and change body position from sitting to recumbent position.