Muhammad Aais Inam-Muscular Dystrophy-(Pakistan)

Name: Muhammad Aais Inam
Sex: Male
Nationality: Pakistani
Age: 10Y
Diagnosis: muscular dystrophy

Before treatment:
It was difficult for him to go up stairs in 2014 and he fell down a lot so he was taken to a local hospital and had a clear diagnosis of "Duchenne muscular dystrophy." He was given vitamin drugs orally and his disease gradually progressed. He had limb weakness, muscle atrophy, muscle weakness and it continued to get worse. At present his gait is wide with a duck step, he can turn over slowly and he can independently keep a sitting position. It is difficult for him to sit up from lying, or stand up from sitting but he can complete it on his own. He is able to take care of himself but for further treatment he was taken to hospital.
His spirit, diet and sleep are good, his urination and defecation are normal. 

Admission PE:
Bp: 114/71mmHg, Hr: 68/min, body temperature: 36.6 degrees. There is no injury or bleeding spots on his skin and mucosa, the respiratory sounds in both lungs were clear and there was no dry or moist rales. The heart beat is powerful with regular cardiac rhythm and with no obvious murmur in the valves. The abdomen was soft and flat with no masses or tenderness. His liver and spleen were normal and there was no edema in the legs.

Nervous System Examination:
Patient was alert and his mental condition is fine. The memory, calculation and orientation ability are normal by examination. Both pupils were equal in size and round, diameter iof 3.0mm, react well to light and the eyeballs can move freely. Bilateral forehead wrinkles are symmetrical, he can close eyes powerfully and showing of  the teeth is normal. The tongue is in middle. He can bulge the cheeks as normal, soft palate can lift as normal but the patient cannot shrug or turn his head powerfully in a normal manner. Muscle power of upper limbs: right upper arm adductor muscle power is 4 degrees, abductor muscle power is 3 degrees, right forearm flexor muscle power is 4 degrees, extensor muscle power is 3 degrees, muscle power of flexor and extensor muscles of carpus is 4 degrees; left upper arm adductor muscle power is 4- degrees, abductor muscle power is 3 degrees, left forearm flexor muscle power is 4- degrees, extensor muscle power is 3- degrees, muscle power of flexor and extensor muscles of carpus is 4 degrees. Grip force of both hands is 4 degrees. Muscle power of proximal lower limbs is 3 degrees, of distal side is 2+ degree. Muscle tone of the 4 limbs is low. Patient can walk without support, with a waddling gait. He can turn over slowly and maintain a sitting posture independently. It is very difficult for him to sit up from a lying position or stand up from a sitting position but he can perform this himself. Tendon reflex of the 4 limbs cannot be induced. The abdominal reflex is weak, the bilateral palm-jerk reflex; Hoffmann sign, Rossilimo sign and Babinski sign are negative. The gross measure of bilateral deep and superficial sensory examination is normal. He cannot perform the finger to nose test, the finger opposite and fast alternate movement are slow and he cannot perform the heel-knee-tibia test because of the weakness. The meningeal irritation sign is negative.

After the admission he received related examinations and was diagnosed with muscular dystrophy. He received 3 times cells regeneration treatment to repair his damaged muscle cells, replace dead nerves, nourish nerves, regulate his immune system and improve blood circulation. This was done along with rehabilitation training.     

After 14 days treatment, his condition is better than before. Liver function is normal now, his CPK level decreased, his endurance is enhanced and his walking gait is getting better. The muscle strength of the pelvic girdle is increased. He can keep kneeling independently for 30 seconds. The muscle power of his four limbs is increased and he can stand on one leg for longer.

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