Dimitar Dojchinov-Muscular Dystrophy-(Macedonia)

Name: Dimitar Dojchinov
Sex: Male
Nationality: Macedonian
Age: 21Y
Diagnosis: 1. Muscular dystrophy 2. Arrhythmia
Discharge Date: 2018/03/18

Before treatment:
The patient was normal when he was born. When he was 5 years old his left leg was weak when he was walking. In the first 10 years his disease progressed slowly, he felt weak in his whole body but he could still do physical activities. 5 years ago his condition became worse. His respiration function was affected and he was diagnosed with muscular dystrophy at a local hospital. At present, his  shoulder girdle, pelvic girdle muscle, arms and legs are all atrophic. He is unable to extend his knees or elbows, it is hard for him to turn over or get up from bed, he can only walk inside his room and he is unable to stand up by himself.
His spirit, sleep and diet are good, his urination and defecation functions are normal.

Admission PE:
Bp: 123/65mmHg, Hr: 95/min, body temperature: 36.5 degrees. Height around 180cm, weight 55Kg. The patient was very thin, there is no injury or bleeding spots of his skin and mucosa. There is chest malformation, the respiratory sounds in both lungs were clear but his cheek could not move as normal when he did a deep breath. There were 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 sunken with no masses or tenderness. The liver and spleen were normal, there was severe muscle atrophy of the shoulder girdle, pelvic girdle, arms and legs. The knee joints and elbow joints could not stretch with the angle around 165 degrees. There was mild ankle joints inversion,  feet drop and poor movement ability.

Nervous System Examination:
Patient was alert and his mental status was good. He had clear speech but with a stammer, memory, orientation and calculation abilities were normal. Both pupils were equal in size and round, diameter of 3.0 mm, react well to light, eyeballs can move freely and there was mild horizontal nystagmus. Bilateral forehead wrinkle is symmetrical, he could close eyes powerfully, the bilateral nasolabial groove depth is the same, tongue is in middle position, showing teeth is normal and the soft palate can lift as normal. The pharyngeal reflex was normal, neck muscle power was fine and he could shrug normally. The right arm distal side muscle power was 3+ degrees, proximal side muscle power was 3- degrees, the adductor muscle power was 3+ degrees, abductor muscle power was 3- degrees, the grip force was 5 degrees. The left arm distal side muscle power was 3- degrees, proximal side muscle power was 2+ degrees, the adductor muscle power was 2+ degrees, the abductor muscle power was 2+ degrees with the hand grip force being 5- degrees. His  proximal side leg muscle power was 2+ degrees, distal side was 3 degrees. The muscle tone of the four limbs was low, he could roll over and sit up himself but with difficulty. He could walk a little with an unstable gait and could not stand up from sitting position. His 4 limbs tendon reflex and abdominal reflex could not be induced by examination. The bilateral palm-jaw reflex, Hoffmann sigh, Rossilimo sign and Babinski sign were negative. His bilateral sensory system examination was normal by gross measure. He could not perform the finger to nose test, the finger opposite movement and the fast alternate movements were clumsy and slow. He could not perform the heel-knee-tibia test, the Meningeal irritation sign was negative.

Treatment:
After the admission he received 3 cell regeneration treatments(neural stem cells and mesenchymal stem cells) to repair his damaged muscle cells, replace dead cells, nourish cells, regulate his immune system and improve blood circulation. This was done with rehabilitation training.     

Post-treatment:
After 12 days treatment his breathing function improved and his blood oxygen concentration improved from 95% to 98-99%. The heart rate decreased and the muscle power of his limbs was stronger. His left arm abductor muscle power reached 3- degrees, the adductor muscle power was 4- degrees. The right arm muscle power was 4 degrees. The patient could now control his legs much better when he was walking.

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