Name: Umar Muhammad            
Sex: Male
Country: Pakistan
Age: 18 years
Diagnosis: 1. Muscular Dystrophy 2. Upper Respiratory Tract Infection 3. Aspiration Pneumonitis
Date: Apr. 10th, 2015
Days Admitted to Hospital: 10 days

Before treatment:
Umar Muhammad always falls over 15 years ago. His lower limbs had muscular atrophy and it became worse. The local hospital diagnose him with Muscular Dystrophy after muscle biopsies. He couldn’t walk 10 years ago. He couldn’t turn over and sit 7 years ago. His muscular atrophy became worse nearly 3 years. He lost a lot of weight. He had pneumonia 2 years ago and he was cured, but his respiratory function became worse, so he used breathing machine. The oxygen saturation level was 85-90% during deep sleep. He had difficult to swallow or chew, sometimes he chocked when he was drinking especially recent 6 months. He could only stay in bed. His thorax, four limbs and spinal were abnormal. The four limbs joints were contractural, he couldn’t move his four limbs and could only move his fingers and feet. He wanted a better treatment so he came to our hospital and diagnosed as Muscular Dystrophy.

His spirit was good, his diet and sleeping were bad and he couldn’t defecate by himself.

Admission PE:
Bp: 94/58mmHg; Hr: 109/min. Temperature: 38.0 degrees. Br: 40/min. Weight: 28kg. He was badly undernourished. His skin and mucous were without yellow stains or petechia. His thorax was abnormal. The respiration of both lungs was weak, with no dry or moist rales. The heart rhythm was normal with no obvious murmur in the valves. The abdomen was soft with no pressing pain or rebound tenderness. The liver and spleen were normal. The muscles of shoulder girdle, pelvic girdle, both upper limbs and lower limbs were severely atrophied. Bilateral hip joints, knee joints and elbow joints had tendon contracture. He couldn’t extend his elbow joints normally, the angle was about 125 degrees. He couldn’t extend his knee joints normally, the angle was around 80 degrees. Bilateral ankles had mild entropion. Both feet were pendulous, and the movement was not normal.

Nervous System Examination:
Umar Muhammad was alert and his spirit was good. He had slurred speech. His memory, calculation, orientation abilities and understanding were normal. Both pupils were equal in size and round, the diameter was 3 mms, both eyes had sensitive response to light stimuli. Both eyeballs could move freely. The forehead wrinkle pattern was symmetrical. The ability to close his eyes was strong. Both nasolabials were equal in depth. The tongue was centred in the oral cavity and the teeth shown without deflection. Both soft palates could be lifted, and the strength was strong, his pharyngeal reflex was normal. The muscle power of his neck was a little weaker, he could only turn around his head a little. He couldn’t shrug his shoulders. The muscle power of four limbs were at level 1 and the muscle tension was a little lower. He couldn’t turn over, sit, stand or walk by himself. The tendon reflex and abdominal reflex were abnormal. His pathological sign was negative. The rough depth determination and epicritic sensibility of both sides were normal. He couldn’t finish the finger-nose test, rapid rotation test, finger-to-finger and both legs’ heel-knee-tibia test. The meningeal irritation sign was negative.

Treatment:
After full examinations, he received treatment to improve circulation, nourish neurons, improve immunity and we used non-invasive ventilator for breath. We also gave him daily physical rehabilitation.

Post-treatment:
After the treatment, his infection had been controlled. His respiratory function was better, the rales of both lung disappeared. The oxygen saturation level during sleeping was 93-98%. He could swallow better and eat more food. The muscle power of four limbs was better, at level 2-and he could grasp.

 E-mails:

Date:2015-12-8

Please find enclosed reports of a boy umer amin.He was on ventilator if you remember he visited you with his mother Wahida and father Mr Amin----You had given 6 months medicines which they used and feel some improvement---They want to know,,any further medicine/which one shud the patient use if you advise ?----Best Regards