Yaser Al Harbi-Multiple Sclerosis-(Saudi Arabia)

The third round of treatment:

Name: Yaser Al Harbi
Sex: Male
Nationality: Saudi Arabian
Age: 40Y
Diagnosis: Multiple Sclerosis
Discharge Date: 2019/05/01

Before treatment:
Six years ago (2013) the patient had left leg muscle weakness, especially after a long walk. After that his leg muscle weakness gradually aggravated, progressing day by day and his left arm was also involved. He was diagnosed with "multiple sclerosis" by CT and MRI of his head and spinal cord in 2014. At present the strength of the left side limbs is weak, especially in the left leg. He has done one cycle of Avonex (Interferon) 30mg, im (once a week) and amantadine Hydrochloride (100mg bid) but his condition was not controlled. He came to our hospital in 2016 and 2017 for treatment. After treatment his limb strength was significantly restored and the balance function was improved. Six months ago the patient had tremor when he moved his right arm. His spirit, diet and sleep are normal. His urination and defecation functions are normal.

Admission PE:
Bp: 111/67mmHg, Hr: 56/min, body temperature: 36.0 degrees. Height: 185cms, weight: 94.5kgs. His physical condition was normal and his nutritional status was good. The skin and mucosa were normal with no yellow stains or petechia. Oropharynx was not congestive. His bony thorax was symmetrical, the respiratory sounds in both lungs were normal and there were no dry or moist rales. The heart sounds were strong with regular cardiac rhythm and no obvious murmur in the valves. The abdomen was flat and soft with no masses or tenderness. His liver and spleen were normal, shifting dullness was negative and the spinal column was normal. There was no edema in the legs. His anus and external genitalia were not examined.

Nervous System Examination:
Yaser Al Harbi was alert, his spirit was good and his speech was clear. His memory, orientation and calculation abilities were normal. Both pupils were equal in size and round, the diameter was 3mm. Both pupils were insensitive to light stimulus and both eye fields were normal. He didn’t have nystagmus. The forehead wrinkles were symmetrical, bilateral nasolabial sulcus was equal in depth. Showing teeth was normal, his tongue was centered in his mouth, his tongue muscle was normal and the uvula was in the right position. His neck moved freely and the muscle tension of his four limbs was normal. The muscle power of the right arm was at level 4+. Left arm proximal muscle power was at level 4-, distal muscle power was at level 4. Left leg muscle power was at level 3+, right leg muscle power was at level 4. The tendon reflex of both arms was basically normal, his right leg tendon reflex was weak, his left leg tendon reflex was normal. His palm jaw reflex, bilateral Hoffmann sign and both Babinski signs were all negative. Bilateral ankle clonus was negative. Deep and shallow sensory examinations were normal. Both sides finger to nose test were not done well, the right side was worse. The left side rapid rotation test was clumsy and his right side rapid rotation test was normal. Bilateral finger to finger test was basically normal, Bilateral ankle-knee-tibia test was not done well. His meningeal irritation sign was negative.

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

Post-treatment:
After 14 days treatment his motor function was improved. The right hand tremor was better than before, his left arm muscle power increased with the proximal muscle power being about 4 degrees. The bilateral finger to nose test was better than before. He can now walk better.

The second round of treatment:

Date of Admission: July 16th, 2017
Treatment hospital/period: Wu Medical Center/9 days

Before treatment:
The patient’s left leg became weak in 2013, especially after a long walk. He didn’t pay much attention to it but after that both his left leg and left arm became weak so he went to a local hospital in 2014. He was diagnosed with multiple sclerosis after some tests. At present, his left leg is weak and his walking is lame,. He used Avonex 30mg once a week and amantadine hydrochloride 100 mg to treat his condition but there was no improvement. He came to our hospital before and his condition became better so he came to our hospital again for another round of treatment.
His spirit and diet are normal. His sleep, urination and defecation functions are normal.

Admission PE:
Bp: 125/73mmHg, Hr: 69/min, body temperature: 36.0 degrees. Height: 183cms, weight: 86kgs. His physical condition was normal and his nutritional status was good. The skin and mucosa were normal with no yellow stains or petechia. Oropharynx was not congestive. His bony thorax was symmetrical. The respiratory sounds in both lungs were normal and there was no dry or moist rales. The heart sounds were strong, the cardiac rhythm was regular with no obvious murmur in the valves. The abdomen was flat and soft, with no masses or tenderness. His liver and spleen were normal. Shifting dullness was negative. Spinal column was normal. There was no edema in his legs, his anus and external genitalia were not examined.

Nervous System Examination:
Yaser Al Harbi was alert and his spirit was good, his speech was clear. His memory, orientation and calculation ability were normal. Both pupils were equal in size and round, the diameter was 3mm. Both pupils were insensitive to light stimulus. Both eye fields were normal. He didn’t have nystagmus. The forehead wrinkles were symmetrical. Bilateral nasolabial sulcus was equal in depth. Showing the teeth was normal. His tongue was centered in his mouth, his tongue muscle was normal, uvula was in the right position and his neck moved freely. The muscle tension of his four limbs was normal. The muscle power of right arm and leg was at level 5. Left arm muscle power was at level 4+, left leg muscle power was at level 3. The tendon reflex of both arms was basically normal, both of his legs tendon reflex was weak. The abdominal reflexes could not be induced. His palm jaw reflex and bilateral Hoffmann sign were negative. Left Babinski sign was positive, right Babinski sign was negative. Bilateral ankle clonus was negative. The cutaneous acupuncture sensation was decreased below his left shoulder. Other sensory examinations were normal. His left side finger to nose test was not done well, left side rapid rotation test was clumsy, his right side finger to nose test and rapid rotation test were normal. Bilateral finger to finger test and ankle-knee-tibia test were normal. He was able to stand on his right leg for 5 seconds, he was unable to stand on the left leg. His meningeal irritation sign was negative.

Treatment:
After the admission, he received related examinations and received 3 neural stem cell injections and 3 mesenchymal stem cell injections to nourish nerves, regulate his immune system and improve blood circulation. This was done with rehabilitation training.

Post-treatment:
After 9 days treatment his left arm muscle power increased to about 5 degrees, left leg muscle power was 4 degrees. He could now stand on his left leg for 5 seconds which was much longer than before.

The first round of treatment:
Date of Admission: July 11th, 2016
Treatment hospital/period: Wu Medical Center/17days

Before treatment:
In 2013, Yaser felt weakness in the left leg without knowing why. This especially happened after a long walk. He didn’t care about it at first, but eventually the condition got worse. His left arm began to become weaker as well. He went to the local hospital and had a CT, MRI and other examinations done. He was diagnosed with multiple sclerosis. At present, the strength of the left leg is weak. The muscle power of the left leg is lower than normal. He limps when he walks. He has decreased sensation. He takes Avonex 30ug,im, once a week. He also takes amantadine hydrochloride 100mg bid. The disease has not been controlled and has progressed slowly.
Yaser has been in good spirits since the onset of the disease. His sleep and appetite were good. His urination routine and bowel movements were good.

Admission PE:
Bp: 123/80mmHg, Hr: 84/min, body temperature: 36.5 degrees. Height: 186cms, weight: 85kgs. Yaser’s physical condition was normal, his nutritional status was good. The skin and mucosa were normal, with no yellow stains or petechia. There was no congestion in the oropharynx. The thorax was symmetrical. The respiratory sounds in both lungs were normal. There were no dry or moist rales. The heart sounds were strong. The cardiac rhythm was regular, with no obvious murmur in the valves. The abdomen was flat and soft, with no masses or tenderness. The liver and spleen were normal. There was no edema in the lower limbs.

Nervous System Examination:
Yaser Al Harbi was alert and in good spirits. His speech was clear. His memory, orientation and calculation ability were normal. Both pupils were equal in size and round, their diameter was 3mm. Both pupils were insensitive to light stimulus. Both eye fields were normal. There was no nystagmus. The forehead wrinkle pattern was symmetrical. The bilateral nasolabial sulcus was equal in depth. His mouth and teeth were in the right position without deflexion. The tongue was centered in his mouth. The tongue muscle was normal. The uvula was in the right position. His neck could move freely. The muscle tension of all four limbs was normal. The muscle power of the right limbs was at level 5. The left hand gripping power was at level 5-, the right hand gripping power was at level 3. The muscle power of the left upper limb was at level 4, the left lower limb was at level 3-. The tendon reflex of both upper limbs was basically normal. The tendon reflex of both lower limbs was weak. The abdominal reflexes were abnormal. His palm jaw reflex and bilateral Hoffmann sign were negative. The left side Babinski sign was positive. The right side Babinski sign was negative. The bilateral ankle clonus was negative. The cutaneous acupuncture sensation was decreased below the left shoulder. The other sensory examinations were normal. The left side finger-to-nose test was not good. The left side rapid rotation test was uncoordinated. The right side finger-to-nose test and rapid rotation test were normal. The bilateral finger-to-finger test and ankle-knee-tibia test were normal. He was able to stand on the right leg for 3 seconds. He was unable to stand on the left leg. The meningeal irritation sign was negative.

Treatment:
After admission, Yaser was diagnosed with multiple sclerosis. He was given 3 neural stem cell injections and 3 mesenchymal stem cell injections to repair his nerves, activate the stem cells in his body, promote the stem cells’ expression of their functions, nourish the nerves, regulate the immune system and improve blood circulation. He also had physical rehabilitation training.

Post-treatment:
After 17 days of treatment, Yaser’s left limbs were more powerful, the muscle power of the left upper limb was at level 5, the left lower limbs was at level 5-. He was able to stand on one leg for a longer time, the right leg for 5 seconds, the left leg for 3 seconds. He was able to walk longer distances. His energy and spirit were better than before.

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E-mails:

Date:2017-1-18

Dear Dr. Susan,

Please find attached patient Yaser Al Harbi Month 5 Lab Report.
To let you know:
Patient had improved a lot, his left hand is very good, he can do anything with
it, but his right hand trembles from time to time. Also, his left leg is weak.
waiting for your evaluation.

Regards

Jessica