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Dear Dr. Khan, Assalamu Alaikum

DOCTOR, you cannot imagine how much I am upset about the illness of my three daughters and am still trying to find out the possibilities for treatment. I hereby submit the following for your sympathtic considerations:

(1) My daughter named SHEIBA UMAIR, 20 years old.

Birth History : Born after a normal full term pregnancy
Developmental History: Crawling, Sitting, walking and speaking at normal age
Schooling : Started to go to the school at the age of 3 1/2 years

Start of the Disease: at the age of 5 years

- Started to walk on the sideways of her feet
- Involuntarily urine and stool
- Indifference

PRESENT CONDITION

- Lying on the bed
- Involuntarily urine and stool
- Speech loss
- Convulsions
- Face expressions - normal
- General health - good

(2) My daughter named WARDAH UMAIR, 15 years old.

Birth History : Born after a normal full term pregnancy
Developmental History: Crawling, Sitting, walking and speaking at normal age
Schooling : Started to go to the school at the age of 3 1/2 years

Start of the Disease: at the age of 5 1/2 years

- Started to walk on her tip toes (pigion toeing)
- Involuntarily urine and stool
- Indifference
- Loss of standing and walking

PRESENT CONDITION

Gradually started to improve hereself at the age 7 years.

- can stand and walk with little help
- understanding and memory - very good
- speech - normal
- control on urine and stool 80% has come back
- feeding by parents
- gneral health - very good
- face expressions - normal

Apparently looks normal but little backward from her age.

(3) My daughter named SARA UMAIR, 12 years old.

Birth History : Born after a normal full term pregnancy
Developmental History: Crawling, Sitting, walking and speaking at normal age
Schooling : Started to go to the school at the age of 3 1/2 years

Start of the Disease: at the age of 5 years

- knees started to go backward while standing or walking
- Involuntarily urine and stool
- Indifference
- loss of standing and walking

PRESENT CONDITION

- Hyperactive
- Cannot stand or walk
- Can sit with support
- Involuntarily urine and stool
- Speech distinct
- Epeliptic convulsions once in a ten days time - started at the age of 11 years (just one year ago)
- Memory - good
- Face expressions - normal
- General health - good

DIAGNOSIS : A precise diagnostic label has not been arrived yet.

MRI/CT SCANS: show WHITE MATTER DISEASE
- PERIPHERAL NERVE DYSFUNCTION
- DISORDER OF MYELIN

Copies of medical records and CT Scans/MRI films are in my possession. In case you would like to examine these, please let me know I shall send same by DHL.

PRESENT MEDICATION: NONE

MY WIFE & MYSELF

First degree relatives. My wife is the daughter of my mother's sister. The wife's father is not a relative of our parents. Her father is from a different family and he has no connection direct or indirect with the families of my father and mother.

MY FAMILY

- One son 19 years Student of Engineering
- One daughter 20 years sick (Sheiba)
- One daughter 15 years sick (Wardah)
- One daughter 12 years sick (Sarah)

Doctor, if you see the least hope for treatment (Medications/Surgical), please give me an appointment I will immediately come over.

Doctor, once again I wish to reiterate that if there is least hope for treatment I will not hesitate to avail that.

Finally I would like to extend my sincere thanks for your sympathy, co-operation and guidance.

Best regards,

Mohd. Ghazi Umair