Dr Fiza Saleem

11/08/2025

08/07/2025

Two to Three Days ago A mother came with her 8-years-old son to the" DHQ Teaching Hospital Narowal Physiotherapy Department" to meet me there. When I saw him ,took history, did assessment I find myself to be unaware of this kind of disease except to know this is a genetic kind of. I took time from his mother to study about him, search about it and then I'll tell you that "K Apky Bachy Ko Kya Hua Hai". and will make a Diagnosis. I had never seen before a case like him in my whole Paediatric case experience in Physiotherapy. After consistent searching I finally wind it up because It was a challenge for me as well as A hope which I saw in his mother eyes that something could be possible for her dear son.

"MYOTONIA CONGENITA (BECKER TYPE)"

Introduction:

It's a rare genetic disorder characterized by myotonia,muscle stiffness and abnormal muscle hypertrophy that gives the impression of Herculean or "BODYBUILDER-like" appearance. There are two main forms of myotonia congenita that has been described: 1) Thomsen disease (Autosomal Dominant Myotonia Congenita Syndrome) and 2) Becker disease( Autosomal Recessive Myotonia Congenita Syndrome)

History:

First described in 1876 by Ausmus Julius Thomas Thomsen(1815-1896) in Schleswig Denmark.He was a German physician and was himself affected by this condition. There were more than 65 member of this large family over seven generations that were diagnosed over with this disease. In 1971 P.F. Becker, a German physician described the more severe variant of Myotonia Congenita.

Classification:

There are two forms of Myotonia Congenita based on inheritance pattern
*. Becker type: Typically manifests between age of 4 and 12 years. Rarely it has been reported that onset may occur as late as approximately 18 years of age. Symptoms are more severe in this type.
*. Thomsen type: The onset of the disease may be apparent in infancy but most often by age 2 to 3 years of age. Symptoms stabilize after onset and do not progress.

Incidence:

Epidemiological studies have estimated the incidence internationally at 0.3 to 0.6:100,000 in the general population.Becker's myotonia congenita is about twice as common as Thomsen's disease.it affects males and females in relatively equal numbers.

Genetic Inheritance:

The mutation in both Becker and Thomsen resides in the muscle CHLORIDE CHANNEL GENE CLCN1 whose locus is on chromosome 7q35. Transmission is Autosomal Dominant for Thomsen and Recessive for Becker.

Pathophysiology:

Decrease conductance of the muscle chloride channel.There is a reduction in Cl ions entering the cell; it remains relatively depolarised resulting in spontaneous oscillations in membrane potential and clinical Myotonia.

Role of Physiotherapy:

*Educating Patient and Family
*Reducing Pain and stiffness
*Preventing muscle shortening
*Managing muscle spasm and body stiffness
*Promoting relaxation
*Increasing endurance and Stamina
*Improving Balance and posture
*Enhancing Walking Ability
*Improving Functional Tasks/ADL's
*Promoting Safety/Minimize risk of injury

27/09/2024

02/09/2024

Our Respected Patient's Veiws 🌸😌🌸Physiotherapy Department of DHQ-Narowal ❤

02/09/2024

Hardwork pays off🌸Physiotherapy Department of DHQ-Narowal ❤

02/09/2024

Our Very innOcent Lil-Champ views abOut Our Physiotherapy Services 😌😊💕🌸Physiotherapy Department of DHQ-Narowal ❤

14/08/2024

Happy Independence Day🇵🇰💚😇

09/08/2024

Pakistan won its last Olympic medal in 1992 Olympics Barcelona- exactly 32 years ago. All of Pakistan’s Gold medals till 92 only ever came from Field Hockey. Arshad Nadeem has not only made history today by setting a new Olympic record for Javelin, but he has also become THE FIRST EVER INDIVIDUAL GOLD for Pakistan. It is important to remember that Arshad Nadeem is a SELF MADE man. With no backing from the state, with no lavish lifestyle, no ads or promotions and very little media attention, it is HIS AND HIS SUCCESS ALONE. Don’t let these corrupt politicians call it “their victory” and take any credit. They did nothing. Arshad competed against athletes with world class facilities and won solely due to his own training. HE IS A REAL HERO OF PAKISTAN. He is our pride instead of those cricket mafia who have hijacked all other sports here. NOW WE HAVE TO CELEBRATE THIS MAN FOR HIS OWN VICTORY. Our true king 👑🫀