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Volume 32, 12 Issues, 2022

Journal of College of Physicians and Surgeons Pakistan (JCPSP), is an open access, peer reviewed monthly biomedical journal of the country published regularly since 1991. College of Physicians and Surgeons Pakistan is the parent body of this Journal.


The College of Physicians and Surgeons of Pakistan (CPSP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide credits to educational activities.

CPSP designates '3 AMA PRA Category 1 Credits' for review of the manuscript of an original study.


Important Announcement for Authors

"As a large number of case reports are awaiting publication, JCPSP has decided to stop acknowledging Case Reports for a certain period of time until the backlog is cleared. Therefore, case reports are regretted from processing".

Latest Articles
Volume 32 | Issue 9 | September 2022
Judicious Use of Laboratory Diagnostic Services

By Faiza Kazi


Perfusion Index Value in Determining the Success of Axillary Block

By Nurgul Cetgen, Dilek Ener, Mevlut Dogukan, Mehmet Duran, Oznur Uludag

ABSTRACT Objective: To evaluate whether the perfusion index (PI) can be used to predict and provide a cut-off value for ultrasound-guided axillary nerve block success. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Anaesthesiology and Reanimation, Adiyaman Unive...

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Anthropometric and Clinical Analyses of the Distal Tibia, Posterior Tibial Tendon, and Flexor Digitorum Longus Tendon on MRI

By Emre Emekli, Ugur Toprak

ABSTRACT Objective: To determine the gender and age differences in posterior tibial tendon (PTT), flexor digitorum longus tendon (FDLT), medial malleolar groove (MMG), and posterior, anterior, and total posterior malleolus (PMP, APM, and TPM, respectively) and evaluate the use of these parameters fo...

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The Effect of Fluid Challenge Test on Optic Nerve Sheath Diameter

By Ozgur Komurcu, Burhan Dost, Neslihan Unal Akdemir, Fatma Ulger

ABSTRACT Objective: To investigate the effect of the fluid challenge test on the optic nerve sheath diameter (ONSD) change. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Anesthesiology and Reanimation, Ondokuz Mayis University Hospital, Samsun, Turkey, from...

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Laparoscopic versus Conventional Open Surgery Approach of Tunica Vaginalis for Palpable Cryptorchidism

By Li-Wei Li, Bin Yang, Dan Liu, Chuang Liu, Shi-Lei Guo

ABSTRACT Objective: To evaluate the advantages of the laparoscopic approach of tunica vaginalis in the treatment of palpable cryptorchidism. Study Design: Randomised clinical comparative study. Place and Duration of Study: Department of Urology Surgery, Baoding Children’s Hospital, Baoding, He...

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Factors Predicting Surgical Treatment in Patients with Adhesive Small Bowel Obstruction: Retrospective Single-centre Study

By Tevfik Kivilcim Uprak, Muhammed Ikbal Akin, Mumin Coskun, Cumhur Yegen

ABSTRACT Objective: To investigate the factors which predict treatment strategy in patients with adhesive small bowel obstruction. Study Design:  Descriptive study. Place and Duration of Study: General Surgery Clinic, Marmara University Medical Faculty, Istanbul, Turkey, between January 2016 a...

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Association of Endometrioma Size with Serum Anti-mullerian Hormone

By Ozlem Karabay Akgul, Hakan Guraslan, Evrim Ebru Kovalak, Tolga Karacan, Tugba Ozcan Aydin, Tugce Cay

ABSTRACT Objective: To evaluate the relationship between the size of endometrioma and serum Anti-mullerian hormone (AMH). Study Design: A Descriptive study. Place and Duration of Study: This study was conducted at the Bagcilar Training and Research Hospital, Istanbul, Turkey, from January 2015 ...


Relationship between the Properties of Paraspinal Muscles and Bone Mineral Density in Osteoporotic Patients

By Zeynep Nilufer Tekin, Bilinc Dogruoz Karatekin

ABSTRACT Objective: To investigate the properties of paraspinal muscle structures in osteoporotic patients, lumbar computed tomography (CT) and their relationship with lumbar and femoral neck bone mineral density (BMD). Study Design: A Descriptive study. Place and Duration of Study: Department of R...

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m6A RNA, FTO, ALKBH5 Expression in Type 2 Diabetic and Obesity Patients

By Erhan Onalan, Burkay Yakar, Ebru Etem Onalan, Koray Karakulak, Tugce Kaymaz, Emir Donder

ABSTRACT Objective: To investigate whether m6A content changes in type 2 diabetes mellitus (T2DM) and obese individuals and whether the relationship of m6A content with the mRNA expression levels of FTO and ALKBH5 genes. Study Design: Cross-sectional study. Place and Duration of Study: Department of...

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Clinical Significance of Expression of Periostin in Non-small Cell Lung Cancer

By Zhixiong Qiao, Lan Zhang, Jinxi He, Wei He

ABSTRACT Objective: To analyse the expression of serum periostin in patients with non-small cell lung cancer (NSCLC) and its clinical significance. Study Design: Descriptive study. Place and Duration of study: General Hospital of Ningxia Medical University, Yinchuan, China, from October 2018 to Oc...

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The Effect of HALP Score on the Prognosis of Gastric Adenocarcinoma

By Zeynep Gok Sargin, Ibrahimhalil Dusunceli

ABSTRACT Objective: To investigate the predictive value of haemoglobin and albumin levels and lymphocyte and platelet (HALP) counts in gastric cancer patients.  Study Design: Descriptive study. Place and Duration of Study: Department of Gastroenterology, Zonguldak Bulent Ecevit University, Fac...

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One-year Visual and Refractive Outcomes of Deep Anterior Lamellar Keratoplasty (DALK) in Patients with Advanced Keratoconus

By Muhammad Abdul Moqeet, Warda Ali, Saad Alam Khan, Aruba Zafar, Hassan Mansoor

ABSTRACT Objective: To determine the one-year visual and refractive outcomes of deep anterior lamellar keratoplasty (DALK) in patients with advanced keratoconus (KC) using inexpensive readily available instruments. Study Design: An observational study. Place and Duration of Study: Department of Co...


Safety and Efficacy of Zoledronic Acid in children with Osteogenesis Imperfecta

By Maira Riaz, Shahnila Hafeez, Mohsina Noor Ibrahim, Zubair Ahmed Khoso, Taj Muhammad Laghari
, Syed Jamal Raza

ABSTRACT Objective: To evaluate the efficacy and safety of zoledronic acid in children with osteogenesis imperfecta (OI). Study Design: Descriptive Study. Place and Duration of Study: National Institute of Child Health, Department of Endocrine and Diabetes, Karachi, Pakistan, from January 2011 to D...

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Laparoscopic versus Open Surgery in Colorectal Cancer: Is Laparoscopy Safe Enough?

By Mehmet Akif Ustuner, Abdulkadir Deniz, Abdurrahman Simsek

ABSTRACT Objective: To compare the early and long-term outcomes of laparoscopic and open surgery in colorectal cancer stages 1-3. Study Design: Comparative study. Place and Duration of Study: Department of Gastroenterological Surgery, Health Sciences University, Gulhane Training and Research Hospita...

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Role of r-irisin in Nicotine-induced Oxidative Stress and Endothelial Dysfunction in BALB/c mice

By Madiha Sarwar, Sadia Ahsin, Gule Naghma Saeed, Hira Ashraf

ABSTRACT Objective: To determine the protective role of irisin in attenuating nicotine-induced oxidative stress in vascular tissue in mice. Study Design: Experimental study. Place and Duration of Study: Foundation University, Islamabad, Pakistan, from January 2019 to June 2020. Methodology: Thirt...

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Effects of Low-intensity Extracorporeal Shockwave Therapy on Erectile Dysfunction: A Systematic Review and Meta-analysis

By Shuai Liu, Jiuzhou Pu, Xu Li, Rongxin Li, Yanan Wang, Zhilong Dong

ABSTRACT This present systemic review and meta-analysis was conducted to assess the effectiveness of low-intensity extracorporeal shockwave therapy (Li-ESWT) on erectile dysfunction (ED) based on the relevant randomised controlled trials (RCTs). A comprehensive search of databases, including Medline...


Comparison of the Effectiveness of Shock Index, Modified Shock Index, and Age Shock Index in COPD Exacerbations

By Salih Kocaoglu, Adnan Karadas

ABSTRACT Objective: To evaluate the effectiveness and practicality of shock index (SI), modified shock index (MSI), and age-shock index (Age-SI) in predicting the prognosis, mortality, ICU and service admission, and the need for intermittent mandatory ventilation (IMV) and nasal intermittent mandato...


Association of C-reactive Protein/Albumin, Procalcitonin/Albumin, Platelet/Lymphocyte, and Lymphocyte/Monocyte Ratio with Mortality in Hospitalised COVID-19 Patients

By Deniz Cekic, Kubilay Issever, Ahmed Cihad Genc, Selcuk Yaylaci, Ahmed Bilal Genc, Ali Tamer

ABSTRACT Objective: To investigate and compare complete blood count and biochemistry parameters such as c-reactive protein/albumin (CRP/ALB) ratio, procalcitonin/albumin (PRO/ALB) ratio, lymphocyte/monocyte (LYM/MON) ratio, platelet/lymphocyte (PLT/LYM) ratio of the recovered/deceased, and ICU (inte...

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Clinicopathological Features and Prognosis of Invasive Micropapillary Carcinoma Compared to Invasive Ductal Carcinoma-NOS: Worse or Better?

By Fugen Vardar Aker, Erhan Ekren, Meryem Dogan, Gunay Gurleyik, Eda Tanrikulu, Basak Bala Oven

ABSTRACT  Objective: To evaluate whether there are differences in invasive micropapillary carcinoma (IMPC) and invasive ductal carcinoma-NOS (IDC-NOS) according to the clinicopathological features and prognosis including molecular subtypes. Study Design: Descriptive study. Place and Duration o...


Salvage for Postpartum Massive Haemorrhage in a Jehovah’s Witness with Intravenous Iron Therapy and Cell Saver System

By Tugba Sarac Sivrikoz, Cigdem Kunt Isguder, Muhterem Melis Canturk, Mukadder Orhan Sungur, Sevgi Kalayoglu Besisik

ABSTRACT Intraoperative cell salvage (ICS) system performs autologous transfusion by filtering and reinfusing the shed blood into corporeal circulation during the surgery. Especially for pregnant Jehovah’s Witnesses, the ICS system could be a life-saving intervention. This report describes the...


Unusual Sites of Leiomyosarcoma: A Study of 3 Interesting Cases

By Bushra Siddiqui, Shahbaz Habib Faridi, Asfa Shams, Jowairiah Hassan

ABSTRACT Leiomyosarcoma malignant tumours arise from the smooth muscle cells. They are rapidly growing tumours with aggressive behaviour and poor prognosis. Although relatively rare, they pose a diagnostic challenge as they comprise a large spectrum of diagnostic entities. Herein, we describe three ...


Role of Recombinant Activated Factor VIIa (rFVIIa) in Bleeding Mycotic Aneurysm of the Abdominal Aorta

By Shaheen Bibi, Irfan Ahsan, Karimullah Makki, Sidra Rauf

ABSTRACT Mycotic aortic aneurysm is an infective disease of the aorta with high mortality rate despite  surgical repair. Recombinant activated factor VIIa (rFVIIa) is approved for the treatment of bleeding in hemophilia and used (off-labeled) in acute bleeding related to the trauma, cardia...


Epithelioid Inflammatory Myofibroblastic Sarcoma with Leukemoid Reaction

By Yuan-Yuan Wan, Cheng-Li Miao, Shi-Bo Liu, Tong Zhang, Cheng-Hua Luo

ABSTRACT Epithelioid inflammatory myofibroblastic sarcoma (EIMS) is a rare and aggressive inflammatory myofibroblastic tumour (IMT) variant. This report identifies the first case of EIMS with leukemoid reaction. This is also the first case in which pancreatic infiltration occurred from the disease o...


Hearing Loss After the First Low Dose Administration of Cisplatin

By Atila Yildirim, Evren Fidan, Feyyaz Ozdemir

ABSTRACT Cisplatin is commonly used antineoplastic drug that is effective against different types of tumours. Nephrotoxicity, neurotoxicity, and ototoxicity constitute the main dose-limiting side effects of the drug. We present a case of sensorineural hearing loss after the first low dose of cisplat...


Mucormycosis of Maxilla: An Enigma to the Clinician

By Suman Sen

ABSTRACT Mucormycosis is an acute opportunistic infection caused by a saprophytic fungus found in the soil, decaying fruits, and vegetables. It is a rapidly progressing fungal infection mainly seen in nose and its surrounding sinuses due to inhalation of the spores of fungus from the contaminated ar...


Coexistence of Colon Perforation and Congenital Lipodystrophy

By Nihan Acar, Turan Acar, Beste Suataman, Nese Ekinci, Fatma Tatar

ABSTRACT Lipodystrophy (LD) is an acquired or congenital rare condition consisting of hyperlipidaemia, glucose intolerance/ insulin resistance, and almost complete absence and storage of adipose tissue. Colon perforations can be observed in type 4 congenital LD. Here, we aimed to present a case of s...


Role of Ruxolitinib in Steroid-Refractory Graft versus Host Disease in Patients Undergoing Allogeneic Stem Cell Transplant

By Hammad Javed, Qamarunnisa Chaudhry, Nighat Shahbaz, Mehreen Ali Khan, Raheel Iftikhar, Muhammad Yousaf

ABSTRACT The objective of this study was to evaluate the role of Ruxolitinib in steroid-refractory graft versus host disease. This retrospective descriptive study was conducted from January 2018 to December 2021. A total of 157 patients underwent allogeneic stem cell transplants during the study per...


Comparison of Low Molecular Weight Heparin Used alone or Combined with Aspirin in the Treatment of Fetal Growth Restriction

By Saiqiong He, Lingling Liang, Sailin He

ABSTRACT The objective of the study was to compare the efficacy of low-molecular weight heparin (LMWH) alone and use in the combination with aspirin in the treatment of fetal growth restriction (FGR) patients. Ninety-six FGR patients were divided into the LMWH group (n=48) and the combined group (n=...


Entrapped Epidural Catheter: An Anaesthetic Challenge

By Priyanka Sethi, Shelly Singh, Darshana Rathod


Concurrence of Thyrolipomatosis with Hyperthyroidism and Ectopic Thyroid Tissue

By Ugur Kesi̇ci̇, Yahya Kaan Karatepe, Bora Isceviren


Posterior Reversible Encephalopathy Syndrome Presented with Typical Radiological Findings

By Enis Ademoglu, Mehmet Muzaffer Islam, Serkan Emre Eroglu


An Urgent Need for Local Guidelines to Address Phosphate Homeostasis in Children with Transfusion-dependent β-thalassemia Major

By Lena Jafri, Arsala Jameel Farooqui, Aysha Habib Khan


Role of Physical Therapy in Palliative Care of Cancer Patients

By Shafaq Altaf, Anam Aftab, Hina Tariq


SUPPLEMENT

Supplement | August 2022 | Volume 32
Impact of Intragastric Balloon: A Rare Complication

By Ghulam Mujtaba, Rida Zehra, Fizra Balkhi, Numra Shaikh

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Invasive and Non-invasive Ductal Carcinoma within Malignant Phyllodes Tumour with Axillary Lymph Node Metastases

By Osman Erdogan, Alper Parlakgumus, Zeynel Abidin Tas, Kemal Yener, Umit Turan

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Cutaneous T-cell Lymphoma Predisposing to Recurrent Infective Endocarditis by Methicillin-resistant Staphylococcus Aureus (MRSA) in a Patient with Intracardiac Defibrillator (ICD)

By Muhammad Azam Shah, Muhammad Adil Soofi, Faisal Alsmadi, Muhammad Amin Ur Rehman, Faisal Abdullah Alghamdi

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Broad Complex Tachycardia, Addison's disease, and Ascending Flacid Paralysis: An Interesting Case on Cardiology Floor

By Nauman Ali

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Two Cases of Interrupted Inferior Vena Cava with Azygos / Hemiazygos Continuation

By Saerah Iffat Zafar, Aliya Halim, Waqas Khalid, Mobeen Shafique, Hina Nasir

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Persistent Left Superior Vena Cava: A Rare Finding for the Internists

By Syed Mohammad Haleem

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Duodenal Ulcer Perforatıon after Actıvated Charcoal Treatment

By Nazmi Ozer, Abdullah Sahin

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A Novel Variant in Paired Box 3 Gene-related with Waardenburg Syndrome Type-1 in an Afghan Family

By Mustafa Dogan, Recep Eroz

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The Case with Short Stature and Intellectual Disability Caused by a Novel 2q12 Duplication

By Pinar Kocaay, Ahmet Cevdet Ceylan, Derya Tepe

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Colonic Obstruction Secondary to Phytobezoar Caused by Vitex Agnus-Castus Seeds: A Case Report

By Erkan Somuncu, Ismail Hakki Alp Solak

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Giant Sigmoidal Lipoma Protruding Through Anal Canal and Causing Sigmoido-rectal Intussusception

By Ali Surmelioglu, Serhat Ozer

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Recurrent Bleeding From a Duodenal Ulcer Halted by Laparoscopic Oversewing Under Endoscopic Guidance

By Feng Chi, Shenkang Zhou

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Granulomatous Inflammation of Greater Omentum Caused by a Migrating Fishbone

By Tao Fan, Chao-Qi Wang, Ying-Jie Song, Wan-Yan Wu, Ya-Nan Wei, Xue-Tao Li

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Neuroendocrine Tumour of the Gallbladder Diagnosed after Cholecystectomy

By Halil Ibrahim Tasci, Esra Zeynep Coskunoglu, Emin Turk, Erdal Karagulle

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A Rare Case of Female Bladder Outlet Obstruction: Severe Introital Stenosis

By Muhammed Fatih Simsekoglu, Oktay Ozman, Mehmet Hamza Gultekin, Bulent Cetinel

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Lafora Body Epilepsy: A Challenging Diagnosis

By Ali Zohair Nomani, Haris Majid Rajput, Hanna Nomani

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Sturge-weber Syndrome with Bilateral Fronto-parieto-temporal Lobe Atrophy and Bilateral Leptomeningeal Angiomatosis: A Rare Case

By Ashok Kumar, Imtiaz Ali Panhwar, Bushra Rehan, Kanchan Shadani

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It does Exist! Traumatic Hemorrhage in Septum Pellucidum

By Murat Seyit, Arif Osun, Atakan Yilmaz, Mert Ozen, Duygu Aras Seyit

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Atypical Presentation of a Primary Thymic Adenocarcinoma

By Hasan Ersoz, Ebru Cakir, Utku Oflazoglu, Berna Dernek

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Colonic Metastasis from Primary Tonsillar Squamous Cell Carcinoma: A Rare Cause of Large Bowel Obstruction

By Tayfun Kaya, Semra Demirli Atici, Dudu Solakolu Kahraman, Huseyin Salih Semiz, Duygu Kahraman

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Glucagonoma Syndrome: A Rare Paraneoplastic Disorder due to Neuroendocrine Tumor of the Pancreas

By Muhammed Aasim Yusuf, Shafqat Mehmood, Jhanzeb Iftikhar, Muhammad Saqib, Muhammad Zeeshan Siddique, Wania Imtiaz

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Control of Oesophageal Tumour-related Bleeding with a Fully Covered Self-expandable Metallic Stent (SEMS) Insertion

By Muhammad Zeeshan Siddique, Muhammad Saqib, Jhanzeb Iftikhar, Muhammed Aasim Yusuf

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Co-existence of Papillary and Medullary Thyroid Carcinoma: Reports of Three Cases

By Murat Calapkulu, Ozen Oz Gul, Soner Cander, Muhammed Fatih Sagiroglu, Ozlem Saraydaroglu, Erdinc Erturk, Canan Ersoy

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Primary Hepatic Sarcomatoid Carcinoma Presenting with Dysphagia: A Rare Presentation

By Khadim Hussain Samejo, Rajesh Mandhwani, Zain Majid, Muhammed Mubarak, Nasir Hassan Luck

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Osteoid Osteoma of Retromolar Trigone: Report of a Rare Case

By Faheem Ahmed, Hamza Hassan Mirza, Zahoor Ahmed Rana, Noaman Ghauri

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Solitary Plasmacytoma in a Patient Presenting with Taste Disturbance

By Ugur Ergun, Ayse Uysal, Hasmet Yazici

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Inflammatory Pseudotumour of Temporal Bone in a Multiple-Comorbidity Patient

By Yao Wang, Chih-Hung Wang, Hsin-Chien Chen

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Carpometacarpal Joint Dislocations as a Rare Cause of Hand Pain

By Ali Celik

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T-cell Acute Lymphoblastic Leukemia in an Infant: A Case Report and Review of Literature

By Neelum Mansoor, Naeem Jabbar

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Laparoscopic Management of Intestinal Obstruction due to a Tight Muscular Cuff Following Transanal Endorectal Pull-through for Hirschsprung’s Disease

By Vanesa Villamil, Juana Maria Sanchez Morote, Maria Josefa Aranda Garcia, Ramon Ruiz Pruneda, Maria Fernandez Ibieta

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A Rare Case of Propionic Acidemia in a Six Months Female Child

By Sobia Irum, Ambreen Rehman, Muhammad Aamir, Zujaja Hina Haroon, Nayyar Chaudhry, Afshan Bibi

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First Documented Case of Pulmonary Alveolar Proteinosis with Atopy Presenting Secondary to CSFR2B Mutation

By Ayse Senay Sasihuseyinoglu, Dilek Ozcan, Arbil Avci, Gursu Kiyan

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Association between Serum Carcino-embryonic Antigen Levels and Micropapillary Bladder Cancer Metastasis in an Elderly Male

By Caner Ediz, Neslihan Kaya Terzi, Serkan Akan, Omer Yilmaz

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Male Urethral Diverticulum with Stones Presenting as Acute Urinary Retention

By Syed Muhammad Nazim, Roshane Shahid Rana, Kaleem Khan Mirani

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Solid Renal Mass in a Transplanted Allograft Kidney: Mucinous Tubular and Spindle Cell Renal Cell Carcinoma

By Erdinc Dincer, Osman Murat Ipek, Sukran Sarikaya Kayipmaz, Oktay Akca

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The Use of Lumbar Drain for Spinal Cord Protection in a Thoraco Abdominal Aortic Aneurysm Surgery

By Saima Rashid, Mohammad Hamid, Sameer Ahmed Malick

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