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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 10 | October 2022
After the Floods! Healthcare Response and Concerns

By Saba Sohail


Insulin-like Peptide-6 Levels in Non-obstructive Azoospermia

By Kemal Gumus, Mehmet Demir, Ismail Dag

ABSTRACT Objective: To investigate the serum versus insulin-like peptide-6 (INSL-6) levels in men with non-obstructive azoospermia (NOA) and normospermia. Study Design: Descriptive study. Place and Duration of Study: Department of Urology, Balikligol State Hospital and Harran University, Sanliu...


Targeted Bleeding Management Guided by Non-Invasive Haemoglobin Measurement in Surgical Patients

By Sukriye Akdag, Seniyye Ulgen Zengin, Gul Cakmak, Tumay Umuroglu, Zeynep Zuhal Aykac, Ayten Saracoglu

ABSTRACT Objective: To assess blood transfusion decisions in blood losses using a continuous total haemoglobin (SpHb) and non-invasive haemoglobin (Hb) device. Study Design: Double-blinded randomised controlled trial. Place and Duration of Study: Marmara University Hospital, Istanbul, Turkey, from M...

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Evaluation of the Effect of Interscalene Brachial Plexus Block on Intracranial Pressure Using Optic Nerve Sheath Diameter and Internal Jugular vein Collapsibility Index

By Oguz Gundogdu, Onur Avci

ABSTRACT Objective: To determine the effect of single-shot interscalene brachial plexus (ISBP) block on intracranial pressure (ICP) by evaluating the extravascular volume effect of the medicine on the internal jugular vein (IJV). Study Design: Interventional study. Place and Duration of Study: Depar...

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Evaluation of Calciferol, Cobalamin, and Stromelysin-1 in Patients with Diabetic Peripheral Neuropathy due to Type-2 Diabetes Mellitus

By Bulent Bilir, Ibrahim Yilmaz, Numan Karaarsalan, Betul Ekiz Bilir, Necati Kaplan, Hanefi Ozbek

ABSTRACT Objective: To evaluate the relationship between calciferol (vitamin D), cobalamin (vitamin-B12), and Stromelysin-1 (MMP-3) circulating levels in patients with diabetic peripheral neuropathy (DPN), patients with DM type 2 (T2DM) without neuropathy, and healthy control groups. Study Design:...

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Abdominal Pain Management and Point-of-care Ultrasound in the Emergency Department: A Randomised, Prospective, Controlled Study

By Yesim Durgun, Yusuf Yurumez, Necip Gokhan Guner, Nuray Aslan, Ensar Durmus, Yavuz Kahraman

ABSTRACT Objective: To determine the effect of point-of-care ultrasound (POCUS) performed during the initial evaluation phase of patients with acute abdominal pain. Study Design: Randomised controlled, parallel-group trial. Place and Duration of Study: Sakarya University Training and Research Hospit...

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Effect of Direct-acting Oral Anticoagulants and Warfarin on Hospital Outcomes in Upper Gastrointestinal Bleeding

By Tevfik Solakoglu, Huseyin Koseoglu, Nurten Turkel Kucukmetin, Mustafa Akar, Rafet Mete

ABSTRACT Objective: To evaluate the comparison of direct-acting oral anticoagulants (DOACs) and warfarin for their effects on major bleeding and hospital outcomes in patients with acute nonvariceal upper gastrointestinal bleeding (NVUGIB). Study Design: An observational study. Place and Duration of ...

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What does the Procalcitonin Level Tell us in Patients with Acute Pancreatitis?

By Berat Ebik, Huseyin Kacmaz, Elif Tugba Tuncel, Medeni Arpa, Feyzullah Ucmak, Muhsin Kaya

ABSTRACT Objective: To determine the factors affecting the procalcitonin level, and its association with the severity of pancreatitis in patients with acute pancreatitis (AP). Study Design: Cross-sectional analytical study. Place and Duration of Study: Division of Gastroenterology, University of Hea...

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Comparison of Peer-Assisted Learning with Traditional Faculty-led Teaching in Family Medicine Clerkship: An Experimental Study

By Muneeza Aamir Sami, Lubna Ansari Baig, Saima Perwaiz Iqbal, Umme Kulsoom Khattak, Farah Gul

ABSTRACT Objective: To compare the effects of reciprocal peer-assisted learning (PAL) with traditional faculty-led teaching on the academic performance of fourth-year medical students in Family Medicine clerkship.   Study Design: An experimental study. Place and Duration of Study: Department of...

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Effect of Local Use of Rifampicin on the Development of Surgical Site Infection after Lumbar Microdiscectomy

By Eyup Cetin, Murat Yucel

ABSTRACT Objective: To investigate the effect of local use of rifampicin (RIF) on the development of postoperative surgical site infection (SSI) after lumbar microdiscectomy. Study Design: Observational study. Place and Duration of Study: Van YuzuncuYil University Medical School Neurosurgery Cl...

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Inflammatory Prognostic Index in Metastatic Renal Carcinoma Treated with Nivolumab

By Ferhat Ekinci, Atike Pinar Erdogan, Serkan Yildirim, Gulcan Bulut, Cengiz Yilmaz, Sabri Barutca

ABSTRACT Objective: To evaluate the utility of inflammatory prognostic index (IPI), albumin, c-reactive protein (CRP), and lactate dehydrogenase (LDH) as predictive biomarkers of oncologic outcome in metastatic renal cell cancer (mRCC) patients treated with nivolumab. Study Design: Descriptive ...

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Percutaneous Uniplanar Pedicle Screw-Rod System with Injured Vertebra Fixation for Thoracolumbar Burst Fracture and Technique Notes

By Qilin Lu, Hui Kang, Chengjie Xiong, Chao Sun, Feng Xu

ABSTRACT Objective: To evaluate the efficacy of percutaneous uniplanar pedicle screw (PUPS) combined with injured vertebra fixation for treating thoracolumbar burst fracture and provide technique notes. Study Design: A descriptive study. Place and Duration of Study: Department of Orthopaedics, Gene...


Neuromuscular Electrical Stimulator as a Protective Treatment against Intensive Care Unit Muscle Wasting in Sepsis/Septic Shock Patients

By Gunes Comba Cebeci, Halil Cebeci, Mehtap Pehlivanlar Kucuk, Ahmet Oguzhan Kucuk, Ilkay Koray Bayrak, Fatma Ulger

ABSTRACT Objective: To investigate the efficacy of neuromuscular electrical stimulation (NMES) application in preventing muscle wasting in intensive care unit (ICU) patients diagnosed with sepsis/septic shock. Study Design: A single-centre, unblinded, parallel-group, prospective, randomised clinica...

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Role of Ondansetron in Reducing Methotrexate Intolerance in Patients with Inflammatory Arthritis

By Saba Saif, Spenta Kakalia, Rizwana Kitchlew, Haseeb Ahmed Khan, Samina Fida, Muhammad Siddique

ABSTRACT Objective: To determine the frequency of intolerance to Methotrexate (MTX) in patients with inflammatory arthritis by using MTX intolerance severity score, and evaluate the effects of Ondansetron in reducing MTX intolerance.  Study Design: Interventional study. Place and Duration of St...

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External Iliac Artery Anastomosis and Internal Iliac Artery Anastomosis for Artery anastomosis in Deceased-donor Kidney Transplantation and Multifactorial Analysis of Graft Survival

By Salih Kara, Ercan Korkut, Nurhak Aksungur, Necip Altundas, Gurkan Ozturk, Zuhal Yetis Demir

ABSTRACT Objective: To determine the effects of surgical techniques applied to arterial anastomosis for kidney transplantation on the graft outcome. Study Design: Observational study. Place and Duration of Study: Organ Transplantation Center, Ataturk University Research Hospital and School of Medici...

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Complication Rates in Different Gastrectomy Techniques of Enhanced Recovery after Surgery for Gastric Cancer: A Meta-analysis

By Zhiming Chen, Hui Xue, Hua Yuan, Jia Wang, Qiuchen Wang, Xiuying Zhang

Abstract The purpose of this study was to analyse the postoperative complications of different gastrectomy methods, and provides guidance for the development of enhanced recovery after surgery (ERAS) protocols. We searched EMBASE, Web of Science, CINAHL, PubMed, MEDLINE, and the Cochrane Central Reg...


The Importance of Mapping Vagus and Laryngeal Nerves Monitoring During Thyroid Surgery

By Selim Dogan, Serkan Sari, Kivilcim Ulusan, Gungor Uzum, Ufuk Oguz Idiz

ABSTRACT Objective: To determine the location of thyroid-related nerves by nerve monitoring and demonstrate the usefulness of Nerve Integrity Monitor in thyroid surgery. Study Design: Descriptive study. Place and Duration of Study: Department of General Surgery, University of Health Sciences, Istanb...

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Clinical Spectrum and Endoscopic Treatment of Gastrointestinal Carcinoid Tumour

By Linyun Xue, Yaowu Cai, Wei Chen, Sijie Chen, Pengxing Xue

ABSTRACT Objective: To analyse the clinical spectrum and endoscopic treatment outcome of patients diagnosed with gastrointestinal carcinoid tumours. Study Design: Case series. Place and Duration of Study: The First Hospital of Putian City of Fujian Province, China from 2012 to 2019. Methodology: Pat...


Surgical and Oncological Outcomes of Hepatic Resection for Hepatocellular Carcinoma: Report from a Low Volume Centre in a Developing Country

By Muhammad Rizwan Khan, Saleema Begum, Muhammad Tayyab ul Hasan Siddiqui

ABSTRACT Objective: To review the surgical and oncological outcomes of patients who underwent hepatic resection for hepatocellular carcinoma (HCC). Study Design: Cohort study. Place and Duration of Study: Department of Surgery of the Aga Khan University Hospital Karachi, from 2008 to 2019. Methodolo...


Cancer: Can CRISPR Become a Game Changer?

By Sikandar Hayat Khan

ABSTRACT Recent development in CRISPR technologies has emerged as a powerful tool for genome editing, which can become a powerful diagnostic and therapeutic option for cancer patients. While literature search demonstrates some successes in this dimension in animal models and phase-I human trials, st...


Spontaneous Forniceal Rupture Identified by Point-of-care Ultrasound

By Ali Celik, Mehmet Altuntas

ABSTRACT Spontaneous forniceal rupture is one of the rarest diagnoses of abrupt onset abdominal pain. Moreover, urolithiasis is the most prevalent cause and coexistent condition. Delayed-phased Contrast-enhanced computed tomography scans or intravenous pyelograms are needed for an exact diagnosis in...


Salvage Intrapartum Splenectomy for the Treatment of Transfusion-refractory Anaemia in a ß-thalassemia Intermedia Patient

By Tugba Sarac Sivrikoz, Murat Ozbalak, Aykut Ozmen, Mustafa Tukenmez, Sevgi Kalayoglu Besisik

ABSTRACT Thalassemia intermedia (TI) patients may need a transfusion during physiological stress conditions, such as pregnancy. We present a case of a female TI patient with emerging transfusion-refractory anaemia during pregnancy, which resolved after splenectomy performed simultaneously with cesar...


Symptomatic Spinal Seeding Metastasis of a Low-grade Oligodendroglioma

By Emrah Keskin, Hasan Ali Aydin, Burak Bahadir, Kenan Simsek, Murat Kalayci

ABSTRACT Extracranial metastases from primary brain tumours are mostly caused by high-grade tumours. Metastases from low-grade intracranial tumours are much rare and usually asymptomatic. We present a case of a symptomatic spinal cord compression with intradural extramedullary and diffuse leptomenin...


Percutaneous Biopsy of Metastatic Bone Lesions Invisible on Conventional Computed Tomography

By Cennet Sahin, Fevziye Kabukcuoglu

ABSTRACT Early detection and histopathological diagnosis of bone lesions with suspected metastasis are crucial for planning treatment of cancer patients. We present computed tomography (CT) findings of three cases with bone metastases that were diagnosed by CT-guided biopsy. All three bone lesions w...


Leiomyosarcoma of Inferior Vena Cava in an Immunocompetent Young-adult Female Patient

By Joao Filipe Gomes, Ines Vieira, Jorge Mendes, David Donaire, Rui Almeida

ABSTRACT Leiomyosarcoma of the inferior vena cava is an extremely rare malignancy originating from the smooth muscle of the vessel wall, with only a few hundred cases reported in the literature. There are no clear guidelines for treatment, but surgical resection is currently the only curative option...


The Fate of Coracoid Graft after Latarjet Procedure: Arthroscopic and Open Findings of Graft Union and Glenoid Remodelling

By Mohd Nizlan, Raymond Yeak Dieu Kiat, Ahmad Hisham Rashid

ABSTRACT Successful Latarjet procedures depend on many factors including graft union and subsequent restoration of the glenoid surface. Coracoid graft union has been studied; however, remodelling of the glenoid has not been studied extensively. We present two Latarjet cases in which coracoid screws ...


Papillary Urothelial Carcinoma Arising from Ureterocele: Is it a Rare Occurrence?

By Ayhan Karakose, Ekrem Akdeniz

ABSTRACT Various hydronephrotic, dysplastic or clinical pathologies can accompany ureterocele, which is a cystic dilatation of the intravesical part of the submucosal ureter. However, the development of cancer in the ureterocele is highly unusual. Hematuria is the most common sign, although imaging ...


A Comparative Study on Removal of Appendectomy Specimen during Laparoscopy

By Tolga Kalayci, Serkan Tayar

Abstract This study included 151 patients and compared four techniques for appendectomy specimen removal during laparoscopy in a tertiary health centre. An endo bag was the most common removal technique which is preferred in the elderly, whereas, direct removal is preferred in younger patients (p=0....


Laboratory Evaluation and Pathological Features of Bone Marrow Metastasis in Non-haematological Malignancies

By Noman Anjum Rana, Asad Mahmood, Helen Mary Robert, Saima Zahir, Muhammad Bilal Asghar, Sana Riaz

ABSTRACT This study aimed to analyse the diagnostic accuracy of different laboratory parameters that can predict bone marrow metastasis. A cross-sectional analytical study was conducted at the Armed Forces Institute of Pathology (AFIP), Rawalpindi from March 2021 to August 2021. Bone marrow aspirate...


Low and Slow: A Pattern Recognition for Overdose with Beta and Calcium Channel Blockers

By Sadaf Sheikh


Repairing Orbital Floor Fracture with Autologous Nasal Septal Cartilage by using Endoscope through Transoral Maxillary Sinus

By Qiang Li, Guo-Ming Zhang


The Role of Rehabilitation Services in the Optimal Management of Urinary Incontinence in Women

By Huma Riaz, Farooq Azam Rathore


Report of a Case with Profound Anaemia from Health Literacy Perspective

By Serdar Ozdemir


Time for Reintroducing HPV Vaccine in Pakistan for Primary Prevention of Cervical Cancer

By Uzma Shamsi, Afshan Anwar, Zainab Samad


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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