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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 8 | August 2022
Telemedicine and COVID-19 Pandemic: Current status, Issues, Challenges and Opportunities

By Waris Qidwai


Relationship of V1 Derivation Biphasic P Waves with Morbidity and Mortality in Myocardial Infarction Cases

By Burak Demirci, Abuzer Coskun, Cilem Bakar, Burak Akin

ABSTRACT Objective: To evaluate the biphasic P (V1bP) wave in lead V1 in terms of three-vessel disease (TVD), bypass, and mortality in patients with acute coronary syndrome. Study Design: A descriptive study. Place and Duration of Study: Department of Emergency Medicine, University of Health Science...

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Coronary Endarterectomy: Postoperative Angiographic Results

By Efe Edem, Hasan Reyhanoglu

ABSTRACT Objective: To compare the postoperative graft patency rates of patients who had undergone coronary endarterectomies (CE) during coronary bypass surgery to those of patients who had not had CE, based on postoperative coronary angiography. Study Design: Comparative descriptive study. Place an...

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Determinants of Coronary Angiography in Non-ST-elevation Myocardial Infarction with Low Ejection Fraction

By Sadik Volkan Emren, Zeynep Yapan Emren, Ahmet Ersecgin, Oktay Senoz

ABSTRACT       Objective: To investigate the clinical and demographic factors affecting the selection of angiography in patients with severe left ventricular systolic dysfunction (SLVSD, ejection fraction lower than 30%) developing non-ST-segment elevation (NSTEMI). St...


Pleth Variability Index Guided Volume Optimisation in Major Gynaecologic Surgery

By Ummahan Dalkilinc Hokenek, Harika Kosluk Gurler, Ayten Saracoglu, Ahmet Kale, Kemal Tolga Saracoglu

ABSTRACT Objective: To compare conventional fluid management (CFM) with pleth variability index (PVI) guided goal-directed fluid management (GDFM) during elective total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO) operations. Study Design: Randomised controlled trial. Place a...

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Short-term Reproductive Outcomes of Nulliparous Women with Previous Ectopic Pregnancy

By Yildiz Akdas Reis, Erol Nadi Varli, Murat Levent Dereli, Turkan Dikici Aktas, Harun Egemen Tolunay, Salim Erkaya

ABSTRACT Objective: To determine the characteristics and subsequent pregnancy outcomes in patients with a previous ectopic pregnancy (EP). Study Design: Descriptive-cross sectional study. Place and Duration of Study: Department of Obstetrics-Gynaecology, Etlik Zubeyde Hanim Maternity and Women&rsqu...


Extrahepatic Biliary Tract Variations is an Effect for Acute Calculous Cholecystitis

By Emre Bozdag, Suleyman Sonmez, Erkan Somuncu, Serhan Yilmaz, Ceren Basaran, Mehmet Abdussamet Bozkurt

ABSTRACT Objective: To evaluate the anatomy of the extrahepatic bile duct and to reveal its importance in the formation of acute calculous cholecystitis (ACC). Study Design: Case-control study. Place and Duration of Study: Department of General Surgery and Radiology, Kanuni Sultan Suleyman Training...


Systemic Immune Inflammation Index as a Key Marker of Survival and Immune-related Adverse Events in Immune Checkpoint Inhibitor Therapy

By Ferhat Ekinci, Onur Yazdan Balcik, Bilgin Demir, Pinar Gursoy, Ahmet Ozveren, Atike Pinar Erdogan

ABSTRACT Objective: To evaluate the prognostic significance of the new index designed by formulating neutrophil, lymphocyte, and platelet counts in patients with metastatic disease receiving immune checkpoint inhibitors (ICI) and its effect on the immune-related adverse events (irAEs). Study Design...

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Flowcytometric Ratios of Immune Cells in the Prognosis and Staging of Acute Biliary Pancreatitis

By Oguzkagan Batikan, Mert Mahsuni Sevinc, Oguzhan Tekin, Derya Sonmez, Selim Dogan, Murat Kegin

ABSTRACT Objective: To evaluate several lymphocyte subtypes with various parameters that can be applied easily and give fast results for their roles in evaluating the stage and prognosis of acute biliary pancreatitis. Study Design: Case-control study. Place and Duration of Study: The Emergency Depar...


Outcomes of Radiofrequency Ablation Therapy of Great Saphenous Veins Insufficiency

By Mehmet Atay, Senel Altun

ABSTRACT Objective: To evaluate the outcomes of radiofrequency ablation (RFA) therapy performed on patients with great saphenous vein insufficiency. Study Design: Descriptive study. Place and Duration of Study: Bahcelievler State Hospital, Istanbul, Turkey, between January 2018 and May 2021 Methodol...

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Evaluation of Prognostic Factors and Trastuzumab-based Treatments in HER2/Neu-positive Metastatic Gastric Cancer

By Izzet Dogan, Senem Karabulut, Didem Tastekin, Ferhat Ferhatoglu, Nail Paksoy, Burak Sakar

ABSTRACT Objective: To determine the efficacy of trastuzumab-based treatment in patients with HER2/neu-positive metastatic gastric cancer. Study Design: Observational study. Place and Duration of Study: Department of Medical Oncology, Istanbul University, Institute of Oncology, Istanbul, Turkey, bet...

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Vasogenic Edema Pattern in Brain Metastasis

By Ezel Yaltirik Bilgin, Ozkan Unal, Nazan Ciledag

ABSTRACT Objective: To determine the relationship of the presence and amount of vasogenic edema with origin, type, and grade of primary cancer. Study Design: Cross-sectional study. Place and Duration of Study: Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Radiology C...

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Comparison of Weekly Low Dose Docetaxel with the Standard Protocol in Hormone-resistant Metastatic Prostate Cancer

By Meral Sayin, Gokhan Celenkoglu

ABSTRACT Objective: To evaluate and compare the effects and toxicity of weekly low dose with three weekly standard doses of docetaxel in hormone-resistant metastatic prostate cancer. Study Design: Descriptive study. Place and Duration of Study: University of Health Sciences, Ankara Training and Res...

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Comparison of HIV-related Ocular Involvement in HAART-naive and HAART-treated Patients

By Yousaf Jamal Mahsood, Mashal Bano, Saima Farooq, Muhammad Zia ud Din Khalil

ABSTRACT Objective: To compare the HIV-related ocular manifestations between HAART-naïve (Highly active antiretroviral therapy) and HAART-treated patients. Study Design: Observational (comparative) Study. Place and Duration of the Study: Department of Ophthalmology and Family Care Centre of Hay...

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Analysis of Risk Factors for Coronary Artery Lesion in Children with Kawasaki Disease

By Bing Bai, Jin-liang Ya, Chao Yan

ABSTRACT Objective: To determine the frequency of coronary artery lesion (CAL) in children with Kawasaki disease (KD) and to analyse the related risk factors of CAL and the predictive value of risk factors for CAL. Study Design: A descriptive study. Place and Duration of Study: Department of Pediat...

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Spectrum of Cystic Fibrosis Conductance Regulator Gene Mutations Reported in Pakistani Descent Cystic Fibrosis Patients

By Hafsa Majid, Aysha Habib Khan, Syed Bilal Hashmi, Tariq Moatter, Asghar Nasir

ABSTRACT Cystic fibrosis (CF) is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. This study aims to determine the genotypic and phenotypic spectrum of the CFTR gene mutations reported in the literature for Pakistani-origin CF patients. Databases were searc...


Laparoscopic Gastro-jejunostomy: An Ideal Solution to the Problem of Gastric Outlet Obstruction Post-corrosive Intake

By Faraz Mahmood Ayyaz, Usman Ismat Butt, Mahmood Ayyaz, Muhammad Umar Warraich, Waris Farooka
, Wasim Hayat Khan

ABSTRACT Objective: To evaluate the outcome of Laparoscopic Gastro-jejunostomy in patients presenting with Gastric Outlet obstruction secondary to Corrosive intake at the Services Hospital. Study Design: Case series. Place and Duration of Study: Department of Surgery, Services Hospital, Lahore, Paki...

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An Analysis of Percutaneous Endoscopic Gastrostomy Complications

By Gokhan Yilmaz, Yusuf Tanrikulu, Beslen Goksoy

ABSTRACT Objective: To determine the indications of early and late complications in 224 patients who underwent Percutaneous Endoscopic Gastrostomy (PEG) procedure. Study Design: Observational study. Place and Duration of Study: Department of General Surgery, Karatay University and Medipol Universi...

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Radiological Recovery of Osteoid Osteoma after CT Guided Percutaneous Radiofrequency Ablation

By Cennet Sahin, Aylin Hasanefendioglu Bayrak, Mujdat Bankaoglu, Mehmet Ali Talmac, Ozgur Genc

ABSTRACT Objective: To observe the necessity and usefulness of follow-up Magnetic Resonance Imaging (MRI) and Computed Tomography Imaging (CTI) after RFA of osteoid osteoma. Study Design: A descriptive study. Place and Duration of Study: Department of Radiology, Sisli Etfal Training and Research Ho...

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An Innovation in the Technique of Recipient Hepatectomy in Living Donor Liver Transplantation

By Shams Uddin, Kaleem Ullah, Abdul Wahab Dogar, Syed Hasnain Abbas, Siraj Khoso, Bilal Ahmed

ABSTRACT Recipient hepatectomy is a challenging surgical procedure. Coagulopathy, multiple collaterals, and dense adhesions secondary to previous spontaneous bacterial peritonitis in cirrhotics are the major contributing factors. However, the appropriate recipient hepatectomy technique can limit the...


Unusual Appearance of Nasal Collagenous Fibroma (Desmoplastic Fibroblastoma) on Imaging

By Xiaolong Liu, Xiang Guo, Linsheng Wang, Yueqin Chen, Hao Yu, Zhanguo Sun

ABSTRACT Collagenous fibroma (CF) is a benign soft tissue tumour with good prognosis. Preoperative imaging diagnosis is essential to avoid unnecessarily extended resection, which may result in irreversible functional damage. However, few studies published to date have reported on the imaging feature...


Cecal Diverticulitis: A Diagnosis to Keep in Mind When Evaluating Acute Appendicitis

By Hakan Bolukbasi

ABSTRACT Cecal diverticulitis is a rare cause of right lower-quadrant abdominal pain. As its symptoms mimic those of acute appendicitis, the final diagnosis in the patients is generally confirmed after surgery. Herein, we report a 45-year man who was admitted to the department of emer...


Insidious Onset of Localised Small Intestinal Perforation by Ingested Plastic Fork

By Serhan Yilmaz, Husnu Aydin, Hakan Bolukbasi

ABSTRACT Ingestion of a foreign body is generally observed in the psychiatric patients and children. Healthy adult individuals may also swallow a foreign body unintentionally. Here, we report a case of a patient who swallowed a plastic fork and treated with laparoscopic repair. A 46-year man was adm...


A Rare Case of Post-pubertal Pure Yolk-sac Tumour Incidentally Diagnosed after Surgical Intervention for Fournier’s Gangrene

By Ahmet Asci, Hakan Bahadir Haberal, Fariba Amini, Deniz Ates Ozdemir, Ahmet Gudeloglu

ABSTRACT The testicular tumour is the most common solid malignancy in males between the ages of 15 and 35 years. Testicular tumours most commonly present with a painless testicular mass. Fournier’s gangrene is necrotising fasciitis of the genital, perineal, and perianal region characterized by...


Brucella Prosthetic Infection in a Patient with Total Knee Prosthesis

By Sabit Numan Kuyubasi, Sermet Inal, Alaadin Oktar Uzumcugil, Sevil Alkan Ceviker, Bunyamin Ari

ABSTRACT Brucella infection is often an occupational disease of veterinarians, agricultural workers, and slaughterhouse workers. The infection is generally spread by contact of broken skin (open cuts or wounds) with infected animal tissues or by ingesting unpasteurized milk and dairy products from t...


Non-Surgical Management of Lingual Hemangioma by Combined Sclerotherapy and Cryotherapy

By Shaul Hameed Kolarkodi, Muhammad Qasim Javed, Mohammed Rafeeq PK, Dhafer Alasmari, Mohammed Faiz CP

ABSTRACT Hemangioma is frequently seen benign tumour of vascular origin, typed into capillary and cavernous hemangiomas based on the nature of vessels in the lesions. Capillary hemangioma is a collection of small capillary-size vessels and shows lobule formation. Cavernous hemangioma is formed by th...


Saved by the Clot in Superior Vena Cava Injury

By Pratikshya Thapaliya, Tanveer Ahmad, Nazish Sikander, Misauq Mazcuri, Ambreen Abid

ABSTRACT Penetrating neck injuries (PNIs) can cause injuries to great vessels. Superior vena cava (SVC) injury from a stab to the neck is rare and when it occurs,  poses a significant risk of exsanguinating hemorrhage. We report a case of a 17-year female who survived a delayed presentation of ...


Opsoclonus-myoclonus Syndrome with Neuroblastoma in Children and their Anaesthetic Management

By Anshu Gupta, Raksha Kundal, Maitree Pandey

ABSTRACT Opsoclonus–myoclonus syndrome (OMS) or the dancing eye syndrome, is a rare inflammatory neurological disorder often with paraneoplastic aetiology. It has an incidence of 1 in 1000,000 population worldwide. Opsoclonus–myoclonus syndrome is associated with 2-3% of patients having ...


Excision of Postchemotherapy Residual Retroperitoneal Mass in Testicular Cancer

By Muhammad Nauman, Mudassir Hussain, Pardeep Kumar, Rehan Mohsin, Gauhar Sultan, Altaf Hashmi

ABSTRACT In this study, patients, who underwent excision of retroperitoneal mass following chemotherapy for testicular cancers from 2006 to 2016, were studied and followed till 2021. The clinical and oncological outcomes were measured. Among 338 patients, who were treated for TC during the entire st...


Obturator-cum-gingival Veneer

By Lubna Memon, Ahsan Inayat


Langerhans Cell Histiocytosis with an Undetected Ileal Polyp

By Mevlut Kiyak, Alpaslan Tanoglu, Dilek Yilmaz


The Potential Utility of Lead Compound, E18, in Inhibiting Docking of SARS-CoV-2 by inhibiting ACE2-B0AT1 Complex

By Faiq Amin, Sahar Zuberi, Syeda Sadia Fatima


Nursing Challenges in Karimabad Valley, Chitral, Pakistan

By Safia Islamuddin


A Rare Cause of Recurrent Melena: Haemangioma of the Small Intestine

By Feng Chi, Yuefu Lan, Liangxian Jiang


‘Empty Toe’ Phenomenon: A Unique Trauma Case

By Sadaf Sheikh, Junaid Khan, Rizwan Haroon


Special Issue

Special Supplement 1 | Volume 32 | Year 2022
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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