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The authors urge clinicians to consider the possibility of Arnold-Chiari Malformation type 1 with other central causes especially in cases where acute respiratory failure is unexplainable.The mortality rates for Klebsiella pneumoniae invasive syndrome range from 4% to 11% with diabetes as a major risk factor. Early diagnosis of KPIS can decrease mortality rate with good outcomes due to sensitivity of K pneumoniae to antibiotics in KPIS.A case of peritonitis following the repair of perforated peptic ulcer using omental flap. The revision
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