In accordance with COPE guidelines, the Journal of Ayub Medical College may issue an Editorial Expression of Concern when serious questions arise regarding the integrity, validity, or ethical conduct of a published article, but the available evidence is insufficient for immediate correction or retraction. Such a notice is issued by the Editor after due consideration, informs readers that an investigation is ongoing or unresolved, and clearly identifies the nature of the concern. The Expression of Concern is linked to the original article and remains part of the scholarly record until the matter is resolved, after which it may be withdrawn, replaced by a correction, or replaced by a retraction as appropriate.