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His abdomen was markedly distended with a visible midline scar from a previous laparotomy with generalised abdominal tenderness, most pronounced in the epigastric region

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Among the upregulated genes are those encoding DNA repair enzymes (BRCA1, ATM), extracellular matrix proteins (COL1A1, COL3A1, ELN) and antioxidant enzymes (SOD1, SOD2, GPX)