Author declaration

Author declaration

[Instructions: Please check all applicable boxes and provide additional information as requested.]

  1. Conflict of Interest

Potential conflict of interest exists:

We wish to draw the attention of the Editor to the following facts, which may be considered as potential conflicts of interest, and to significant financial contributions to this work:

The nature of potential conflict of interest is described below:

No conflict of interest exists.

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

  1. Funding

Funding was received for this work.

All of the sources of funding for the work described in this publication are acknowledged below:

[List funding sources and their role in study design, data analysis, and result interpretation]

No funding was received for this work.

  1. Intellectual Property

We confirm that we have given due consideration to the protection of intellectual property associated with this work and that there are no impediments to publication, including the timing of publication, with respect to intellectual property. In so doing we confirm that we have followed the regulations of our institutions concerning intellectual property.

  1. Research Ethics

We further confirm that any aspect of the work covered in this manuscript that has involved human patients has been conducted with the ethical approval of all relevant bodies and that such approvals are acknowledged within the manuscript.

IRB approval was obtained (required for studies and series of 3 or more cases)

Written consent to publish potentially identifying information, such as details or the case and photographs, was obtained from the patient(s) or their legal guardian(s).

We confirm that the manuscript has been read and approved by all named authors.

We confirm that the order of authors listed in the manuscript has been approved by all named authors.

 

  1. Contact with the Editorial Office

The Corresponding Author declared on the title page of the manuscript is:

[Insert name below]

 

 

I the undersigned agree with all of the above.

 

           Corresponding Author (Fist, Last)            Signature                           Date

 

  1. ___________________               _____________                 ______________