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England, who at 3-0 up had already won the five-match series, were 181 for three at tea, 311 runs behind Australia's first innings 492 for nine declared and still needing a further 112 to avoid the follow-on.
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Medical reports from the West Indies suspected a seizure but PCB wants to reassess Umar Akmal's condition. Umar was dropped from Pakistan's failed campaign in the Champions Trophy in June earlier this year but made a successful return in the series against the West Indies last month.
Michael Clarke, having previously said, "this is not a charity tour, it's not about giving blokes a go and hoping for the best," found himself having to defend the selectors' decision Tuesday to give a Test debut to James Faulkner, which appeared to be a classic case of taking a punt on a player with the series lost.