Fast bowler Umar Gul will return home after failing to recover from a back injury, adding to Pakistan's fitness problems on the eve of the crucial second Test against India here on Thursday.
Pakistan, seeking to avoid their first Test series loss in India in more than two decades, were racing against time to find 11 fit players following injuries and illness in their 15-man squad.
Pakistan's last Test series defeat in India came in 1980. They trail 1-0 in the three-match series following their six-wicket loss in the opening game in New Delhi on Monday.
Ace paceman Shoaib Akhtar is still recovering from a chest infection, skipper Shoaib Malik from an ankle injury, and batsman Misbah-ul-Haq and fast bowler Mohammad Sami from viral infections.
"We have too many fitness problems in the team at the moment. I felt pain while jogging. I will have one more fitness test on Friday before I decide anything," said Malik, who was injured playing football after the first match.
"Gul bowled at the nets, but he felt pain. He needs treatment and that's why he is going home. We need four specialist bowlers for a Test match. I hope we will be able to manage it."
Malik said Akhtar was still under treatment and it was too early to say whether he would be available for the match.
Akhtar was the lone Pakistani bowler to trouble India in the opening match as he finished with six wickets, including four in the second innings. Gul has so far bagged 67 wickets in 16 Tests.
Pakistan now have only three fit bowlers -- spinners Danish Kaneria and Abdur Rehman, and seamer Sohail Tanvir, who has only played one Test.
"We have no option but to win this Test, but we are struggling with fitness problems. These are difficult times for us. We just hope the players will recover in time," said the Pakistani captain.
"We have given options (for replacements) to selectors. It's up to them to decide who to send."
India captain Anil Kumble vowed the turn the heat on the tourists, saying his team would like to wrap up the series with a second successive victory.
"It's important for us to maintain the momentum we gained in the previous match and turn the screws. It's a great opportunity for us to go 2-0 up and seal the series here," he said.
"We have to perform up to our potential and ensure we gain a 2-0 lead. There were a couple of areas where we could have done better in the previous game, like we should have scored more runs in the first innings."
India could manage only 276 in the first innings before achieving a 203-run target with ease on the fifth and final day.
"Overall, I was happy with the way we played in the last match," said Kumble, leading the side in his first Test series.
When asked whether the current Pakistani side were vulnerable, Kumble said: "Probably they are missing Inzamam-ul-Haq who was the pillar of their middle order in the past.
"They still have a good team and that they had proved in the previous Test by extending the game into the last day. It could have been a closer game."
Inzamam quit international cricket after a two-Test home series against South Africa in September. Under his captaincy, Pakistan drew a three-Test series 1-1 on their last tour of India in 2005.