Visa Refused. Medical Report not submitted?????

I applied for the Academic visa (12 months) from Karachi VAC and submitted all relevant documents alongwith my application.
The copy of the Medical Report of IOM was also attached with the application. But today I got the refusal letter stating that
"I have refused your application for visit visa because I am not satisfied that you meet the requirements of paragraph(s) 3.12(b)(iv), 4.22 of Appendix V: Immigration Rules for visitors....." and that
"You have failed to provide a medical report. Therefore, Your application for a visit visa has been refused under paragraph v3.12(b)(iv)."

In the end it states that
"In relation to this decision there is no right to appeal or right to administrative review."

Since I have attached the medical report of TB issued by IOM, I don't know what went wrong?

Any idea / help? What should I do?
Shall I apply again?
Do I need to attach the original medical report of IOM?

Any help and guidance will be highly appreciated.

Regards