Objective: To analyze Chest X-ray findings in COVID 19 positive patients, presented at corona filtration center, Benazir Bhutto Hospital Rawalpindi, based on CXR classification of British Society of Thoracic Imaging (BSTI). Methods: In this study, all RT-PCR COVID-19 positive patients screened at corona filtration center, Benazir Bhutto hospital Rawalpindi from 20th March 2020 to 10th April 2020 were included. Mean age of the cohort with age range was calculated. Presenting complaints & Co-morbid were analyzed and tabulated in frequencies and percentages. Portable CXR findings were classified according to BSTI classification and documented in frequencies and percentages. Results: Mean age of the patients was 44 years. Presenting complaints were cough 20 (67%), fever 18 (60%), shortness of breath 11 (37%), sore throat six (20%), loss of sense of taste and smell four(13%). Main co-morbid was hypertension six (20%). Two (7%) patients had normal and seven (23%) had classical COVID CXRs. 21 (70%) patients were in indeterminate group with only one (3%) having unilateral lung disease. Three (10%) patients had diffuse lung involvement and 18(60%) had peripheral lung involvement. Majority of patients 19 (63%), had bilateral middle and lower zonal involvement. Conclusions: In this study, COVID-19 CXRs generally manifested a spectrum of pure ground glass, mixed ground glass opacities to consolidation in bilateral peripheral middle and lower lung zones. BSTI CXR reporting classification of COVID-19 is valid in our patients with addition of middle zonal involvement in classical COVID-19 criteria as opposed to just lower zone involvement. doi: https://doi.org/10.12669/pjms.36.COVID19-S4.2778 How to cite this:Durrani M, Inam-ul-Haq, Kalsoom U, Yousaf A. Chest X-rays findings in COVID 19 patients at a University Teaching Hospital - A descriptive study. Pak J Med Sci. 2020;36(COVID19-S4):---------. doi: https://doi.org/10.12669/pjms.36.COVID19-S4.2778 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective: Various imaging modalities can be employed for the placenta accreta diagnosis like USG and MRI, however, their exact diagnostic accuracy is yet to be established. This study was conducted for determining the accuracy of ultrasonography in diagnosing morbidly adherent placenta in women with a previous scar, taking the per-operative findings as gold standard. Methods: This descriptive cross-sectional study was carried out at department of Radiology, Benazir Bhutto Hospital, Rawalpindi from 6th January 2019 to 5th July 2019. Using non-probability purposive sampling 118 pregnant women with single pregnancy of age 18-40 years were included. Both grey scale and color doppler findings of ultrasound were employed for ascertaining presence or absence of morbidly adherent placenta. Per-operative findings of all patients who underwent cesarean section afterwards in their respective wards were registered. The findings of USG were then compared with the per-operative observations. Results: Among patients in whom USG findings were of morbidly adherent placenta, 60 were true positive while 05 were false positive, whereas, in the patients with no evidence of morbidly adherent placenta on USG, 03 were false negative while 50 were true negative. The sensitivity, specificity, positive predictive value negative predictive value and diagnostic accuracy of USG in diagnosing morbidly adherent placenta in previous scar women, taking per -operative findings as gold standard was 95.24%, 90.91%, 92.31%, 94.34% and 93.22% respectively. Conclusion: It can be inferred from our study that USG is a very sensitive and accurate non-invasive imaging technique for the diagnosis of morbidly adherent placenta. Keywords: morbidly adherent placenta, ultrasonography, sensitivity. How to cite: Yousaf A., Durrani M., Riaz K., Kalsoom U., Parvez H. Diagnostic accuracy of ultrasonography in diagnosing morbidly adherent placenta, taking intra-operative findings as gold standard. Esculapio. 2021; 17(01): 71-74

Background:   To assess the diagnostic performances of HRCT for COVID 19 pneumonia for efficient triage of patients, in comparison with RT-PCR reverse transcription polymerase chain reaction test.   Method:   It is retrospective comparative study conducted in Benazir Bhutto hospital affiliated with Rawalpindi medical university from March 25th to April 25th, 2021.  HRCT of 500 patients were selected from central computer server and their RT-PCR results were also obtained from the HMS system of the hospital. HRCT were reported as “Definitely COVID positive”, “Possible COVID positive” or “COVID negative” by experienced radiologists. Sensitivity, Specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated using the final RT-PCR test as standard of reference. Results:   RT-PCR test of 207 patients was positive, whereas 293 were reported negative. HRCT was reported as “Definitely COVID positive” in 222 cases (44.4 %), “Possible COVID positive” in 24 cases (4.8%) and “COVID negative” in 254 cases (50.8%). Comparing only Definitely COVID positive category with RT-PCR results sensitivity, specificity. PPV and NPV were 90.3%, 88%,84.2% and 92.8%   Conclusion:   CT chest is the most reliable, sensitive and rapid tool for triaging of patients as COVID positive or negative in busy emergency departments as compared to RT-PCR which is time consuming and has limitations such as faulty sampling technique, limited kits and variable sensitivity

Introduction: Chest X-ray and Computed tomography(CT) of chest play an important role in the diagnosis and management of the Coronavirus disease (COVID-19). As chest CT may not be readily available in most clinical setups X-ray Chest plays a pivotal role in such clinical scenarios and an irreplaceable initial radiological investigation of these patients. Objective: The objective of this article is to identify and elaborate the commonest appearances and patterns of lung changes on Chest X rays in COVID-19 positive patients confirmed on RT-PCR COVID testing. Materials and Methods: Cross-sectional descriptive-analytical study of Chest X-ray findings of 294  RT-PCR confirmed COVID-19 patients admitted across 3 hospitals (Rawalpindi institute of urology (RIU), Benazir Bhutto Hospital (BBH) and Holy Family Hospital (HFH)) from March 30th, 2020 till April 30th, 2020. CXR was analyzed for consolidation patches, ground-glass opacification (GGO), multi-lobe involvement, bilateral distribution, and pleural fluid. The chest X-ray with positive findings was graded into mild, moderate, and severe grades using BSTI (British Society of Thoracic imaging) guidelines. Results: Mean age of study patients was 45.5 years. Among the study population 230 (78.2 %) were male and 64 (21.8%) female. On baseline chest X rays, consolidations were the commonest finding (n=84, 28.5%), followed by ground-glass opacity (n=17, 5.7 %). The more common locations were peripheral and lower zones, and the majority had bilateral lung involvement (Table 1). Pleural effusions were found in only 5 of the study patients.  Among these patients, 187 (63.6%) had an initial normal chest X-ray. Moreover, 35, 34, and 38patients had mild, moderate, and severe diseases respectively. Conclusion: Chest X-ray is an important initial radiological investigation for COVID 19 patients and plays an important role in the management during the course of the disease.

Objectives: To compare Chest X-rays findings in COVID-19 suspected and confirmed patients on RT-PCR, presented at corona filtration center, Benazir Bhutto hospital Rawalpindi. Methods: In this study, Chest radiographs of 100 COVID-19 RT-PCR positive confirmed patients were compared with 100 RT-PCR negative suspected COVID-19 patients screened at corona filtration center, Benazir Bhutto Hospital Rawalpindi from November 2020 to December 2020. Data on demographics, presenting complaints, co-morbid, lesion characteristic, distribution and attenuation, lobar involvement, pleural effusion and lymphadenopathy were collected. Associations between imaging characteristics and COVID-19 pneumonia were analyzed with univariate and multivariate logistic regression modals. Results: Chest X-rays findings revealed bilateral lung consolidation with peripheral and diffuse distribution, involving middle and lower lobe to be statistically significant (p<0.05) between RT-PCR positives and negative patients. Peripheral distribution was associated with an 11.08-fold risk in COVID-19 positive patients than diffuse distribution. Middle lobe involvement had four folds risk and lower lobe involvement had 11.04 folds risk in COVID-19 cases as compared to upper lobe involvement. Consolidation had 2.6 folds risk in COVID-19 positive cases. Conclusions: Bilateral, peripheral distribution of middle and lower lobes ground glass haze or consolidation with no pleural effusion is significantly related to COVID-19 pneumonia. Overlapping imaging features of the infectious and non-infectious COVID mimickers can be further excluded by detailed clinical evaluation and further radiological workup. doi: https://doi.org/10.12669/pjms.38.1.4624 How to cite this:Durrani M, Shahid A, Kalsoom U, Inam-ul-Haq, Yousaf A, Naveed S. Comparison of Chest X-rays findings in COVID-19 suspected and confirmed cases at a university teaching hospital: A retrospective comparative study. Pak J Med Sci. 2022;38(1):---------.  doi: https://doi.org/10.12669/pjms.38.1.4624 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.