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Objective: To determine the accuracy of CT chest in diagnosis of COVID-19 taking RT-PCR-testing as gold standard. Materials and Methods: A total of 150 patients of suspicion of COVID-19 who were referred for CT Chest in Radiology Department of Nishtar Medical University Multan from June-2020 to May-2021 were included. In all patients, two RT-PCR test results were obtained with 7 days of admission in hospital. Presence of any of these positive was labelled as COVID-19 infection. CT chest was performed in all patients within 2 days of admission in hospital using 128 slices CT scan machine. The diagnosis of COVID-19 infection was made according to the recommendations by Radiological Society of North America (RSNA) protocol. Results: Mean age was 51.3±14.7 years. 78 (52%) patients were male and 72 (48%) patients were female. RTPCR test was positive in 89 (59.3%) patients. While the CT chest findings were suggestive of COVID-19 infection in 130 (86.7%) patients. The sensitivity of CT chest was 95.5%, specificity 26.2%, PPV wad 65.4% and NPV was 80.0%. Conclusion: CT chest has a very good sensitivity for detection of COVID-19, it can be used as a rapid diagnostic tool especially in areas of pandemic. However, the specificity of CT chest is low, that can limit its use in low COVID-19 affected areas. Keywords: COVID-19, Computed tomography, False Positive, True Positive, Positive Predictive Value, Negative Predictive Value.

Introduction Distal radius fractures are common. Treatment depends on a multitude of factors including the pattern / displacement of the fracture, patient age, pre-morbid function, and surgeon preference. We aim to investigate the effect of the pandemic on the management and short-term outcomes of patients with DRF’s. Method Retrospective review of all adult DRF’s two months before and after BOA released emergency standards on trauma management. The primary outcome measure was the proportion of patients managed non-operatively before and during COVID-19. Data extracted: demographics, comorbidities, cognitive baseline, treatment, and follow-up. Radiographs were reviewed for displacement [dorsal tilt (>10o), ulnar variance (>3mm), intra-articular step (>2mm)]. Results Pre-COVID (n = 29), COVID (n = 35). Characteristics were comparable in terms of median age (66 and 72 years, p = 0.41), %aged ≤65 (48% and 37%, p = 0.37), dominant side fracture (36% and 40%, p = 0.52), presence ≥ 2 co-morbidities (41% and 43%, p = 0.91). More patients were managed non-operatively during COVID (86% vs. 69%, p = 0.11), 2 of whom had unstable fracture pattern and developed malunion, compared to none in pre-COVID period. Conclusions Management of DRF’s remains a controversial topic, particularly in age <65 years. Long term follow up of patients with significant fracture displacement managed conservatively during COVID pandemic could help guide future practice.

Objective: To compare the diagnostic accuracy of MRI and CT for detection of acute cerebral haemorrahge. Study Design: Comparative Study Place and Duration: Mohiuddin Islamic Teaching Hospital Mirpur AJK for period of six months from 1st August, 2020 to 31stJanuary, 2021. Methodology: A total of 20 patients of both genders with age of 25 years and onward with intracerebral hemorrhage who underwent MRI following CT in the first 6 hours of onset and last known well time and admission in stroke center were included in the study. The follow up time duration for both the scans was 24 hours to 48hours. The Mc-Nemar test was used to determine the comparison between MRI and CT on contingency table. Results: The mean age of the participants was 53.26±2.45. The frequency of the male participants was 13(65%) and that of female was 7(35%). All cases were of acute ICH 20(100%). The number of positive cases on MRI and CT scan was 17, while the frequency of positive cases on MRI and negative on CT scan was 3 with the p- value of less than 0.001 and a confidence interval of 95%. (See table 1 for details). The interrater reliability for acute ICH on MRI is from 0.72 to 0.80 on k statistics. The interrater reliability for acute ICH on CT is from 0.83 to 0.92. Conclusion: It is concluded that the findings of MRI scan were more accurate than CT in the detection of acute intracerebral hemorrhage. Keywords: Acute Cerebral Hemorrhage, MRI, CT, Diagnostic Accuracy

Background: Timely diagnosis has become important because the safety and efficacy of acute cerebral ischemia depend on rapid and accurate assessment and treatment within a few hours of the onset of symptoms.The overall incidence of stroke is about 2.4 per thousand people, with a small geographical difference. Studies have shown that the echo MRI gradient is as accurate as CT within 6 hours of the onset of symptoms in patients with acute stroke. Methodology: This study is a one-time prospective comparison of CT and MRI in acute stroke assessment. The study was conducted from April 2020 to September 2020at the Hayatabad Medical Complex in Peshawar, with the ethical approval of the hospital ethical review committee. Regardless of the onset date, the severity of symptoms, or final clinical diagnosis, a series of patients suspected of further referral to a stroke staff at the hospital are eligible. Results: Results showed that out of 178 patients referred for clinical suspicion of stroke, acute stroke corresponds to almost two-thirds of the final clinical diagnosis. MRI found 92 out of 178 acute strokes and 29 out of 178 CT. According to study results, the MRI has a higher frequency for detecting any acute stroke (ischemic or hemorrhagic) compared with CT (p <0.0001). All four readers agreed that 143 patients with MRI and 103 patients with CT respectively, 143 patients (80%, 76–84%) had an acute stroke. Conclusion: MRI is better for detecting acute ischemia than CT and can detect both acute and chronic bleeding. This should therefore be the preferred test method for accurate diagnosis of patients with suspected acute stroke. Samples of patients cover a variety of diseases that may arise in an emergency with a suspected stroke so that the results can be applied immediately in the clinic. Keywords: Magnetic Resonance Imaging, Computed tomography, Acutestroke.