Background: PCOS is a leading cause of infertility globally. Polycystic ovarian syndrome (PCOS) is a complicated disease pigeon-holed by high testosterone levels, irregular menstruation, and/or tiny cysts on one or both ovaries. The disease can be anatomical (polycystic ovaries) or biochemical (hyperandrogenemia). Follicular developmental inhibition, ovarian microcysts, anovulation, and menstrual irregularities are all symptoms of hyperandrogenism, a clinical characteristic of PCOS. Objective: The objective is to determine the chances of infertility in a patient presenting with PCOS in childbearing age. Methodology: Data was collected from Medline, PubMed, ScienceDirect, and the Obsgyne online library for papers published between 2005 and 2021 using specified MeSH keywords in this systematic review. We examined 10 cross-sectional type analytical studies for data collecting in this systematic work. Results: 10 studies conducted between the years 2005 to 2021 were included in this systematic review. There were 3900 women in the study, ranging in age from 10 to 40. The 2nd most prevalent etiology of feminine factor-related infertility was determined to be PCOS in this investigation. In 70% of cases of anovulatory infertility, PCOS is the reason. As a result, it's critical to screen for and treat it in primary care settings. Ultrasound is the best modality for the detection of PCOS. PCOS has been identified using ultrasonography methods in several investigations. The basal follicle counts by TVS might be included among sonographic findings in the diagnosis of PCOS, with basal follicle counts of more than 10 is a PCOS criterion. Slightly swollen stroma, hypertrophy, enhanced ovarian mass and thickness, and the percentage of ovarian stroma to total ovary area are among the other characteristics. Conclusion: From this systematic review we concluded that infertility is most commonly caused by PCOS. In 70% of cases of anovulatory infertility, PCOS is the reason. Despite the fact that TVS is the gold standard for detecting ovarian abnormalities in young girls we examine trans-abdominally by using a high-frequency probe. Ultrasonography results for PCOS of the periphery cyst patterns include a considerable variety of small subcapsular follicles (10 follicles with a maximal diameter of 8 millimeter), enhanced ovarian volume (12.3 millimeter), and increased echo density of the ovarian stroma.

Aim: This study was designed to evaluate umbilical artery Doppler indices [systolic/diastolic (S/D) ratio and pulsatility index (PI)] in normal fetus at term. Doppler ultrasound of umbilical arteries is widely accepted as a primary tool for quantitative analysis of fetoplacental and uteroplacental blood flow in highrisk pregnancies.Materials and methods: A total of 100 normal singleton pregnant women were recruited in this study from the Radiology Department Fatima Memorial Hospital (FMH) from August 3, 2012 to November 30, 2012. Their gestational ages were from 37 to 40 weeks.Results: A total of 100 Doppler indices measurements were performed. The values of S/D ratio were less than 3 and the values of mean PI were less than 1 from 37 to 40 weeks of gestation. Conclusion:Umbilical artery Doppler indices among normal pregnant women in our population are similar to most published reference values from other parts of the world.Clinical significance: This normative data will serve as a basis for the evaluation of the umbilical artery circulation in our population.

Background: Pain in knee joint is prime cause of disability particularly among postmenopausal women. Ultrasound is a non-invasive and safe imaging modality for the evaluation of knee joint pathologies. Objective: To prove multiparity as a potential cause of femoral cartilage thinning inside knee joint causing pain in postmenopausal women. Methodology: Two hundred knee of 100 postmenopausal women of various parity were conveniently selected. Patients with all other risk factors of the knee joint pain which acts as effect modifying factors were excluded. Femoral articular cartilage was measured at the lateral, central and medial aspect of the knee joint and their average was calculated. Results: 51.12 ±4.46 years was the mean age of patients (ranging from 46 to 60 years). A strong negative relation was found between the parity of the patient and the femoral articular cartilage thickness at the lateral, central and medial aspect of the knee joint of all the patients with a p-value less than 0.1. Significant variation was observed in the femoral articular cartilage thickness in various parties. Conclusion: The femoral articular cartilage decreases in size significantly with an increase in the number of deliveries (parity). So, multiparity is one of the potential causes of femoral cartilage degradation in knees joint.

Objective: The purpose of this study is to decide the prevalence of primary and secondary infertility. Material and Method: In this systematic review facts extracted by Medline, PubMed, science direct and Obs gyne online library that were queried for studies posted between 2005 to 2021 by using specific MeSH terms. We extracted data from 15 cross sectional studies that was carried out in discipline exercise regions of tertiary care health facility. Results: This study shows data from population surveys reporting on occurrence of number one and secondary infertility. Fifteen research furnished estimates of primary and secondary infertility incidence in 6400 infertile couple. Out of 6400 infertile patients 3600 (fifty six.25%) offering with primary and 2800 (43.2%) supplying with secondary infertility. Age distribution with number one infertility confirmed that the majority of the participants belong to the most fertile age institution. Age distribution of women with secondary infertility confirmed that majority belongs to the age institution of 30–39 years. The primary results of the modern researches had been the primary infertility’s high rate (fifty six.25%) and excessive charge of female factors among infertile couples. Although, it has been said in other researches that female variables (40%), male variables (40%) or a combination (20%) of each could be associated to the causes of infertility. Motive of the couple’s infertility turned into determined on the basis of their examination results and medical history. As compared to the secondary infertility, number one infertility occurrence was higher within the people approaching a tertiary care middle of public zone. Conclusion: From this systematic evaluate we concluded that as compared to secondary infertility, the primary infertility’s superiority is higher. The marriage age is increasing which impacts reasons with male variables and unexplained infertility greater generally observed with increasing age of marriage. Female component stays a principle reason for the infertility including some unexplained reasons and means. In the population coming to a public region tertiary care center, the number one infertility’s prevalence is higher as compared to the prevalence of secondary infertility.

Stroke is typically the most frequent cause of disability and fth leading cause of death in the past, early detection of acute brain infarct may be challenging for non-invasive diagnostic imaging, but recent  advancement in diagnostic imaging makes it possible.

Background: Polyps of the lower reproductive tract are found in 7.8-50% of women. Endometrial polyps located at the fundal and tubocornual regions mechanically affect fertility. The recent advances in TVU and hysteroscopy provide an accurate diagnosis and effective treatment of polyp in the female reproductive tract. Objective: The goal of this systematic review is to highlight updates to the epidemiology, clinical presentation and imaging modalities for gynaecological polyps providing guidance to the best clinical decisions. It also highlights prevalence of infertility in gynaecological polyps. Study Design: Systemic review Material and methods: During December 2020 we searched Google scholar, Pub med, Medscape, Web of Science, Scientific Information Database and Magiran research articles from 2010 -2020. The selected articles identified through electronic search were 60 articles and 50 were selected for the review. Results: Endometrial polyps are the most frequently diagnosed type of gynaecological polyp. They have been implicated in 50% cases of abnormal uterine bleeding and 35% patients with infertility. The developments of high-resolution 2D and 4D ultrasound, contrast sonography and hysteroscopy helps the clinicians in diagnosing polyps efficiently. Hysteroscopy is the gold standard and histology is essential for the ultimate diagnosis and malignancy exclusion. Conclusions: The review of literature suggest that the polyps are common cause of abnormal uterine bleeding and have strong association with infertility. Polyps can be confidently diagnosed on ultrasound with Doppler imaging. Hysteroscopy and histopathological evaluation is considered essential for diagnosis of gynaecological polyps. Key words: Endometrial polyp, Cervical polyp, Infertility, Ultrasonography, Sonohysterography, Hysteroscopy.

Objectives: The objective was to determine the accuracy of Gray Scale versus Doppler Ultrasound to Detect Deep Venous Thrombosis in Lower Extremities. Study Design: Cross Sectional Analytical study.  Setting: The University of Lahore and Shalimar Hospital Lahore. Period: May to October 2020. Material & Methods: After a permission from the ethical committee and a written consent of the patients, on the basis of the clinical suspicions of deep vein thrombosis, A total of 140 patients of both the genders, aging from 20 to 90 years, were referred for Gray Scale & Doppler ultrasound examination. The convenient sampling technique and Statistical software for social sciences (SPSS version 22.0) were used for the analysis of data. Results: In 140 patients’ present study on Gray Scale ultrasound, 120 (85%) cases were observed  with significantly increased blood vessel size, intraluminal echogenicity and a loss of compressibility However, on Doppler ultrasound, 130 (92%) cases were detected possessing significantly increased blood vessel size, intraluminal echogenicity, absence of blood flow and negative augmentation effect. Conclusions: From the result of present study, it is concluded that Doppler may be used as gold standard to diagnose the DVT in the lower extremities. This study concludes also that DVT detection accuracy difference between Doppler and Gray Scale ultrasound is minor i.e. 1:1.08. This minor difference encourages the radiology practitioners of periphery to screen DVT in lower extremities through Gray Scale ultrasound, if Doppler ultrasound is unavailable there.

Acknowledgement: Knowledge of vascular hemodynamics of a particular region is essential to draw a fine line between normal and a pathological state. Face is highly vascular and little is known about normal blood flow characteristics of its superficial arteries. Thus there is a need to assess the normal blood flow characteristics of the face and to establish a normative database. This may later be helpful in planning of aesthetic procedures, face reconstruction following trauma or during surgery and in follow up examination of many skin diseases.To evaluate the blood flow of superficial arteries of face by Doppler ultrasound in young adults. Methods: A cross sectional descriptive study was conducted at University of Lahore Teaching Hospital and University Ultrasound Clinic Green Town, Lahore. Data was collected according to inclusion criteria. Sample size of 311 patients were included in this research comprising 112 (36%) females and 199(63.9%) were males. Data entry and analysis was done by using SPSS version-23. Results: Analysis of data showed that out of 311 patients 112 (36%) females and 199(63.9%) were males, According to the result analysis of the total number of 311 patients, facial artery had a mean diameter of 1.4 mm ( 0.14cm) and diameter of temporal artery at tragus  was calculated 1.5mm ( 0.15cm) with SD 0.2. Facial and temporal artery average PSV among individuals was 26.8 ± 5.3 and 35.2 ± 11.9 respectively.  Average RI value of facial artery was 0.81± 0.05 mm and for temporal was 1.0  ± 0.8 mm . Conclusion: The facial and temporal artery can be assessed on Doppler ultrasound for velocity and resistance parameters. No significant difference was seen in the parameters between males and females.