The purpose of current study is to evaluate findings of COVID fourth wave through Computed Tomography (CT) Imaging in Malakand division of Pakistan. Thus, to obtain the research findings, the study adopted experimental approach to evaluate how the CT scan facilitates the radiologists to study about fourth wave of COVID-19, and how the experiment can be implemented in Malakand, Pakistan. The patients with COVID-19 positive were involved in the study, where the results of their CT scan were analyzed to evaluate the difference in examination and other factors associated with COVID symptoms. Total 50 patients with COVID positive were involved in the study from Malakand division of Pakistan, and their CT imaging was performed in a well-known hospital of Swat. The findings were then analyzed through CT Images, which showed that approximately, 81% of the participant’s images were found with patchy ground-glass opacities, whereas 69% patients were found with patchy consolidations. Also, 31% patients had nodules found in CT imaging. Also, in 52% patients, the interlobular septal thickness was also observed, which had thickened the vascular, air bronchogram, or fibrous foci. Further conclusions were drawn on the effectiveness of the CT scan images in prediction of COVID impact on the patients in future.

During the past few decades, the world of radiologists has been remarkably influenced by the progress in advanced technology. A multi-parametric analysis is required regarding pathological alterations and in-depth details corresponding to each case because of extended the imaging spectrum. The total dependency is mostly upon imaging. Therefore, radiologists need to meet up the complex health quality standards. Radiologists mostly report and scan cases referred from Surgical, Medicine, Pediatrics, orthopedics and Gynecology. And on the other hand they face certain critical issues and challenges in dealing with medico-legal cases. Although they have to follow medical protocols but medico-legal cases are still very difficult to handle. This research highlights all the issues and challenges regarding medico-legal cases faced by the department of Radiology and Emergency of Saidu teaching Hospital Swat. This study was conducted at this Saidu Teaching Hospital Swat, and the study duration was 6 months (April 2021-September 2021). More than 116 people (doctors, radiologists, nurses, and paramedical staff) have participated in this research. Results show that radiologists and other medical staff handle the unexpected and critical challenges in these cases. While writing examination findings, reporting CT scans, MRI, X-Rays and doing ultrasounds, they face political, patient attendant, hospital, and other party pressure to alter the reports to make other party guilty. This article addressed all the issues and challenges that radiologists meet in medical-legal cases.

BACKGROUND: Infertility is not uncommon in our female population as we live in a geographicalarea where the population growth rates are amongst the highest in the world. A variety of cultural normsand values force couples to enhance family. So a sensitive and dedicated efforts need to be made to lookinto the causes of secondary infertility and their treatment.OBJECTIVES: To determine the frequency of bilateral tubal obstruction and common factors leadingto it among women presenting with secondary infertility.METHODOLOGY: It was a hospital based descriptive cross sectional study conducted at thedepartment of obstetrics & gynecology Postgraduate medical institute LRH Peshawar from 8th August2011 to 8th July 2013. Data was collected by non probability consecutive sampling technique. A total of260 patients were enrolled in study. In patients presenting with secondary infertilityhysterosalphingography was performed, in those with bilateral tubal obstruction detailed history wastaken to detect, the history of instrumentation to genital tract, lower abdominal surgery or history ofPID. Laparoscopy was done in all patients with bilateral tube obstruction to confirm the diagnosis anddetermine causes.RESULTS: In this study mean age was 30 with standard deviation of ±2.12. Bilateral tubal obstructionwas found in 73(28%) of the cases, out of which history of pelvic inflammatory disease was presentin15 (21%) followed by history of instrumentation of genital tract in 11(15%) of cases. Positive historyof lower abdominal surgery was present in 4(5%) and 3(4%) patients had fibroids.CONCLUSION: Tubal pathology is one of the main causes of female infertility. A great caution isrequired in pelvic operative techniques to prevent infection and tubal damage.KEY WORDS: secondary infertility, bilateral tubal obstruction, pelvic inflammatory disease.