 Good morning everyone. Myself, Dr. Navish Sharma from the Panagan Medical College and Hospital. I'm here to present my paper on city finding in COVID positive patients. Ames and objective of this paper is to estimate the typical and the typical chest findings in the COVID-19 RTPCR positive patient for better assessment of the role of the chest in the COVID-19 management. Introduction to the novel coronavirus first reported in the Wuhan China in December 2019 and the disease is rapidly spread throughout the world and declared pandemic by the World Health Organization on March 7 2020 on 12 March 2020. It is an infectious disease caused by the severe acute respiratory syndrome that effect both upper and the lower low and present cases are typical or the organized pneumonia. And for diagnosis for rapid diagnosis early treatment of the patient and more importantly for quick isolation of patient to stop the chain of the transmission. Standard technique for diagnosis of COVID-19 patient is the RTPCR but because of its unavailability or because of its false negative results and many countries do not have any resources to conduct RTPCR on a large scale. So imaging finding has to be done and imaging finding can be done in RTPCR negative patient and result can be achieved significantly faster and offering a potential role in supporting rapid decision making for the treatment and a solution of that patient. And the choice is also a debate whether we have to do chest x-ray for the CT but chest x-ray having a screening modality because it not only giving the faster result but it also reduce the exposure to the other patient in the staff. However chest x-ray having its own limitation it does not rule out the COVID-19 pneumonia. CT on the other hand show more sensitivity than the RTPCR chest x-ray and it help in the early diagnosis better assessment of the diseases change and all the findings that we'll describe later can be seen very early in the disease course so it will help in isolation and treatment of the patient in a very early stage. Material and method this is a prospective study that is done in our college and total 100 patients were taken and all the patients underwent for known contrast just sitting in a radiology department using semen 16-scopes channel scope and all the volumetric chest CT were assessed at the lung window 1500 ww and 1500 length and medicinal window 400 window window width and the 60 window length with using 2D coronal and societal plane for better assessment of the extent of the disease. Imaging findings are analyzed by two radiologists with experience of the 10 years and the six years respectively findings we will describe later. And this is the CT severity score based visual score will give score of 0 to 5 and this describe the involvement of the lobes from 0 to 5 score and total score is from 0 to 25 0 there is no involvement 25 there is a maximum involvement is there and this is a result 100 patient out of 100 patient the range of the age is 22 years to 86 years and the mean age is 850 years of age and this table describe the age and the sex distribution of the patient and this table describe the characteristic findings that we will find in the chest CT of the patient of the covid positive patient most common is ground glass opacity followed by the consolidation followed by the reticulation crazy paving appearance sub plural line and like findings like mediation lymph adenopathy not used literally fusion inverted hello sign hello sign and pericardial infusion they are less commonly seen and in our study usually hello and the pericardial infusion is not even seen in our patients and this study will show the involvement frequency of involvement this table show the frequency of involvement of the lobes and the CT severity mean a number of lobe affected and gg and consolidation relation whether they present along with each other or they present separately most common finding is gg usually peripheral predominance and less commonly have central predominance and sometime neither have central and the peripheral predominance like in this image we can see there is a peripheral predominance of the gq and in this image we can see in first image we can see there is neither a peripheral and the central predominance and in second image we can see the gq along with the problematic changes and in this image we can see multifocal patch involvement of the ground glass opacity and arrowhead show the sub plural linear opacity and this is an image exit in the coronal image which will show a diffuse involvement of the gg of the all the lobes of the lung and giving the total security score of 24 out of 25 and washout appearance is given consolidation is the second most common involvement in the disease of the covid positive patient and it is usually a lower lobe is involved with posterior in the peripheral predominance like shown by the arrows and arrowhead blue arrowhead will show the vascular enlargement now the discussion with discussion will see that rtbc is the world standard but chest it is a vital component in diagnosis allows them for patient suspected of having covid-19 infection indeed rtbc are having limitation using some center and the possibility false negative results the national health commission of people republic of china have encouraged diagnosis based on the clinical and the chest city finding alone chest it is more sensitive diagnostic tool in our symptomatic patient with sensitivity 98 percent as compared to rtbc are in the chest x-ray it is also in better assessment of serative covid-19 pneumonia by cities for the school findings that are consistent with our study and they are described by the various study will giving the name of that study which conclude every finding we will find in our patient like most common finding that will find in our study is the gg usually gg usually show bilateral peripheral and patchy involvement of the lung that is also seen in our study like in this we will show the bilateral patchy peripheral involvement of the lobes by the gg second most common finding is the reticulation it is mostly caused by the lymphocytic infiltration of the interstitial tissue with interlobe and the septal thing other finding is the crazy paving pattern crazy paving pattern is the gg along with the interlobular or interlobular septal that is superimposed over the gg like in this we can find the gg there is along with the interlobular septal in in this exhale city we can see the ground glass of basically superimposed septal thickening giving the crazy paving appearance by shown by the arrows consolidation is the third most common finding which is seen in our study and this is an exhale city we will show the consolidation shown by the red arrows involving the bilateral mainly the lower lobe with posterior and the peripheral predominance this is also exhale and anansity which will show the sub pleural curvilinear lines as shown by the arrows and arrowhead above show the ground glass opacity and there are bronchic tessus also sub pleural transparent line and vessel enlargement is also seen in our study and this exhale and anansity will show the bronchic tessus changes shown by the arrowhead and that second exhale and anansity will show the sub pleural transparent line between the area of the gg and the visceral pleural consistent with sub pleural transparent lines and this image will show the vascular enlargement other finding that is medecinal lymph adenopathy halosine pericardial effusion were not noted even in our patient and there are also limitations that most of the patient will be doing city already received their treatment and patient underwent our CT is mostly the ill patient that will undergo that image to know the severity of the disease like in those two CT we can see the reverse halosine thank you that's that's all from my side these are my references