At least 54 people, including four soldiers, have been killed in an exchange of fire between Pakistan's army and gunmen in Mohmand, in the country’s tribal belt bordering Afghanistan.
Local administration official Maqsood Hassan told AFP news agency that rebels attacked a security force patrol in the Baizai area of Mohmand, triggering an exchange of fire on Thursday.
"Four soldiers and 10 militants were killed in the attack, which was repulsed," Hassan said.
A separate offensive, backed by helicopter gunships and jets, targeting gunmen’s hideouts in different areas of Mohmand killed 40 rebels, Hassan said.
He noted that two or three civilians died when a mortar shell hit a home in the region, but he declined to speculate which side fired the shell.
Zabit Khan, a local official, confirmed the incidents and casualties.
Journalists and aid workers do not have independent access to the battlefield, so the deaths could not be confirmed independently.
A White House report released this week said Pakistan lacked a coherent strategy to permanently rid the region of gunmen.
It drew attention to Mohmand, where for a third time in two years troops are attempting to clear insurgent strongholds, saying operations had been hampered by resistance, poor weather, refugees and bomb caches.
Pakistan on Thursday rejected the report as "unwarranted" and said it would not be held accountable for US-led failures in Afghanistan, where American troops are leading a 10-year war against the Taliban.
Pakistan argues that its troops are already dangerously overstretched. With an estimated 147,000 forces in the northwest -- more than the number of US led foreign troops in Afghanistan -- the army has also endured heavy losses.