Objective: The aim of this study is to compare the outcomes of chemotherapy with radiology and use of pembrolizumab among the patients had metastatic triple negative breast cancer and did not receive any treatment yet. Study Design: Comparative/Observational study. Place and Duration: Breast Clinic Ganga Ram Hospital Mazang Road, Lahore. April 2021-Sep 2021 Methods: Total 70 patients of aged 25-75 years were presented in this study. Patients had metastatic triple negative breast cancer and did not receive any treatment yet were included. Demographically detailed of enrolled cases age, body mass index, co-morbidities and literacy were calculated after taking informed written consent. Patients were equally divided into two groups, I and II. Group I had 35 patients and received pembrolizumab 200 mg every 2-weeks for six months while in group II 35 patients received chemotherapy (75mg Adriamycin) every 21-days for six months. Regular follow up among patients were conducted. Post-treatment outcomes among both groups were assessed and compared in terms of efficacy, control of disease, mortality and recurrence rate. SPSS 24.0 version was used to analyze complete data. Results: Mean age of the patients in group I was 58.01±4.34 years with mean BMI 28.21±6.22 kg/m2 and in group II mean age was 57.88±6.88 years with mean BMI 27.94±9.42 kg/m2. Frequency of literacy in group I was 18 (51.4%) and in group II 20 (57.1%) patients were literate. Hypertension was the most common comorbidity found in 13 (37.1%) in group I and 14 (40%) in group II followed by arthritis and diabetes mellitus. Post-treatment effectiveness in group I was 15 (42.9%) higher as compared to group II 10 (28.6%), partial recovery found in 11 (31.4%) and 8 (22.9%) among both groups, stability in disease was found higher among patients of group II 12 (34.3%) as compared to group I 7 (20%). Mortality in group I was 3 (8.6%) and in group II 5 (14.3%). Recurrence rate in pembrolizumab group was 2 (5.7%) lower as compared to chemotherapy group 4 (11.4%). Conclusion: In this research we concluded that the use of pembrolizumab injection for the treatment of breast cancer was effective and useful in terms of low mortality rate with recurrence rate and higher number of recovery, but rate of stability among disease was higher in chemotherapy group. Both treatments were effective for reduction in the prevalence of disease. Keywords: Breast Cancer, Chemotherapy, Pembrolizumab, Mortality, Recurrence

Background and Objective: The COVID-19 pandemic is an ongoing health challenge for both developed and developing countries worldwide. The epidemiological and clinical features of COVID-19 should be analyzed in our country. The current study aims to evaluate the demographic features and clinical profile of COVID-19 patients ina Tertiary Care Hospital of Rahim Yar Khan, Pakistan. Materials and Methods: This observational, cross-sectional study was conducted on 85 patients with positive real-time reverse transcriptase-polymerase chain reaction (RT-PCR) verified by nasopharyngeal swabs and throat at Covid 19 setup in Sheikh Zayed Hopsital, Rahim Yar Khan, Pakistan for period of six months i.e from September 2020 to February 2021. Institutional consensus protocol and COVID-19 SOPs were followed to investigate each individual. Various parameters such as symptom presentation, demographics’ details, ventilator therapy and oxygen required, and co-morbidities were studied. Results: The mean age of the patients was 37.6±5.7 years with an age range of 15 to 81 years. Of the total 104 patients enrolled, 60 (58%)were male and 44 (42%). The prevalence of COVID-19 caused by contact was 67 (65%).Symptomatic patients out of enrolled were 49 (47.1%). In this study, a significant association was found between severe COVID-19 and parameters such ashypertension and diabetes history, and patients having age above 65 years. Out of104 COVID-19 positive patients, symptomatic complaints were as follows; Cough 29(27.9%), fever 63 (60.6%), and breathe shortness 12 (11.5%). Tachypnea (RR>24), hypoxia and comorbid illness were found 32 (31%), 27 (25.8%), and 45 (43.2%)respectively. About 19 (18.2%) patients needed intensive care unit admission with 5 (4.8%) required immediate ventilation assistance. Mortality was 3.8% (4 patients) observed in this study. Conclusion: The COVID-19 pandemic mortalityrate is higher among patients above 60 years of age and with co-morbidities. TheCOVID-19 majority of patients presented in our hospital were of young or average age and asymptomatic. Respiratory symptoms were present in half and fever was recorded in more than half patients. Comorbidities patients were more venerableto the COVID_19 complications. Early admission and aggressive treatment must beprovided to COVID-19 patients to help reduce the mortality rate. Keywords: COVID-19,Comorbidities, Hypoxia