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

Aim: The goal of this study is to find out how common vitamin D deficiency is in patients with corona virus disease and what the consequences are. Study Design: Observational /Prospective Place and Duration: Institute of Basic medical sciences, Khyber Medical University (KMU), Jan 2021-Oct 2021. Materials & Methods: This study included 120 patients of both genders who had been diagnosed with covid-19. Patients ranged in age from 15 to 75 years. After receiving written agreement, demographically detailed such as age, sex, and BMI were recorded. All of the patients had a 5 mL blood sample obtained to check their vitamin D levels. 25(OH)D < 25 nmol/L (10 ng/dL) was considered severe Vitamin D insufficiency. The prevalence of vitamin D insufficiency as well as negative effects were investigated. SPSS 23.0 was used to analyse the data. Results: The mean age of the 120 patients was 40.11±8.64 years, with 68 (56.7%) males and 52 (43.3%) females. There were 52 patients (43.3%) with severe vitamin D insufficiency. There were 17 deaths of the total number of patients in the study. Vitamin D deficiency was associated with a higher mortality rate in patients with covid-19 disease than in those who had normal levels of vitamin D, a finding that was statistically significant at the 0.05 level. Conclusion: It was found that severe deficiency of vitamin D and death in individuals with covid-19 illness had a strong association. Keywords: Mortality, Vitamin D Deficiency, Covid-19,