Placental site trophoblastic tumor (PSTT), a rare form of gestational trophoblastic disease (GTD) has a wide clinical and biological spectrum with benign to malignant potential. PSTT can occur after any type of pregnancy and no specific risk factors have been established. Mitotic index is the most important prognostic factor in determining the outcome of disease. Though early and benign disease is cured with surgery, for advanced metastatic disease, chemotherapy plays an important role in management. However, chemotherapy resistance is a main obstacle in achieving adequate control in patients with advanced disease. This article reviews the literature on this rare disease and tries to provide a comprehensive view on its management.

Objectives of the study: To find out the incidence of Covid 19 in patients reporting to a tertiary care private hospital set up and to find out its treatment outcome. Methodology: Study Design: Descriptive cross sectional six months’ study conducted in a private hospital, Karachi, Pakistan. Non-probability convenient consecutive sampling was used for the study. A total of 367 patients reported to the OPD of the hospital were included for the study who were screened during the study period. Out of these, 328 (89.4%) patients were found Covid 19 positive. Inclusion and Exclusion Criteria: Patients complaining of fever, dry cough and tiredness were further checked and interrogated for other symptoms e. g. aches and pains, sore throat, diarrhea, conjunctivitis, headache, loss of taste and smell, skin rash, discoloration of fingers or toes. Once these symptoms were found to be present investigation further continued with the diagnostic tests. Patients who did not come under the inclusion criteria were excluded from the study. Research Procedure: The following tests were conducted for further confirmation: Rapid antigen test, COVID PCR, COVID Antibodies, Chest X-ray, HRCT - CT scan of the chest, inflammatory Markers - (Ferritin, LDH, Dimers). Conclusion: COVID 19 pandemic is an unprecedented crisis and it has altered the lifestyles of people. Out of the total suspected cases 89.4% were confirmed for Covid 19 and the cure rate was 87%, while the death ratio was recorded 2.5%.

Leptospirosis is an infectious condition with a wide clinical spectrum that can present with mild symptoms to severe life threatening situations. Amongst this spectrum, Acute Pulmonary Distress and Haemorrhage can manifest, which poses a challenging dilemma in the management of these patients. Inadequate ventilatory strategies can lead to high mortality within this group of patients. Early detection, prompt treatment, with good interdepartmental communication and good team work are essential. We present a case of a 28-year-old young male who presented in the acute setting with respiratory distress, and pulmonary haemorrhage which was successfully treated with venovenous extra corporeal membrane oxygenation.