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Multisystem Inflammatory Syndrome (MIS) is a newer, rarer and dangerous childhood disease that require early attention and is associated with Coronavirus Disease-2019 (COVID-19) infection. This article reports four clinically ill children of age 6-15 years admitted to Aster CMI hospital, Bengaluru, Karnataka, India, during October and November 2020. The diagnosis was based on elevated laboratory values (D-Dimer, C-reactive Protein (CRP), and Ferritin) and positive COVID-19 antibody test. No infectious aetiologies were identified. All patients presented at Emergency Room (ER) with hypotensive shock and were treated with inotropic support, Intravenous Immunoglobulin (IV-Ig), and steroids. Children responded well to treatment and were discharged within a period of 8-11 days. Clinical characteristics are necessary for understanding more about newly identified paediatric illness. [ABSTRACT FROM AUTHOR]

TITLE : BLEEDING JEJUNAL METASTASES FROM AN ALVEOLAR SOFT PART SARCOMA Authors: Elvis Peter Joseph, Suraj Manjunath, Harisk K, Anuradha A* Affiliations: Departments of Surgical Oncology &Pathology*, St. John's Medical College & Hospital, Bangalore - 560 034. India INTRODUCTION Alveolar soft part sarcoma (ASPS) is a rare malignant soft tissue tumor that most often originates in the thigh or buttocks in young adults with a proclivity for metastases to the lung, bone and brain. Hematogenous metastases to the gastrointestinal tract from ASPS is an extremely rare occurrence with only a few case reports. CASE REPORT A 48 year old house wife, a known case of Alveolar soft part sarcoma (ASPS) left thigh ( since 1990) with pulmonary secondaries presented with h/o two episodes of malena to emergency department in shock. She was resuscitated and EGD done showed an actively bleeding jejunal tumor not amendable to endoscopic measures. She was taken up for emergency laparotomy and a palliative resection of jejunal tumor was done. Histopathological analysis showed features of an alveolar soft part sarcoma. DISCUSSION Alveolar soft part sarcoma (ASPS ) is a rare tumor of unknown etiology with predilection for young females and is characterized by slow growth and an early high frequency of distant metastases. The presence of metastasis though a carries a poorer prognosis does not preclude a long survival . Hematogenous metastases to the gastrointestinal tract from ASPS is exceedingly rare. CONCLUSION We report a 48 year-old female patient with a long history of metastatic Alveolar Soft Part Sarcoma, who presented with chief complaints of a bleeding tumor in jejunum on an esophagogastroduodenoscopy (EGD) in hemorrhagic shock. [ABSTRACT FROM AUTHOR]