ABSTRACT
Background: Preoperative carcinoembryonic antigen (CEA) level is considered as a factor predictive of survival in colorectal cancer patients. Patients with normal (<5 ng/ml) or lower pre- operative CEA levels were reported to have significantly longer survival. Objective: To evaluate the prognostic significance of preoperative CEA levels of patients with colorectal cancer in Taiwan. Methods: Between Jan 2016 and Dec 2017, 39 patients with histologically confirmed colorectal cancers were evaluated retrospectively at the General Surgery Department of Hayatabad Medical Complex Peshawar. All patients had undergone potentially curative surgery. Patients with metastatic diseases were not included. 5-Fluorouracil-based adjuvant chemotherapy was administered if the patients had Dukes’ C disease. Reference to the Dukes’ classification was according to the classical criteria described in 1932 for carcinoma of the rectum and adapted for use in colonic tumors. Data on gender, age, degree of tumor differentiation, location of the tumor, tumor size, lymph node metastasis, penetration of the bowel wall and preoperative CEA levels were analyzed to deter mine their association with survival. Blood samples for CEA measurement were taken a few days before operation and were analyzed using the radioimmunoassay method. Results: Total 39 patients were included in the study. Age ranged between 30-80 years with a mean age of 55 years. There were 26(66.7%) males and 13(33.3%) females, with male to female ratio of 2:1. Patients with preoperative CEA levels of <5 ng/ml had significantly longer survival than those with preoperative CEA levels of >5 ng/ml. The median 5 years survival rate for patients with preoperative CEA <5 ng/ml was 51.2 months, while 35.5 years for >5 ng/ml patients respectively (p < 0.001). The tumour was primary located at the colon in 23(59%) while the rest was found at the rectum 16(41%). Tumour size was <2cm in 25(64.1%) and >2cm in 14(35.9%) patients. ...............

ABSTRACT
Background: Rectal bleeding is considered an important sign of colonic disease, particularly colorectal cancer. Rectal bleeding is considered to be an alarm feature in particular for colorectal cancer that, in tum, is the second- leading cause of cancer death globally. Colonoscopy has been reported recently as cost effective method of evaluating asymptomatic rectal bleeding 14, while rectal bleeding as a diagnostic indicator has been questioned in general practice. Objective: The objective of this study is to determine the frequency of common causes of bleeding per rectum among patients presenting to surgical OPD at tertiary care hospital. Materials and Methods: This descriptive cross sectional study was carried out at Department of General Surgery Hayatabad Medical Complex Peshawar from September 2021 to March 2022. Total of 164 patients with lower GI bleed were included in the study. All patients were enrolled in a consecutive manner and subjected to lower GI proctoscopy, other relevant investigations to detect the cause of GI bleed. Results: Total 164 patients were included. Age ranged between 15-60 years with a mean age of 37.5 years. There were 107(65.2%) male and 57(34.8%) female, with a male to female ratio of 1.9:1. Age distribution was analyzed as 63(38.4%) belongs to age group of 20-30 years, 30(18.3%) in 30-40 years, 26(15.9%) in 40-50 years and 45(27.4%) in age group 50-60 years respectively. On proctoscopy, hemorrhoids were found in 54(32.9%) patients, colitis in 15(9.1%), inflammatory bowel diseases (IBD) in 39(23.8%), ulcerative colitis in 29(17.7%), diverticular diseases in 10(6.1%) and abdominal TB in 17(10.4%). None of the patients had colorectal cancer. Conclusion: Hemorrhoids, inflammatory bowel diseases and ulcerative colitis were common causes of lower gastrointestinal bleed in our population and ulcerative colitis was significantly high in female patients.

ABSTRACT
The Aedes aegypti mosquito is the main vector of dengue fever in Indonesia. Control using synthetic chemical insecticides has a bad impact. Vegetable insecticides from salam leaf extract are a solution to reduce the negative impact of synthetic chemical insecticides. the aim of this study is To determine the efficacy of salam leaf extracts against the death of the Aedes aegypti mosquito. This research was carried out experimentally with the Post-test design with a control group (Post Test Only Control Group), namely, the experimental group receive treatment or intervention (X) followed by a second measurement or observation (O2), with the study population being all Aedes aegypti mosquitoes which were bred in the Laboratory and Workshop of the Environmental Health Department of the Health Polytechnic of the Ministry of Health of Aceh. The results of the efficacy test of salam leaf ethanol extract by spraying obtained LC 50 = 69.103% and LC 90 = 299.972%, by fogging LC 50 = 43.937% and LC 90 = 311.879%. Salam leaves are very effective, the efficacy of Aedes aegypti mosquito mortality is carried out by spray or fogging at a concentration of 90 LC. It is hoped that the results of this study can be applied in the community for efforts to eradicate Aedes aegypti mosquitoes by using vegetable insecticides that can reduce the effects of synthetic chemicals.