Fatema Jawad  ( 7/6, Rimpa Plaza, M. A. Jinnah Road, Karachi. )

BREAST CANCER IN MULTAN. Bhutta, R.A., Afro; N.Pak. J. Med. Res., 1988; 27: 165 - 169.
1361 patients suffering from neoplastic dis­ease and registered in the Department of Pathol­ogy, Nishtar Medical College, Multan, between January 1983 and December 1986 were studied. The object of the study was to determine the histological type of cancer among patients from the major referral institute. Of the 1361 patients registered with neoplastic disease, 202 cases had breast cancer. Of these 6 cases were males and 196 were females. All cases had mastectomies orbreast biopsies done. The most common type of cancer found was infiltrating ductal carcinoma followed by medul­lary, tubular, pagets, mucinous, lobular, and cys­tosarcoma phylloides. All male patients had in­filtrating ductal carcinoma. Three patients were below 20 years of age whereas 73 women were premenopausal and still menstruating. It was concluded from the study that breast cancer constituted 15 percent of all cancers and the most common type was the infiltrating ductal carcinoma. In contrast to studies in the west, breast cancer was diagnosed a decade earlier here. It was also observed that the diet consumed by the population siudied was rich in saturated animal fats and low in total protein. Epidemiological studies have! suggested that a high fat diet is associated with an increased risk of breast cancer.
NEONATAL HYPERBILIRUBINAEMIA ASSOCIATED WJTR OXYTOCIN INDUCED LABOUR. Rashid, Y., Mannan, J., Jabeen, M. Fak. J. Med. Res., 1988; 27: 171-175.
To determine a possible relationship be­tween intrapartum use of oxytocin and subsequent development of neonatal hyperbilirubinaemia, 150 full term newborns were studied. 52 babies were born to mothers whose labour was induced by oxytocin, 48 were spontaneous vaginal deliveries and 50 were delivered through lower segment caesarian sections. The oxytocin used was in a dose of 5 i.u./100 ml. in 34 cases, 7.5 i.u./100 ml. in 10 cases and 10 i.u./100 ml. in 8 cases, infused at a rate of 60 drops per minute. Cord blood and venous blood was collected from all neonates at 0,24,48,72 and 120 hours for estimation of serum bilirubin, sodium and potassium, serum osmolality and PCV. The mean birth weight, gestational age and Apgar score were the same in all the three groups. The mean serum bilirubin levels of infants born through oxytocin levels were higher than the other two groups at 0 hour, 24 hours and 48 hours. At 72 hours there was no significant difference. There was also no difference in the PCV of the three groups. Serum sodium and potassium and osmolality in neonates of the oxytocin group were significantly lower. The results of this study show a definite association between hyperbilirubinaemia and use of intrapartum oxytocin. Other workers have also reported similar observations. The reasons sug­gested are enhanced placento - fetal transfusion resulting in increased cell mass and increased bilirubin formation. Increased fragility of RBCS and hyperos­molality of red cells both caused by oxytocin and thus causing easy destruction and hyperbiliru­binaemia is another suggested theory. The present study supports the latter theory. It was concluded that a definite association exists between intrapartum use of oxytocin and develop­inent of neonatal hyperbilirubinaemia. It is thus advisable to use oxytocin only when really required and in doses with minimal side effects.