Universal screening for gestational diabetes mellitus (GDM), detects more cases and improves maternal and offspring prognosis. Of all the screening tests, World Health Organization (WHO) procedure is simple and cost effective; the only disadvantage is that the pregnant woman has to come in the fasting state to undergo oral glucose tolerance test (OGTT). Hence, we undertook a study to elucidate a test that is casual and reliable to diagnose GDM. A total of 800 pregnant women underwent 75-g glucose challenge test (GCT) irrespective of the time of the last meal and their 2-h plasma glucose (PG) was estimated. They also underwent a 2-h 75-g OGTT recommended by WHO after 72 h. There was no statistically significant difference in the glycemic profile between GCT and WHO OGTT in the diagnosis of GDM. In conclusion, GCT performed irrespective of the last meal timing is a patient-friendly approach and causes least disturbance in the pregnant woman's routine activities.

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Bacterial contamination of platelets poses the greatest risk of mortality and morbidity to platelet transfusion recipients. Some European countries have introduced routine bacterial monitoring of platelets to reduce the risk of transmission of bacteria. A pilot study was carried out at the Northern Ireland Blood Transfusion Service, using the BacT/ALERT automated culture system, to assess the operational feasibility of routine bacterial monitoring of platelets. About 4885 platelet concentrates (PCs) were tested in a 1-year period. Of the 28 (0.57%) initial reactive cultures, 13 (46%) were reproducible on repeat culturing. Of these, 10 were detected within 24 h of incubation either in aerobic or both aerobic and anaerobic culture bottles. A sample of time-expired units (423) that had initial negative culture results remained negative when retested on day 8. About 213 time-expired units were subjected to routine quality assessment and more than 85% were found to conform to quality standards specified in the UKBTS guidelines for platelet count (> or =240 x 10(9) per adult dose PC) and pH (6.4-7.4). There was a reduction in the platelet count because of the volume removed (15 mL) for sampling. Routine bacterial testing with day 2 sampling and a negative culture result after 24 h as a mandatory release criterion would improve product safety. Implementation of 100% testing would be operationally feasible but may require extension of the shelf life if unacceptable wastage is to be avoided.

Objective:To assess the validity of Diabetes in Pregnancy Study Group India (DIPSI) guidelines, a modified version of the WHO criterion to diagnose gestational diabetes mellitus (GDM).Materials and Methods:A total of 1 463 consecutive pregnant women in the second and third trimester of pregnancy underwent 75 g oral glucose tolerance test (OGTT) and 2-h plasma glucose (PG) was measured by the glucose oxidase-peroxidase (GOD-POD) method. GDM was diagnosed with 2-h PG ≥ 7.8 mmol/L (WHO criteria) and the rest were classified as normal glucose tolerant (NGT) women. GDM women were advised medical nutrition therapy (MNT) for two weeks. Those who failed to reach the target glycemic level of FPG < 5.0 mmol/L and 2-h PG < 6.67 mmol/L with MNT were advised insulin. All of them were followed throughout pregnancy until delivery. Birth weight of 90th percentile (> 3.45 kg) in the neonates was considered as macrosomia (primary outcome).Results:The mean maternal age and body mass index were 23.60±3.32 years and 21.5±4.06 kg/m2 respectively. The mean gestational age was 27.9±5.56 weeks. DIPSI criterion identified 196 women (13.4%) as GDM and the rest as NGT. Insulin was required in 19 (9.7%) women with GDM. Macrosomia was observed in 9.9% GDM women with intervention and 9.8% in NGT (P = 1.000).Conclusion:DIPSI criterion is a one step-cost effective and evidence-based procedure to diagnose GDM in any socio-economic setting.

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