BACKGROUNDMaternal hyperglycemia is considered a risk factor for fetal morbidity. Since there is a high prevalence of diabetes mellitus among the population of Bahrain, we conducted a prospective population-based study of gestational diabetes mellitus (GDM) in non-diabetic pregnant women.SUBJECTS AND METHODSAll non-diabetic pregnant women attending antenatal clinics during January 2001 to December 2002 (n=10 495) were screened for GDM during the 24th to 28th weeks of gestation. All positive subjects based on a 50-g glucose challenge test (GCT) were further evaluated by a diagnostic 75-g oral glucose tolerance test (OGTT). The birth weight of the child and post-delivery insulin resistance were monitored. The homeostasis model of insulin resistance (HOMA-IR) was used to assess insulin resistance.RESULTSOf 10 495 non-diabetic pregnant women screened, 32.8% (n=3443) had plasma glucose ≥7.8 mmol/L (140 mg/dL) in the GCT. The 75-g OGTT found a prevalence of GDM of 13.5%. There were twice as many Bahrainis as expatriates. Of children born to women with GDM, 6.5% had a birth weight >4000 g. Post-delivery evaluation of insulin resistance indicated that 33% of women with GDM had a HOMA-IR value >2.CONCLUSIONThe population of Bahrain is a high-risk ethnic group for GDM. The association of insulin resistance in the post-gravid state with GDM among 33% of the study population suggests that insulin resistance, the possible cause of the pathophysiological mechanism underlying the development of gestational diabetes, continues in the post gravid state.

This prospective study was conducted to examine the prevalence of cholelithiasis in sickle cell disease and the relationship of its frequency to age and hematological parameters. Sixty-five patients with sickle cell disease attending Salmaniya Medical Center were interviewed and clinically examined. Their hematological parameters were assessed and an abdominal ultrasound examination was carried out. Twenty patients (30.8%) had gallstones, and 2 patients (3%) had biliary sludge. No significant relationship was found between the frequency of cholelithiasis and age or hematological parameters (hemoglobin and hemoglobin F values, microcytosis and reticulocyte count).

SUMMARY A 64‐year‐old female presented with episodes of small bowel obstruction. Ultrasound and barium meal showed a polypoidal lesion in the proximal segment of small bowel. The patient underwent emergency surgery because of signs of impending acute intestinal obstruction. Pathology showed characteristic features of an inflammatory fibroid polyp (IFP) which is an important though rare benign cause of small bowel obstruction. We document clinical and pathological aspects of this case.