Background: Acute myocardial infarction (AMI) is one of the leading causes of death in developed and developing countries. Age is an important non-modifiable risk factor for acute myocardial infarction. Objectives: The objective of the study was to explore the relationship of advancing age with the risk of acute myocardial infarction. Methods: It was a cross-sectional study conducted in 2019 after getting approval from Institutional Review board of University of Health Sciences, Lahore. Written informed consent and thorough history was taken from the study participants. Group 1 included 45 AMI patients aged 20-60 years. Group 2 included 45 healthy individuals aged 20-60 years. Independent sample t test and chi-square tests were applied for analysis of data. Results: Mean age was significantly higher in AMI patients (50.52±7.31) as compared to healthy controls (30.67±7.20). The risk of AMI increases with advancing age (p<0.001, OR= 2.78). Conclusions: Advancing age is an important risk factor for acute myocardial infarction.

Objective: To investigate the role and relationship of serum Vitamin B12 and Glutathione peroxidase in pregnancy with gestational diabetes mellitus (GDM). Study Design: Comparative cross-sectional study. Place and Duration of Study: Physiology Department, University of Health Sciences, Lahore Pakistan, from Feb 2019 to Mar 2020. Methodology: Ninty pregnant women were recruited, fulfilling the inclusion and exclusion criteria. Women with GDM were the cases, and those without GDM were the controls. Serum Vitamin B12 and Glutathione peroxidase were measured by ELISA. Results: Serum Vitamin B12 was significantly lower in cases compared to controls (158.98±7.38 and 357.48±42.07mg/dL, respectively, at p<0.001. Glutathione peroxidase was also significantly lower in cases compared to controls (2.68±1.13U/mL and 5.53±1.05U/mL, respectively, at p<0.001. Correlation analysis showed that Vitamin B12 and Glutathione peroxidase had a significant positive correlation in cases (p<0.001 and rho=0.76) and a non-significant correlation in controls (p=0.87 and rho=-0.024). Linear regression analysis showed that Vitamin B12 positively affects Glutathione peroxidase (β=0.13, p<0.001).Vitamin B12 and Glutathione peroxidase have a significant, negative effect on fasting blood glucose (β =-0.06, p<0.001 and β=-3.66, p<0.001, respectively). Conclusion: Deficient Vitamin B12 leads to reduced Glutathione levels in GDM pregnancy. A deficiency of these two predicts elevated blood sugar levels.

Background: Gestational diabetes mellitus leads to adverse pregnancy outcomes. Objectives: The objective of the study was to explore the relationship of spontaneous abortions with gestational diabetes mellitus in pregnant women from rural and urban Lahore. Methods: This cross-sectional study was conducted at University of Health Sciences, Lahore in 2019. Among 60 pregnant women sampled, 30 had gestational diabetes mellitus (GDM) and 30 were normal pregnant controls. Pregnant women were sampled from different hospitals of rural and urban areas of Lahore. Independent sample t-test was applied for analyzing the data. Chi- square test was used to analyze the categorical variables. Association of fasting blood glucose (FBG) and abortions was checked. Odd ratio and relative risk were calculated. Results: Mean fasting blood sugar levels were significantly higher in GDM group (105 mg/dL) as compared to non-GDM group (80.50 mg/dL) at p<0.001. The proportions of the women with increased number of abortions had significantly higher blood glucose levels (OR 5.091, 95% CI, RR 1.27). Conclusions: Gestational diabetes mellitus is associated with an increased risk of spontaneous abortions.

Objectives: To determine the levels of vitamin B12 in pregnant women and to explore the relationship of vitamin B12 with maternal BMI and gestational diabetes mellitus. Methods: This cross-sectional study was conducted at Department of Physiology, UHS, Lahore from February 2019 to March 2020. Ninety pregnant women in early third trimester of pregnancy were selected. Forty-five women had gestational diabetes and forty-five were healthy pregnant women. Serum vitamin B12 and fasting blood glucose (FBG) levels were determined by ELISA and glucose oxidase method respectively. 1st trimester BMI was also recorded. SPSS version 23 was used to analyze the data. Results: Serum vitamin B12 was significantly lower in GDM group (149.41±13.66) as compared to non-GDM group (357.49±42.07). BMI was significantly higher in GDM group (32.94±2.10) as compared to non-GDM group (23.52±1.83). Significant negative correlation (-0.78**) was observed between 1st trimester BMI and vitamin B12 in late pregnancy. Regression analysis revealed that high BMI was associated with decrease in vitamin B12 and increased risk of gestational diabetes mellitus (3.26***). Moreover, vitamin B12 was partially mediating the relationship between BMI and FBG. Conclusion: Low vitamin B12 levels have an association with maternal BMI and gestational diabetes mellitus. doi: https://doi.org/10.12669/pjms.38.4.5120 How to cite this:Kanwal A, Bashir A. Vitamin B12 in Pregnancy and its Relationship with Maternal BMI and Gestational Diabetes Mellitus. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.5120 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Human activities to boost economic wellbeing have degraded the environment on many fronts to the extent that earth has reached its planetary boundaries by sabotaging its self-regulating equilibrium system. This study investigates the impact of air pollution (proxied by various indicators) on health expenditure over a panel consisting of 188 countries for the period 2000-2018. The impact of air pollution on health expenditures was analyzed using the GMM estimations. Findings suggest that health expenditures are increased due to air pollution caused by economic activities. The study urges that governments should reconsider their policies by creating a balance between economic growth and environmental sustainability. While spending on a sustainable environment, humans can have better health and working capacities that will ultimately contribute to the overall economy. A carbon taxing system on businesses that use obsolete technologies can also contribute towards a sustainable environment and reduced air pollution.