Advanced paternal age how does it affect fertility and pregnancy related outcomes?

When compared to maternal age, paternal age has not attracted the same attention throughout history. Advanced paternal age has been sometimes incriminated as a possible factor that can affect pregnancy and its outcomes. In this review, we discuss the effect of paternal age on fertility, miscarriage, chromosomal abnormalities, congenital anomalies, perinatal outcomes, and neurodevelopmental disorders. In fact, advanced paternal age is associated with decreased semen quality leading to lower pregnancy rates, longer time to conception, and a higher number of miscarriages. Additionally, an increase in the rate of adverse pregnancy outcomes, such as congenital anomalies and preeclampsia, is reported when the father's age is advanced. However, no significant effect on the outcome of assisted reproductive technology [ART] or the risk of trisomies, is confirmed

Cerebral aneurismal rupture with subarachnoid hemorrhage during pregnancy: a case report

Background: Intracranial hemorrhage due to arteriovenous malformation or intracranial aneurysm is a rare but severe complication of pregnancy with maternal and fetal mortality of 20% and 33% respectively. Whether to deliver the patient first, or to treat the aneurysm first is still controversial, but an emergency cesarean section followed by aneurismal treatment appears to be a widely accepted strategy in pregnant women with cerebral aneurysmal complications

Case: A 38-year-old patient, G3P2A0, presented at 36 gestational weeks with a diffuse bilateral subarachnoid hemorrhage with fourth ventricle bleeding and hydrocephalus. She had a cerebral aneurysm of the left posterior communicating artery on arteriography. A cesarean section was performed on the first day of admission, and an external ventricular derivation with clipping of the aneurysm on the left posterior communicating artery were done immediately after the cesarean section. Mother and newborn were discharged from hospital in a good health status except Broca's aphasia in the mother

Conclusion: In the absence of categorical recommendations, we stress the role of combined care by both neurosurgeons and obstetricians, on a case to case basis according to gestational age, mother neurological status and experience of caregivers

History for temporomandibular disorders. A simplified technique

As a result of the widespread nature of temporomandibular disorders [TMD], a screening for its occurrence has been recommended as a part of the routine dental examination by leading dental organizations. The purpose of this study was to provide dentists and other health care providers with an Arabic TMD routine history form, after being modified and translated from a recent English one and evaluated clinically. One hundred Saudi male subjects were used to trial test the Arabic TMD routine history form. The median time for patients to fill the form was 2 minutes. Immediately after completing the TMD form, each subject was given a survey questionnaire form to fill out, in order to determine if the routine history form was "clear and understandable." The survey findings indicated that 77 per cent of the subjects understood all 16 items on the Arabic routine history form. The remaining 23 per cent of the subjects had some difficulty in understanding one [or both] of two items. related to not knowing the meanings of 'temple area' and 'teeth clenching and grinding.' Recommendations were made in order to add clarity to the two "unclear items" for dental patients. further, reasons for needing the Arabic TMD routine history form [along with a TMD screening examination] as an essential part of the routine dental examination are discussed