When we age, not only our aches and pains worsen, our skin wrinkles, teeth fall out, and our hair disappears, voices show sign of age as well. Few of us just think about how important it is until it stops functioning properly. In advanced age, we loose some of the fine coordination that we had in younger years, we loose muscle mass, our mucous membrane become thin and dry. Aging affect two main aspects of vocal fold anatomy and function. First, much like muscles elsewhere in the body, muscles of the vocal fold loses bulk (atrophy). Second, the flexible tissues which are responsible for vocal fold vibration during voicing (i.e. superficial lamina propria) become thinner, stiffer and less pliable. Together these changes sometimes results in voice which is percieved as sounding 'old'. The aging and upper aerodigestive tract:The phonatory organ is composed of the resonator (larynx), the articulator (supraglottic structures) and the compressor (lungs). Age related changes in any one or all of these structures can have a direct impact on voice quality and general comfort level (direct factors). 1

Objective: To determine the impact of antenatal care on maternal morbidity. Study Design: Comparative cross-sectional study. Place and Duration of Study: Obstetric Departments of three military hospitals in Northern Punjab cities of Rawalpindi, Jehlum and Mangla, from Jan to Mar 2019. Methodology: Data of all mothers who gave live births in the selected military hospitals were collected. These mothers were classified as booked and unbooked on the basis of number of antenatal care visits. Maternal morbidities and complications of pregnancy were recorded. The data were analyzed using Statistical Packages for Social Science (SPSS) version 20. Results: In our study, 254 (8.8%) of mothers were unbooked, 2273 (78.8%) were partially booked and 358 (12.4%) were booked. 894 (31%) mothers did not have any co-morbidity while 1991 (69%) mother had co-morbidity. Out of 749 (27.5%) mothers had anaemia, 869 (30.1%) had hypertension, 141 (30.1%) had diabetes mellitus, 24 (0.8%) cardiac disease, 39 (1.4%) had tuberculosis, 9 (0.3%) had liver disease 13 (0.5%) had kidney disease, 69 (2.4%) had allergies while 33 (1.1%) had other diseases. These complications were significantly greater in unbooked patients as compared to booked patients (p<0.001) Out of total 2885 mothers who gave live births in three military hospitals, only one (0.034%) mother died (who was unbooked) in Jhelum Hospital. Its Maternal Mortality Ratio (MMR) was 34.66 per 100,000 live births. Conclusion: In our study population anemia, hypertension and diabetes were the most common comorbidities in expecting mothers. Unbooked mothers had more morbidities and complications of pregnancy than.........

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