A Research Study On Platelet Rich Plasma - 3304 Words

Abstract Background: Platelet-rich plasma (PRP) is defined as a high concentration of platelets suspended in a small volume of plasma and was proposed for periodontal tissue regeneration. However, although it has been widely studied, there is much controversy on its efficacy. Purpose: To study and meta-analyze the effectiveness by means of clinical attachment level, probing depth reduction, bleeding, suppuration and recession of PRP for periodontal intrabony defects on randomized clinical trials (RCT) Material and methods: An electronic literature search was conducted by two reviewers (AR and AM) in several databases up to February 2014. The PICO question was: Do intrabony defects in treatment for periodontal regeneration with PRP have a higher or similar efficacy that other periodontal regeneration treatments? Articles were included in this systematic review if they were RCT with10 or more human subjects, reporting the radiographic and clinical outcomes PRP for guided tissue regeneration in intrabony periodontal defects. Random effects meta-analyses of the selected studies were applied to avoid any bias being caused by methodological differences between studies. Results: Twenty-two papers of full text of these articles were then obtained, and reviewed. Of these, 18 articles fulfilled the inclusion criteria and subsequently were qualitatively analyzed. Eleven articles were included for evaluating of PPD. The WMD was 0.86 mm, with a 95% CI= 0.44 mm to 1.29 mm. For BL, 2Show MoreRelatedEssay On Wound Regeneration1161 Words   |  5 PagesThe greatest challenge in clinical research trials is the development of bioactive surgical additives to reduce the post operative signs and symptoms by regulating inflammation and increase the speed of healing process. [1] An extensive intra cellular and extra cellular set of event are carried out in the healing of soft and hard tissue which are medicated by signalling proteins. [2]Yet complete self-regeneration in many tissues and organs after injury is limited. In endogenous regenerative medicineRead MoreThe Effect Of Platelet Rich Plasma On Recovery2033 Words   |  9 PagesThe Effect of Platelet Rich Pla sma hamstring Recovery Justin Turner Research and Design April 29, 2014 2PLATELET RICH PLASMA Turner Abstract Muscle injuries are one of the most common injures athletes experience. Most muscle injuries come from excessive strain and pull on the muscles, which come from different movements such as jumping and running. The normal healing time for a muscle strain is about 3-6 weeks. Research has found a new healing agent called Platelet Rich plasma, which is aRead MoreAssay Parameters Determine The Platelet Mediated Clumping Phenotype For It / C10 Parasite Line Essay1702 Words   |  7 Pagesdetermine the platelet-mediated clumping phenotype for IT/C10 parasite line Frank G. Onyambu1,2,4, Peter C. Bull3,4, David J. Roberts1,2 1. Nuffield Division of Clinical Laboratory Sciences, University of Oxford, John Radcliffe Hospital, OX3 9DU, Oxford, UK 2. NHS Blood and Transplant, Blood Research Lab, John Radcliffe Hospital, OX3 9DU, Oxford, UK 3. Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, OX3 9DU, Oxford, UK 4. KEMRI-Wellcome Trust Research ProgrammeRead MorePp For Knee Oa 2013719 Words   |  3 Pagesphysician, an orthopedic surgeon who discussed current research in regenerative medicine and osteoarthritis. Drew Marcos, Physical therapist, who discussed a practical way to analyze the pitching mechanics and the key moments in the movement of this overhead motion. In Cardone presentation, His main focus was on Platelet-rich plasma (PRP), (plasmas that come from the patient’s body, and is centrifuged to increase the concentration of platelets combined with remaining blood). He also discussed theRead MoreThe Field Of Cosmetics And The Treatment Of Injuries, Skin, And Hair1891 Words   |  8 Pagesorthopedics. Platelets are one of the essential components found in blood, known best for their importance in coagulation. They contain proteins known as growth factors that play an essential role in healing damaged tissue (Lubkowska et al., 2012). The normal range of platelets in healthy human blood ranges from 150,000 to 450,000 platelets per microliter of blood (Daly, 2011). Advancements in the methods and techniques for the isolation of particular cells have made it possible to purify platelets fromRead MoreStem Cancer Case Studies1698 Words   |  7 PagesAnother trial involved a 60-year-old man, who lived an active lifestyle. He had a de generative joint disease, a 60% meniscus tear. They injected his knee twice over one year with stem cells and Platelet Rich Plasma (PRP). To obtain platelet rich plasma, blood is spun to isolate platelets. These platelets contain growth factors, that when injected into damaged tissue or organ can help promote a person feeling back to their normal self. This therapy has given him long periods of relief and he was ableRead MoreSupply Chain of Blood and Products in a Blood Bank2515 Words   |  10 PagesThe objective of this case study is 1. To study the existing supply chain of blood and blood products in a regional blood bank 2. To identify cost and risk related problems in the supply chain of blood and blood products and to develop a solution for cost and risk minimization. BACKGROUND Human blood is not an ordinary commodity because it cannot be substituted and its need will always exist. Blood and blood products are also perishable, which complicates things even further. Shortages lead to highRead MoreRemoval Of The Lower Impacted Third Molars Case Study1359 Words   |  6 Pagesto the oral environment is more susceptible to periodontal infection and thus to greater periodontal attachment loss.(2–5) Similarly, deeply impacted L3Ms often leads to periodontal defects after its surgical removal.(6,7) In this sense, several studies have shown that periodontal healing of the 2Ms after 3M removal is accompanied by intraosseous defects and deep periodontal pockets, especially in patients older than 26 years with a mesioangular or horizontal impaction and pre-existing periodontalRead MoreBiological Therapy Case Study830 Words   |  4 Pageselimination of pain 68. From the current results of animal experiments, biological methods are expected to be able to resto re the structure of degenerative disc, but whether it can eliminate the pain is still not clear. Recent results from animal studies have shown that injection of growth factors can reduce the expression of inflammatory cytokines in degenerative intervertebral discs. Biologically active substance injection: for early intervention of intervertebral disc, can promote cell proliferationRead MoreA Research Study On Stem Cell Therapy1450 Words   |  6 Pagescell research actually started in the mid 1800’s. Scientists first discovered that certain cells within the body could develop into other cells. Stem cell research has since developed stem cell therapy treatments like bone marrow transplant , stem cell therapy for Parkinson’s, and stem cell therapy for Alzheimer’s disease. This is a very promising treatment for all kinds of degenerative diseases because of the stem cells’ regenerative abilities. From what we know about stem cell research so far

Why Is It So Difficult - 1121 Words

Conclusion Many of the new requirements seem unfair and confusing, as well as downright impossible for the small business owner to navigate due to conflicting advice on the internet. Why is it so difficult, and seemingly against regulations, for the small S corporation to provide additional assistance to the employees, including the shareholders? It seems that as a result of ACA, many employers saw that it made more sense to allow employees to acquire insurance through the marketplace. A win-win since the employee can take advantage of tax credits, and the company saves money. I would venture a guess, that the IRS and DOL would rather the small employer carry the burden of insurance costs through group health plans; which means removing incentives to reimbursement plans through the marketplace. (Weiss, 2014) Instead agencies have succeeded in creating an additional after-tax expense; which is borne by the employees of small businesses. Not so affordable and not really fair either. As the marketplace seems to be here to stay; I would recommend that the legislature pass a bill that will provide small business S corporation marketplace reform relief . The tax credits available to businesses that do provide group plans are complicated, and are difficult to qualify for. Additionally, the credits phase out over time and are a small portion of the sometimes overwhelming costs. Few employers are benefited from the credits to the point that a group plan makes sense. IShow MoreRelatedWhy Is It So Difficult For Me?1619 Words   |  7 Pagesemotion causing some outward distress, but I did not know how to express my feelings in words. All I wanted was a way to release my words so they could fall out of my mouth and relieve me from my build up of emotions, but the words would not come. It was as if my emotions were bottled up inside me waiting to explode like a bomb, but it never exploded. Why is it so difficult for me to express emotions in words that can be heard by o thers? This ability must be something instinctual, maybe something writtenRead MoreWhy Is It So Difficult For People?1310 Words   |  6 PagesWith that statistic holding true, why is it so difficult for people to do it? I interviewed her in order to learn about the experience of moving, the difficulties people experience when they go through the process, and after, and to find out why they do it. I also was interested in learning about the process of moving to a different place, very different from home, and how that effected their lives. The transition process cannot be easy, yet so many people do it, so it must be worth it in the end.Read MoreWhy is Dieting so Difficult?739 Words   |  3 PagesPeople find dieting impossible. It shouldnt be so hard. The Internet and the media provide better access to health and diet advice than ever before. There is a gym on every corner, health-conscious lifestyles are more common than ever, and organic foods are in every grocery store, yet waistlines continue expanding. Smartphone apps that track weight and calorie intake are downloaded then forgotten after their users see no progress. The few people that are able to significantly lose weight are heraldedRead MoreWhy Is Parenting So Difficult?956 Words   |  4 PagesWhy is parenting so difficult? Shouldn’t a mother be ‘hardwired’ into knowing how to raise an infant? First of all, we can not classify one universal way of parenting as there is no ‘one right way of doing it’. Each and every mother should have the confidence in trusting her nurturing instincts and disregard any advice from others. â€Å"If your younger child is headed into danger, into traffic, you can grab them and hold them, but you should und er no circumstances hit them.† ++++++ Good parenting isRead MoreWhy Is It So Difficult For My Student? Essay1205 Words   |  5 PagesWhy is it so difficult for my student to learn the vocabulary in science and social studies? I teach the same concepts to those students, but what is missing. This is a question I get many times from general education teachers. The struggle becomes evident when students with disabilities struggle with vocabulary in the content areas. I work directly with resource reading students and share many techniques with the science and history teachers. My research focus is meeting the needs of resourceRead MoreWhy Is It so Difficult to Define Poverty1766 Words   |  8 PagesSocial Welfare Theory and Methodology Why is so difficult to define poverty In general, the term poverty refers to a social and economic condition which is undesirable for any individual or group in society. This essay will discuss different approaches used to define poverty. 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The Arab Spring serves as the case in point to elucidate the problem. Furthermore, it is necessary to describe the role of international actors in preventing as well as solving intra-state conflicts. Interventionism, as a conflict managementRead MoreWhy Supply Chain Management Is So Difficult By Michael Bean1562 Words   |  7 PagesHW #1 Near Beer Game When running a business as a supply chain manager you have to make sure your supplies are equal to your consumers demand for your products. That seems easy right? Not really. When reading Bullwhip and Beer: Why Supply Chain Management is so difficult by Michael Bean we get and understanding of how hard being a supply chain manager can be. In the article Mr. Bean explains that Suppliers, manufactures, sales people, and customers have their own understanding of what real demand

Overcoming Foreign Language Anxiety Free Essays

OVERCOMING FOREIGN LANGUAGE ANXIETY By Saranda Nuredini Instructor: Luiza Zeqiri Course: ESP Communication I January 2012 â€Å"Sweaty palms, shaking hands, dry mouth and muscle tension mean for many of us, that we are about to speak in public. Couple this fear of speaking in public with performing or speaking in another language and the success of the speaker may be dramatically compromised† (Leigh, 2009). By having to speak in a foreign language, the amount of fear in us grows and transforms into the feeling of anxiety, which is scientifically named as a Foreign Language Anxiety (FLA). We will write a custom essay sample on Overcoming Foreign Language Anxiety or any similar topic only for you Order Now The fear of dealing in a foreign language environment is most felt when a student must perform orally in some way but it can also occur when listening, reading or writing (Brantmeier, 2005). FLA has been the subject of many scholarly surveys and papers as overcoming it can lead to better and faster language acquisition as well as a much more pleasurable learning experience (Guess, 2007). Between one third and one half of second language learners suffer from FLA (Von Worde, 2003; Randall 2007) and it is important to be aware that many of these students have not come up with a way to deal with their anxiety (Hauck Hurd, 1991). This research paper aims to outline the causes and effects of FLA as well as the ways that help overcoming it. Despite the fact that Foreign Language Anxiety has been proven to be the main concern to the modern teaching environment, a progress has been noticed at the development of the overcoming strategies. The overcoming foreign language anxiety process includes strategies that can be implemented by the teacher, a tutor and the students. The causes of this kind of anxiety vary from the student itself. According to the article â€Å"Factors Associated with Foreign Language Anxiety†, there are variables like age, previous academic success or previous high school experience with foreign languages which may contribute to the fear of learning a foreign language (Leigh, 2009). Nevertheless, the most common causes according to Ph. D. Renee Von Worde (2003) are the non-comprehension of the target language, speaking activities during language class and the public error correction by the teacher. Moreover, it is interesting to note that FLA occurs more commonly in mandatory language classes. This is because students who are not language inclined are ‘‘forced’’ to take them (Guess, 1997). Feeling insecure about the knowledge at a certain foreign language can have drastic side effects for the foreign language student. The extreme stress, the beating heart or clammy hands are the most common ones. There may also appear problems with attainment, preservation and production in the foreign language (Von Worde, 2003). According to Professor Von Worde (2003), â€Å"If anxiety impairs cognitive function, students who are anxious may learn less and also may not be able to demonstrate what they have learned. Therefore, they may experience even more failure, which in turn escalates their anxiety†. In extreme cases, the student may even not show up to classes just to avoid speaking (Von Worde, 2003). If we could find and isolate what it is that makes us nervous, we could increase our learning abilities and have a more enjoyable learning experience (Leigh, 2009). Ideally, teachers can provide a learning environment that may reduce the fear associated with learning another language for their students (Guess, 1997; Von Worde, 2003). However, not only the teacher can help to the overcoming foreign language anxiety process. The question remains how someone can overcome their fears in language learning to develop language skills to their full potential (Leigh, 2009). There are implementable ways that beside the teachers, the tutor and the students themselves can use to reduce the anxiety and insecurity they feel. The methods and the behavior of a language teacher during language classes play a significant role at the development of a student speaking confidence. There are several things that a teacher may do to decrease anxiety felt in the classroom according to Von Worde (2003): * Pick topics to teach that are relevant to the students. * Try and make the learning ‘‘fun’’. * Try to create a sense of community where the students feel more comfortable in front of each other. One suggestion made was to have the students sit in a circle. * Avoid calling on people or putting them on the spot. Besides the above mentioned suggestions, a teacher can take the initiative to create a â€Å"mistake happy zone†. Teachers can avoid correcting students during certain sections of the day (e. g. for 30 minutes we will talk amongst ourselves). In this way, students do not need to fear working on perfect grammar, but rather they can just talk without feeling judged. This allows students to get a feel for fluency and letting go (Leigh, 2009). A tutor can also be very helpful to its students when it comes to overcoming those language obstacles. By judging of the state of its student, a tutor has the freedom to choose which of the above mentioned suggestions will be used during the overcoming process. Although there may not be a classroom of students to whom the tutor is teaching, the one-on-one environment allows a greater sense of intimacy and a safer atmosphere (Leigh, 2009). Alongside to the teachers and tutors effort, the most significant role still remains the one from the student itself. According to Amanda Leigh, a student should take the following recommendations in action to â€Å"boost their self-confidence in speaking, reading and writing a language†: * Be aware of Foreign Language Anxiety- Knowing that you are not alone in feeling self-conscious or afraid of speaking in a foreign language is half the battle (Von Worde, 2003). Fear of speaking in front of people is normal and so is performing in another language, even if it is just with your friends. * Set 4 or 5 SMART (specific, measurable, attainable, realistic, timely) language goals for yourself in your academic term- Attach numbers to your learning so that you can see your improvement. Make measurable goals and make sure that they are realistic. Do some research to see what level you should be at by end of your term in a different country. Do not expect to be bilingual on your return to your home country. Be prepared- If you are prepared for your class or presentation then you will feel more confident in front of people. Feeling more prepared makes you feel relaxed which allows for better communication and language skills (Guess, 2007). Prepare by going over your work or presentation at least twice reading, then at least twice out loud. Get someone to help proofread. * Maintain a positive attitude- Even though it may seem hard, try and have a positive attitude. Happy people will learn faster and have a more pleasurable learning experience (Bayer, 2004). Smile. Make native speakers aware that you are happy to be corrected. * Do some research- Find out how other students handle their anxiety. Many of their suggestions may work for you. Look online or ask around. Alter their strategies so they work for you. By adopting some of these suggestions, there is a chance that a student will personally begin to overcome their foreign language learning fears. Students may choose to adopt one of these strategies and tailor it towards their needs until they find something that works for them (Leigh, 2009). To sum up, Foreign Language Anxiety has been labeled as an issue that should not be ignored and should be handled carefully. Therefore, the overcoming FLA process includes effort that should be made from the students as well as from the teachers and tutors. This will not only help students to overcome their fear and anxiety, but will also enable language teachers and tutors to reach a higher progress at their subject. In my opinion, the main goal of the overcoming progress should be to create a comfortable teaching environment where a speaking accent or grammar mistake will not mean the end of the world. As Guess claims, â€Å"the trick is to convince the students that discomfort is a good thing- that’s when the real learning process will begin. †. References Bayer, R. (2004). Benefits of happiness; Upper Bay Counseling and Support Services, Inc. Retrieved Jan 03, 2012, from: http://www. upperbay. org/articles/benefits%20of%20happiness. pdf . Brantmeier, C. (2005). Anxiety about L2 reading or L2 reading tasks. A study with advanced language learners. The Reading Matrix. Vol. 5, No. 2. Retrieved Jan. , 2012, from:http://74. 125. 95. 132/search? q=cache:4pmdX6G7bwJ:www. readingmatrix. com/articles/brantmeier/article4. df+reading+matrix. +2005+Foreign+Language+Anxietyhl=enct=clnkcd=1gl=ca Guess, A. (1997, June). Overcoming Language Anxiety. Inside Higher Ed. Retrieved Jan. , 2012, from http://www. insidehighered. com/news/2007/06/29/language. Hauck, M. Hurd, S. (1991). Exploring the link between language anxiety and learner self-management in open language learning context s. European Journal of Open, Distance and E- learning. Retrieved Jan 05, 2012, from: http://www. eurodl. org/materials/contrib/2005/Mirjam_Hauck. htm. Randall, K. (2007). Words fail me. The University of Texas at Austin. Retrieved Jan. 06, How to cite Overcoming Foreign Language Anxiety, Essays

Subcutaneous Fentanyl and Intramuscular Pethidine - MyAssignmenthelp

Question: Discuss about the Subcutaneous Fentanyl and Intramuscular Pethidine. Answer: Introduction: Pethidine is a form of drug that is used for relieving the pain. Pethidine are sometimes used as the analgesic form of pain relief medication for childbirth related pain and the pain associated with the surgery (Fenwick et al., 2015). The other form of name for Pethidine is Methadone. The classifications of Pethidine are as follows: Synthetic narcotic Narcotic detoxification adjunct Opioid analgesic An antagonist is a drug that acts by blocking opioids by attaching to the opiod receptors without activating them.Antagonistscause no opioid effect and block full agonist opioids. The indicators for the use of the drug are as follows: It is used for the prehospitality phase for the isolation of the extreme form of pain due to the severe form of pain that has been occurred due to severe trauma. These drugs are often recommended for severe, chronic pain and are also used for the detoxification and for the promotion of health of the patients with the opiate form of abstinence syndrome. The contraindications for the use of the drug are as follows: It is often contraindicated in patients who have the hypersensitivity for the drugs. It should be used very cautiously in case of the debilitated pregnant woman having renal or hepatic impairments, hypothyroidism and acute form of abdominal conditions, prostatic hyperplasia, HI, asthma, increased form of the intracranial pressure, urethral structures and the Addisons disease. There are certain forms of precautions that are needed to be taken for the correct usage of the drug. During the administration of the drug a woman who is pregnant needs to be careful about the harmful effects of narcotic form of the analgesics. The administration of the drug is to be made after taking proper precaution for the woman if she is already under the action of taking the narcotics (Fleet, Jones Belan, 2017). The adverse forms of effects for the usage of the drugs are as follows: The symptoms of cholera, sedation, sensorium, euphoria, dizziness, insomnia, seizures, syncope and agitation The hypotension, cardiac arrests, bradycardiac shocks, palpitation, nausea, disturbances in the visual periphery, vomiting, constipation, retention of the urine and urticaria The interactions, stability and the compatibility of the drugs are as follows: The use of the concomitant Central nervous system potentiates the respiratory of the drugs and the depression level of the CNS and also the effects of the hypotensive and the sedations. The combination of the use of the anticholergenics that may essentially cause the paralytic form of the ileus The special forms of considerations are as follows: The most common form of signs and the symptoms that are due to the overdose of the drug can cause the depression of the CNS and the depression in the respiration of the individual. The woman who essentially becomes physically very much dependent on the drugs that are been experienced with the acute form of withdrawal of the syndrome that are been given to a narcotic form of antagonists. The uses of the drugs are to be done with the caution and the monitor it very closely. Pathedine is a widely used drug for the relief of the pain during the labour. It is a similar form of drug that acts the same as the morphine and the heroine. These drugs belong to the family of drugs that are known as the opioids. The morphines is a natural form of drugs that are been extracted from the opium poppy, where there are pethidine is made out of synthetics (Martin et al., 2017). Pethidines were first used in Germany in the year 1940 for reducing the pain in the labour that are continued for the present day. It essentially works my mimicking the effects of the endorphins that are like the own morphine of the body. One of the major functions of the endorphins is to acts the natural form of pain killer for the woman. The Pethidine is been attached to the special form of sites on the outside of the cells of the nerves (Tveit et al, 2017). These sites are known as the opioids receptors. Once these pethidines are been attached to the receptors, the chain of the events that occur can result from depression and the normal form of activity for a little period. The effects of the Pathidine drugs are far more severe than the endorphins. The effect of the pethidin on the body of the women is readily observed after it has been administered. The person becomes drowsy, dizzy and the appearances of her eyes may also change. In addition, her perceptions about the events occurring around might change. The Pethidine acts on the central nervous systems by inhibiting the signals of the pain that are that are been sent to the brain. The subsequent can generally result to the pain that are been experienced by the women who are going through the labour pain. The most common and easiest way to give the pethidine to the women going through labour is to inject it into the muscles. The occasional form of the pethidine administration is injecting it in the vein through a drip. It is usually prescribed by the doctors, however, they are been given by the midwives. The dosage that the women receive usually ranges from 50 mg upto the level of 100mg. The total volume that are been injected into the muscles is one to two millilitres. The Pethidine may not be provided in the adequate pain relief for some of the women. Since nausea and vomiting are common, the medications may be mixed with the pethidine for helping to reduce this form of effects (Goods Martis, 2014). The other potential forms of the side effects for the woman who is in labour include problems in urination, drying of the mouth, hallucinations, the respiratory depressions, low amount of blood pressure and various allergic reactions. It has been observed that there are no impacts on the baby if the mother is under the observation of the Pethidine drug. The pethidine is known for crossing the placenta and is found to have their traces in the breast milk. The major effect for the baby is that the presence of the drug in the mothers milk can cause severe form of respiratory troubles. These effect can also worsen if the baby is born after one to two hours from injecting the drug to the mother. Therefore, this is one of the major reasons for which the pethidine are been avoided during the expected period of birth. An antidote might be been given for reversing the level of the drug. However, the effects of the antidote only last for a shorter period and tend to diminish. As a result, the baby may also experience the same form of the breathing problems. The babies are at risk of suffering from jaundice (Goods Martis, 2014). The drug can also affect the sucking reflex of the baby and may lead to new complications that a re related to the breast feeding for the first few days. The baby may also require the special form of care or the neonatal form of intensive care from the various effects of the pethidine, resulting in the separation of the mother and the baby. In the United Kingdom, it has been observed that it is very common for the hospitals to claim that they have the normal birth rate of about 80 percent. However, the study of the midwives birth rates are about five maternity units delivering between 1200 and up to the 5500 women every year that has revealed that about 1 to 6 first time mothers and 1 to 3 women have the second and subsequent form of labor that defines the normal births that are administered without the interventions or the drugs. However, it is difficult to find data on the number of babies who have been exposed to the drugs to understand the changes in normal behavior after birth due to the administration of the drug. The usage of the pethidine is the becoming less popular since there are a number of loopholes. Pethidine can effectively make the labour difficult and its effect can definitely wear out within a short span of time. It makes them light headed, unaware, disoriented, woozy etc. It has been also seen that occasionally, some of the women also experiences major hallucinations with the intake of pathidine. Further, it can also cause the problems on the respiratory tracts in the babies shortly after the birth especially in the case of the babies who are premature. This is because when the drug crosses the placenta, it makes the baby woozy and it makes the baby less likely to breathe in a vigorous manner at the time of the birth. However, pethidine can make the baby very less responsive and sleepy over the first few days after the birth that can help in the process of breast-feeding. The midwife needs to inject the pethidine into the thigh. The Pethidine can make them feel sick so that the injection is likely to support other forms of drug for addressing the health concerns. The midwife can also give the mother the doses of pethidine in about 50 mg or about 100mg. She can also repeat the dosage that is between the hours and three hours that is not having any other form of the drug for controlling the effect of the drug. The midwife should also take care that the woman does not have more than 400 mg in the next one day (Tveit et al., 2013). It has been observed in several cases that some women are more sensitive towards the opioids than others. However, the medication can have positive form of effects on the women who are given a small amount of dose of the same. A 50 mg of the drug may suit the woman well in the initial stage and they can be henceforth cautious about the drugs that can suit the mother. The midwife can also sent suggest some form of vaginal examination and see how the cervix may have been dilated, before giving the patient some form pethidine. The mother should also stop taking pathedine, if the midwife thinks that the mother is close to expecting the birth as it can essentially make the baby drowsy and effect the breathing of the child. Therefore, these are the above ways through which the drug influences the care of the midwives. References Fenwick, J., Gamble, J., Brittain, H., Sneddon, A. (2015). Birth outcomes: Private practising midwives at Gold Coast University Hospital.Women and Birth,28, S13-S14. Fleet, J. A. (2015).A Comparison of Intranasal Fentanyl, Subcutaneous Fentanyl and Intramuscular Pethidine during Childbirth: A Randomised Controlled Trial(Doctoral dissertation, Flinders University). Fleet, J. A., Jones, M., Belan, I. (2017). Taking the alternative route: Women's experience of intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for labour analgesia.Midwifery,53, 15-19. Fleet, J., Belan, I., Jones, M. J., Ullah, S., Cyna, A. M. (2016). A Comparison of Fentanyl With Pethidine for Pain Relief During Childbirth: A Randomized-Controlled Trial.Obstetric Anesthesia Digest,36(2), 102-103. Goodson, C., Martis, R. (2014). Pethidine: to prescribe or not to prescribe? A discussion surrounding pethidine's place in midwifery practice and New Zealand prescribing legislation.New Zealand College of Midwives Journal,49. Izumi, M., Uematsu, S., Watanabe, A., Manabe, E., Yau, S. Y., Leung, C. Y., ... Cheng, W. S. (2017). Midwifery and Nursing Care.J. Obstet. Gynaecol. Res,43(S1), 83-86. Larkin, P., Begley, C. M., Devane, D. (2017). Womens preferences for childbirth experiences in the Republic of Ireland; a mixed methods study.BMC pregnancy and childbirth,17(1), 19. Martin, T., Hauck, Y., Fenwick, J., Butt, J., Wood, J. (2014). Evaluation of a next birth after caesarean antenatal clinic on women's birth intention and outcomes, knowledge, confidence, fear and perceptions of care.Evidence-Based Midwifery,12(1), 11-5. Niven, C. A. (2013).Psychological care for families: before, during and after birth. Butterworth-Heinemann. Steel, A., Adams, J., Sibbritt, D., Broom, A., Gallois, C., Frawley, J. (2015). Managing the pain of labour: factors associated with the use of labour pain management for pregnant Australian women.Health Expectations,18(5), 1633-1644. Tveit, T. O., Halvorsen, A., Seiler, S., Rosland, J. H. (2013). Efficacy and side effects of intravenous remifentanil patient-controlled analgesia used in a stepwise approach for labour: an observational study.International journal of obstetric anesthesia,22(1), 19-25. Wilson, M., MacArthur, C., Smith, F. G., Homer, L., Handley, K., Daniels, J. (2016). The RESPITE trial: remifentanil intravenously administered patient-controlled analgesia (PCA) versus pethidine intramuscular injection for pain relief in labour: study protocol for a randomised controlled trial.Trials,17(1), 591.