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Using cryotherapy, <scp>EMLA</scp> (eutectic lidocaine/prilocaine) cream, or lidocaine spray to reduce pain during arteriovenous fistula puncture: A randomized controlled trial
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Abstract<sec><title>Introduction

In hemodialysis patients, pain associated with needle insertion into an arteriovenous fistula is a physical and psychological problem. The aim of this study was to assess the effectiveness of pre‐puncture application of an ice pack, EMLA cream, or lidocaine spray to reduce pain associated with access puncture.

Methods

This was a multicenter study done in nine hemodialysis centers in Iraq. The study utilized a randomized, parallel‐group design, in which patients being dialyzed using an arteriovenous access were allocated into one of four groups. Access puncture was preceded by nothing (control group), by use of ice pack cooling at the puncture site, by application of EMLA cream, or by application of lidocaine spray. Pain after access puncture was assessed during a single treatment for each patient. Pain was quantified using a Visual Analogue Scale.

Findings

A total of 1548 patients agreed to participate, and 1041 patients were included in the data analysis. Use of an ice pack, EMLA cream, or lidocaine spray each was associated with a lower pain score on access puncture compared with no pretreatment. The mean Visual Analogue Scores in the four groups were: 69.7 ± 15.7 in the controls, 39.8 ± 13.2 in the ice pack group, 45 ± 18.4 in the EMLA group, and 52.9 ± 15.2 in lidocaine group. Ranking of the pain severity scores suggested that ice pack use was associated with the least pain, followed by use of EMLA cream and use of lidocaine spray (severity score ranking, from lowest to highest, being 1.62, 2.18, and 2.63, respectively).

Discussion

Application of an ice pack prior to vascular access puncture is a fast and inexpensive technique to limit pain associated with this procedure.

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Publication Date
Fri Nov 01 2019
Journal Name
Journal Of Craniofacial Surgery
Risk Factors for Fistula Development Following Palatoplasty
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Purpose:

The aim of this study is to assess the influence of some risks factors on the fistula development after palatoplasty to improve the outcome of the patients

Patients and Methods:

A total of 48 patients (the males were 22, The females were 26) were included in this study. All the patients were examined weekly for the first month postoperatively to assess any breakdown in the wound by inspection and by asking the parents for any nasal regurgitation during fluids feeding.

Results:
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Publication Date
Sun Jan 02 2022
Journal Name
Journal Of The College Of Languages (jcl)
To Domesticate or to Foreignize: An Approach to Translating Fables and Fairy Tales
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      The present study deals with the strategies used in the Arabic translations of the most popular genres of children’s literature; namely fairy tales and fables as an attempt to identify the best methods and strategies to be adopted in translating these genres to fulfill the ultimate purpose of enriching the children’s knowledge in addition to attracting their interest and arousing the joy sought for in every piece of literature.

The study sets off from three dominating trends: the first calls for the adoption of domestication strategy of translation as the most appropriate and effective strategy in translation for children. In the same line, the second opposes using the foreignization strategy, w

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Publication Date
Wed Sep 29 2021
Journal Name
Biomass Conversion And Biorefinery
Encapsulated deep eutectic solvent for esterification of free fatty acid
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A novel encapsulated deep eutectic solvent (DES) was introduced for biodiesel production via a two-step process. The DES was encapsulated in medical capsules and were used to reduce the free fatty acid (FFA) content of acidic crude palm oil (ACPO) to the minimum acceptable level (< 1%). The DES was synthesized from methyltriphenylphosphonium bromide (MTPB) and p-toluenesulfonic acid (PTSA). The effects pertaining to different operating conditions such as capsule dosage, reaction time, molar ratio, and reaction temperature were optimized. The FFA content of ACPO was reduced from existing 9.61% to less than 1% under optimum operating conditions. This indicated that encapsulated MTPB-DES performed high catalytic activity in FFA esterificatio

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
Factors Affecting Attaching Ruling to Its Cause (Illah) or to Its Reason (Hikmah): A Study in Usul Al Fiqh
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There is a theoretical controversy in the books of Usul al-Fiqh, in the past and the present, about whether the ruling should be attached to its reason (al-Hikmah), or its apparent and stable cause (al-Illah). Looking at the practical cases of the jurists, we found them sometimes attaching rulings to its reason, and sometimes to its cause, so there is a need to know the factors that affect their choices. By extrapolation, the researcher reached at nine factors that affect referring the ruling to its cause or to its reason in jurisprudential cases.

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Publication Date
Sun Dec 30 2012
Journal Name
Al-kindy College Medical Journal
The Necessity of Teaching Diabetic Patients the Correct way of Insulin Administration: A Clinical Trial to Improve Glycemic Control
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Background: It is important to achieve good glycemic control to avoid long-term diabetic complications. It has been largely debated about the role of correct way of insulin administration to get the desired glycemic control.
Objective: To evaluate the effect of teaching diabetic patients who are on insulin therapy the correct way of injecting insulin and its effect on glycemic control.
Methods: A non randomized clinical trial with 820 diabetic patients on insulin therapy on whom A1 c estimation was performed before and after three months of teaching them the right injection technique.
Results : Sixty seven patients (8.17%) had A1 c 6.5% before they were enrolled in the study while the majority (753 patents, 91.82%) had A1 c 6.5%

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
The Necessity of Teaching Diabetic Patients the Correct way of Insulin Administration: A Clinical Trial to Improve Glycemic Control
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Background: It is important to achieve good glycemic control to avoid long-term diabetic complications. It has been largely debated about the role of correct way of insulin administration to get the desired glycemic control.
Objective: To evaluate the effect of teaching diabetic patients who are on insulin therapy the correct way of injecting insulin and its effect on glycemic control.
Methods: A non randomized clinical trial with 820 diabetic patients on insulin therapy on whom A1 c estimation was performed before and after three months of teaching them the right injection technique.
Results : Sixty seven patients (8.17%) had A1 c 6.5% before they were enrolled in the study while the majority (753 patents, 91.82%) had A1 c 6.5%

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Publication Date
Sat Jun 01 2019
Journal Name
International Journal Of Electrical And Computer Engineering (ijece)
Bulk binding approach for PMIPv6 protocol to reduce handoff latency in IoT
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<p>Mobility management protocols are very essential in the new research area of Internet of Things (IoT) as the static attributes of nodes are no longer dominant in the current environment. Proxy MIPv6 (PMIPv6) protocol is a network-based mobility management protocol, where the mobility process is relied on the network entities, named, Mobile Access Gateways (MAGs) and Local Mobility Anchor (LMA). PMIPv6 is considered as the most suitable mobility protocol for WSN as it relieves the sensor nodes from participating in the mobility signaling. However, in PMIPv6, a separate signaling is required for each mobile node (MN) registration, which may increase the network signaling overhead and lead to increase the total handoff latency

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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Impact of Brix 3000 and conventional restorative treatment on pain reaction during caries removal among group of children in Baghdad city
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Background: Pain and the usage of local anesthetic agents are still real problem in pediatric dentistry, for these reasons, the use of minimal invasive dentistry (MID) in regard to the patient comfort is important especially for children, anxious and uncooperative patients. Chemomechanical caries removal (CMCR) methods involve the selective removal of the carious dentine hence it avoided the painful removal of the sound dentine and the anxiety resulted due to the vibration of the hand piece which is also decreased thus it appears to be more acceptable and comfortable to the patient. Aims of this study: This study was conducted among group of children to assess and compare the anxiety rating scale (during and after treatment) between the

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Publication Date
Tue Jan 01 2019
Journal Name
Advances On Computational Intelligence In Energy
A Theoretical Framework for Big Data Analytics Based on Computational Intelligent Algorithms with the Potential to Reduce Energy Consumption
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Within the framework of big data, energy issues are highly significant. Despite the significance of energy, theoretical studies focusing primarily on the issue of energy within big data analytics in relation to computational intelligent algorithms are scarce. The purpose of this study is to explore the theoretical aspects of energy issues in big data analytics in relation to computational intelligent algorithms since this is critical in exploring the emperica aspects of big data. In this chapter, we present a theoretical study of energy issues related to applications of computational intelligent algorithms in big data analytics. This work highlights that big data analytics using computational intelligent algorithms generates a very high amo

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Publication Date
Thu Jun 15 2023
Journal Name
Alustath Journal For Human And Social Sciences
The Effectiveness of a Cognitive-Behavioral Treatment Program to Reduce Nervous Fatigue for Mothers of Children with Cerebral Palsy
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Cognitive-behavioral therapy is one of the most important relatively recent; treatment programs that attempt to modify behavior and control psychological disorders by modifying the individual's thinking style and awareness of himself and his environment, and cognitive reconstruction by replacing negative thoughts with positive ones. The current study aimed to know the effectiveness of a cognitive behavioral treatment program in reducing nervous fatigue among mothers of children with cerebral palsy. The sample on which the nervous fatigue scale was applied consisted of (30) mothers whose son suffers from cerebral palsy, and the results indicated that (24) mothers suffer from nervous fatigue. This sample was divided

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