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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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The current research aims to develop a guidance program suitable for high school students and apply it to them in order to ensure the reduction of addiction to the use of different means of communication. The researchers used the scale of addiction to the means of communication (SAS) to measure the level of addiction as well as to identify the impact of the proposed guidance program in reducing the degree of addiction to communication. It was applied to a sample of (20) female students divided equally into two groups: an experimental group of (10) female students and a control group of (10) female students from the secondary level in a school under the department of education in the education of the alma

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Studying the relationship between the number of unit cells and the dislocation density of a crystal through the x-ray diffraction pattern of barium oxide nanoparticles
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In this research, the X-ray diffraction pattern was used, which was obtained experimentally after preparation of barium oxide powder. A program was used to analyze the X-ray diffraction lines of barium oxide nanoparticles, and then the particle size was calculated by using the Williamson-Hall method, where it was found that the value of the particle size is 25.356 nm. Also, the dislocation density was calculated, which is equal to1.555 x1015 (lines/nm2), and the value of the unit cell number was also calculated, as it is equal to 23831.

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