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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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Tue Jun 02 2026
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Studying the effect of addition a composite of silanized Nano-Al2O3 and plasma treated polypropylene fibers on some physical and mechanical properties of heat cured PMMA denture base material
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Background: Polymethyl methacrylate (PMMA) is the most commonly used material in denture fabrication. The material is far from ideal in fulfilling the mechanical requirements, like low impact and transverse strength, poor thermal conductivity. The purpose of this study was to evaluate the effect of addition a composite of surface treated Nano Aluminum oxide (Al2O3) filler and plasma treated polypropylene fiber (PP) on some properties of denture base material. Materials and methods: One hundred fifty prepared specimens were divided into 5 groups according to the tests, each group consisted of 30 specimens and these were subdivided into 3 groups (unreinforced heat cured acrylic resin as control group),reinforced acrylic resin with( 0.5%wt Nan

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Tue Jun 02 2026
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Revista Iberoamericana De Psicología Del Ejercicio Y El Deporte, Issn 1886-8576, Vol. 17, Nº. 5, 2022, Págs. 269-271
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Publication Date
Mon Jan 01 2018
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Research Journal Of Pharmacy And Technology
Impact of Human Cytomegalovirus Infection associated with the expressed protein of mutated <i>BRCA1</i> gene in breast tissues from a group of Iraqi Female Patients with Breast Carcinoma
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Sun Feb 03 2019
Journal Name
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Transformational Leadership Dimensions and Its Role in the Rationalization of Banking Decisions: An Exploratory Esearch of the Views of A Sample of the Officials In the Iraqi Private Banks
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The current research aims to find out the role of transformational leadership in decision-making wise, to cope with the decline in some of the banking performance indicators as a result of the absence of the modern concept of the leadership of those so-called B (Transformational Leadership) and preventing benefit from the advantages in the banks, and I test the research on a sample of the Iraqi private banks through applied to a sample (77) Mdermvud and Associate Director and Advisor to the Chairman of the Department, the distributors (7) banks, and used the head of the questionnaire as a tool to collect data and information. For the purpose of access to the results, the research sought to test two hypotheses two main hypotheses sub pop

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Publication Date
Wed Mar 30 2022
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Journal Of Economics And Administrative Sciences
The Role of External Audit in Limiting Creative Accounting Practices in Light of International Standards from The Point of View of Certified Accountancy Experts in Iraq as a Model
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This research aims to solve a problem in the field of accounting and financial knowledge in the world today, that is, the problem of creative accounting. Especially after the global financial crisis and the collapse of many large companies in the world, people find that they use creative accounting methods to distinguish them from reality, showing the results of their activities and their financial status. This research discusses the concept of creative accounting, the most important methods used in financial statements and its relationship with external auditing, and procedures to limit accounting creativity. This study uses descriptive analysis methods after confirming its theoretical aspects in practice. Using the statistical

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Publication Date
Wed Dec 15 2021
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Al-academy
The communicative education of fine arts in the COVID-19 crisis and its manifestations in the modernization of the works of the Iraqi painter "Nabil Ali as a model"
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 This study attempts to address the importance of communicative digitization in the field of various arts for the sake of continuity of shopping and aesthetic, artistic and intellectual appreciation of artistic achievements by the recipient on various places of their residence in light of the COVID 19 crisis, and to highlight the importance of the plastic arts of the Iraqi painter exclusively and how it expresses in a contemporary way the environment or life reality in Iraq in light of this crisis. With all its implications affecting the life reality from various aspects and methods of its negative and positive employment. As for the research procedures, the researcher reviewed the research methodology represented by the descriptive ana

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Tue Jun 02 2026
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A Comparative Study In (resilience And Immunity) Psychological And The Level Of Skillful Performance In Some Ball Skills In Rhythmic Gymnastics Between Students Of The Second And Third Stages
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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Synthesis, Characterization and Study of Antibacterial Activity of a New Schiff Base Ligand and Its Complexes with Co(II), Ni(II), Cu(II), Cd(II) and Hg(II) Metal Ions
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Some coordination complexes of Co(ІІ), Ni(ІІ), Cu(ІІ), Cd(ІІ) and Hg(ІІ) are reacted in ethanol with Schiff base ligand derived from of 2,4,6- trihydroxybenzophenone and 3-aminophenol using microwave irradiation and then reacted with metal salts in ethanol as a solvent in 1:2 ratio (metal: ligand). The ligand [H4L] is characterized by FTIR, UV-Vis, C.H.N, 1H-NMR,13C-NMR, and mass spectra. The metal complexes are characterized by atomic absorption, infrared spectra, electronic spectra, molar conductance, (C.H.N for Ni(ІІ) complex) and magnetic moment measurements. These measurements indicate that the ligand coordinates with metal (ІІ) ion in a tridentate manner through the nitrogen and oxygen atoms of the ligand, octahed

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Synthesis, Characterization and Study of Antibacterial Activity of a New Schiff Base Ligand and Its Complexes with Co(II), Ni(II), Cu(II), Cd(II) and Hg(II) Metal Ions
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Publication Date
Sun Jun 05 2016
Journal Name
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Synthesis, Characterization and Study of Antibacterial Activity of a New Schiff Base Ligand and Its Complexes with Co(II), Ni(II), Cu(II), Cd(II) and Hg(II) Metal Ions
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Some coordination complexes of Co(??), Ni(??), Cu(??), Cd(??) and Hg(??) are reacted in ethanol with Schiff base ligand derived from of 2,4,6- trihydroxybenzophenone and 3-aminophenol using microwave irradiation and then reacted with metal salts in ethanol as a solvent in 1:2 ratio (metal: ligand). The ligand [H4L] is characterized by FTIR, UV-Vis, C.H.N, 1H-NMR,13C-NMR, and mass spectra. The metal complexes are characterized by atomic absorption, infrared spectra, electronic spectra, molar conductance, (C.H.N for Ni(??) complex) and magnetic moment measurements. These measurements indicate that the ligand coordinates with metal (??) ion in a tridentate manner through the nitrogen and oxygen atoms of the ligand, octahedral st

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