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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
Wed Sep 01 2021
Journal Name
Journal Of Engineering
Thermal Buckling of Laminated Composite Plates Using a Simple Four Variable Plate Theory
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In this study, the thermal buckling behavior of composite laminate plates cross-ply and angle-ply all edged simply supported subjected to a uniform temperature field is investigated, using a simple trigonometric shear deformation theory. Four unknown variables are involved in the theory, and satisfied the zero traction boundary condition on the surface without using shear correction factors, Hamilton's principle is used to derive equations of  motion depending on a Simple Four Variable Plate Theory for cross-ply and angle-ply, and then solved through Navier's double trigonometric sequence, to obtain critical buckling temperature for laminated composite plates. Effect of changing some design parameters such as, ortho

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Publication Date
Thu Jan 11 2018
Journal Name
Al-khwarizmi Engineering Journal
Control on a 2-D Wing Flutter Using an Adaptive Nonlinear Neural Controller
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An adaptive nonlinear neural controller to reduce the nonlinear flutter in 2-D wing is proposed in the paper. The nonlinearities in the system come from the quasi steady aerodynamic model and torsional spring in pitch direction. Time domain simulations are used to examine the dynamic aero elastic instabilities of the system (e.g. the onset of flutter and limit cycle oscillation, LCO). The structure of the controller consists of two models :the modified Elman neural network (MENN) and the feed forward multi-layer Perceptron (MLP). The MENN model is trained with off-line and on-line stages to guarantee that the outputs of the model accurately represent the plunge and pitch motion of the wing and this neural model acts as the identifier. Th

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Mechanical Science And Technology
Optimization of a rectangular pin fin using elliptical perforations with different inclination angles
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Publication Date
Thu Jan 31 2019
Journal Name
International Journal Of Ambient Energy
Energy generation by membraneless microfluidic fuel cell using acidic wastewater as a fuel
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A simple and novel membraneless paper-based microfluidic fuel cell was presented in this study. The occurrence of laminar flow was employed to ensure no mixing of the fuel and oxidant fluids along the bath of reaction. The acidic wastewater was used as a fuel. It was an air-breathing cell, so air and tab water were used as oxidants. Both the fuel and tab water flowed continuously under gravity. Whatman filter paper was used for preparation of the fuel cell channel and two carbon fibre electrodes were used and firmed on the edges of the cell. The performance of the cell was examined over three consecutive days. The results indicated that the present cell has the potential to generate electric power, but an extensive study is required to harv

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Publication Date
Mon Jun 05 2023
Journal Name
Journal Of Engineering
Effect of Velocity on Dissolved Oxygen Cathodic Polarization using a Rotating Cylinder Electrode
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The aim of the present work to study the effect of changing velocity (Reynold's number) on oxygen cathodic polarization using brass rotating cylinder electrode in 0.1, 0.3 and 0.5N NaCl solutions (PH = 7) at temperatures 40, 50 and 600 C. Cathodic polarization experiments were conducted as a function of electrode rotational speed and concentration.

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Publication Date
Sun May 01 2022
Journal Name
Journal Of Engineering
Attitude and Altitude Control of Quadrotor Carrying a Suspended Payload using Genetic Algorithm
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The need for quick airborne transportation is critical, especially in emergencies. Drones with suspended payloads might be used to accomplish quick airborne transportation. Due to the environment or the drone's motion, the slung load may oscillate and lead the drone to fall. The altitude and attitude controls are the backbones of the drone's stability, and they must be adequately designed. Because of their symmetrical and simple structure, quadrotor helicopters are one of the most popular drone classes. In this work, a genetic algorithm with two weighted terms fitness function is used to adjust a Proportional-Integral-Derivative (PID) controller to compensate for the altitude and attitude controllers in a quadrotor drone with a slun

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Publication Date
Sat Jan 01 2011
Journal Name
Journal Of Engineering
TREATMENT OF A HIGH STRENGTH ACIDIC INDUSTRIAL CHEMICAL WASTEWATER USING EXPANDED BED ADSORBER
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Treatment of a high strength acidic industrial wastewater was attempted by activated carbon
adsorption to evaluate the feasibility of yielding effluents of reusable qualities. The experimental
methods which were employed in this investigation included batch and column studies. The
former was used to evaluate the rate and equilibrium of carbon adsorption, while the latter was
used to determine treatment efficiencies and performance characteristics. Fixed bed and expanded
bed adsorbers were constructed in the column studies. In this study, the adsorption behavior of acetic acid onto activated carbon was examined as a function of the concentration of the adsorbate, contact time and adsorbent dosage. The adsorption data was mo

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Publication Date
Sun May 01 2022
Journal Name
Journal Of Engineering
Attitude and Altitude Control of Quadrotor Carrying a Suspended Payload using Genetic Algorithm
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The need for quick airborne transportation is critical, especially in emergencies. Drones with suspended payloads might be used to accomplish quick airborne transportation. Due to the environment or the drone's motion, the slung load may oscillate and lead the drone to fall. The altitude and attitude controls are the backbones of the drone's stability, and they must be adequately designed. Because of their symmetrical and simple structure, quadrotor helicopters are one of the most popular drone classes. In this work, a genetic algorithm with two weighted terms fitness function is used to adjust a Proportional-Integral-Derivative (PID) controller to compensate for the altitude and attitude controllers in a quadrotor drone

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Publication Date
Thu Jun 29 2017
Journal Name
College Of Islamic Sciences
Fairness in explaining the provisions of endowments A study to clarify the provisions of endowments according to the views of the Jaafari school of thought compared to the provisions of Iraqi laws.
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In The Name of Allah Most Gracious Most Merciful

It is no secret to everyone that the endowment is an important nucleus for the prosperity of Islamic civilization, especially in the fields of education, health, economy, and defensive military actions that fall within the door of jihad, and so on. Al-Ashraf, Qom Al-Quds, Cairo, and other parts of the Islamic world. What we will see in the research.

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Publication Date
Wed Jul 22 2015
Journal Name
Plant Growth Regulation
Effect of photosynthetic photon flux density on growth, photosynthetic competence and antioxidant enzymes activity during ex vitro acclimatization of Dieffenbachia cultivars
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