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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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Fri Jun 27 2025
Journal Name
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Maximum bite force among a group of Iraqi children in relation to mandibular growth rotation
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Sun Jan 01 2012
Journal Name
Journal Of Engineering
DESIGN OF A VARIABLE GAIN NONLINEAR FUZZY CONTROLLER AND PERFORMANCE ENHANCEMENT DUE TO GAIN VARIATION
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In this paper, variable gain nonlinear PD and PI fuzzy logic controllers are designed and the effect of the variable gain characteristic of these controllers is analyzed to show its contribution in enhancing the performance of the closed loop system over a conventional linear PID controller. Simulation results and time domain performance characteristics show how these fuzzy controllers outperform the conventional PID controller when used to control a nonlinear plant and a plant that has time delay.

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Tue Dec 06 2022
Journal Name
International Journal Of Professional Business Review
A Comparative Study to Reveal Earnings Management in Emerging Markets: Evidence from Tunisia and Iraq
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Purpose: The purpose of the study is to compare and evaluate Earnings Management in Tunisia and Iraq.   Theoretical framework: Earnings Management is an important topic that has been studied by a significant number of researchers, as well as those who are interested in the accounting profession. Earnings Management has gotten a lot of attention from academics, professionals, and other interested parties in recent years (e.g. Kliestik et al., 2020; Rahman et al., 2021; Gamra &Ellouze, 2021)   Design/methodology/approach: The sample includes ten banks listed on the Bourse of Tunisia and Iraq Stock Exchanges for the year 2017. We have used a model of Kothari et al., (2005) as a tool to measure Earnings Management in both mark

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Sun Jan 01 2017
Journal Name
البحوث التربويةوالنفسية
Preparing a teacher’s guide for computer books for the intermediate stage according to learning styles
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Publication Date
Tue Jan 17 2023
Journal Name
International Journal Of Online And Biomedical Engineering (ijoe)
An Image Feature Extraction to Generate a Key for Encryption in Cyber Security Medical Environments
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Cyber security is a term utilized for describing a collection of technologies, procedures, and practices that try protecting an online environment of a user or an organization. For medical images among most important and delicate data kinds in computer systems, the medical reasons require that all patient data, including images, be encrypted before being transferred over computer networks by healthcare companies. This paper presents a new direction of the encryption method research by encrypting the image based on the domain of the feature extracted to generate a key for the encryption process. The encryption process is started by applying edges detection. After dividing the bits of the edge image into (3×3) windows, the diffusions

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Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
What Bukhari shortened to a bug in its attribution: (Applied study in the correct mosque)
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This study aims to show some of Imam Al-Bukhari's criticism of the Hadith from the Metn side, and part of his methodology in dealing with the correct hadiths that are tainted by a bug. This research focuses on what Imam Al-Bukhari summarized in his Sahih illusion of the narrator in his attribution, or uniqueness of the narrator, or to suggest a novel. We find that Bukhari sometimes abbreviates the hadeeth, and does not bring it out completely in his Sahih. He is satisfied with the abbreviated position but has done so because of a bug in it. The Bukhari usually does not declare his intention but knows this through tracking, inspection, and research of the correct hadiths.

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Publication Date
Fri Dec 01 2017
Journal Name
2017 11th Asian Control Conference (ascc)
Super-twisting based integral sliding mode control applied to a rotary flexible joint robot manipulator
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Tue Jan 02 2018
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The effectiveness of a proposed program to solve the problem of mixing Arabic letters similar to the voice of students in the second grade primary
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The purpose of this research is to demonstrate the effectiveness of a program to address the problem of mixing similar letters in the Arabic language for students in the second grade of primary and to achieve the goal of the research. The researcher followed the experimental method to suit the nature of this research and found that there are statistically significant differences between the tribal and remote tests, The effectiveness of the proposed educational program. At the end of the research, the researcher recommends several recommendations, the most important of which are: 1 - Training students to correct pronunciation of the outlets, especially in the first three stages of primary education (primary) and the use of direct training

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Publication Date
Sat Oct 28 2023
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Experimental Investigation of the Mechanical and Structural Properties of a Functionally Graded Material by Adding Alumina Nanoparticles Using A Centrifugal Technique
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In this work, functionally graded materials were synthesized by centrifugal technique at different
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and the pure epoxy material. The mechanical tests showed that graded and non-graded added alumina
(Al2O3) nanoparticles enhanced the effect more than pure epoxy. The maximum difference in impact strength
occurred at (FGM), which was loaded from the rich side of the nano-alumina where the maximum value was
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Controlling the Unbalanced Voltages of a Series-Connected Lead-Acid Batteries in a PV Power Storage System using Dynamic Capacitor Technique
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Lead-acid batteries have been used increasingly in recent years in solar power systems, especially in homes and small businesses, due to their cheapness and advanced development in manufacturing them. However, these batteries have low voltages and low capacities, to increase voltage and capacities, they need to be connected in series and parallel. Whether they are connected in series or parallel, their voltages and capacities must be equal otherwise the quality of service will be degraded. The fact that these different voltages are inherent in their manufacturing, but these unbalanced voltages can be controlled. Using a switched capacitor is a method that was used in many methods for balancing voltages, but their respons

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