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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
Sat Oct 28 2023
Journal Name
Baghdad Science Journal
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
volume fractions 0.5, 1, 1.5, and 2% Vf with a rotation speed of 1200 rpm and a constant rotation time, T
= 6 min . The mechanical properties were characterized to study the graded and non-graded nanocomposites
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
at 1% Vf by 133.33% of the sample epoxy side. The flexural strength and Young modulus of the fu

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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
A study of Land Zoning in the base of Traffic Noise Pollution Levels using ArcGIS: Kirkuk City as a Case Study
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This study is an approach to assign the land area of  Kirkuk city [ a city located in the northern of Iraq, 236 kilometers north of  Baghdad  and 83 kilometers  south of  Erbil [ Climatic atlas of  Iraq, 1941-1970  ]  into different  multi zones by using Satellite image and Arc Map10.3,  zones of different traffic noise pollutions. Land zonings process like what achieved in this paper will help and of it’s of a high interest point for the future of Kirkuk city especially urban

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Publication Date
Mon May 01 2023
Journal Name
Chemical Engineering Research And Design
Treatment of petroleum refinery wastewater by electrofenton process using a low cost porous graphite air-diffusion cathode with a novel design
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Publication Date
Sun Apr 30 2023
Journal Name
Al-kindy College Medical Journal
The Surgical outcomes of fundus-first technique in lowering the rate of bile duct injuries and bleeding during open cholecystectomy that facing intraoperative difficulties: A single-center prospective study: The surgical outcomes of open fundus-first cholecystectomy technique.
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Background: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.

Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underw

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Publication Date
Fri Dec 01 2023
Journal Name
Case Studies In Chemical And Environmental Engineering
Removal of copper from a simulated wastewater by electromembrane extraction technique using a novel electrolytic cell provided with a flat polypropylene membrane infused with 1-octanol and DEHP as a carrier
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Publication Date
Fri May 19 2023
Journal Name
Revista Iberoamericana De PsicologÍa Del Ejercicio Y El Deporte
THE EFFECT OF SPECIAL EXERCISES ACCORDING TO A DESIGNED DEVICE IN DEVELOPING THE PERFORMANCE OF A KINETIC CHAIN ON THE BALANCE BEAM DEVICE
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Publication Date
Sat Sep 01 2007
Journal Name
Al-khwarizmi Engineering Journal
Free Convective Heat Transfer with Different Sections Lengths Placed at the Exit of a Vertical Circular Tube subjected to a Constant Heat Flux
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A free convective heat transfer from the inside surface of a uniformly heated vertical circular tube has been experimentally investigated under a constant wall heat flux boundary condition for laminar air flow in the ranges of RaL from 6.9108 to 5109. The effect of the different sections (restrictions) lengths placed at the exit of the heated tube on the surface temperature distribution, the local and average heat transfer coefficients were examined. The experimental apparatus consists of aluminum circular tube with 900 mm length and 30 mm inside diameter (L/D=30). The exit sections (restrictions) were included circular tubes having the same inside diameter as the heated tube but with different lengths of

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Publication Date
Tue Nov 18 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Nutritional Status among a Group of Preschool Children in Relation to Concentration of Selected Elements in Saliva and Caries Severity (A Comparative Study)
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Background: Nutritional status during childhood is very important for individual development and growth. Nutrition has local and systemic effect on the oral health by affecting dental health and salivary composition. This study was aimed to determine effect of iron, sodium and potassium ions in saliva on the nutritional status and to determine the effect of nutritional status on caries severity among preschool children. Material and Methods: The sample consists of 90 children aged 4 and 5 years of both genders, selected from 6 kindergartens in Al-Resafa aspect of Baghdad province. Children classified according to their nutritional status into three groups (normalweight, underweight and overweight). Nutritional status was determined by usi

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Publication Date
Tue Sep 27 2022
Journal Name
Al–bahith Al–a'alami
Motives for public exposure to advertisement through smart phone applications and its purchasing decisions relationship (A research drawn from a Master Degree thesis)
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Advertisement on smart phone shopping apps are a new way of driving users to satisfy their needs and influence their purchasing decisions, In this way, the research could be aimed to know The role of the relationship between the motivations for audience exposure to shopping apps advertisement and purchasing decisions, In order to achieve the objectives of the research, the researcher adopted the survey method and used the questionnaire and the scale to collect data and information, The researcher chose the "random sample multi stages", The sample size was (475) respondents from Baghdad city center (18 years and above) women and men.

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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Adopting the green value chain to achieve sustainable competitive advantage: study to views of a sample from Ur General Company for Engineering Industries in Dhi Qar
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       In light of the developments and intense competition that the world has witnessed, the need to search for a sustainable and continuous competitive advantage for economic units has emerged, as the economic units must not lose sight of their interest in the activities they perform to achieve that advantage, and it can be said that the goal of the research is to identify the theoretical dimensions of the green value chain represented by: (Green research and development, green design, green manufacturing, green marketing, green services) and the dimensions of the sustainable competitive advantage represented by (quality, creativity, innovation, cost, response to the customer), as well as identifyi

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