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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
Fri Jun 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Oral Health Knowledge and Behavior in Relation to Oral Hygiene and Gingival Condition among a Group of Industry Workers
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Background: In Iraqi communities, the workers considered the largest population groups, so increasing their dental education by increasing the care for their dental health knowledge and behavior is very important, the present study was aimed to evaluate the gingival health and oral hygiene in relation to knowledge and behavior among a group of a workers selected randomly from Al Fedaa company in Baghdad city. Materials and methods: A sample of 110 workers (65 men and 45 women) included in this study, a questionnaire used to evaluate their oral health knowledge and behavior. The gingival health condition of the workers was examined by using Loe and Silness index (1963), Silness and Loe index (1964) was used to asses plaque quantity, and Ramf

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Publication Date
Sat Jun 25 2022
Journal Name
International Journal Of Drug Delivery Technology
Statistical Design based on Response Surface Methodology to Optimize the Production of a Yellow Pigment by Streptomyces thinghirensis AF7
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Although its wide utilization in microbial cultures, the one factor-at-a-time method, failed to find the true optimum, this is due to the interaction between optimized parameters which is not taken into account. Therefore, in order to find the true optimum conditions, it is necessary to repeat the one factor-at-a-time method in many sequential experimental runs, which is extremely time-consuming and expensive for many variables. This work is an attempt to enhance bioactive yellow pigment production by Streptomyces thinghirensis based on a statistical design. The yellow pigment demonstrated inhibitory effects against Escherichia coli and Staphylococcus aureus and was characterized by UV-vis spectroscopy which showed lambda maximum of

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Publication Date
Wed Jun 26 2019
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The Iraqi Geological Journal
A MODIFIED WATER INJECTION TECHNIQUE TO IMPROVE OIL RECOVERY: MISHRIF CARBONATE RESERVOIRS IN SOUTHERN IRAQ OIL FIELDS, CASE STUDY
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A modified water injection technique has organized by this study to improve oil recovery of the Mishrif reservoirs using polymerized alkaline surfactant water (PAS-Water) injection. It is planned to modify the existing water injection technology, first to control and balance the hazardous troublemaker reservoir facies of fifty-micron pore sizes with over 500 millidarcies permeability, along with the non-troublemaker types of less than twenty micron pore sizes with 45 to 100 millidarcies permeability. Second to control Mishrif reservoirs rock-wettability. Special core analysis under reservoir conditions of 2250 psi and 90 °C has carried out on tens of standard core plugs with heterogeneous buildup, using the proposed renewal water f

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Publication Date
Wed Jan 01 2020
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Agricultural extension system industrial managers in the light of their training needs to face job stress - A field study
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Publication Date
Sun Apr 30 2023
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Circulating Interleukin-23 Levels in Rheumatoid Arthritis and its Relationship to Disease Activity: a Systematic Review with Meta-Analysis
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Background: Rheumatoid arthritis (RA) is a chronic and systemic autoimmune disease that is characterized by severe synovial inflammation, cartilage erosion, bone loss, and generalized vasculopathy. Although the immunologic mechanism of RA is still unclear, it is now thought to be a primarily Th17-driven disease. Along with other factors, IL-23 stimulates the expansion of Th17 cells from naive CD4+ T cells.

Objective: The objective of this study is to assess the circulating levels of interleukin (IL)-23 in rheumatoid arthritis (RA) and determine the correlation between plasma/serum IL-23 levels and disease activity. So, we performed a systematic review with meta-analysis comparing

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Publication Date
Thu Jun 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Dental caries severity in relation to selected salivary variables among a group of pregnant women in Baghdad city/Iraq
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Background: During pregnancy many physiological, anatomical and biochemical changes take place that affect almost all body systems. In the oral pregnant women have serious changes such as more sever dental caries. This study was conducted to measure dental caries severity and selected salivary variables (salivary flow rate, PH and viscosity)and to find the relation of dental caries with these salivary variables. Subjects, materials and methods: The study group consisted of 60 pregnant women that were divided into three equal groups according to trimester (20 pregnant women in each trimester).They were selected randomly from the Maternal and Child Health Care Centers in Baghdad city, the age range was 20-25 years. In addition to 20 unmarried

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Wed Mar 01 2023
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The deubiquitylase-ubiquitin-specific protease 4 absence in HeLa cells leads to a reduction in Semliki Forest virus replication
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Sun Jun 07 2015
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A comparative study to determine the nature of the eye lens protein in the two types of birds Iraqi
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The study showed significant differences between the average weight lens and the average amount protein in the lens between that Kestrel Falco tinnunculus L. and the Collared Dove Streptopelia decaocto F. , also the study electrical migration of lens proteins having one bundle of crystalline –? in Kestrel compared with three bundles in Collared Dove, two bundles of crystalline – ? in both , and crystalline – ? appeared as one bundle in both birds.

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Publication Date
Thu Nov 20 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Salivary gland tumors: A review of 171 cases, with particular reference to histological types, site, age and gender distribution
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Background: Salivary tumors are uncommon, being of low incidence worldwide. This study aimed to assess cases collected in this series of salivary gland tumors in regard to histopathological typing, in relation to age, site and gender. Materials and methods: This is a retrospective study; cases were collected from public and private laboratories. A total number of 171 cases were collected. The slides were reviewed and reclassified for histopathological typing according to WHO classification 2005. Results: Benign tumors were more common than malignant tumors. The most common histological type was benign mixed tumor, followed by Warthin’s tumor. The most common malignant tumor was adenoid cystic carcinoma. One hundred twenty three cases ou

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Publication Date
Wed May 18 2022
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The effectof a proposed strategy according to realistic mathematics theory on the mathematical interrelation of third-grade intermediate students
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The current study aimed at (identifying the impact of a proposed strategy based on the realistic mathematics theory in the mathematical interrelation among the third intermediate grade students), two samples from the third intermediate grade were tested in a school affiliated to Rusafa I General education Directorate in Baghdad for the academic year (2022-2021)the experimental group will study according to the proposed strategy and it consisted of (30) female students , the control group will study through the traditional method and the number of its students is (30), thus the study sample consisted of (60) female students, the two groups were equalized in the variables (age in months, intelligence, prior knowledge) and to achieve the study

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