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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
Mon Jul 18 2022
Journal Name
International Journal Of Early Childhood Special Education
The effectiveness of a proposed teaching strategy according to The Common Knowledge Construction Model in Mathematical Proficiency for middle school student
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This research aims to know the effectiveness of teaching with a proposed strategy according to the common Knowledge construction modelin mathematical proficiency among students of the second middle class. The researchers adopted the method of the experimental approach, as the experimental design was used for two independent and equal groups with a post-test. The experiment was applied to a sample consisting of (83) students divided into two groups: an experimental comprising (42) students and a control group, the second comprising (41) students., from Badr Shaker Al-Sayyab Intermediate School for Boys, for the first semester of the academic year (2021-2022), the two groups were rewarded in four variables: (chronological age calculated in mo

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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Financial Innovation as an Entrance to Sustainable Financing A Case Study of Islamic Banks in the State of Qatar (2014-2018)
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While the impact of the fourth Industrial Revolution on the economy keeps accelerating, the signs of the fifth industrial revolution, whose key is innovation and creativity started to evolve. However, the challenge of achieving sustainable development and its goals remains faced by the global organizations; In this situation, Islamic banks are exposed to many challenges among which is the challenge of keeping themselves abreast of the latest developments in the modern technology which in turn is a tool for continuity and competition. On the flip side, to avoid the negative impact that these changes can have such as an increased gap between financial innovations and the requirements of sustainable development. Islamic banks in the

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Publication Date
Sun Mar 01 2020
Journal Name
Sustainable Chemistry And Pharmacy
A sustainable approach to utilize olive pips for the sorption of lead ions: Numerical modeling with aid of artificial neural network
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Publication Date
Wed Jun 01 2022
Journal Name
Political Sciences Journal
US-Russian Interventions in the Caspian-Caucasus Basin Countries after 2001: (Strategies to Re-Impose Control and Influence as a Model)
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Today, the five Caspian riparian states on the shores of the Caspian Sea (Kazakhstan, Turkmenistan, Azerbaijan, Russia, and Iran) have become a front for ambitions and international and regional competition, especially in light of the features and characteristics that natural geography has endowed them with and their enjoyment of a group of economic and mineral wealth that are not optimally exploited so far which made it a strategic attraction area for international trends and interventions, especially Western ones. It is a battleground for major international companies aiming to monopolize promising industrial investments in order to impose control and influence on the region’s resources and economic wealth and thus impose their forei

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Publication Date
Tue Jul 08 2025
Journal Name
Journal Of Baghdad College Of Dentistry
An Assessment of Alpha-Amylase as Salivary Psychological Stress Marker in Relation to Temporomandibular Disorders among a Sample of Dental Students
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Background: University dental students perceived a higher level of stress prior to the final exam associated with raised salivary alpha-amylase levels which could be considered as a useful noninvasive biomarker for measuring acute stress. Using a Helkimo anamnestic and clinical dysfunction scoring for temporomandibular disorders can give a better insight about the association of this marker and temporomandibular disorders. The aim of this study was to evaluation level of salivary alpha-amylase in stressor students with temporomandibular disorders and the relation between the marker in relation to temporomandibular disorders severity. This might give a better understanding to the role of psychological stress as an etiological factor for deve

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Publication Date
Sun Mar 02 2014
Journal Name
Baghdad Science Journal
Determination of Advanced Oxidation Protein Products, E3 SUMO-Protein Ligase NSE2[NSMCE2], as a Marker to Predict Child Acute Lymphoblastic Leukemia
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Acute lymphoblastic leukemia (ALL) is a cancer of the blood and bone marrow (spongy tissue in the center of bone). In ALL, too many bone marrow stem cells develop into a type of white blood cell called lymphocytes. These abnormal lymphocytes are not able to fight infection very well. The aim of this study was to investigate possible links between E3 SUMO-Protein Ligase NSE2 [NSMCE2] and increase DNA damage in the childhood patients with Acute lymphoblastic leukemia (ALL). Laboratory investigations including hemoglobin(Hb) ,white blood cell (WBC) , serum total protein , albumin ,globulin , in addition to serum total antioxidant activity (TAA) , Advanced oxidation protein products(AOPP) and E3 SUMO-Protein Ligase NSE2[NSMCE2]. Blood samples

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The concept of suspense and mystery with some references to dickens s Novels ; A tale of two cities and Great expectations
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Publication Date
Tue Jul 08 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Dental caries among a group of boys with β-thalassemia major (10-12 years old) in relation to salivary Mutans streptococci
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Background: Beta thalassemia major is an inherited disorder that may affect general and oral health.The purpose of this study was toassess the severity of dental caries in relation to oral cleanliness, mutans streptococciamong a group of boys with beta thalassemia majorin comparison with a control group. Materials and Methods: The study involved 30 boys with BTM aged 10-12 years compared to 30 healthy boys with the same age group. d1-4mfs and D1-4 MFS indices were applied (Muhlemann, 1976), the viable counts of mutans streptococci in stimulated saliva were also determined. Results: The entire thalassemic group was caries-active. For both dentitions, a higher dmfs/DMFS values were recorded for study compared to control group, difference was

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Publication Date
Fri Dec 02 2022
Journal Name
Nankai Business Review International
Evaluating the dimensions of strategic intent according to the Hamel and Prahalad model/a case study in Oil Projects SCOP Company
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Purpose

The purpose of this study is to examine the dimensions of strategic intent (SI; see Appendix 1) according to the Hamel and Prahalad model as a building for the future, relying on today’s knowledge-based and proactive strategic directions of management as long-term and deep-perspective creative directions, objective vision and rational analysis, integrative in work, survival structure and comprehensiveness in perception.

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Publication Date
Wed Mar 12 2025
Journal Name
The Alarba'een Journal
Analyzing and tracking the data of the millions sized gatherings for the Arba'in visit and proposing alternative ways to relieve congestion using spatial analysis algorithms
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The city of Karbala is one of the most important holy places for visitors and pilgrims from the Islamic faith, especially through the Arabian visit, when crowds of millions gather to commemorate the martyrdom of Imam Hussein. Offering services and medical treatments during this time is very important, especially when the crowds head to their destination (the holy shrine of Imam Hussein (a.s)). In recent years, the Arba'in visit has witnessed an obvious growth in the number of participants. The biggest challenge is the health risks, and the preventive measures for both organizers and visitors. Researchers identified various challenges and factors to facilitating the Arba'in visit. The purpose of this research is to deal with the religious an

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