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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
Thu Aug 01 2024
Journal Name
Iop Conference Series: Earth And Environmental Science
Combining Bourgoyne and Young Equations by Bagging Tree Regression to Predict Rate of Penetration in a Southern Iraqi Field, Case Study
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Abstract<p>Achieving an accurate and optimal rate of penetration (ROP) is critical for a cost-effective and safe drilling operation. While different techniques have been used to achieve this goal, each approach has limitations, prompting researchers to seek solutions. This study’s objective is to conduct the strategy of combining the Bourgoyne and Young (BYM) ROP equations with Bagging Tree regression in a southern Iraqi field. Although BYM equations are commonly used and widespread to estimate drilling rates, they need more specific drilling parameters to capture different ROP complexities. The Bagging Tree algorithm, a random forest variant, addresses these limitations by blending domain kno</p> ... Show More
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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.

Design/methodology/approach

The quantitative approach was used based on research, detection and proof, as data were collected from leader

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Publication Date
Tue Nov 16 2021
Journal Name
Eurasian Chemical Communications
The role of metalloendopeptidase (MEP) as a vital predictor of early diabetic nephropathy and its relationship to some other biochemical variables
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Metalloendo peptidase is a neutral endopeptidase that cleaves peptides at the amino side of hydrophobic residues and inactivates several peptide hormones, including atrial natriuretic factor, giucagon, enkephalin, substance p, neurotensin, oxytocin, and bradykinin. It is also a major enzyme for the degradation of beta-amyloid. This study aimed to measure enzyme activity and compare it with other biochemical changes in sera patients with diabetic nephropathy. The study included 35 pathological samples of people with diabetic nephropathy, 24 samples from males and 11 samples from females, as well as the same number of healthy people as a comparison group of 15 males, 20 females, with the ages of both groups of patients with diabetic nephropat

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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
Fri Nov 21 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 Jan 13 2023
Journal Name
World Academy Of Sciences Journal
Potential effects of miR‑146 expression in relation to malondialdehyde as a biomarker for oxidative damage in patients with breast cancer
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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Evaluation of Investment Decisions in the health sector according to a strategic: Case study in Amir al-Mu'minin Specialized Hospital Approach
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                  The current study aims to apply the methods of evaluating investment decisions to extract the highest value and reduce the economic and environmental costs of the health sector according to the strategy.In order to achieve the objectives of the study, the researcher relied on the deductive approach in the theoretical aspect by collecting sources and previous studies. He also used the applied practical approach, relying on the data and reports of Amir almuminin Hospital for the period (2017-2031) for the purpose of evaluating investment decisions in the hospital. A set of conclusions, the most important of which is: The failure to apply

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Publication Date
Fri Nov 21 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Concentrations of selected elements in permanent teeth and enamel among a group of adolescent girls in relation to severity of caries
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Background: Human teeth considered to be an important etiological host factor in relation to dental caries through its morphology and composition. Elements may incorporate in tooth structure during pre and post-eruptive period changing the resistance for caries. The aims of this study were to determine the concentration of selected major (Calcium and phosphorus) and trace elements (Ferrous iron, nickel, chromium and aluminum) in permanent teeth and enamel among a group of adolescent girls in relation to severity of dental caries Material and Methods: The study group consisted of 25 girls with an age of 13-15 years old referred by Orthodontists for extractions of upper first premolars (two sides). Tooth and enamel samples were prepared for

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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 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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