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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
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Preparation and Evaluation of Atenolol Floating Beads as a Controlled Delivery System
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         This study aims to encapsulate atenolol within floating alginate-ethylcellulose beads as an oral controlled-release delivery system using aqueous colloidal polymer dispersion (ACPD) method.To optimize drug entrapment efficiency and dissolution behavior of the prepared beads, different parameters of drug: polymer ratio, polymer mixture ratio, and gelling agent concentration were involved.The prepared beads were investigated with respect to their buoyancy, encapsulation efficiency, and dissolution behavior in the media: 0.1 N HCl (pH 1.2), acetate buffer (pH 4.6) and phosphate buffer (pH 6.8). The release kinetics and mechanism of the drug from the prepared beads was investigated.All prepare

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Publication Date
Sun Sep 01 2024
Journal Name
Journal Of Cleaner Production
Emulsion liquid membrane pertraction of soap from crude biodiesel using activated carbon and glycol based deep eutectic solvents
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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Maternal knowledge related to anemia during pregnancy among a sample of mothers attending Primary Health Care centers. Baghdad.
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Background: Anaemia is a major public health concern and is one of the most prevalent health issue in women within reproductive age group.

Objective: to assess maternal knowledge related to anaemia during pregnancy.

Type of the study: A cross –sectional study.

Method: The study including 200 mothers who attended selected primary health care centres, Baghdad during November and December 2015, they completed a previously prepared questionnaire coveringsocio-demographic characteristics and knowledge regarding anaemia in 4 main domains. The responses were analysed by using frequency, percentage and percent score for each statement a

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Petroleum Science And Engineering
Operation of a MEG pilot regeneration system for organic acid and alkalinity removal during MDEA to FFCI switchover
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Publication Date
Mon May 01 2023
Journal Name
Wiadomości Lekarskie Medical Advances
EVALUATION OF VEST-OVER-PANT TECHNIQUE IN THE TREATMENT OF POST-HYPOSPADIAS URETHROCUTANEOUS FISTULA
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The aim: In this study, we present and evaluate the vest-over-pants technique as a simple way to correct urethrocutaneous fistulas after hypospadias. Materials and methods: Between October 2018 and June 2020, twenty male patients aged 5 to 20 years came to us with post hypospadias repair fistula, these patients underwent vest-over-pant repair of their fistula. The size of fistula was ranging between 2.5-5 mm. The distribution of fistula was coronal (3 patients), distal penile (9 patients), midshaft (2 patients) and proximal penile (6 patients). In 14 patients there were single fistula and 6 patients had more than one fistula. Eleven of patients were exposed to a previous failed fistula repair procedure. Results: Six months after the operati

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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Faculty Of Medicine Baghdad
Outcome of buccal mucosal patch graft in the Management of recurrent hypospadias urethrocutaneous fistula
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Background: urethrocutaneous fistula after hypospadias surgery repair is the most common complication and remains a frustrating problem for surgeon and the patient. The problem is exacerbated because the urethrocutaneous fistula may recur which adds more demands surgery. Objectives: The purpose of this study is to evaluate of the use of oral mucosal graft for management of recurrent urethrocutaneous fistula after hypospadias repair. Patients and Methods: twelfth patients with age ranging from 4 year to 15 years were presented with history of recurrent fistula. Most of fistula were located in proximal penile and penoscrotal region (58.3%) . those patients were repaired by using oral mucosal graft with mean postoperative follow up period up t

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Publication Date
Mon Jul 21 2014
Journal Name
Sensors
Reduction of the Dimensionality of the EEG Channels during Scoliosis Correction Surgeries Using a Wavelet Decomposition Technique
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This paper presents a comparison between the electroencephalogram (EEG) channels during scoliosis correction surgeries. Surgeons use many hand tools and electronic devices that directly affect the EEG channels. These noises do not affect the EEG channels uniformly. This research provides a complete system to find the least affected channel by the noise. The presented system consists of five stages: filtering, wavelet decomposing (Level 4), processing the signal bands using four different criteria (mean, energy, entropy and standard deviation), finding the useful channel according to the criteria’s value and, finally, generating a combinational signal from Channels 1 and 2. Experimentally, two channels of EEG data were recorded fro

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Publication Date
Mon Jun 01 2026
Journal Name
Ieee Access
Offline Voice-Controlled Lower Limb Rehabilitation Robot Using Forward Kinematics and Fuzzy Command Matching
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Lower limb Rehabilitation Robots (LLRRs) assist in therapeutic tasks that involve gait recovery and joint mobility recovery of the lower limbs, in patients recovering from neurologic injuries such as stroke as well as spinal cord injury. LLRRs can sometimes be driven by preprogrammed trajectories or Inverse Kinematics (IK) trajectories, which bring increased computational demand and command supported interaction. This paper proposes an interactive control framework for LLRRs using a hybrid mix of Forward Kinematics (FK) driven movement and an offline Voice Conversational Agent (VCA), based on the Vosk speech recognition engine. The framework proposed is modular in nature that is completely “local”, running offline with no need for the I

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Publication Date
Thu Oct 09 2025
Journal Name
Frontiers In Medicine
Mixed pain: clinical practice recommendations
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Mixed pain, defined by the concurrent involvement of nociceptive, neuropathic, and sometimes nociplastic mechanisms, poses a significant diagnostic and therapeutic challenge within modern pain medicine. This complex pain phenotype is increasingly recognized as a prevalent and burdensome clinical entity, yet it remains substantially underdiagnosed and sub-optimally managed across diverse healthcare settings. Epidemiological data indicate that mixed pain affects a substantial proportion of patients with chronic pain syndromes and is consistently associated with more severe symptomatology, prolonged pain duration, functional impairment, diminished quality of life, and escalated healthcare resource utilization compared to pain of a sing

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Publication Date
Sat Dec 31 2016
Journal Name
Al-kindy College Medical Journal
Dorsal plication during penile orthoplasty with and without neurovascular bundle mobilizationA comparative clinical trial conducted At Ghazy Al-Hariri teaching hospital for surgical specialties (2013 –2015)
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Background: Dorsal plication on each side of the penis at the 2 and 10-o’clock positions had been a mainstay for correction of ventral penile curvature. However, because only the 12-o’clock position proved to be a nerve-free zone, dorsal plication at the 12-o’clock position can be advocated.

Objectives: To evaluate tunica albuginea plication with and without neurovascular bundle mobilization in patients with ventral penile curvature. Type of the study: A prospective study.

Methods: A 34 patients with a mean age of (4.8 ± 0.54) years, Who still

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