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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 Jun 03 2017
Journal Name
Journal Of Diagnostic Medical Sonography
The Diagnostic Accuracy of Sonography, With Graded Compression to Image Acute Appendicitis Compared to Histopathologic Results
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Acute appendicitis is the most common surgical abdominal emergency. Its clinical diagnosis remains a challenge to surgeons, so different imaging options were introduced to improve diagnostic accuracy. Among these imaging modality choices, diagnostic medical sonography (DMS) is a simple, easily available, and cost effective clinical tool. The purpose of this study was to assess the accuracy of DMS, in the diagnosis of acute appendicitis compared to the histopathology report, as a gold standard. Between May 2015 and May 2016, 215 patients with suspected appendicitis were examined with DMS. The DMS findings were recorded as positive and negative for acute appendicitis and compared with the histopathological results, as a gold standard

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Psychological and Social Reasons Leading to Juveniles Delinquency: Psychological and Social Reasons Leading to Juveniles Delinquency
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Abstract
Disturbs the social system in any society specially in Iraq other than
other Islamic and Arabic countries. That is according to the abnormal
conditions that Iraq has past through as wars and blockage, and lastly the
invasion. Therefore it has been necessary to put this phenomenon under
study and analysis to discover Juvenile Delinquency is one of the most
prominent social phenomenon that the important reasons behind it, and trying
to treat what can be treated of the effects of it upon society.
This study is mainly concerned with the explaining the social factors
leading toward juvenile delinquency trying to crystallize the problem of the
study in the following question: (What are the psychological,

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Models of measurement and disclosure of fair value accounting - Applied to contribute to company garments mixed
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The research aims to provide a method to measure the fair value of the most environmentally friendly of Iraq and through the application of method of measuring the fair value of the company garments contribute to mixed as the company is of the economic units of the industrial sector and included in the Iraqi market for securities as a profit and distributes profits to shareholders since the method of measurement of the fair value based on the divided profits as toxic in a deduction of Cash Dividends cash for measuring fair value, and will also be in this research to clarify the disclosure of accounting for fair value and choose the method of disclosure most appropriate to the beneficiaries of accounting disclosure, as will be cho

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Voluntary Obedience for Tthe Taxpayers to Find End to Tax Evasions in Iraq
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The Voluntary Obedience has great importance for the modern taxes systems and its management and this is meant the taxpayer whom in charge to pay of his taxes obligations voluntarily , he is very known of himself whereas he prepared his finishing accountings and present them as samples prepared by taxes management and settle the tax sum directly according to specified income , which has an impact to find end to tax evasion as result lead to increase the tax income and achieve the justice for the taxpayer and the state treasury

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Determining the Optimal Ratio of Liquidity in Iraqi Commercial Banks for period (2005-2013): applied research using Iraqi Commercial Banks as a sample study
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  This study  focused on a fundamental issue which was represented by ability of Iraqi central bank in facing the difficulty of determining  the optimal ratio of liquidity in the Iraqi banks in terms of the balancing between its obligations to the depositors and borrowers, and liquidate their funds on one hand and the risks on the other hand.the search aimed  for achieving the goals which represented by identifying the possibility of Iraqi banks to apply the regulations rules and  instructions  issued by central bank  of  Iraq in determining  ratio  of  liquidity and  its  appropriate with Iraqi  banks  action to implement  a  reasonable  profit to&

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Publication Date
Fri Nov 21 2025
Journal Name
Journal Of Physical Education
Special Exercises Using A Proposed Training Apprentice And Its Effect On Some Biomechanical Indicators and Achieving 110m Hurdles For players Under 20 years old
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Publication Date
Sun May 11 2025
Journal Name
Journal Of Information Systems Engineering And Management
The Effect of the Learning Mastery Strategy using Interactive Learning Techniques as a Therapeutic Method on the Achievement of Secondary School Students in Mathematics
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  The current research aims to identify the effect of the learning mastery strategy using interactive learning as a therapeutic method on the achievement of secondary school students in mathematics. To achieve the research objective, the researcher selected second-grade middle school students at Al-Haybah Intermediate School for Boys and determined his research sample, which consisted of (77) students distributed into two sections: Section (A) the experimental group, with (38) students, and Section (B) the control group, with (39) students. The statistical equivalence of the two research sample groups was confirmed in the variables (intelligence test, previous achievement, and previous knowledge test). The researchers chose the par

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Publication Date
Fri Sep 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Reliability of the multipeg™ transducer in measuring dental implant stability by using a resonance frequency analysis device (Osstell®): An observational clinical study
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Background: Measuring implant stability is an important issue in predicting treatment success. Dental implant stability is usually measured through resonance frequency analysis (RFA). Osstell® RFA devices can be used with transducers (Smartpeg™) that correspond to the implants used as well as with transducers designed for application with Penguin® RFA devices (Multipeg™). Aims: This study aims to assess the reliability of a MultiPeg™ transducer with an Osstell® device in measuring dental implant stability. Materials and Methods: Sixteen healthy participants who required dental implant treatment were enrolled in this study. Implant stability was measured by using an Osstell® device with two transducers, namely, Smartpeg™ and M

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Publication Date
Sun Jan 14 2018
Journal Name
Journal Of Engineering
The effect of Laser Shock Peening on Fatigue Life Using Pure Water and Hydrofluoric Acid As a Confining Layer of Al – Alloy 7075-T6
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Laser shock peening (LSP) is deemed as a deep-rooted technology for stimulating compressive residual stresses below the surface of metallic elements. As a result, fatigue lifespan is improved, and the substance properties become further resistant to wear and corrosion. The LSP provides more unfailing surface treatment and a potential decrease in microstructural damage. Laser shock peening is a well-organized method measured up to the mechanical shoot peening. This kind of surface handling can be fulfilled via an intense laser pulse focused on a substantial surface in extremely shorter intervals. In this work, Hydrofluoric Acid (HF) and pure water as a coating layer were utilized as a new technique to improve the properti

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Publication Date
Thu Dec 13 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Causes of maternal death in Mizan Aman and Gebretsadik shawo general hospitals from 2011 – 2015: A case - control study using propensity score matching analysis
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Objective: To identify causes of maternal death in Mizan Aman and Gebretsadik shawo general hospitals
Methodology: A case control study on 595 charts, 119 cases and 476 controls was conducted in Mizan
Aman & Gebretsadik shawo general hospitals. Data was analyzed by STATA 13.1. Propensity score
matching analysis was used to see causes of maternal death.
Results: Hemorrhage were the main direct causes of maternal death which accounts 47.9% (β =0.58
(95% CI (0.28,0.87)) in hospital but when projected to population based the sample (β =0.26 (95% CI
(0.22,0.31)). Followed by infection 36 (25.21%) (β = 0.50 (95% CI (0.08, 0.92)). when projected to
population based the sample PIH 7.6%) is significant cause (β = 0.16

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