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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
Sun Mar 06 2011
Journal Name
Baghdad Science Journal
Toxoplasmosis: Serious disease during pregnancy
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Toxoplasmosis is an infection caused by Toxoplasma gondii that leads to abortion or hydrocephalus during pregnancy.One hundered and twenty two aborted women were selected for this study. Serum samples were collected form Al-Kadhmia and Kamal Al-Samari Hospitals,and laboratories around Baghdad, and tested for specific IgG and IgM anti-toxoplasma antibodies to confirm toxoplasmosis in those women by using ELISA test.The result recorded that 51(41.8%) women had antibodies against Toxoplasma gondii, 25(59.5%) women were positive for IgG, and 17(40.5%) women were positive forIgM, while 9(17.6%)women were positive for both.

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Publication Date
Wed Jan 01 2025
Journal Name
Kuwait Journal Of Science
Detection of the most frequent sources of dust storms in Iraq during 2020–2023 using space tools
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Dust storms are typical in arid and semi-arid regions such as the Middle East; the frequency and severity of dust storms have grown dramatically in Iraq in recent years. This paper identifies the dust storm sources in Iraq using remotely sensed data from Meteosat-spinning enhanced visible and infrared imager (SEVIRI) bands. Extracted combined satellite images and simulated frontal dust storm trajectories, using the Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model, are used to identify the most influential sources in the Middle East and Iraq. Out of 132 dust storms in Iraq during 2020–2023, the most frequent occurred in the spring and summer. A dust source frequency percentage map (DSFPM) is generated using ArcGIS so

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Publication Date
Thu Jun 28 2018
Journal Name
Journal Of The College Of Education For Women
Self-confidence among the children of Riyadh (Before-during-after) Play and its relation to parental treatment methods
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The basis of the personality of each individual lies in the early years of his or her life. If the personality of the child has been well organized and if the motives have been fully expressed and effectively directed, the child will have a strong will, happy self-confidence and a strong personality. If there is a failure In the early years, the individual will be unable to meet his responsibilities in life and may be the victim of many psychological disorders. The family is a learning process through which children acquire the customs, traditions, attitudes and values ​​prevailing in their social environment. (Pre-and-after) play and its relationship to parenting methods of (democratic-bullying-overprotection- and neglect), which wi

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Publication Date
Sat Sep 13 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of ER: YAG laser on enamel resistance to caries during orthodontic treatment: An in vitro study
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Background: One common undesirable side effect of orthodontic treatment with fixed appliances is the development of incipient caries lesions around brackets, particularly in patients with poor oral hygiene. Different methods have been used to prevent demineralization; the recent effort to improve the resistance against the demineralization is by the application of lasers. Materials and method: Thirty human premolars extracted for orthodontic purposes were used to test the effect of two energy level of ER-YAG laser on enamel resistance to demineralization. The brackets were bonded on the teeth and all the labial surface excluding 2 mm area gingival to the brackets were painted with acid resistance varnish. Three groups were generated. The fi

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Publication Date
Tue Jun 30 2015
Journal Name
Al-kindy College Medical Journal
Epidemiological characteristics of acute symptomatic hepatitis A in Al Alwyia pediatric teaching hospital during 2013
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ABSTRACTBackground: Concerns about hepatitis A infections is increasing worldwide specially after improving economic and sanitary conditions in many countries making older age groups who escape infection on early life vulnerable to infection.Objectives: The objectives were to estimate the frequency of hepatitis A among children consulting Al Alwyia pediatric Teaching Hospital during the year 2013 and to study some demographic characteristics of the disease.Methods: This cross - sectional hospital -based study wasconducted during 2013-2014 and include pediatric patients(43525 patients) who consult Al Alwyia pediatric hospitalduring that time. The outcome is total IgM antibodies tohepatitis A virus detected using Enzyme Linked FluorescentA

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Publication Date
Mon Oct 12 2020
Journal Name
Molecules
Phase Change Process in a Zigzag Plate Latent Heat Storage System during Melting and Solidification
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Applying a well-performing heat exchanger is an efficient way to fortify the relatively low thermal response of phase-change materials (PCMs), which have broad application prospects in the fields of thermal management and energy storage. In this study, an improved PCM melting and solidification in corrugated (zigzag) plate heat exchanger are numerically examined compared with smooth (flat) plate heat exchanger in both horizontal and vertical positions. The effects of the channel width (0.5 W, W, and 2 W) and the airflow temperature (318 K, 323 K, and 328 K) are exclusively studied and reported. The results reveal the much better performance of the horizontal corrugated configuration compared with the smooth channel during both melti

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Publication Date
Mon Jun 30 2025
Journal Name
Scripta Medica
Case Report: A Rare Presentation of Sigmoid Volvulus During Pregnancy With an Integrative Postoperative Approach
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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of Engineering
Optimal Economic Design of Diversion Structures during Construction of a Dam by Particle Swarm Optimization
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Publication Date
Mon Jan 01 2018
Journal Name
International Journal Of Science And Research (ijsr)
Optimal Economic Design of Diversion Structures during Construction of a Dam by Particle Swarm Optimization
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Diverting river flow during construction of a main dam involves the construction of cofferdams, and tunnels, channels or other temporary passages. Diversion channels are commonly used in wide valleys where the high flow makes tunnels or culverts uneconomic. The diversion works must form part of the overall project design since it will have a major impact on its cost, as well as on the design, construction program and overall cost of the permanent works. Construction costs contain of excavation, lining of the channel, and construction of upstream and downstream cofferdams. The optimization model was applied to obtain optimalchannel cross section, height of upstream cofferdam, and height of downstream cofferdamwith minimum construction cost

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Publication Date
Tue Mar 01 2022
Journal Name
Academy Of Accounting And Financial Studies Journal
Impact of Digital Audit on Improving performance Quality and Reduce Costs An applied research in a sample of private auditing firms and offices
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