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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 Oct 01 2022
Journal Name
Colloids And Surfaces A: Physicochemical And Engineering Aspects
Application of natural deep eutectic solvents in bulk liquid membrane system for removal of free glycerol from crude fatty acid methyl ester
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Fatty Acid Methyl Ester (FAME) produced from biomass offers several advantages such as renewability and sustainability. The typical production process of FAME is accompanied by various impurities such as alcohol, soap, glycerol, and the spent catalyst. Therefore, the most challenging part of the FAME production is the purification process. In this work, a novel application of bulk liquid membrane (BLM) developed from conventional solvent extraction methods was investigated for the removal of glycerol from FAME. The extraction and stripping processes are combined into a single system, allowing for simultaneous solvent recovery whereby low-cost quaternary ammonium salt-glycerol-based deep eutectic solvent (DES) is used as the membrane phase.

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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 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
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 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 Aug 03 2020
Journal Name
Rawal Medical Journal
Surgical fixation and grafting of traumatic distal tibia atrophic nonunion with or without platelet-rich plasma: A comparative study
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Objective: To compare distal tibia nonunion plating and grafting with and without platelet-rich plasma (PRP) regarding union rate, union time and complications Conclusion: Combining PRP with autologous bone graft results in a higher union rate, less healing duration, less post-operative pain, and more callus formation. (Rawal Med J 202;45:629- 632). Methodology: In this prospective comparative study, 32 patients with nonunion tibia from July 2017 January 2019 were divided into two groups: group A (16 cases) were treated by plating and grafting with PRP and group B (16 cases) were treated by plating and grafting only. Keywords: Tibial nonunion, bone graft, plateletrich plasma. Results: There was higher union rate in group A related to group

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Publication Date
Wed Sep 14 2022
Journal Name
Lecture Notes In Civil Engineering
Effect of Nozzle Condition and Type in the Spray Quality in Wheat Plants
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Publication Date
Tue Sep 03 2019
Journal Name
Rawal Medical Journal
Evaluation of low back pain among female obese patients and associated risk factors
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Background: obesity is nowadays a pandemic condition. Obese subjects are commonly characterized by musculoskeletal disorders and particularly by non-specific low back pain (LBP). However, the relationship between obesity and LBP remain to date unsupported by an objective measurement of the mechanical behavior of spine and it is morphology in obese subjects. . Objectives: To identify the relationship between obesity and LBP regarding (height, weight, sleeping, chronic diseases, smoking, and steroid). Method: A cross-sectional study was conducted from the first of January 2016 to January 2018 in obe

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Publication Date
Mon Jan 02 2012
Journal Name
Journal Of The Faculty Of Medical Baghdad
Comparative study between ultrasound findings and intra-operative in non-traumatic abdominal pain
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