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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
Tue Mar 02 2021
Journal Name
Sustainability
Effect of Twisted Fin Array in a Triple-Tube Latent Heat Storage System during the Charging Mode
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This study aims to assess the effect of adding twisted fins in a triple-tube heat exchanger used for latent heat storage compared with using straight fins and no fins. In the proposed heat exchanger, phase change material (PCM) is placed between the middle annulus while hot water is passed in the inner tube and outer annulus in a counter-current direction, as a superior method to melt the PCM and store the thermal energy. The behavior of the system was assessed regarding the liquid fraction and temperature distributions as well as charging time and energy storage rate. The results indicate the advantages of adding twisted fins compared with those of using straight fins. The effect of several twisted fins was also studied to discover

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Publication Date
Wed Mar 16 2022
Journal Name
Journal Of Educational And Psychological Researches
The Extent to Which Future Skills are Employed During Teaching from the Viewpoint of Students of Islamic Studies and their Relationship to Students' Attitude towards Future Profession
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The research aims to identify the relationship between employing future skills during teaching from the viewpoint of students of Islamic studies at the Northern Border University, as well as their attitudes towards future professions. The researcher employed the correlational descriptive approach. The tools were a questionnaire for employing future skills, and a scale for the attitude towards the future profession. The two research tools were applied to a random sample of (242) male and female students from the department of Islamic Studies, College of Education and Arts. The findings showed that the total level of employing future skills and their three axes during teaching was average. It was also found that the attitude towards future

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Publication Date
Sun Jan 01 2017
Journal Name
Analytical Methods
Determination of pharmaceuticals in freshwater sediments using ultrasonic-assisted extraction with SPE clean-up and HPLC-DAD or LC-ESI-MS/MS detection
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A robust and sensitive analytical method is presented for the extraction and determination of six pharmaceuticals in freshwater sediments.

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Publication Date
Fri Apr 04 2025
Journal Name
European Journal Of Dentistry
The Effectiveness of Conventional and Advanced Aligning Archwires: The Insights of Two Randomized Clinical Trials
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Abstract<p> Objectives This study aimed to compare the clinical effectiveness of four aligning archwires: Superelastic Nickel-Titanium (Superelastic-NiTi), SmartArch, Copper-Nickel-Titanium (Cu-NiTi), and Speed Tubular coaxial-Nickel-Titanium (Tubular coaxial-NiTi), regarding the alignment efficiency, associated perception of pain, and possibility of inducing root resorption.</p><p> Materials and Methods This study includes two randomized clinical trials run in parallel. Patients with 5 to 9 mm of mandibular anterior teeth crowding according to Little's irregularity index (LII) who needed fixed orthodontic appliances without extraction were randomly assigned to four groups of</p> ... Show More
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Publication Date
Thu Jun 25 2020
Journal Name
International Journal Of Drug Delivery Technology
Development and Characterization of Controlled Release Tablets of Candesartan Cilexetil/ β‑Cyclodextrin Inclusion Complex
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Objective: Matrix tablet approach is one of the delivery systems intended for poorly water-soluble drugs, like candesartan cilexetil (CC). CC is a class II drug used for the treatment of hypertension. Methods: Matrix tablets from (F1x to F18z) were prepared in the presence of β‑cyclodextrin. Matrix tablet formulation ensures control release of the drug and higher dissolution by β‑cyclodextrin. Fourier transform infrared spectroscopy (FTIR), and differential scanning calorimetry (DSC) were used to study compatibility. Results: The angle of repose determination showed good flow for most of the formulas, besides having good compressibility. Weight variation test for all formulas showed accepted value. Drug content measurement sho

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Publication Date
Thu Jun 25 2020
Journal Name
International Journal Of Drug Delivery Technology
Development and Characterization of Controlled Release Tablets of Candesartan Cilexetil/ β‑Cyclodextrin Inclusion Complex
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Objective: Matrix tablet approach is one of the delivery systems intended for poorly water-soluble drugs, like candesartan cilexetil (CC). CC is a class II drug used for the treatment of hypertension. Methods: Matrix tablets from (F1x to F18z) were prepared in the presence of β‑cyclodextrin. Matrix tablet formulation ensures control release of the drug and higher dissolution by β‑cyclodextrin. Fourier transform infrared spectroscopy (FTIR), and differential scanning calorimetry (DSC) were used to study compatibility. Results: The angle of repose determination showed good flow for most of the formulas, besides having good compressibility. Weight variation test for all formulas showed accepted value. Drug content measurement sho

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Publication Date
Thu Jan 01 2015
Journal Name
Chemical And Process Engineering Research
Synthesis and Characterization of Gelatin-G-Poly (Acryloyl Amide) Proflavine and Controlled Release Study
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Gelatin-grafted N- proflavine acryl amide was synthesized through two steps; firstly the Gelatin was grafted with acrylic acid free radically using Ammonium per-sulfate at 60℃, Then it was modified to its corresponding acyl chloride derivation, second step included the substitution with amino group of proflavine, in this research Gelatin was used as a natural nontoxic, water soluble polymer as a drug carrier. The prepared pro drug polymer was characterized by FTIR and 1H-NMR spectroscopies, Controlled drug release was studied in different pH values at 37℃. Many advantages were obtained comparing with other known methods.

Publication Date
Thu Jun 27 2024
Journal Name
Iraqi Journal Of Pharmaceutical Sciences( P-issn 1683 - 3597 E-issn 2521 - 3512)
Impact of Gliclazide Modified Release or Glimepiride as Add-on Therapy to Metformin on Glycemic and Oxidative Stress Parameters in Type 2 Diabetic Patients
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Background: Type 2 diabetes mellitus is a condition characterized by an elevation of oxidative stress, which has been implicated in diabetic progression and its vascular complications. Aim: Assessing the impact of gliclazide modified release (MR) versus glimepiride on oxidative stress markers, glycemic indices, lipid profile, and estimated glomerular filtration rate in uncontrolled type 2 diabetic patients on metformin monotherapy. Methods: This was an observational comparative study conducted in Thi-Qar specialized diabetic, endocrine, and metabolism center. Sixty-six patients were randomized into two groups based on the addition of the sulfonylureas (SUs). Group 1 (33 patients) was on gliclazide MR, whereas Group 2 (33 patients)

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Publication Date
Fri Apr 30 2021
Journal Name
Al-kindy College Medical Journal
Outcome of Perforated Gallbadder during Laparoscopic Cholecystectomy
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Background: Laparoscopic cholecystectomy (LC) has become the standard treatment for symptomatic cholelithiasis. Bile duct injury and accidental gallbladder perforation with spillage of bile and stone are common complications of LC. This study was carried out to assess the early complications of gallbladder perforation during LC, and identify the risk factor of that perforation.

Objectives: to evaluate the early complications which may occur after the perforation of the gallbladder during laparoscopic cholecystectomy and to determine the risk factors which are associated with the perforation of the gall bladder. 

Subjects and methods: A prospective comparative study o

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Publication Date
Thu Sep 15 2022
Journal Name
Romanian Neurosurgery
Cervical carotid artery vasospasm during cerebral angiography
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Background: Vasospasm occurs commonly in the intracranial arteries as a complication of subarachnoid haemorrhage. On the other hand, extracranial Internal carotid artery (ICA) vasospasm is scarce, and it may occur due to mechanical manipulation during cerebral angiography. We report a case of cervical carotid artery vasospasm during diagnostic cerebral angiography, which caused anterior cerebral artery territory hypoperfusion, to discuss potential risk factors. Case description: For a 22-year-old female with a ten-year history of epilepsy on multiple drugs, brain magnetic resonance imaging (MRI) showed frontal periventricular developmental venous anomaly. Diagnostic catheter cerebral angiography was used to better identify the vas

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