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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 Jul 09 2023
Journal Name
Journal Of Engineering
Proposed Modification to Increase Main Swept Back Wing Efficiency for Aircraft Aermacchi Siai S211
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A winglet is devices attached at the wing tips, used to improve aircraft wing efficiency by reduction influence wing tips vortices and induct drag, increasing lift force at the wing tips and effective aspect ratio without adding greatly to the structural stress and weight in the wing structure. This paper is presented three-dimensional numerical analysis to proposed modification swept back wing by adding Raked winglets devices at the main wing tips belong the two seat trainer aircraft type Aermacchi Siai S211 by using Fluent ANSYS 13 software. CFD numerical analysis process was performed at the same flight boundary conditions indifferent wing angle of attacks with constant air flow velocity V∞ =50 (m/sec), ambient pressure Po=101325 (P

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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of Planner And Development
The Quantitative Analysis To Assess The Efficiency Of The Transport Network In Sader City
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     This research examines the quantitative analysis to assess the efficiency of the transport network in Sadr City, where the study area suffers from a large traffic movement  for the variability of traffic flow and intensity at peak hours as a result of inside traffic and outside of it, especially in the neighborhoods of population with  economic concentration.                                                           &n

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Publication Date
Wed Apr 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The use of management principles to Fayol in the implementation of competitive strategies Porter
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This paper aims to review the intellectual to the most important thought leaders administrative and strategic They both (Henry Fayol and Michelle Porter), who forward a lot of ideas that have helped countries in the advancement and progress their economies , has been drawing literature theoretical common border in Contributions ( Fayol ) philosophical and between applications ( Porter ), which reversed strategies of the three ( the leadership of the cost, differentiation, and focus ), so browse search how to apply and use the principles of Fayol in the implementation of strategies competitiveness of Porter, and stems from a problem ( ( to what extent a reflection of the principles ( Fayol) fourteen strategies (Porter ) competitiv

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Proposed Entropy Loss function and application to find Bayesian estimator for Exponential distribution parameter
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The aim of this paper to find Bayes estimator under new loss function assemble between symmetric and asymmetric loss functions, namely, proposed entropy loss function, where this function that merge between entropy loss function and the squared Log error Loss function, which is quite asymmetric in nature. then comparison a the Bayes estimators of exponential distribution under the proposed function, whoever, loss functions ingredient for the proposed function the using a standard mean square error (MSE) and Bias quantity (Mbias), where the generation of the random data using the simulation for estimate exponential distribution parameters different sample sizes (n=10,50,100) and (N=1000), taking initial

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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Barriers to Baseline Needs for Early Detection of Breast Cancer among Iraqi Female Patients
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Background: Breast Cancer is the most common malignancy among the Iraqi population; the majority of cases are still diagnosed at advanced stages with poor prospects of cure. Early detection through promoting public awareness is one of the promising tools in its control. Objectives: To evaluate the baseline needs for breast cancer awareness in Iraq through exploring level of knowledge, beliefs and behavior towards the disease and highlighting barriers to screening among a sample of Iraqi women complaining of breast cancer. Methodology: Two-hundred samples were enrolled in this study; gathered from the National

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Publication Date
Tue Jul 05 2022
Journal Name
Journal Of Pharmaceutical Care
Epidemiological and Clinical Factors Affecting the Response to Etanercept Among Patients with Rheumatoid Arthritis
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Publication Date
Thu Aug 24 2023
Journal Name
Migration Letters
Imaginative Interconnection and its Relationship to Spatial Thinking Among Preparatory School Students in Mathematics
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Publication Date
Thu Aug 01 2013
Journal Name
Biochemistry
Mechanistic Insights from the Binding of Substrate and Carbocation Intermediate Analogues to Aristolochene Synthase
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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Smart Flow Steering Agent for End-to-End Delay Improvement in Software-Defined Networks
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To ensure fault tolerance and distributed management, distributed protocols are employed as one of the major architectural concepts underlying the Internet. However, inefficiency, instability and fragility could be potentially overcome with the help of the novel networking architecture called software-defined networking (SDN). The main property of this architecture is the separation of the control and data planes. To reduce congestion and thus improve latency and throughput, there must be homogeneous distribution of the traffic load over the different network paths. This paper presents a smart flow steering agent (SFSA) for data flow routing based on current network conditions. To enhance throughput and minimize latency, the SFSA distrib

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Publication Date
Sat Jun 26 2021
Journal Name
Journal Of The College Of Education For Women
The Wisdom-Based Thinking and its Relationship to the Psychological Capital: طلل غالب علوان
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The present study aims to identify wisdom-based thinking and its relationship to psychological capital. It further aims to find out the differences in the level of wisdom-based thinking and psychological capital according to the variables of gender and specialization (scientific, humanities). To achieve this, the study has been conducted on a sample of (380) male and female students. The two scales, wisdom-based thinking and psychological capital are implemented to the sample after being constructed by the researcher and after ensuring their psychometric characteristics' suitability for the study's aims. Results concerning the first aim have shown that there is a significant relationship among students. The second aim has revealed that t

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