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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 May 08 2011
Journal Name
Journal Of Planner And Development
the best way to deal with the center of the ancient city of Najaf
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The historic cities in the Arab and Islamic world (including the cities of the holy shrines in Iraq) suffer from many and varied problems and most notably it is clear in its origin functional structure. It had been transformed from a basic place to live for a few thousand of the population to the center or part of the main center of large city populations of more than one million. Functional structure of the ancient city have been change with the beginning of the twentieth century and accelerated rate of change in the second half of the last century. The research aims to analyze the problems of the historic centers of holy cities and analyze the methods of dealing with these problems, leading to discrimination method could be the

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Publication Date
Thu Jun 01 2023
Journal Name
Neurology Asia
Integrin alpha-4 gene polymorphism in relation to natalizumab response in multiple sclerosis patients
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Objectives: The aim of this study was to assess the possible the association between +3061 (G>A, rs1143676) missense mutation in exon 24 of the integrin α-4 subunit (ITGA-4) gene and the response to natalizumab in a sample of Iraqi multiple sclerosis patients. Methods: A sample of 59 patients with multiple sclerosis (16 males and 43 females; mean age of 32 years; age range of 15 to 52 years) receiving natalizumab for at least 12 consecutive months were involved in the study between March and August/ 2022. The sample was categorized into two groups according to their response to natalizumab treatment (responders and non-responders). Polymerase chain reaction and Sanger’s sequencing for the extracted deoxyribonucleic acid was pe

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of Orally -Administered Calcium Carbonate to Pregnant Women with Mild Pre-eclampsia
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Pre-eclampsia is the most common medical complication of pregnancy associated with increased maternal and infant mortality and morbidity. Its exact etiology is not known, although several evidences indicate that various elements might play an important role in pre-eclampsia. This study was carried out to analyze and to compare the concentration of calcium, in mild pre-eclampsia and in normal pregnant women , and to determine the effect of oral supplementation with calcium on mild pre-eclampsia  , and whether this effect is related to the change in the level of serum calcium. Forty- five women  in the third trimester of pregnancy were selected to participate in this study and divided  into: fifteen apparently healthy, normo

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Publication Date
Thu Jun 30 2022
Journal Name
Iraqi Journal Of Laser
PDF Fiber Laser Effect on Bond Strength of Titanium implant abutment to Resin Cement
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Aim: surface modification of titanium using fiber laser 1064 nm to enhance the bond strength to resin cement. Material and Methods: thirty titanium discs of 0.6 cm x 0.3 cm (diameter and thickness respectively) were categorized after preparation into three groups (n=10) as follows: control group with no surface treatment and two test groups were treated with fiber laser after estimation the appropriate parameters in the pilot study which are 81 ns pulse duration, 30,000 Hz frequency, 50 µm spot size and 10,000 mm/s scanning speed and different average power values (10 W and 20 W) depending on the tested group. Titanium discs surface characterization was performed by scanning electron microscope (SEM), a

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Publication Date
Sat Mar 26 2022
Journal Name
Indian Journal Of Ecology
Assessment of Antimicrobial Resistance to Klebsiella pneumonia Isolated from Various Clinical Samples in Baghdad
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Klebsiella pneumoniae is a severe opportunistic strain of enteric bacteria that is a major cause of urinary tract infection and pneumonia. This study was conducted in Baghdad City during September 2020-November 2020 on 50 clinical samples of urine, vaginal, sputum, wound swabs, ear swabs, and burn swabs. strains were identified using the VITEK-2 compact system and tested in K. pneumoniae terms of susceptibility to various antimicrobial drugs by Kirby-Bauer test. The isolates were more predominant in the females (56%) compared to males (44%). The antibiotic resistance rate of varied among different isolated clinical sample sources. K. pneumoniae K. pneumoniae isolated from different clinical specimens differed with respect

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Publication Date
Sat Sep 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Role of Tourism Industry in the Developing of Economie to Iraq for (1990- 2009)
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The Developing economies of countries have witnessed essential changes to words the development of tourism industry in the 21st century . in addition to adopting same of policies and strategies to grow up with the tourism sector to make it one of the important economic sector to compete the tourist cal  developments in the wear .

As for the tourism sector in Iraq ,it's still afresh one , has many of elements which can be in vested ,needs a wide strategies of tourist cal in statutes and variety completive services and change of success for the locale and forgin investor ,the essential aim after this research is to prompt the national economic through the tourism industry and making concisen

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Publication Date
Sat Jun 01 2024
Journal Name
Journal Of Scientific Development For Studies And Research
The Role of E-Learning in teaching the Arabic language to non- native speakers
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After the information revolution that occurred in the Western world, and the developments in all fields, especially in the field of education and e-learning, from an integrated system based on the effective employment of information and communication technology in the teaching and learning processes through an environment rich in computer and Internet applications, the community and the learner were able to access information sources and learning at any time and place, in a way that achieves mutual interaction between the elements of the system and the surrounding environment. After the occurrence of the phenomenon of Covid 19, it led to a major interruption in all educational systems that had never happened before, and the disrupt

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Publication Date
Sun Apr 17 2016
Journal Name
Al-academy
The art of make-up and its relation to personality play: زيد سالم سليمان
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It is well known that the art of theater is based on multiple elements come in the forefront of Representative and his work, and must be of such a representative of the kits help him to complete his work and take it out the image that aspires to it is team work, and these supplies are in the two main axes:First: Internal supplies which runs from the imagination through the focusing and memory Representative and adapts to situations and positions and others.The second is a foreign supplies, which starts from his words and gestures and his movement and his voice, which is the need to requirements help to maturation and completion of this aspect, including the lighting, costumes, decor, make-up, is the role of make-up theater and its import

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Publication Date
Tue Dec 05 2023
Journal Name
Engineering, Technology &amp; Applied Science Research
Theoretical Analysis of Composite RC Beams with Pultruded GFRP Beams subjected to Impact Loading
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Glass Fiber Reinforced Polymer (GFRP) beams have gained attention due to their promising mechanical properties and potential for structural applications. Combining GFRP core and encasing materials creates a composite beam with superior mechanical properties. This paper describes the testing encased GFRP beams as composite Reinforced Concrete (RC) beams under low-velocity impact load. Theoretical analysis was used with practical results to simulate the tested beams' behavior and predict the generated energies during the impact loading. The impact response was investigated using repeated drops of 42.5 kg falling mass from various heights. An analysis was performed using accelerometer readings to calculate the generalized inertial load. The in

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Publication Date
Sun Nov 28 2021
Journal Name
Route Educational & Social Science Journal
ARTISTIC EXPRESSION AMONG PRIMARY SCHOOL STUDENTS AND ITS RELATIONSHIP TO THE CONTEMPLATIVE THINKING VARIABLE
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The early childhood stage, which is usually described as establishing the development and growth of most of the child’s mental, psychological, moral, and physical abilities, so scientists and researchers have been interested in the growth and upbringing of the child, especially for the specified period between (6 until the age of 11) due to the importance of education in this stage. The age stage in terms of developing the child’s senses and experiences, because he is by nature inclined to play and draw in his instinctive activity, according to which his natural responses to stimuli and his contemplation of what surrounds him change. Since drawing plays an important role in raising a child from an emotional and intellectual point of vie

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