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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 01 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Administrative control procedures and their relation to evaluating the job performance: in the companies department
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The study sought to highlight the importance of applying the administrative control procedures which play an important role in assessing the performance of the employees of the tax administration and specifically the companies department by setting the standards and objectives of the department on the basis of which in the implementation of its work and identify deviations and errors and find appropriate solutions and evaluate the results according to appropriate solutions, The study of the problem of research, namely the extent to which the tax administration applied to the administrative control procedures in view of its importance in evaluating the performance of its employees and the extent of their application to the legislations an

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Publication Date
Sun May 12 2024
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المؤتمر العلمي الدولي الثالث للعلوم الاجتماعية والإنسانية بعنوان (دور الجامعات في تطوير النظام التعليمي وفق متطلبات التنمية المستدامة
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To approach the problem of individual oppression with an international perspective drawing on Foucauldian concepts, this paper compares George Orwell’s 1984 (1949) and the Iraqi Sinan Antoon’s I’jaam (2004), which was translated into English in 2007. Even though Orwell and Antoon come from dissimilar cultural backgrounds, religions and epochs, they have tackled the issue of individuals’ oppression through their oppressed characters in a strikingly similar way. Hence, by applying the theories of both the American School of Comparative Literature and Foucauldian concepts, the current study attempts to establish a relationship between the Western and Eastern ways of dealing with the issue of oppression as an international problem in au

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Publication Date
Wed Jan 30 2019
Journal Name
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Creative thinking and its relationship to solving the problems of professional skills For kindergarten teachers
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Current search aims to identify the creative thinking of the kindergarten teachers and
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Publication Date
Tue Apr 30 2024
Journal Name
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Wellbore Instability Analysis to Determine the Safe Mud Weight Window for Deep Well, Halfaya Oilfield
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Wellbore instability is one of the most common issues encountered during drilling operations. This problem becomes enormous when drilling deep wells that are passing through many different formations. The purpose of this study is to evaluate wellbore failure criteria by constructing a one-dimensional mechanical earth model (1D-MEM) that will help to predict a safe mud-weight window for deep wells. An integrated log measurement has been used to compute MEM components for nine formations along the studied well. Repeated formation pressure and laboratory core testing are used to validate the calculated results. The prediction of mud weight along the nine studied formations shows that for Ahmadi, Nahr Umr, Shuaiba, and Zubair formations

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Publication Date
Sat Sep 13 2025
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Periodontal condition in relation to nutritional status among kindergarten children in Al-Ramadi city/Iraq
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Background: Nutrition can affect periodontal disease through contributing to microbial growth in the gingival crevice, affecting the immunological response to bacterial antigens and assisting the repair mechanism of the connective tissue at the local site after injury from plaque and calculus. The aim of this study was to assess the prevalence of Oral hygiene (plaque and calculus) and gingivitis in relation to age, gender and nutritional status. Materials and methods: The sample included (444) kindergarten children at age of (4 and 5 years old) males and females from urban areas in Al-Ramadi city. The assessment of nutritional status was performed using anthropometr

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Publication Date
Sat Sep 13 2025
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Effect of silica layer on bonding strength of thermoplastic nylon to cold cure acrylic resin
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Background: The combination of thermoplastic nylon resin materials and auto polymerizing resin is necessary in some situation for repair and adjustment. This study evaluated shear bond strength between thermoplastic nylon material (flexible) and auto polymerizing acrylic resin subjected to holes and silica coated layer. Materials and Method: Forty five (45) specimens were prepared from flexible acrylic bonded to auto-polymerizing acrylic resin and divided into three groups according to the surface treatments as follows: Group A: 15 specimens of flexible acrylic bonded with cold-cure acrylic by holes. Group B: 15 specimens of flexible acrylic bonded with cold-cure acrylic by silica coated layer. Group C: 15 specimens of flexible acrylic bon

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Publication Date
Sat Jun 15 2019
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Taste Detection Thresholds in Relation to Salivary and Serum Zinc in Patients on Simvastatin Treatment
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Background: Hyperlipidemia is an elevated fat (lipids), mostly cholesterol and triglycerides, in the blood. These lipids usually bind to proteins to remain circulated so-called lipoprotein. Aims of the study: To determine taste detection threshold and estimate the trace elements (zinc) in serum and saliva of those patients and compare all of these with healthy control subjects. Methods: Eighty subjects were incorporated in this study, thy were divided into two groups: forty patients on simvastatin treatment age between (35-60) years, and forty healthy control of age range between (35-60) years. Saliva was collected by non-stimulated technique within 10 minutes. Serum was obtained from each subject. Zinc was estimated in serum and saliva

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Coaches and analysts face a significant challenge of inaccurate estimation when analyzing Men's 100 Meter Sprint Performance, particularly when there is limited data available. This necessitates the use of modern technologies to address the problem of inaccurate estimation. Unfortunately, current methods used to estimate Men's 100 Meter Sprint Performance indexes in Iraq are ineffective, highlighting the need to adopt new and advanced technologies that are fast, accurate, and flexible. Therefore, the objective of this study was to utilize an advanced method known as artificial neural networks to estimate four key indexes: Accelerate First of 10 meters, Speed Rate, Time First of 10 meters, and Reaction Time. The application of artifi

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Background: Dental caries is the most common oral problem, although dental caries is not life threating, it has aharmful effect on quality of life. Socioeconomic factors were found to be strong predictors of the prevalence of oral diseases in children, likes family income, occupational prestige, and education. The aim of this study is to assess the effect of socioeconomic factors on occurrence dental caries in their children. Materials and methods: The sample consists of 550 kindergartens children aged between (4-5) years were selected randomly, girls and boys. The kindergartens selection was randomly from different geographical areas in Al-Najaf governorate. Information was taken from children's parents using questionnaire with the help o

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Publication Date
Mon Jul 03 2017
Journal Name
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The interaction of Porphyromonas gingivalis with host epithelial cells and its relevance to periodontal disease
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Periodontitis is one of the most prevalent bacterial diseases affecting man with up to 90% of the global population affected. Its severe form can lead to the tooth loss in 10-15% of the population worldwide. The disease is caused by a dysbiosis of the local microbiota and one organism that contributes to this alteration in the bacterial population is Prophyromonas gingivalis. This organism possesses a range of virulence factors that appear to contribute to its growth and survival at a periodontal site amongst which is its ability to invade oral epithelial cells. Such an invasion strategy provides a means of evasion of host defence mechanisms, persistence at a site and the opportunity for dissemination to other sites in the mouth. However, p

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