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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 Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Imagination as a Path to Reality
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Imagination as a Path to Reality

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Publication Date
Thu Nov 22 2018
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Synthesis and Thermal Electo Conductivity of Some New Triazole Derivatives Bearing Azo or Azomethain Group
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Newly acid hydrazide was synthesized from ethyl 2-(2,3-dimethoxyphenoxy) acetate (2), which is cyclized to the corresponding  4-amino-1,2,4-triazole (3). Five newly azo derivatives (4a-e) were synthesized from this 1,2,4-triazole by converting the amine group to diazonium salt then reacted with various substituent phenol,as well three newly imine derivatives (5a-c) were synthesized from reacting the amine group of compound (3) with three aryl aldehyde. The thermal electro conductivity of these compounds was tested at 30, 50, 75 and 100 áµ’C. compound 4a showed interesting electro conductivity at 75áµ’C as well 5a at 75áµ’C while 5b showed significant conductivity at 100 áµ’C

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Publication Date
Thu Jan 30 2020
Journal Name
Al-kindy College Medical Journal
The Impact of Prophylactic Dexamethasone, Metoclopramide or both on Nausea and Vomiting After Laparoscopic Cholecystectomy
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Background: Postoperative nausea and vomiting (PONV) are one of the most common complaints following laparoscopic cholecystectomy.

Objective: This study was designed to compare the effects of dexamethasone, metoclopramide, and their combination on preventing PONV in patients undergoing laparoscopic cholecystectomy.

Methods: A total of 135 patients enrolled in the study. American Society of Anesthesiologists (ASA) physical status I and II patients were included in this randomized, double blind, placebo-controlled study. Patients were randomly assigned to group A administered 8mg iv dexamethasone, group B received metoclopramide 10 mg, group C received combination of 8mg de

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Using cleaner production costs to achieve sustainable competitive advantage
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Abstract

                Target costing and cleaner production are among the most important techniques in the field of cost and management accounting, which, when integrated, enable economic units to achieve the goal of cost management by reducing it by calculating cost more accurately than traditional methods.To achieve this, the researcher relied on the inductive approach in writing the theoretical framework for the research, relying on foreign and Arabic books, dissertations and university theses, foreign and Arabic research and periodicals related to the subject of the research, and relying on the descriptive and analytical approach in

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Publication Date
Mon Aug 28 2023
Journal Name
Journal Of Planner And Development
Using GIS to identify hazardous earthquake locations in Iran
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The objective of all planning research is to plan for human comfort and safety, and one of the most significant natural dangers to which humans are exposed is earthquake risk; therefore, earthquake risks must be anticipated, and with the advancement of global technology, it is possible to obtain information on earthquake hazards. GIS has been utilized extensively in the field of environmental assessment research due to its high potential, and GIS is a crucial application in seismic risk assessment. This paper examines the methodologies used in recent GIS-based seismic risk studies, their primary environmental impacts on urban areas, and the complexity of the relationship between the applied methodological approaches and the resulting env

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Publication Date
Tue Jan 01 2019
Journal Name
Science International
USING CRYPTOANALYSIS POLICIES AND TECHNIQUES TO CREATE STRONG PASSWORD
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Publication Date
Thu Dec 04 2008
Journal Name
Journal Of Engineering
IMPROVEMENT OF SOIL USING GEOGRIDS TO RESIST ECCENTRIC LOADS.
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This paper presents the results of experimental investigations to predict the bearing capacity of square footing on geogrid-reinforced loose sand by performing model tests. The effects of several parameters were studied in order to study the general behavior of improving the soil by using the geogrid. These parameters include the eccentricity value, depth of first layer of reinforcement, and vertical spacing of reinforcement layers. The results of the experimental work indicated that there was an optimum reinforcement embedment depth at which the bearing capacity was the highest when single-layer reinforcement was used. The increase of (z/B) (vertical spacing of reinforcement layer/width of footing) above 1.5 has no effect on the re

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Publication Date
Thu Jun 15 2023
Journal Name
Romanian Neurosurgery
Delayed intraoperative rupture of clipped aneurysm during the awaking from anaesthesia
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Introduction. Intraoperative rupture (IOR) of an aneurysm is a frightful complication that causes significant morbidity and mortality worldwide. IOR can be attributed to various parameters, including hypertension, increased intracranial pressure (ICP), fragility of the vessels, and inadequate anaesthesia. IOR due to insufficient anaesthesia is scarcely reported in the literature. Here, we describe a re-ruptured anterior communicating artery (ACoA) after incomplete clipping of the neck during craniotomy closure due to unintended early wake-up from anaesthesia with a discussion about the management. Case description. A 38-year-old male suddenly developed a severe headache, a brief loss of consciousness, and vomiting. Computed tomogr

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Publication Date
Tue Nov 11 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Expression of RANKL by dental cells during eruption of mice teeth
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Background : In order for a tooth to erupt, two obvious requirements are needed. First, there has to be alveolar bone resorption of the bone overlying the crown of the tooth such that an eruption pathway is formed. Second, resorption of bony crypt and apposition of new one, third, there has to be a biological process that will result in the tooth moving through this eruption pathway.The amniotic sac contains a considerable quantity of stem cells. These amniotic stem cells are multipotent and able to differentiate into various tissues, which may be useful for human application. Receptor activator of nuclear factor kappa B ligand (RANKL) is concentrated on bone biology, more specifically bone metabolism. RANKL plays a vital role in osteoclast

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Publication Date
Sun Dec 02 2018
Journal Name
Journal Of The College Of Education For Women
Political Thought in Russia During the 21st Century, Targets and Features
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The features of strategic thought transformation in Russia based on attempt confirm the Russian influenced on Region of Eastern Europe through series of common defense treaties and mutual security between USSR and another states this treaties emphasis size on direct Russian supervision on these states in addition, Russia in trusted to formation communism regimes in its vital space, Russia inherited the status of former USSR in political and economic levels.

           Shortly we can see that Russia witnessed large Transformation in political strategic thought as a result of change in internal strategic environment and change of nature understanding which influenced on Russia. This

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