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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 Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
A solution to the Lifely Disobedience and its Effect to Stop Divorce
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Allah legislated marriage and made it dwelling, fellowship and mercy between
the two couples, Prophet Moh'd (peace of Allah and blessing be upon him) ordered a
husband to look after his wife, treat her with full charity and make love with here
every kindly. On the other hand, he ordered a wife to obey her husband and respect
him deeply, nevertheless, some obstacles may sometimes be appeared within the life
of their marriage, this may be caused by either a husband or a wife. This problem is
called lifely disobedience (AL-Noshooz).
In the other words, this means that a wife begins to hate her husband, refuse his orders
and not obey him.
In brief, they hate each other which leads to some marks appear in their
m

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Publication Date
Wed Mar 20 2019
Journal Name
Al-khwarizmi Engineering Journal
Design and Simulation of Closed Loop Proportional Integral (PI) Controlled Boost Converter and 3-phase Inverter for Photovoltaic (PV) Applications
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This research deals with the design and simulation of a solar power system consisting of a KC200GT solar panel, a closed loop boost converter and a three phase inverter by using Matlab / Simulink. The mathematical equations of the solar panel design are presented. The electrical characteristics of the panel are tested at the values ​​of 1000  for light radiation and 25 °C for temperature environment. The Proportional Integral (PI) controller is connected   as feedback with the Boost converter to obtain a stable output voltage by reducing the oscillations in the voltage to charge a battery connected to the output of the converter. Two methods (Particle Swarm Optimization (PSO) and Zeigler- Nichols) are used for tuning

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Publication Date
Tue Jun 17 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Root resorption and anti-dentine antibody level in serum and saliva of well-controlled type ? diabetic patients undergoing orthodontic treatment
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Background: Diabetic mellitus type ? is a metabolic disorder of diverse etiological factors, characterized by hyperglycemia resulting from an absolute deficiency of insulin affected childhood and adolescent. Some of these patients seek an orthodontic care .The orthodontist who is treating these medically compromised patients should have a working knowledge of the multitude of medically complex problems. This information will support and enable for delivery of high standards of dental care in general and orthodontic care in particular. The aim of this study was to analyze serum IgG levels and salivary secretory IgA (sIgA) levels in human dentine extract (HDE) before (T0) and 6 months after (T6) orthodontic treatment and to correlate anti-HDE

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Publication Date
Tue Jun 17 2025
Journal Name
Al–bahith Al–a'alami
SOCIAL MEDIA AND ITS ROLE IN THE PRODUCTION AND NUTRITION OF CRISES: "ANALYTICAL STUDY OF A SAMPLE OF TWITTER DURING THE GULF CRISIS 2017"
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Social networking sites have become very popular since the beginning of the current decade and have become linked to our daily life. We follow the news, Analyses  and opinions on the one issue in a way that attracts millions of users and the number grows every secon On Twitter, one of the most important social networking sites, all social groups rushed from the president to the last citizen to open accounts when they found themselves forced to do so .

During the recent Gulf crisis, Twitter was buzzing with Twitter, which achieved the largest circulation globally. Instead of serving the issue and directing it to serve the Arab interest, most of the publications were on th

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Publication Date
Mon Sep 19 2022
Journal Name
Gynecology And Obstetrics Case Report
A Case Report of Intrauterine Fetal Death with Three Loops of Umbilical Cord around Neck, Keratin Hair Treatment during Pregnancy Could be the Cause
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Publication Date
Fri Nov 24 2017
Journal Name
Journal Of Engineering
A New Analytic Method to Tune a Fractional Order PID Controller
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This paper proposes a new method to tune a fractional order PID controller. This method utilizes both the analytic and numeric approach to determine the controller parameters. The control design specifications that must be achieved by the control system are gain crossover frequency, phase margin, and peak magnitude at the resonant frequency, where the latter is a new design specification suggested by this paper. These specifications results in three equations in five unknown variables. Assuming that certain relations exist between two variables and discretizing one of them, a performance index can be evaluated and the optimal controller parameters that minimize this performance index are selected. As a case study, a thir

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Publication Date
Fri Nov 24 2017
Journal Name
Journal Of Engineering
A new analytic method to tune a fractional order PID controller
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This paper proposes a new method to tune a fractional order PID controller. This method utilizes both the analytic and numeric approach to determine the controller parameters. The control design specifications that must be achieved by the control system are gain crossover frequency, phase margin, and peak magnitude at the resonant frequency, where the latter is a new design specification suggested by this paper. These specifications results in three equations in five unknown variables. Assuming that certain relations exist between two variables and discretizing one of them, a performance index can be evaluated and the optimal controller parameters that minimize this performance index are selected. As a case study, a third order linear time

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation the Role of Clinical Pharmacist on Prevents or Reduced the Medication Error in Emergency Department
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Objective: To identify the role and importance of the clinical pharmacist in the Emergency Department on prevent
or reduced the medication error.
Methodology: We collected the medical file of 3400 patients, 1400 patient's file in (A) hospital, and 1000 patient's
file in each of (B and C) hospital, who admitted to the ED, at primary weekdays between 8 am to 2 pm, and
recorded all the intervention made by clinical pharmacist through an active search in clinical charts, with analysis
of the daily medical prescription. The potential severity of harm of the medication error judged by two reviewers,
a permanent emergency physician, and clinical pharmacist based on the National Coordinating Council (NCC) of
Medication Error

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Publication Date
Fri Jun 30 2023
Journal Name
Journal Of The College Of Education For Women
Bestiality and the Deconstruction of Family Cohesion in Edward Albee's The Goat or, Who Is Sylvia?
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Edward Albee (1928-2016) is an American  dramatist who is notorious for his controversial works. Albee's plays generate a crisis of a restraint situation and a point of no return where characters trespass the limits and get caught up in a tragic cycle. The Goat or Who is Sylvia? )2000) is one of his controversial pieces, addressing (human-animal relations). This theatrical masterpiece unleashes man's wildest desires and ravaging behavior. Bestiality is a criminal offense placed in the domain of mental disorders attributed to the lack of emotional support, anxiety, depression, and psychological problems. It is also a serious moral infraction of communities' socio-religious traditions. In this play, Martin’s bestiality lead

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Publication Date
Fri Sep 01 2017
Journal Name
Journal Of Bridge Engineering
Novel Demountable Shear Connector for Accelerated Disassembly, Repair, or Replacement of Precast Steel-Concrete Composite Bridges
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A novel demountable shear connector for precast steel-concrete composite bridges is presented. The connector uses high-strength steel bolts, which are fastened to the top flange of the steel beam with the aid of a special locking nut configuration that prevents bolts from slipping within their holes. Moreover, the connector promotes accelerated construction and overcomes the typical construction tolerance issues of precast structures. Most importantly, the connector allows bridge disassembly. Therefore, it can address different bridge deterioration scenarios with minimum disturbance to traffic flow including the following: (1) precast deck panels can be rapidly uplifted and replaced; (2) connectors can be rapidly removed and replaced; and (

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