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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
Tue Nov 11 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
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 Nov 11 2025
Journal Name
Journal Of Physical Education
The Effect of Exercises Using Maximum Strength Assisting Training Apparatus On Some Working Muscles&#39; Electric Activity During Bench Press For Physical Strength Athletes Of Baghdad Clubs
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Publication Date
Wed Jun 01 2022
Journal Name
Political Sciences Journal
Political Transformations in The Republic of Turkmenistan During the Period (1991-2021)
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After the fall of the Soviet Union, a number of Eastern Bloc countries and Soviet republics have witnessed political transition. However, Turkmenistan, as one of the former Soviet republics, succeeded to preserve the authoritarian nature of the former Soviet regime. This study seeks to answer a number of research questions, the most prominent of which are: How were the political elite in Turkmenistan able to preserve the legacy of the Soviet policy based on centralization of power and individual rule?. The study reaches a set of conclusions, the most important of which are:

1-The roots of the tyranny in Turkmenistan are du to internal and external structural factors. The most important of which are: the former Soviet policies of m

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Publication Date
Sun Mar 01 2009
Journal Name
Al-khwarizmi Engineering Journal
Mass Transfer Coefficient During Cathodic Protection of Low Carbon Steel in Seawater
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The aim of this research is to calculate mass transfer coefficient, kd, during cathodic protection of low carbon steel in neutral seawater (3.5% W/V NaCl in distilled water with pH = 7). Two types of cathodic protection were used:

First: Sacrificial anode cathodic protection (SACP) were a pipeline of steel carrying seawater  using zinc as a sacrificial anode and with variable temperatures ranged (0 – 45oC) and volumetric flow rate ranged (5 – 900 lit/hr). It was found that the kd increases with increasing temperature and volumetric flow rate of seawater, where kd ranged (0.24×10-6 – 41.6×10-6 m/s).

Second: Impressed current cathodic pr

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Publication Date
Sat Dec 01 2018
Journal Name
Political Sciences Journal
Protecting woman during armed conflicts under the development of international humanitarian law
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The international humanitarian law found the special rules to protect women meanwhile the armed conflicts whether international or non-international. These rules are adopted for woman because of two reasons : that she is from civilians and on the other hand that her special constitution demands a special protection. The international community's attention of women is increased as a result of the tragic situation that faced women around the world especially in the Middle East and particularly in Iraq during the American-British war and ISIS period, these two periods sort many negative effects that reach women such as captivity, slavery, sexual enslavement and rape women especially Yazidis and Christians....

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Publication Date
Sun Nov 27 2022
Journal Name
Al–bahith Al–a'alami
Municipality of Baghdad’s communication means and methods during imposing the law operations
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This study aims at  identifying  how Baghdad Municipality employs public relations in law enforcement operations and the role played by the Municipality in communication and communicating with the public, raising their awareness and educating them to not  abuse public property.  As for the research tools, the researcher used the questionnaire as a data  collection tool in addition to an analytical description of the means and methods of communication for public relations on  Baghdad Municipality Facebook page.

The research comes out with a set of result; the most important of which are:
The means through which citizens learned about the existence of campaigns to impose the law an eliminate violati

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Publication Date
Mon Oct 01 2018
Journal Name
Advances In Animal And Veterinary Sciences
Predictor Ultrasonographic Evaluation of the Testis during Pubertal Age in Ram Lambs
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Publication Date
Thu Dec 01 2022
Journal Name
مجلة األستاذ للعلوم اإلنسانية واالجتماعية
THE ANALYSIS OF SEMANTIC MACRO STRUCTURE IN WHO SPEECHES DURING CORONA VIRUS
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Publication Date
Thu Jan 07 2021
Journal Name
Journal Of Craniofacial Surgery
Management of Maxillofacial Trauma in Attempt Suicide Patients During COVID-19 Pandemic
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