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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 Jul 20 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Gender Distribution of Coronary Artery Calcium Score and Degree of Stenosis Assessed by Computed Tomography Angiography in Iraqi Patients with Chest Pain
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Background: Sex variations in coronary artery disease (CAD) are well documented. However, sex differences in coronary artery calcium (CAC) and its role in the detection of coronary artery stenosis remain controversial. Objective: To assess the impact of sex variation on coronary artery calcification and its efficacy in predicting coronary artery stenosis. Methods: This is a cross-sectional observational study including 230 consecutive patients with suspected CAD (120 men and 110 women) referred for coronary computed tomography angiography (CCTA). The study analyzed sex-based differences in the sensitivity and specificity of coronary artery calcification (CAC) for detecting moderate to severe stenosis across various coronary arteries

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Publication Date
Wed Jun 18 2025
Journal Name
Journal Of Physical Education
Using of special exercises to mtaulp speed to pass the test (150×20) for women football referees
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Publication Date
Sat Aug 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Using BIM for Optimizing the Upgrading Cost to Convert the Traditional Buildings to Sustainable Buildings in Iraq
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Abstract<p>A high percentage of existing buildings in Iraq are traditional buildings, yet there is approximately no such green building in Baghdad or other governorates. Most of these buildings require urgent upgrading to increase their performance (operationally, economically, and environmentally), also the building owners looking for identifying and implementing many of the green building measures to reduce the operational and maintenance costs of their buildings. The decision-makers need to support the possibility of achieving sustainable measures of existing building rating systems such as LEED or BREEAM, and that would require an optimization model. The goal of this study is to maximize the</p> ... Show More
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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of The College Of Languages (jcl)
Dylan Thomas:The Vision of Death as a Prologue to a New Life
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Dylan Thomas (1914-1953) is a modern poet belongs to the apocalyptic movement of the 1940's.This movement is influenced by the doctrines and techniques of surrealism.

              Poetry for him should not be primarily concerned with man in society, but with the celebration of spiritual truth. It should bring to light the hidden causes, hence  his personal interest is to strip darkness and explore the inward motives. To do this he uses a cluster of images: a constant building up and breaking down of images. His poetry depends on the romantic spontaneity, suggestiveness of the Symbolists and the the surrealists' mysterious liberation of the unconsciousness and

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Publication Date
Mon Mar 03 2014
Journal Name
Journal Of Baghdad College Of Dentistry
Stem Cells a Novel Approach to Periodontal Regeneration: A Review of Literature
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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of The College Of Languages
Dylan Thomas:The vision of Death as a Prologue to a New Life
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Dylan Thomas (1914-1953) is a modern poet belongs to the apocalyptic movement of the 1940's.This movement is influenced by the doctrines and techniques of surrealism. Poetry for him should not be primarily concerned with man in society, but with the celebration of spiritual truth. It should bring to light the hidden causes, hence his personal interest is to strip darkness and explore the inward motives. To do this he uses a cluster of images: a constant building up and breaking down of images. His poetry depends on the romantic spontaneity, suggestiveness of the Symbolists and the the surrealists' mysterious liberation of the unconsciousness and the emotional involvement in the dynamics of life. In "Light Breaks

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Publication Date
Wed Jun 18 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Stem cells a novel approach to periodontal regeneration (A review of literature)
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In this review of literature, the light will be concentrated on the role of stem cells as an approach in periodontal regeneration.

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Publication Date
Mon Jun 15 2020
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of dental enamel color after fixed orthodontic therapy using two types of protectors to prevent white spot lesions (A prospective clinical study)
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Background: The aim of this study is to evaluate the color change ∆E of the dental enamel following treatment with 2 kinds of protector (icon infiltrant, clinpro varnish) before fixed orthodontic treatment to avoid the possible white spot lesions. Materials and Methods: Fifty four subjects treated with fixed appliances were divided into 3 groups: the 1st group was control, while the 2nd and 3rd groups were treated with icon infiltrant and clinpro varnish before bonding procedure, respectively. Color parameters (L,a,b) were recorded for the middle and gingival thirds before and after bonding procedure to get the ∆E of each group. Results: One-way ANOVA test showed a non-significant difference in ∆E between the 3 groups a

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Publication Date
Wed Apr 19 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Derivation of Mathematical Equations to Calculate the Geographical Coordinates of Unknown Position Situated at a Distance from the Observer Position Using GPS Data
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     This research introduced the derivation of mathematical equations to calculate the Cartesian and geographical coordinates of a site situated at a far distance from the observer position by using GPS data. The geographical coordinates (Ï•obs., λ obs., hobs.) for observer position were transformed to Cartesian coordinates (X obs., Y obs., Z obs.) of observer position itself. Then the Cartesian coordinates of unknown position mathematically were calculated from these calculated equations, and its transformed to geographical coordinates of (Ï•unk., λunk.) position.
 

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Publication Date
Wed Jun 18 2025
Journal Name
Journal Of Administration And Economics
Using the Maximum Likelihood Method with a Suggested Weight to Estimate the Effect of Some Pollutants on the Tigris River- City of Kut
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The aim of this research is to use robust technique by trimming, as the analysis of maximum likelihood (ML) often fails in the case of outliers in the studied phenomenon. Where the (MLE) will lose its advantages because of the bad influence caused by the Outliers. In order to address this problem, new statistical methods have been developed so as not to be affected by the outliers. These methods have robustness or resistance. Therefore, maximum trimmed likelihood: (MTL) is a good alternative to achieve more results. Acceptability and analogies, but weights can be used to increase the efficiency of the resulting capacities and to increase the strength of the estimate using the maximum weighted trimmed likelihood (MWTL). In order to perform t

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