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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
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Internal Debt Options during the Two Double Shocks and Its Impact on Foreign Reserve in Iraq
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The research aims at a statement Internal Debt options during shocks and the impact of this borrowing in the volume of the foreign reserve, using induction and deduction with available data analysis. During the period (2004-2013) did not require the use of borrowing across (financial institutions, discounted transfers, bonds); it was only sufficient by transfer with commercial banks that can finance of temporary budget deficits: rose and decline of volume of foreign reserve according to the changes of oil prices and the volume of purchases and sales of the Central Bank of Iraq. Central Bank of Iraq (CBI) has significantly contributed to Internal Debt through bond and discounted transfers in the secondary market; thus, funding the

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Nurses’ Knowledge Regarding Oxytocin Administration during Labor at Maternity Hospitals in Al-Kut City
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Objectives of the study: To assess nurses knowledge regarding oxytocin administration during labor and
delivery in maternity hospitals, and to find out the relationship between nurses knowledge and studied
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Methodology: Descriptive analytic study was conducted on non-probability sample (convenient) of (70) nurses
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Publication Date
Wed Jun 01 2011
Journal Name
Journal Of The College Of Languages (jcl)
From Personal Issues to National Concerns: A Study in E.M Forster’s Where Angels Fear to Tread & Howards End
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            E.M. Forster (1879-1970) is one of the important novelists who dealt with the personal and social lives of the people in England during the early beginning of the twentieth century. During his literary career, he developed gradually his views about man and his position in society.

 In his first novel, Where Angels Fear to Tread (1902), the focus is laid on local and personal issues in the lives of the characters. It is limited to the relations between neighbours in small communities. Though the setting is shifted to Italy, Forster does not make full use of this shift to present cultural or racial conflicts; rather he limits his plot to the private tr

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Publication Date
Fri Nov 14 2025
Journal Name
Al–bahith Al–a'alami
MOTIVES FOR STUDENTS TO BE EXPOSED TO EDUCATIONAL PROGRAMS ON TV CHANNELS (Iraqi educational channels as a model)
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The educational function of television is one of the basic functions in light of the technical development that included the specialized satellite channels in all its fields, including the educational field, as its role became parallel to the role of educational institutions. These studies are among the descriptive studies in terms of the type of study methodology that describes the phenomenon, interprets its and extract the results and relationships between the variables. The study sample was multistage (random and intentional) included the students of the sixth academic and literary preparatory stage in the city of Baghdad.
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Publication Date
Fri Mar 31 2017
Journal Name
Al-khwarizmi Engineering Journal
Experimental Study to the Effect of Natural Particles Added to Unsaturated Polyester Resin of a Polymer Matrix Composite
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Experimental investigations had been done in this study to demonstrate the effect of natural particles used as a reinforcement material to unsaturated polyester resin. The tensile test and water absorption were investigated according to (ASTM D638) and (ASTM D570), respectively. The influence of sunflower husk and pomegranate husk particles, used as a reinforcement material, on the tensile strength, Young's modulus and water absorption with different weight fraction (3%, 7% and 10%) and particle grain size (50µm, 100 µm and 150 µm), has been investigated. The water absorption of polymer composites was studied by measuring the specimen weight before and after immersion in water for one hundred days. In the experiments of tensile test,

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Publication Date
Thu Feb 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Use Simulation To Differentiate Between Some Modern Methods To the Model GM(1,1) To Find Missing Values And Estimate Parameters With A Practical Application
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Abstract

       The grey system model GM(1,1) is the model of the prediction of the time series and the basis of the grey theory. This research presents the methods for estimating parameters of the grey model GM(1,1) is the accumulative method (ACC), the exponential method (EXP), modified exponential method (Mod EXP) and the Particle Swarm Optimization method (PSO). These methods were compared based on the Mean square error (MSE) and the Mean Absolute percentage error (MAPE) as a basis comparator and the simulation method was adopted for the best of the four methods, The best method was obtained and then applied to real data. This data represents the consumption rate of two types of oils a he

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Publication Date
Thu Jan 11 2024
Journal Name
Eximia
Using an educational method according to special exercises to perform the skill of bow and develop flexibility for cub wrestlers in Iraq
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creating unique exercises utilizing a teaching approach that works with the research sample, determining how special exercises affect the development of torso flexibility, and determining how special exercises affect the development of bow ability. Activate the search The results of the pre- and post-tests for the control and experimental research groups show a statistically significant association that is favoring the post-test in the development of bow skill performance Using the experimental technique, the researcher set up one group and gave them two tests (pre and post) based on scientific theories that made sense for the topic at hand. Forty adolescent wrestlers from the Adhamiya Club in the Baghdad Governorate were recognized

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the tax examiner's procedures in increasing or decreasing tax revenue : Applied research in the General Authority for Taxes
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Abstract:

               The tax is one of the elements of the general revenues of the state and contributes to covering its expenses. Taxes are imposed in most countries of the world. The tax proceeds depend on a set of factors that contribute either positively or negatively to the tax share by increasing or decreasing it. Therefore, the research aims to demonstrate the role of the tax examiner's procedures in achieving the validity of the taxable base and its reflection on the tax proceeds, as well as reviewing the tax examiner's procedures related to the tax return process. Examination and tax audit of the financial statements, as well as presenting the financial statements to an independent and i

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Publication Date
Wed Oct 23 2024
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Improving the Mechanical, Thermoelectric Insulations, and Wettability Properties of Acrylic Polymers: Effect of Silica or Cement Nanoparticles Loading and Plasma Treatment
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The acrylic polymer composites in this study are made up of various weight ratios of cement or silica nanoparticles (1, 3, 5, and 10 wt%) using the casting method. The effects of doping ratio/type on mechanical, dielectric, thermal, and hydrophobic properties were investigated. Acrylic polymer composites containing 5 wt% cement or silica nanoparticles had the lowest abrasion wear rates and the highest shore-D hardness and impact strength. The increase in the inclusion of cement or silica nanoparticles enhanced surface roughness, water contact angle (WCA), and thermal insulation. Acrylic/cement composites demonstrated higher mechanical, electrical, and thermal insulation properties than acrylic/silica composites because of their lowe

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Publication Date
Fri Nov 14 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of nutritional status on mesiodistal and bucco/ lingual or palatal diameters of permanent teeth among fifteen years old students
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Background: Malnutrition during human growth affects the size of the tissues at different stages of life, body proportions, body chemistry, as well as quality and texture of tissues. Teeth are particularly sensitive to malnutrition. Malnutrition may affect odontometric measurement involving tooth size dimensions. The aim of this study was to estimate the effect of nutrition on teeth size dimension measurements among students aged 15 years old. Materials and methods: This study was conducted among malnourished group in comparison to well-nourished group matching with age and gender. The present study included 167 students aged 15 years (83 malnourished and 84 well-nourished). The assessment of nutritional status was done by using body mass

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