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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 Sep 16 2025
Journal Name
Construction Materials
Molasses-Modified Mortars: A Sustainable Approach to Improve Cement Mortar Performance
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The utilization of sugarcane molasses (SCM), a byproduct of sugar refining, offers a promising bio-based alternative to conventional chemical admixtures in cementitious systems. This study investigates the effects of SCM at five dosage levels, 0.25%, 0.50%, 0.75%, 1.00%, and 1.25% by weight of cement, on cement mortar performance across fresh, mechanical, thermal, durability, and density criteria. A comprehensive experimental methodology was employed, including flow table testing, compressive strength (7, 14, and 28 days) and flexural strength measurements, embedded thermal sensors for real-time hydration monitoring, water absorption and chloride ion penetration tests, as well as 28-day density determination. Results revealed clear

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Publication Date
Mon Jan 01 2018
Journal Name
International Journal Of Science And Research (ijsr)
Generalization of Rough Set Theory Using a Finite Number of a Finite d. g.'s
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This paper is concerned with introducing and studying the new approximation operators based on a finite family of d. g. 'swhich are the core concept in this paper. In addition, we study generalization of some Pawlak's concepts and we offer generalize the definition of accuracy measure of approximations by using a finite family of d. g. 's.

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Publication Date
Mon Jun 28 2021
Journal Name
Journal Of Engineering
Effective quality control of a municipal wastewater treatment plant using Geographic information systems: A Review
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Inefficient wastewater disposal and wastewater discharge problems in water bodies have led to increasing pollution in water bodies.  Pollutants in the river contribute to increasing the biological oxygen demand (BOD), total suspended solids (SS), total dissolved solids (TDS), chemical oxygen demand (COD), and toxic metals render this water unsuitable for consumption and even pose a significant risk to human health. Over the last few years, water conservation has been the subject of growing awareness and concern throughout the world, so this research focused on review studies of researches that studied the importance of water quality of wastewater treated disposal in water bodies and modern technology to management w

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Publication Date
Wed Nov 05 2014
Journal Name
International Journal Of Applied Mathematical Research
Approximate solution of a model describing biological species living together using a new iterative method
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Publication Date
Wed Dec 25 2019
Journal Name
Journal Of Engineering
Link Failure Recovery for a Large-Scale Video Surveillance System using a Software-Defined Network
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The software-defined network (SDN) is a new technology that separates the control plane from data plane for the network devices. One of the most significant issues in the video surveillance system is the link failure. When the path failure occurs, the monitoring center cannot receive the video from the cameras. In this paper, two methods are proposed to solve this problem.  The first method uses the Dijkstra algorithm to re-find the path at the source node switch. The second method uses the Dijkstra algorithm to re-find the path at the ingress node switch (or failed link).

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Publication Date
Fri Nov 14 2025
Journal Name
Journal Of Baghdad College Of Dentistry
A comparative study to evaluate the shear bond strength of different resin sealers to dentin (An in vitro study)
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Background: One of the major problems in endodontics is micro-leakage of root canal fillings which might contribute to the failure of endodontic treatment. To avoid this problem, a variety of sealers have been tested. The objective of this, in vitro, study was to evaluate the shear bond strength of four resin based sealers (AH plus, silver free AH26, RealSeal SE and Perma Evolution permanent root canal filling material) to dentin. Materials and Methods: Forty non-carious extracted lower premolars were used. The 2mm of the occlusal surfaces of teeth were sectioned, to expose the dentin surface. The exposed dentin surfaces of teeth were washed with 5ml of 2.5% NaOCl solution followed by 5ml of 17 % EDTA then rinsed by deionized water to remov

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
A Suggested Model for Using a Students Attendance Management Information Systems/ A Case Study In Lebanese French University/ Erbil
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This study aims to design unified  electronic information system to manage students attendance in Lebanese French university/Erbil, as a system that simplifies the process of entering and counting the students absence, and generate absence reports to expel students who passed  the acceptable limit of being absent, and by that we can replace the traditional way of  using papers to count absence,  with  a complete electronically system for managing students attendance, in a way that makes the results accurate and unchangeable by the students.

            In order to achieve the study's objectives, we designed an information syst

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Publication Date
Thu Dec 01 2022
Journal Name
Caspian Journal Of Environmental Sciences
Histological study of liver in Dhub lizard Uromastyx aegyptius microlepis (Blanford, 1874) during the period of hibernation
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Scopus
Publication Date
Tue Sep 04 2018
Journal Name
Al-khwarizmi Engineering Journal
Study the Effect of Cutting Parameters on Temperature Distribution and Tool Life During Turning Stainless Steel 316L
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This paper is focused on studying the effect of cutting parameters (spindle speed, feed and depth of cut) on the response (temperature and tool life) during turning process. The inserts used in this study are carbide inserts coated with TiAlN (Titanum, Aluminium and Nitride) for machining a shaft of stainless steel 316L. Finite difference method was used to find the temperature distribution. The experimental results were done using infrared camera while the simulation process was performed using Matlab software package. The results showed that the  maximum difference between the experimental and simulation results was equal to 19.3 , so, a good agreement between the experimental and simulation results  was achieved. Tool life w

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Publication Date
Wed Jun 01 2022
Journal Name
Political Sciences Journal
The impact of the Turkish intervention in northern Syria on the Syrian Turkish relations during (2011-2019)
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This study aimed to provide a theoretical framework for the impact of the Turkish intervention in northern Syria and the extent of its impact on the relations between the two countries.

It also sought to answer the study's main question: What is the impact of the Turkish intervention in northern Syria on Turkish-Syrian relations during the period 2011-2019 ?.   

In this study, the historical method, the descriptive method, and the systems analysis method were used, with the aim of arriving at an accurate and realistic understanding of the Turkish-Syrian relations.

The study reached a set of results, the most important of which was that the Syrian-Turkish relations are based on interests, and that all alliances and

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