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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 Dec 24 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Potential Positive Effects using Coenzyme Q10 Supplement as Adjuvant Therapy to Gabapentin for Managing Diabetic Neuropathy
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The most prevalent chronic complication of diabetes mellitus is diabetic neuropathy. The pathogenesis of diabetic neuropathy is exacerbated by hyperglycemia-induced oxidative stress, which causes nerves to deteriorate in a programmed manner. Many clinical trials depend on supplement in an attempt to improve neuropathy symptoms such as (pain & tingling) and patient quality of life, one of them is Coenzyme Q10 which is reported to have an anti-inflammatory and antioxidant effects, and was totally nontoxic and non-reported side effects. This study aimed to evaluate using a Coenzyme Q10 supplement as an adjuvant therapy to gabapentin to improve the clinical symptoms of diabetic neuropathy in relation to its anti-inflammatory and antioxid

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Publication Date
Mon Jan 02 2017
Journal Name
Al-academy
How to build a virtual personal imagined in the picture, directed by James Cameron (Avatar) movie as a model
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The personal drama in particular, and one of the key elements underlying the dramatic structure to convey ideas and visions presented by the author when writing the text of the dramatic fall after that on the way out the submission form that suits the proposals of the text and processors directorial would push the wheel of dramatic structure to the front. So take the maker of the artwork (writer) undertook the transfer of those events and personalities in art presumed sometimes real and sometimes, in order to enrich the art inspired by the human reality through the ages, and full of its themes and ideas that led to the development experiences of peoples experiences of living. Therefore, we find it important to research in the characters

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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Capability to a chive An Effective Marketing Performance In Banks: applied Study in a sample of Iraqi Banks
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The marketing of banking service is considered to be one of the impotent fields which showed a universal inebriates . He research showed the comparison between the application of marketing in ideas and application for loot government and private Iraqi bank. The research comets of four parts; Mythology / the concept and the importance of Banking Marketing / Research applichlion/ Conelnion and  recommendation.

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Publication Date
Sun Feb 14 2021
Journal Name
Biochemical And Cellular Archives
A RETROSPECTIVE STUDY TO EVALUATE SOME POTENTIAL RISK INDICATORS ON OSSEOINTEGRATED DENTAL IMPLANTS IN A SAMPLE OF IRAQI PATIENTS
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Determining risk indicators for dental implants is an essential strategy for preventing peri-implant diseases and effective diagnosis of dental implant success. To investigate the impact of certain potential factors on the osseointegrated dental implant. Eighty-four individuals were included in our study, 50 cases as a patient’s group and 34 participants as a control group. All cases were diagnosed based on certain criteria, 30 (60%) of patients had peri-implantitis, 20 (40%) with severe periimplantitis, 36(72%) were generalized, and 15 (30%) as localized peri-implantitis cases. The study has indicated that 44.7% of dental implants were in the anterior maxilla, followed by (27.3%) posterior maxilla, (17.4%) posterior mandible, and (10.4%)

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Publication Date
Fri May 05 2023
Journal Name
International Journal Of Professional Business Review
Optimal no. Of Crew in a Workshop Subject to Minimize the Total Cost
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Purpose: The main objective of this paper is, to determine the optimal no. of technicians’ men in a workshop crew of an Industrial System.   Theoretical framework: The purpose of applying these tools is to explore their ability to reduce costs and improvements that can be obtained in the process of providing services to the end customer.   Design/methodology/approach: The literature structure review was built from analyzing 12 of scientific papers and books, from web sciences and the Elsevier database. The papers were analyzed from descriptive, methodologic, and citation characteristics.   Finding:  By applying the equation model of the paper, the optimal no. of technician men in the crew of the workshop can be determined when

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Publication Date
Tue Jan 29 2019
Journal Name
Journal Of The College Of Education For Women
Geopolitical dimensions to build a dam on the downstream Renaissance (Egypt and Sudan)
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Varied uses of international rivers in the past few decades dramatically, resulting in this multiplicity of uses and all associated with it for the occurrence of freshwater scarcity activities, and thus an increase in conflicts and disputes around on the rights of each of the riparian countries to benefit from the waters of the river at various purposes, particularly the establishment of dams on some of them as is the case (Renaissance Ethiopian) big impact on downstream countries Dam (Egypt and Sudan), due to the Oukuahma at the end of the Nile Valley made them vulnerable to environmental fluctuations, political crises facing the Nile basin countries, and any reduction in the proportion of water is not only the Nile River, but for all r

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Publication Date
Tue Nov 01 2016
Journal Name
2016 International Conference On Advanced Mechatronic Systems (icamechs)
Hierarchical sliding mode control applied to a single-link flexible joint robot manipulator
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Trajectory tracking and vibration suppression are essential objectives in a flexible joint manipulator control. The flexible joint manipulator is an under-actuated system, in which the number of control actions is less than the degree of freedom to be controlled. It is very challenging to control the underactuated nonlinear system with two degree of freedom. This paper presents a hierarchical sliding mode control (HSMC) for a rotary flexible joint manipulator (RFJM). Firstly, the rotary flexible joint manipulator is modeled by two subsystems. Secondly, the sliding surfaces for both subsystems are constructed. Finally, the control action is designed based on the Lyapunov function. Computer simulation results demonstrate the effectiveness of

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Publication Date
Thu Oct 06 2011
Journal Name
Fes Journal Of Engineering Sciences
Derivation of a New Equation to Obtain the Permeability Coefficient of Clayey Soils
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The main objective of this research is to find the coefficient of permeability (k) of the soil and especially clayey soil by finding the degree of consolidation (rate of consolidation). New modify procedure is proposed by using the odometer (consolidation) device. The ordinary conventional permeability test usually takes a long time by preparing and by testing and this could cause some problems especially if there is a need to do a large number of this test and there were a limited number of technicians and/or apparatus. From this point of view the importance of this research is clear, since the modified procedure will require a time of 25 minute only. Derivation made to produce an equation which could be used to fined the permeabi

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Publication Date
Fri Jan 12 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Are Newly Graduated Pharmacists Competent to Perform Adequately in Hospitals? A Qualitative Study
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Objectives: To assess the qualifications and performance of newly graduated pharmacists and explore factors that affect their performance in public hospitals. Methods: This qualitative study included face-to-face, semi-structured interviews with hospital practitioner pharmacists. It was conducted between March and May 2023 in Kerbala province, Iraq. The participating pharmacists were selected purposefully because they had three or more years of work experience at governmental hospitals. The audio-recording interviews were transcribed. Thematic analyses were used to generate themes and subthemes from the interviews. Results: Twenty-seven hospital pharmacists participated in this study. The study found that there are several factors t

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Publication Date
Fri Aug 10 2018
Journal Name
In Book: Challenges In Mechanics Of Time-dependent Materials, Volume 2edition: 1stchapter: 11
A Case Study to Evaluate Live Load Distributions for Pre-stressed RC Bridge
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