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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
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
A Stylistic Study of Cohesion in Relation to Narrative Techniques in Religious Discourse
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Cohesion is well known as the study of the relationships, whether grammatical and/or lexical, between the different elements of a particular text by the use of what are commonly called 'cohesive devices'. These devices bring connectivity and bind a text together. Besides, the nature and the amount of such cohesive devices usually affect the understanding of that text in the sense of making it easier to comprehend.  The present study is intendedto examine the use of grammatical cohesive devicesin relation to narrative techniques. The story of Joseph from the Holy Quran has been selected to be examined by using Halliday and Hasan's Model of Cohesion (1976, 1989). The aim of the study is to comparatively examine to what extent the type

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Publication Date
Tue Jan 01 2019
Journal Name
Wireless Communications And Mobile Computing
Corrigendum to “Developing a Video Buffer Framework for Video Streaming in Cellular Networks”
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Publication Date
Fri Aug 10 2018
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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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Publication Date
Wed Jun 15 2022
Journal Name
Journal Of Sensors
A Modern Approach towards an Industry 4.0 Model: From Driving Technologies to Management
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Every so often, a confluence of novel technologies emerges that radically transforms every aspect of the industry, the global economy, and finally, the way we live. These sharp leaps of human ingenuity are known as industrial revolutions, and we are currently in the midst of the fourth such revolution, coined Industry 4.0 by the World Economic Forum. Building on their guideline set of technologies that encompass Industry 4.0, we present a full set of pillar technologies on which Industry 4.0 project portfolio management rests as well as the foundation technologies that support these pillars. A complete model of an Industry 4.0 factory which relies on these pillar technologies is presented. The full set of pillars encompasses cyberph

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Publication Date
Thu Sep 07 2023
Journal Name
Journal Of Language Studies
A Sociolinguistic Study of Selected Iraqi-Arabic Dialects with Reference to TV Series
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The dramatic series on television have a great impact on people’sattitudes towards dialects of language varieties, by relating theconceptual pictures or prototypes presented by series’ characters tothose dialects. This study aims to show the influence of TV series onIraqi university learners’ gender and age in relating positive ornegative semantic qualities to their dialects. To this end, 150 Iraqi EFLlearners have participated in this study to examine their attitudestowards Baghdadi, Mousli and Nasiriya dialects. The data arecollected by Lambert, Hodgson, Gardner, Fillenbaum's (1960)matched guise technique and then labeled by Willmorth’s (1988)subjective reaction test. A structured interview is conducted to supportthe data

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Publication Date
Thu Oct 01 2020
Journal Name
Journal Of Engineering
Developing a Model to Estimate the Productivity of Ready Mixed Concrete Batch Plant
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Productivity estimating of ready mixed concrete batch plant is an essential tool for the successful completion of the construction process. It is defined as the output of the system per unit of time. Usually, the actual productivity values of construction equipment in the site are not consistent with the nominal ones. Therefore, it is necessary to make a comprehensive evaluation of the nominal productivity of equipment concerning the effected factors and then re-evaluate them according to the actual values.

In this paper, the forecasting system was employed is an Artificial Intelligence technique (AI). It is represented by Artificial Neural Network (ANN) to establish the predicted model to estimate wet ready mixe

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Publication Date
Mon Feb 19 2018
Journal Name
Al-academy
Directing Techniques to Process the Radio Drama Script ( Khata'a Play as a Sample)
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     The radio drama is considered to be one of the arts that is discovered after a long period of theater's discovery. Initially , it was the broad framework of the theater's work when radio was broadcasting the shows on the huge theaters. This beginning encouraged many of the radio specialists to correlate plays with radio and make a novice and distinctive type of art. Thus, radio drama made its first step including the following   ( plays, short and long series drama as well as other types of radio arts). Because of the above mentioned , the researcher is stimulating  to study directing techniques to process the radio drama script ( Khata'a play as a sample).

The first chapter deals with the

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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
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 Apr 24 2018
Journal Name
Journal Of The American Geriatrics Society
A Systems Approach to Identify Factors Influencing Adverse Drug Events in Nursing Homes
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The objectives of the study were to identify the incidence rate and characteristics of adverse drug events (ADEs) in nursing homes (NHs) using the ADE trigger tool and to evaluate the relationships between resident and facility work system factors and incidence of ADEs using the System Engineering Initiative for Patient Safety (SEIPS) model. The study used 2 observational quantitative methods, retrospective resident chart extraction, and surveys. The participating staff included Directors of nursing, registered nurses, certified nurse assistants (CNAs). Data were collected from fall 2016 to spring 2017 from 11 NHs in 9 cities in Iowa. Binary logistic regression with generalized estimated equations was used to measure the association

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