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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
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
Sun Aug 01 2021
Journal Name
Journal Of Engineering
Reuse of Glass waste as a partial replacement to fine aggregates in concrete
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As human societies grow, the problem of waste management becomes one of the pressing issues that need to be addressed. Recycling and reuse of waste are effective waste management measures that prevent pollution and conserve natural resources. In this study, the possibility of using glass waste as an alternative was used as a partial weight substitute for fine aggregates with replacement ratios of 10, 20, 30, and 40% by the weight, and formed into test models (15 cm * 15 cm ) cube and (15 cm * 30 cm) cylinder, then matured and tested their strength compression and tensile strength at the age of 7 and 28 days and compared with a reference or conventional concrete with a mixing ratio (1: 1.5: 3) as well as testing its worka

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Publication Date
Mon Mar 09 2026
Journal Name
Journal Of Asian Architecture And Building Engineering
Visual storytelling and place-based learning: a generative approach to architectural cultural awareness
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In architectural learning, it is difficult to stimulate cultural awareness through the traditional education approaches, which results in historic places being neglected as knowledge sources. This research explores the premise that sketch-based visual storytelling may act as a generative approach to connect cognition, emotion, and behavior in historical contexts. The study adopts a qualitative methodology to explore a learning experience comprising two phases: the first is a formal educational setting, and the second is a historical and cultural context, aiming to investigate the role of sketch-based storytelling in enhancing cultural awareness. MAXQDA was employed to code the students’ storyboards on three levels of cultural awareness, m

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Publication Date
Mon Jul 01 2024
Journal Name
Baghdad Science Journal
Preparing a Compound of New Nanoparticles of Lactam, PE to Improve Their Specifications
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يدور هذا البحث حول خواص البولي ايثيلين (PE) باستخدام اللاكتام مع مركبات أكسيد النانو المعدنية المستخرجة من نبات (القرنفل) وهي براعم زهرة شجرة القرنفل كمثبت وعامل اختزال . حيث يستقر أكسيد النانو ويغطي البوليمر الطبيعي. الهدف من الدراسة هو أن أكسيد النانو يؤدي أفضل ترابط للمركبات المحضرة ، بسبب زيادة مساحة السطح ، وبالتالي القدرة على الارتباط بالبوليمر المحضر. والقدرة على الثبات الإلكتروني بسبب كثرة الروابط

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Publication Date
Wed May 04 2022
Journal Name
Theory And Practice In Language Studies
Investigating EFL Learners’ Ability to Analyse Poetic Language: A Pedagogical Corpus Stylistic Approach
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Pedagogical stylistics refers to the application of the tools of stylistics in the teaching of the English language as a foreign or a second language.  Teaching and learning poetry is challenging. Thus, pedagogical corpus stylistics (Henceforth, PCS) approach has been introduced to Iraqi undergraduate foreign language learners (EFL) to guide them to analyze poetic language.  The study aims to make students interact with authentic examples of poetic language and answer questions about it. The main objective of the study is to examine whether PCS tools enable the learners to provide linguistic evidence from the poetic texts they are exposed to. This in turn ensures objective poetic analyses. Moreover, it aims to enable EFL Iraqi stu

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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
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
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 Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Extent to Which the Internal audit function contributes to improving administrative performance: A field study in the Baghdad Health Department / Rusafa
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Abstract:

                The internal audit is considered the safety valve for senior management in all institutions. It aims to protect property, and raise the efficiency and effectiveness of the administrative performance, by following up on compliance with laws and instructions and the application of regulations in a way that increases the administrative performance of the department. The internal audit is possible to determine Weaknesses or imbalances in the administrative performance. To achieve this goal, an analytical descriptive methodology was adopted. The Baghdad Health Department / Al-Rosana was considered as society for this s

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Publication Date
Sat Jun 28 2025
Journal Name
Journal Of Physical Education
Mineral and sugar concentrations taken during matches and their effect on some physical and functional abilities of football players
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Many athletes believe that it enhances the level of performance during training and competition, in addition to compensating for fluids during exercise when the levels of temperature and humidity in the atmosphere rise during the athlete's intensive training, as it increases the requirements for fluid compensation to avoid the risk of potential thermal disorders. If training continues for more than an hour causing fatigue, athletes are advised to drink carbohydrate drinks that quickly convert to glucose in the blood, while sodium should be included in the fluids consumed during exercise or matches that last more than (1-2 hours). The effect of drinking a drink containing 12% carbohydrates and electrolytes before each half of a simul

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