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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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Fri Jan 01 2016
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Tue Jan 01 2019
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A cross-sectional study was conducted on 80 type 2 diabetic patients aged 20-60 years in Baghdad and 20 non diabetic persons as controls. Laboratory assessment of glucose related parameters; Fasting blood sugar (FBS), Glycated hemoglobin (HbA1c), Insulin and Insulin resistance (IR), renal function test; Blood urea, serum creatinine, Calcium (Ca) and Phosphorus (P), Calcium regulating hormones; Parathyroid hormone (PTH), calcitonin and vitamin D, cytokines, Adiponectin and Tumor necrosis factor (TNF-α) and comparison these parameters between patients and controls. The results: a high significant (p˂0.01) increase in FBG level in the patients (211.34 ± 11.20 mg/dl) as compared with control (85.89 ± 3.07 mg/dl). A high significant (p˂0.01

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Mon Dec 31 2018
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The current research aimed to analyze the importance, correlation and the effect of independent variables represented by marketing variables on the dependent variable represented by local brand, through taking ENIEM as a model for this study, which represents a sensitive sector for the Algerian consumer. The results of the study evinced that the Algerian consumer has a positive image toward the brand ENIEM given marketing variables which has acquired considerable importance to this consumer. Also, the results of this study showed a statistically significant correlation between marketing variables and good perception toward the brand ENIEM, at the same time, the existence of a statistically significant effect for each of these variables o

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Publication Date
Wed Sep 29 2021
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The research deals with the statement of the importance of unanimous in Islamic Sharia in terms of being the third source of Islamic legislation after the Holy Qur’an and the Sunnah of the Prophet, and the extent of interest of the scholars of interpretation in it, and those who took great interest in mentioning what was agreed upon in every site that necessitated mentioning its issues within, or mentioning an event that has encountered an unanimous, and in various sciences, to extract and extrapolate Sharia rules when these rules are lost in the texts, because it is based on them and derived from them. Among these distinguished scholars is Muhammad bin Jarir al-Tabari. Besides, the research discusses in

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