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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
Wed Jan 02 2019
Journal Name
Journal Of The College Of Languages (jcl)
Peculiarity of Colloquial and Popular Vocabulary in a Collection of the Poet Alexi Kaltsof's Letters: Varonech Bazars: Специфика просторечной и диалектной лексики в эпистолярном дискурсе «воронежского прасола» Алексея кольцова
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The paper studies the description of the colloquial and popular vocabulary  used by wholesales tradesmen in Varonech before the Bolshevik Revolution . The vocabulary were used in the personal letters written by the poet and sent to famous poets and critics like Belenisky, kryvesky and Malsheve. And some were sent to his father and his sister. Not only did these letter bear the personal taste, but they represented a literary product reflecting on the poet's impressions, views, ambitions, and opinion in arts, poetry, prose, and theatre. The researcher used about thirty instances of various levels of grammar, style and phonology, all representing colloquial vocabulary used commonly at the time of Alexi&nbsp

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The reflection of strategic knowledge management on an improvement of excellent performance: A survey study at the Institution of Industrial Development and Research- the Ministry of Iraqi Industry (IDRMII)
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The current study aims to investigate the effect of strategic knowledge management practices on an excellent performance at the Institution of Industrial Development and Research- the Ministry of Iraqi Industry (IDRMII). The present research is designed according to the descriptive method. To achieve the mentioned research objective, the researchers used the questionnaire as the main data collection tool. The research sample was 150 managers who are working at the top and middle management levels. To analyses the data gathered and reaching the results, several statistical techniques were used within AMOS.V25, SPSS.V21Software, This study reached a set of results, the most important of which is the existence of a positive correlat

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
The Role of External Audit in Limiting Creative Accounting Practices in Light of International Standards from The Point of View of Certified Accountancy Experts in Iraq as a Model
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This research aims to solve a problem in the field of accounting and financial knowledge in the world today, that is, the problem of creative accounting. Especially after the global financial crisis and the collapse of many large companies in the world, people find that they use creative accounting methods to distinguish them from reality, showing the results of their activities and their financial status. This research discusses the concept of creative accounting, the most important methods used in financial statements and its relationship with external auditing, and procedures to limit accounting creativity. This study uses descriptive analysis methods after confirming its theoretical aspects in practice. Using the statistical

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Publication Date
Fri Sep 26 2025
Journal Name
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The Problemic of the ambiguous relationship between the media and terrorism, and the problems arising from… An exploratory study of a sample of journalists, writers and researchers in Baghdad
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This study examined the problematic of the ambiguous relationship between the media and terrorism and the problems that result from press coverage of terroristic incidents. The paper sought to show the classification and confrontation of such incidents had been established from the point of view of a sample of media professionals, researchers and writers who are frequenters of Al-Mutanabi Street in Baghdad. The media outlets that carry this coverage would not give up their media mission as well as the terrorists would not be given an opportunity to take advantage of this coverage in achieving their goals and objectives. Furthermore, the terrorist organizations would have no chance to exploit these means to deliver their terroristic messa

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Publication Date
Fri Sep 26 2025
Journal Name
Al-fatih Journal
The impact of the use of some herbal sedative level of achievement in the development of air pistolEmpirical researchOn a sample of players Faculty of Physical Education for Girls
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تعد الرماية واحدة من الألعاب التي يقاس مستوى الانجاز فيها بالأرقام إذ ارتفعت الأرقام المسجلة بالنسبة لسلاح المسدس الهوائي حتى وصلت عند بعض الأبطال العالميين إلى الانجاز النهائي ، وقد لجأ المدربون إلى مختلف الطرق التدريبية, وان ضعف الثبات والتركيز هما اللذان يقودان إلى هبوط مستوى الانجاز في الرماية ، ولتحقيق التركيز والثبات المطلوبين أثناء الرمي يجب التدريب على مطاولة حمل السلاح التي تعد من أصعب تدريبات الر

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Publication Date
Fri Sep 26 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Studying the effect of addition a composite of silanized Nano-Al2O3 and plasma treated polypropylene fibers on some physical and mechanical properties of heat cured PMMA denture base material
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Background: Polymethyl methacrylate (PMMA) is the most commonly used material in denture fabrication. The material is far from ideal in fulfilling the mechanical requirements, like low impact and transverse strength, poor thermal conductivity. The purpose of this study was to evaluate the effect of addition a composite of surface treated Nano Aluminum oxide (Al2O3) filler and plasma treated polypropylene fiber (PP) on some properties of denture base material. Materials and methods: One hundred fifty prepared specimens were divided into 5 groups according to the tests, each group consisted of 30 specimens and these were subdivided into 3 groups (unreinforced heat cured acrylic resin as control group),reinforced acrylic resin with( 0.5%wt Nan

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Publication Date
Sun Mar 01 2020
Journal Name
Fisheries &amp; Aquatic Life
Directional fluctuating asymmetry in certain morphological characters as a pollution indicator: Tigris catfish (<i>Silurus triostegus</i>) collected from the Euphrates, Tigris, and Shatt al-Arab Rivers in Iraq
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Abstract<p>The relationship between pollution levels in river sediment and fluctuating asymmetry of resident silurid fish species, <italic>Silurus triostegus</italic> Heckel, was assessed. Eight bilateral body proportions were analyzed in 1,500 fish from eight river locations. Sediment pollution was measured based on the analysis of heavy metals (Cd, Cr, Cu, Ni, Pb and Zn) and organochlorine pesticides (DDT, DDD, DDE, chlordane, dieldrin, and lindane). The mean quotient approach (mERMq) was used to characterize sediment toxicity, which ranged from low to moderate levels for heavy metals and from low to severe for organochlorides. Variation was noted in the measurements of fish body mor</p> ... Show More
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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
A Proposed Training Program for School Leaders in the Sultanate of Oman on the Planning Practices of the Kaufman Model in Light of the Needs and Challenges of Reality
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The study aims to build a proposed training program for school leaders in the Sultanate of Oman on the planning practices of the Kaufman model in light of the needs and challenges of reality. It also aims to identify the challenges facing school leaders in practicing the stages of strategic planning. To achieve these objectives, the study adopted the descriptive approach due to its suitability to the nature of the study. A questionnaire was used to collect the needed data. The study sample included (225) individuals from school principals, their assistants and senior teachers in post-basic education in the Sultanate of Oman. After processing the data statistically, the study concluded that the reality of planning practices for school lea

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Technical requirements for the application of economic intelligence and its impact On the dimensions of strategic success of banks: An applied research on a sample of Iraqi banks private
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This research sheds light on one of the important and vital topics for the banking sectors (technical requirements for the application of economic intelligence) namely by (Hardware, equipment, communication networks, software, databases). And the dimensions of the strategic success of the banks represented by(Customer satisfaction, customer trust, quality of service, growth) In the three Iraqi private banks, namely(Assyria International Investment, Mansour Investment, International Development Investment and Finance). Its implementation is an urgent necessity in order to improve the quality of its banking services to win the satisfaction of its customers and their confidence and then grow to achieve stra

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Publication Date
Sun Nov 24 2024
Journal Name
Polymer-plastics Technology And Materials
Li <sub>2</sub> CO <sub>3</sub> as a Modifier for PVA/PVP/PEG Blend Polymer Electrolytes: Effects on Structural Integrity, Electrical Performance, Thermal Behavior and Optical Properties
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