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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
Mon Mar 30 2026
Journal Name
Iraqi Journal Of Science
A modified time series model using conditional and unconditional estimations with applications to a real dataset
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Modern statistical techniques offer a range of methodologies for modelling time series data, with conditional and unconditional approaches providing complementary insights that enhance overall model accuracy. This article introduced a modified ARIMA model employing conditional and unconditional parameter estimates. The methodology for the new model based on novel methods is provided. The prediction process, one and two steps ahead, is covered in detail, and a novel algorithm is presented. The best model is picked based on various measurement criteria, such as coefficient of determination (R2), root mean squared error (RMSE), and mean absolute scaled error (MASE). The suggested model is applied to a monthly petrol sales dataset (Jan

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Publication Date
Wed Jan 03 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Assessment of Adherence and Self-Efficacy in a Sample of Iraqi Patients Receiving Warfarin or Direct Oral Anticoagulants
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Background: While warfarin and direct oral anticoagulants (DOACs) are used to manage thromboembolic events, they possess several features that impact adherence. Objective: To assess medication adherence and self-efficacy in patients receiving warfarin or DOAC treatment. Methods: A cross-sectional study was performed at Ibn Al-Bitar Hospital in Baghdad from December 2022 to May 2023 on patients receiving either warfarin or DOACs. The Arabic version of the Adherence to Refills and Medications Scale (ARMS) questionnaire and the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6C) questionnaire were used to assess adherence and self-efficacy. Results: 181 patients were enrolled in the study, of whom 56.9% received warfarin an

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Publication Date
Tue Oct 01 2024
Journal Name
Journal Of Physics: Conference Series
A comparative Analytical Investigation of Different Geomagnetic Storms During Solar Cycles 23 and 24
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Abstract<p>In this work, the geomagnetic storms that occurred during solar cycles 23 and 24 were classified based on the value of the Disturbance Storm Time index (Dst), which was considered an indicator of the strength of geomagnetic conditions. The special criterion of Dst >-50 nT was adopted in the classification process of the geomagnetic storms based on the minimum daily value of the Dst-index. The number of geomagnetic storms that occurred during the study period was counted according to the adopted criteria, including moderate storms with (Dst >-50 nT), strong storms with (Dst >-100 nT), severe storms with (Dst >-200 nT), and great storms with (Dst >-350 nT). The statistica</p> ... Show More
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Publication Date
Sun Mar 01 2020
Journal Name
Materials Research Express
Spray pyrolysis of graphene oxide based composite for optical and wettability applications
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Abstract<p>In this study, silica-graphene oxide nano–composites were prepared by sol-gel technique and deposited by spray pyrolysis method on glass substrate. The effect of changing the graphene/silica ratio on the optical properties and wetting of these nano–structures has been investigated. The structural and morphological properties of the thin films have been studied by x-ray diffraction spectroscopy (XRD), field emission scanning electron microscope (FESEM), energy dispersive x-ray spectroscopy (EDS) and atomic force microscope (AFM). XRD results show that silica structures present in the synthesized films exhibit amorphous character and there is a poor arrangement in graphene plates al</p> ... Show More
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Publication Date
Tue Jan 15 2013
Journal Name
Journal Of Kerbala University 11 (3)‏
Effect ofchemicalfertilizerand foliar spray ofgibberellicacidon mineral element andgibberellin-likesubstances content on someolivecultivars‏
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Publication Date
Wed Jan 01 2020
Journal Name
Plant Archives
Study of deposited spray quality of spraying agents with different physical properties
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The spray quality of two spraying agents with different physical properties was investigated under laboratory conditions to find whether the measurement of deposited drops could be affected by spraying those agents. The first spraying agent Moddus, which is a plant growth regulator, has a surface tension of 28 mN m-1 with almost half the value of the second spraying agent Kelpak (58 mN m-1). A mini boom sprayer containing three flat fan nozzles (XR 11003) was used in the test with three traveling speeds (4.74, 5.42 and 8.13 km. h-1). The test was performed to evaluate the quality of spray drops (spray coverage, spray density and stains diameter) after they were deposited on water sensitive papers (WSP). The results showed a higher ability o

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Publication Date
Mon Oct 23 2023
Journal Name
Journal Of Optics
Studying the effect of cadmium chloride and thiourea concentrations on the structural and optical properties of CdS films deposited using the spray pyrolysis technique
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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of nurses’ knowledge toward pain management of leukemic child under chemotherapy
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Objective(s): To evaluate nurses' knowledge toward pain management of leukemic child in oncology wards
how were receiving chemotherapy.
Methodology: A descriptive study was conducted in two hospitals on (40) nurses, who provided care for the
children with leukemia in oncology wards (2) hospitals (Children Welfare Teaching Hospital and Child’s Central
Teaching Hospital) in Baghdad city from October 2010 up to the 27th of October 2011 for the purpose of
evaluating their knowledge towards pain management for leukemic child. A purposive "non-probability
sample" was selected that consisted of (40) nurse who are working in oncology wards. A questionnaire format
was used which consist of (2) parts, the first part includes

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Publication Date
Wed Sep 11 2024
Journal Name
Lecture Notes In Civil Engineering
An Image Processing Algorithm to Address the Problem of Stains Merge on Water Sensitive Papers and Its Impact on the Evaluation of Spray Quality Indicators
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There are many techniques that can be used to estimate the spray quality traits such as the spray coverage, droplet density, droplet count, and droplet diameter. One of the most common techniques is to use water sensitive papers (WSP) as a spray collector on field conditions and analyzing them using several software. However, possible merger of some droplets could occur after they deposit on WSP, and this could affect the accuracy of the results. In this research, image processing technique was used for better estimation of the spray traits, and to overcome the problem of droplet merger. The droplets were classified as non-merged and merged droplets based on their roundness, then the merged droplets were separated based on the average non-m

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Global Pharma Technology
Synthesis & Characterization of Chitosan Schiff Base Hydrogel for Controlled Drug Release
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Chitosan-schiff base with three different ratios of para-Dimethyl aminobenzaldehyde& chitosan Schiff base hydrogels have been prepared for controlled drug release study. The synthesized chitosan Schiff base and chitosan Schiff base hydrogel were characterized by FT-IR, UV-Visible, SEM, analysis. Swelling properties of the hydrogel were investigated at three different media pH (2, 7, 10). The swelling degree varied with the pH, amount of crosslinking agent glutaraldehyde and with the amount of paraDimethylaminobenzaldehyde for the hydrogels. All hydrogels were used for controlled drug release system. Aspirin was used as model drug, in three different buffer solution (2, 7, 10) as release media. The rate of release of drugs in the pH2 is more

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