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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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Thu Jul 31 2025
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Root resorption and anti-dentine antibody level in serum and saliva of well-controlled type ? diabetic patients undergoing orthodontic treatment
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Background: Diabetic mellitus type ? is a metabolic disorder of diverse etiological factors, characterized by hyperglycemia resulting from an absolute deficiency of insulin affected childhood and adolescent. Some of these patients seek an orthodontic care .The orthodontist who is treating these medically compromised patients should have a working knowledge of the multitude of medically complex problems. This information will support and enable for delivery of high standards of dental care in general and orthodontic care in particular. The aim of this study was to analyze serum IgG levels and salivary secretory IgA (sIgA) levels in human dentine extract (HDE) before (T0) and 6 months after (T6) orthodontic treatment and to correlate anti-HDE

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Wed Mar 20 2019
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Design and Simulation of Closed Loop Proportional Integral (PI) Controlled Boost Converter and 3-phase Inverter for Photovoltaic (PV) Applications
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This research deals with the design and simulation of a solar power system consisting of a KC200GT solar panel, a closed loop boost converter and a three phase inverter by using Matlab / Simulink. The mathematical equations of the solar panel design are presented. The electrical characteristics of the panel are tested at the values ​​of 1000  for light radiation and 25 °C for temperature environment. The Proportional Integral (PI) controller is connected   as feedback with the Boost converter to obtain a stable output voltage by reducing the oscillations in the voltage to charge a battery connected to the output of the converter. Two methods (Particle Swarm Optimization (PSO) and Zeigler- Nichols) are used for tuning

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The efficacy of non‐surgical platelet‐rich fibrin application on clinical periodontal parameters and periostin level in periodontitis: Clinical trial
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Wed Jun 01 2016
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A Novel Analytical Model to Design Piezoelectric Patches Used to Repair Cracked Beams
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In this paper, an analytical solution describing the deflection of a cracked beam repaired with piezoelectric patch is introduced. The solution is derived using perturbation method. A novel analytical model to calculate the proper dimensions of piezoelectric patches used to repair cracked beams is also introduced. This model shows that the thickness of the piezoelectric patch depends mainly on the thickness of the cracked beam, the electro-mechanical properties of the patch material, the applied load and the crack location. Furthermore, the model shows that the length of the piezoelectric patches depends on the thickness of the patch as well as it depends on the length of the cracked beam and the crack depth. The additional flexibil

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Using BIM for Optimizing the Upgrading Cost to Convert the Traditional Buildings to Sustainable Buildings in Iraq
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Abstract<p>A high percentage of existing buildings in Iraq are traditional buildings, yet there is approximately no such green building in Baghdad or other governorates. Most of these buildings require urgent upgrading to increase their performance (operationally, economically, and environmentally), also the building owners looking for identifying and implementing many of the green building measures to reduce the operational and maintenance costs of their buildings. The decision-makers need to support the possibility of achieving sustainable measures of existing building rating systems such as LEED or BREEAM, and that would require an optimization model. The goal of this study is to maximize the</p> ... Show More
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