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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
Sun Jun 07 2015
Journal Name
Baghdad Science Journal
On Fully (m,n)-stable modules relative to an ideal A of
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Let R be a commutative ring with non-zero identity element. For two fixed positive integers m and n. A right R-module M is called fully (m,n) -stable relative to ideal A of , if for each n-generated submodule of Mm and R-homomorphism . In this paper we give some characterization theorems and properties of fully (m,n) -stable modules relative to an ideal A of . which generalize the results of fully stable modules relative to an ideal A of R.

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Publication Date
Sat Mar 01 2025
Journal Name
Basic Education College Magazine For Educational And Humanities Sciences
The Transformation of Power: A Study of Coriolanus from Soldier to Statesman
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William Shakespeare's play Coriolanus explores the journey of power and the transformation of a skilled warrior into a statesman. This paper employs Machiavelli’s framework of pragmatic statecraft to analyse Coriolanus’s tragic failure as a political leader despite his unparalleled prowess as a Roman general. It analyses Coriolanus's political career, revealing how his military skills, while effective in warfare, do not translate into political success. The paper shows that Coriolanus’s contempt for performative politics, refusal to adopt civic diplomacy, and failure to soften aristocratic pride with populist appeal turn plebeians against him and alienate patricians. His upholding of martial honour — fostered by his mother Volumnia

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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
A Suggested Conception to Employ Gamificatio in Teaching the General Education Curricula
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The study aimed to build a suggested conception for employing gamification in teaching the general education curricula. Using the analytical method of the previous analytical studies in Teaching, which agreed with the determinants of the analysis of 20 studies from 2014 to 2019, they come on order: points, badges, leaderboards, and then levels. The four most commonly used theories are the theory of self-determination, flow theory, the theory of planned behavior and social theory. In addition, the researcher identified the most commonly used models in gamification, respectively: the ARCS model and the user-based design model. Based on the results of the analysis and using the descriptive approach, the researcher presented a practical perc

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Publication Date
Sat Jun 01 2024
Journal Name
Alexandria Engineering Journal
U-Net for genomic sequencing: A novel approach to DNA sequence classification
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The precise classification of DNA sequences is pivotal in genomics, holding significant implications for personalized medicine. The stakes are particularly high when classifying key genetic markers such as BRAC, related to breast cancer susceptibility; BRAF, associated with various malignancies; and KRAS, a recognized oncogene. Conventional machine learning techniques often necessitate intricate feature engineering and may not capture the full spectrum of sequence dependencies. To ameliorate these limitations, this study employs an adapted UNet architecture, originally designed for biomedical image segmentation, to classify DNA sequences.The attention mechanism was also tested LONG WITH u-Net architecture to precisely classify DNA sequences

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Publication Date
Tue Aug 01 2023
Journal Name
Proceedings Of International Structural Engineering And Construction
COLORED ROOFS: A SOLUTION TO MITIGATION UHI AND REDUCING URBAN SURFACE HEATING
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The city is a built-up urban space and multifunctional structures that ensure safety, health and the best shelter for humans. All its built structures had various urban roofs influenced by different climate circumstances. That creates peculiarities and changes within the urban local climate and an increase in the impact of urban heat islands (UHI) with wastage of energy. The research question is less information dealing with the renovation of existing urban roofs using color as a strategy to mitigate the impact of UHI. In order to achieve local urban sustainability; the research focused on solutions using different materials and treatments to reduce urban surface heating emissions. The results showed that the new and old technologies, produ

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Publication Date
Tue May 16 2023
Journal Name
Journal Of Engineering
Natural Convection Heat Transfer from a Plane Wall to Thermally Stratified Environment
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The effect of linear thermal stratification in stable stationary ambient fluid on free convective flow of a viscous incompressible fluid along a plane wall is numerically investigated in the present work. The governing equations of continuity, momentum and energy are solved numerically using finite difference method with Alternating Direct implicit Scheme. The velocity, temperature distributions
and the Nusselt number are discussed numerically for various values of physical parameters and presented through graphs. ANSYS program also used to solve the problem. The results show that the effect of stratification parameter is marginalized with the increase in Prandtl number, and the increase in Grashof number does not practically vary the

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Publication Date
Mon Dec 30 2019
Journal Name
College Of Islamic Sciences
The Holy Qur’an Approach to Evidence (Signs of branding as a template)
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The aim of the current research is to study a topic from the Qur’anic topics, few have researched it and realized its content, so people knew it in one name in the Qur’an in another name, and due to the ancientity of the topic and its contemporaneity, I wanted to write about it. The research has an introduction, three demands, and a conclusion with the most important results of the research:
As for the introduction: It was to indicate the importance of the topic and an optional reason for it.
As for the first requirement: it included the definition of reasoning, its divisions, and its characteristics.
As for the second requirement, it was to indicate the meaning, types, and methods of labeling it.
As for the third require

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Publication Date
Mon Jul 01 2019
Journal Name
International Journal Of Swarm Intelligence Research
A New Strategy Based on GSABAT to Solve Single Objective Optimization Problem
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This article proposes a new strategy based on a hybrid method that combines the gravitational search algorithm (GSA) with the bat algorithm (BAT) to solve a single-objective optimization problem. It first runs GSA, followed by BAT as the second step. The proposed approach relies on a parameter between 0 and 1 to address the problem of falling into local research because the lack of a local search mechanism increases intensity search, whereas diversity remains high and easily falls into the local optimum. The improvement is equivalent to the speed of the original BAT. Access speed is increased for the best solution. All solutions in the population are updated before the end of the operation of the proposed algorithm. The diversification f

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Construction Engineering And Management
Developing a Decision-Making Framework to Select Safety Technologies for Highway Construction
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Publication Date
Wed Nov 22 2017
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
THE EFFECT OF FERMENTATION AND BAKING PROCESSES ON THE PHYATE DEGRADATION DURING THE PROCESS OF MANUFACTURING WHOLE WHEAT FLOUR BREAD.: THE EFFECT OF FERMENTATION AND BAKING PROCESSES ON THE PHYATE DEGRADATION DURING THE PROCESS OF MANUFACTURING WHOLE WHEAT FLOUR BREAD.
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In this research, the influence of the fermentation treatments and baking in Iraqi’s flour type (Ibaa 99, Al-rashed, Tamus, Abu-grabe) and Turkish flour type (Muaamel) on phytic acid was investigated. In whole wheat flour, the phytic acid was (1500, 1290, 1450, 1230, 1440 ( mg/ 100 g flour respectively, and the inorganic phosphorous was (29.18, 25.15, 23.89, 20.85, 22.83) mg/100 g flour respectively. The dough prepared from flour with a higher phytic acid content also contained higher amount of phytic acid. During fermentation, degradation of phytic acid occurred. The cumulative loss of phytic acid after fermentation in all type of dough was ~ 23, 22, 34, 26 and 27% respectively،While increased of inorganic phosphorous occurred. The c

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