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Comparing the Efficacy of Paracetamol, Diclofenac, and Ketorolac on Post-Appendectomy Outcomes in Children and Adolescents
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Abstract

urgent surgical intervention and appendectomy until now represent standard treatment for uncomplicated cases of appendicitis. Nausea, vomiting and pain after surgery are the most frequent issues facing patients and affecting patient quality of life and responsible for many cases of readmission after surgery. Ketorolac and diclofenac represent the most commonly prescribed non-steroidal anti-inflammatory used in postoperative setting and they cause many side effects as gastrointestinal, kidney and cardiac adverse effect in addition to increased risk of bleeding. Paracetamol is currently among the most frequently prescribed medication worldwide and it can be used safely for all age groups. This study aimed to compare the analgesic efficacy and safety of paracetamol, diclofenac, and ketorolac when used after appendectomy and to assess their efficacy regarding nausea and vomiting in children and adolescents. A randomized, single-blinded, comparative, observational prospective clinical study was carried out on patients diagnosed with acute appendicitis and assigned for emergent appendectomy between October 2018 to May 2019 in Al- Zahraa Teaching Hospital in Al-Najaf province, Iraq.120 patients were randomly distributed into three groups who received diclofenac sodium suppositories (2mg/kg), IV Paracetamol )15mg/ kg every 6 hr.(, and IV  Ketorolac )0.5mg/ kg( immediately after surgery. All patients were observed for pain, nausea and vomiting and bleeding. Patients received ketorolac had a high percentage of the decrease in pain score between 30 and 60 min. after surgery, while paracetamol was the next and diclofenac sodium was the last. Regarding nausea and vomiting after surgery, ketorolac had higher percentage of the decrease in nausea, vomiting score during first day after surgery followed by diclofenac and paracetamol respectively. The present study also showed that there is no significant difference between groups regarding bleeding after surgery. It is concluded that ketorolac has higher analgesic efficacy compared with paracetamol and diclofenac with no risk of nausea and vomiting and bleeding when used after appendectomy.

Keywords: Postoperative pain, Ketorolac, Diclofenac, Paracetamol, Appendectomy.

 

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Publication Date
Wed Nov 07 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of mothers' practices toward children with steroid – sensitive nephrotic syndrome at pediatrics hospitals in Baghdad city
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Objective(s): To assess mothers' practices toward children with steroid – sensitive Nephrotic Syndrome (SSNS) who
are visiting nephrology consultation units, and to find out the relationships between their practices and the
demographical data for mother and child.
Methodology: A descriptive study was carried out at nephrology consultation units of Baghdad pediatrics hospitals
(Child's Central Pediatric Teaching Hospital, Al-kadimiyia Teaching Hospital, and Welfare Teaching Hospital) started
from February 18th to the end of July 2009. A purposive sample of (80) mothers who company their children were
selected. The data were collected through a constructed questionnaire, with two parts; the first part is concerned with<

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Publication Date
Sat Mar 03 2018
Journal Name
International Journal Of Science And Research
In Vivo Mechanical and Histological Evaluation of the Effect of Vacuum Storage and Ultra Violet Light Treatment of Titanium Implants on Osseointegration
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Background: Titanium implant is widely used in dentistry because of its extraordinary biocompatibility and mechanical properties. To increase bone–implant connection and provide early loading after placement, implant is stored in different storage medium and treated with UV light. Both of them are applicable methods to increase the bioactivity of titanium and overcome the biological aging. This study was designed to assess the effect of vacuum storage method and air storage with and without UV light treated of Cp Ti implant mechanically and histologically. Materials and methods: Titanium screws were acid etched and prepared in four different modes using different storage methods (air or vacuum and, with or without UV treatment. The implan

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Publication Date
Sun Dec 31 2023
Journal Name
Journal Of Pioneering Medical Science
Nurses' Perception Toward Therapeutic Strategies for Children with Pneumonia
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Background: Pneumonia is the common lower respiratory tract infection among pediatrics, especially under five; it is a common cause of under-five children morbidity and mortality. Objectives of study: To identify nurses' perceptions toward therapeutic strategies for children with pneumonia and to find the association between their perceptions and their demographic variables. Methods: A Convenient sample of 46 nurses in Baghdad city from three hospitals) Kadhimiya Hospital for Children, Central Teaching Hospital of Pediatrics, and Child Welfare Teaching Hospital) included in the study to identify their perceptions regarding pneumonia in children. Results: The results of the study present that most of the nurses' participants in the a

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of nurses' knowledge towards signs of gross motor delay for children at Alhawija District in Kirkuk Governorate
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Background: the early identification of developmental disabilities allows intervention at the earliest possible point to
improve the developmental potential.
Objective: Identify the scope of knowledge of nurses toward signs of gross motor delay for children and its relation to
their demographic characteristics.
Methodology: A descriptive study design was conducted at (18) primary health care centers in first of the primary
health care sector of Alhawija District in Kirkuk Governorate. This study started from September 2010 to the end of
January 2011, in order to identify the level of nurses' knowledge toward signs of gross motor delay for children in
primary health care centers. Non probability (purposive) sample of

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Publication Date
Sun Dec 01 2019
Journal Name
Baghdad Science Journal
Histological and Physiological Studies on the Long-term Effect of Different Concentrations of Energy Drink (Tiger) on the Renal and Hepatic Systems of Young Mice
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The present study aims to investigate the long-term histopathological, and physiological effects of different concentrations of a commercially available energy drink (Tiger) on liver and kidney of young mice. Sixteen Balb/c male mice,6 -week old, were divided into 4 groups (n=4). Two groups consumed the energy drink at a concentration of 28µl energy drink/ml water. One group were killed after 10 days (T1), another group were killed after 20 days (T2). Other group of mice consumed the energy drink at a final concentration of 14µl/ml for 20 days (T3). The last group was provided only with water and served as control. Mice of all groups drank around 3 ml per day. The histopathological study on liver of treated groups showed many changes s

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Publication Date
Thu Nov 14 2019
Journal Name
Advances In Intelligent Systems And Computing
The Application of Bus Rapid Transit System in the City of Baquba and Its Impact on Reducing Daily Trips
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Publication Date
Tue Mar 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
The effect of intellectual capital on the Total quality management of higher education and scientific research institutions in Baghdad
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         The purpose and goal of the research revolve around the diagnosis of intellectual capital as the logical indicator to study an effective human resource management practice and its influential role in determining the overall quality management of higher education institutions and scientific research in Baghdad.

       To achieve the purpose of the research, an upgraded standard questionnaire was used to collect data and distribute it to the selected sample in a statistical manner from the study population of (5) institutions affiliated with the Ministry of Higher Education and Scientific Resear

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Publication Date
Sun Jan 01 2023
Journal Name
Revista Iberoamericana De Psicología Del Ejercicio Y El Deporte
THE IMPACT OF ENGINEERING ANXIETY ON STUDENTS: A COMPREHENSIVE STUDY IN THE FIELDS OF SPORT, ECONOMICS, AND TEACHING METHODS
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Publication Date
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The phenomenon of Corruption and its impact on the growing problem of Unemployment in Iraq after a year ( 2003 ).
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        Corruption is a phenomenon that exists in all times and places, they appear in the developing countries and in developed countries, and in all political systems. And its repercussions and economic repercussions on the society in which it is rampant, and lead to the undermining of economic development and obstruction, is also working on increasing poverty and unemployment, as well as its role in the worsening of social problems, and political instability. And corruption is deviant behavior is illegal and contrary to the teachings of the religious and moral values. The emergence of this phenomenon is due to several reasons, including political, economic, social and cultura

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Publication Date
Fri Jun 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of Molecular Imprinting on the Loading and Release of Poorly Water Soluble Drug in Hydrogel Gontact Lenses
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Therapeutic contact lenses TCLs is an approach used to enhance corneal residence time and reduce frequent instillation, which is a problem with eye drops.  The problem with CLs is loading of hydrophobic drugs. In this research the CLs were prepared with molecular imprinting MI to enhance the loading of itraconazole, which is used as antifungal drug for fungal keratitis. CLs using different  concentration of hydroxyethyl methacrylate HEMA and methacrylic acid MAA were prepared with and without MI using PEGDA (25 μL) and AIBN (37 mg) as crosslinker and initiator respectively. All the prepared CLs were clear and have good folding endurance. MICLs had significantly higher drug loading compared to conventional CLs. The release of i

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