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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
Fri May 17 2019
Journal Name
Biochem. Cell.arch
THE EFFICACY OF GOLD NANOPARTICLES IN INHIBITING THE TOXICEFFECT OF TAMOXIFEN ON THE KIDNEYS OF MALE ALBINO MICE
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Publication Date
Thu Nov 01 2018
Journal Name
Al-kindy College Medical Journal
The Efficacy and Safety Of Using Hydrochlorothiazide As Adjuvant Therapy In Pediatric Urinary Tract Infections
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Background: Acute urinary tract infection is a common bacterial infection causing illness in infants and children. At age of seven, 8% of girls and 2% of boys will have at least one episode. Although drinking water and using home remedies are known to help to flush away bacteria and keeps them from sticking to the bladder wall, researches to test the efficacy and safety of hydrochlorothiazide's diuretic effect as adjuvant to the antibiotics in pediatric age groups are lacking, and so this research was to address this subject.

Objectives: To assess the effectiveness   and  the safety of hydrochlorothiazide as adjuvant therapy to the antibiotics in treating acute urinary tract infect

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Publication Date
Wed May 24 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Science
Direct and Indirect Spectrophotometric Determination of Paracetamol in Pharmaceutical Preparations By Oxidative Coupling With p-Amino-2-hydroxy Sodium Benzoate
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New simple and sensitive spectrophotometric methods for the determination of paracetamol in aqueous medium were developed. The first method is based on coupling of paracetamol with p-amino-2-hydroxy sodium benzoate (AHB) in the presence of sodium periodate, as oxidizing agent, to form a brownish-orange compound which shows a λmax at 470 nm. The molar absorptivity (εmax) of the colored product was found to be (3371) l. mole1. cm-1 and Sandel’s index 0.0449 μg. cm-2. The method follows Beer’s law in the concentration range of 12.5-500.0 μg of paracetamol in a final volume of 25 ml (0.5-20.0) μg. ml-1 with relative standard deviation percent (RSD%) ranged between 0.26-4.71% and accuracy, expressed by recovery percent, 95-106% for five

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Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Physics: Conference Series
Motivational efficacy of lasers on marrow haemopoetic cells
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Abstract<p>Lasers has been proved to increase tissue oxygenation, activate marrow progenitor cells, expanse the microcirculation, accelerate the restoration of functions, stimulate adaptation ability and stabilization of the hormonal status. The semisolid tissue present in the epiphysis of the bone where it’s structure is spongy or cancellous is bone marrow and it formed about 4% of body weight, the marrow is composed of hemopoietic cells, however, the structure of the marrow is of both cellular and non – cellular components. The hemopoietic stem cells are responsible of producing white blood cells, red corpuscles, platelets in addition to the fibroblasts, macrophages, adipocytes, osteoblast</p> ... Show More
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Publication Date
Sun Sep 02 2007
Journal Name
Iraqi Postgraduate Medical Journal
The Efficacy of Dextran 70 on Reticuloendothelial System in Systemically Infected Mice with Klebsiella Pneumoniae
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The reticuloendothelial system (RES) play an important role in immunity against bacterial infection and Klebsiella pneumoniae one of the most common causes of hospital-acquired infections. Dextran70 (D70), a polysaccharide, may alter functions of this system through changing many biological activities in the tissues.

Publication Date
Fri Sep 01 2023
Journal Name
Civil Engineering Journal
Fundamental Challenges and Management Opportunities in Post Disaster Reconstruction Project
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The study examines the root causes of delays that the project manager is unable to resolve or how the decision-maker can identify the best opportunities to get over these obstacles by considering the project constraints defined as the project triangle (cost, time, and quality) in post-disaster reconstruction projects to review the real challenges to overcome these obstacles. The methodology relied on the exploratory description and qualitative data examined. 43 valid questionnaires were distributed to qualified experienced engineers. A list of 49 factors causes was collected from previous international and local studies. A Relative Important Index (RII) is adapted to determine the level of importance of each sub-criterion in the fou

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Publication Date
Thu Jan 07 2021
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Efficacy and Safety of Sacral Neuromodulation in Treatment of Refractory Overactive Bladder
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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
Challenges Faced by Families of Children with Intellectual Disabilities and Its Effect on the Psychological Health in the Asir
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Abstract

This research aims to identify the challenges faced by families of children with intellectual disabilities and to identify the impact of the challenges facing them on the mental health of their children with intellectual disabilities. Based on the following questions: What is the nature of the challenges faced by families of children with disabilities and how do these challenges affect the mental health of their children with intellectual disabilities? The study was conducted on a sample of four families of six children with intellectual disabilities, depending on the degree and type of disability. To achieve the study's objectives, the qualitative approach was used, Because of the importance of accessin

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Publication Date
Sun Mar 13 2011
Journal Name
Baghdad Science Journal
Effect of Diclofenac (Voltaren) in histological structure of kidney in male Rabbits (Oryctolagus cuniculus )
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This study was designed to know the effect of Diclofenac sodium (voltaren) drug on the histological composition of kidney in domestic rabbits . Twelve adult males with (1.4) kg weight . The first group of animals administrated orally by 1 ml of Voltaren with 6 mg/kg , while the second group with (1) ml of distal water (as control group ) . the administrated continue for (60) days sequentially. The treatment with voltaren showed pathological cases in tissues and cells of kidney including necrosis, infilteration ,congestion in blood vessels edema.Also epithelial separation in kidney tubules in comparison with control group Conclusion from the above results, revealed that voltaren had negative effects on the kidn

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Publication Date
Thu Jun 12 2025
Journal Name
Folia Medica 67(3): E149216
Impact of thumb sucking on salivary melatonin, Candida albicans, and dental caries in children
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Introduction: Salivary melatonin is a critical antioxidant that contributes to oral health by mitigating oxidative stress. Psychological stress linked to thumb sucking may disrupt oral homeostasis, leading to conditions such as dental caries and fungal infections. Aim: This study explores the relationships between thumb sucking, salivary melatonin levels, dental caries, and the presence of Candida albicans (CA) in children. Materials and methods: A case-control study was conducted with 60 children aged 4-5 years at the University of Baghdad’s College of Dentistry. Participants were divided into thumb-sucking (n=30) and non-thumb-sucking (n=30) groups. Salivary melatonin levels were measured using enzyme-linked immunoso

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