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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
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
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
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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Publication Date
Tue Aug 08 2023
Journal Name
مجلة حمورابي للدراسات
adolescents exposure to the specialized satellite channel cartoon network and its relationship to their level of technological culture
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Publication Date
Mon Mar 14 2022
Journal Name
International Journal Of Health Sciences
Comparing the histological effect of Thymol from multiple sources with blood lipids profile and liver enzymes in Albino Mice
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The therapeutic value of the phenolic component and pure thymol was well known; this study comprised the extraction of crude phenol from two plants (Thymus vulgaris and Artemisia annua) which contain thymol with pure thymol and evaluate their effect on hematological and histological by using three different concentrations of each plant extract and pure thymol to tested them on lab mice. All the mice were allowed free access to water and feed for 21 days in laboratory conditions; orally, pure water was administered to the control mice (group I), while groups II, III, and IV were given orally with T. vulgaris, A. annua, combination of last two crude phenol plant extract 50:50 and pure thymol respectively. The levels of CHO, TRI, and HDL were

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Publication Date
Sun Jun 02 2024
Journal Name
Methods And Objects Of Chemical Analysis
Simultaneous Spectrophotometric Determination of Piroxicam, Naproxen, Diclofenac Sodium and Mefenamic Acid in Pharmaceutical Formulations by Partial Least Squares Method
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A chemometric method, partial least squares regression (PLS) was applied for the simultaneous determination of piroxicam (PIR), naproxen (NAP), diclofenac sodium (DIC), and mefenamic acid (MEF) in synthetic mixtures and commercial formulations. The proposed method is based on the use of spectrophotometric data coupled with PLS multivariate calibration. The Spectra of drugs were recorded at concentrations in the linear range of 1.0 - 10 μg mL-1 for NAP and from 1.0 - 20 μg mL-1 for PIR, DIC, and MEF. 34 sets of mixtures were used for calibration and 10 sets of mixtures were used for validation in the wavelength range of 200 to 400 nm with the wavelength interval λ = 1 nm in methanol. This method has been used successfully to quant

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Publication Date
Mon Sep 09 2013
Journal Name
Plant Biology
Comparing simple root phenotyping methods on a core set of rice genotypes
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Abstract<p>Interest in belowground plant growth is increasing, especially in relation to arguments that shallow‐rooted cultivars are efficient at exploiting soil phosphorus while deep‐rooted ones will access water at depth. However, methods for assessing roots in large numbers of plants are diverse and direct comparisons of methods are rare. Three methods for measuring root growth traits were evaluated for utility in discriminating rice cultivars: soil‐filled rhizotrons, hydroponics and soil‐filled pots whose bottom was sealed with a non‐woven fabric (a potential method for assessing root penetration ability). A set of 38 rice genotypes including the Oryza<styled-content style="fixed-case">SNP</styled-content></p> ... Show More
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Publication Date
Wed Jan 01 2014
Journal Name
Int. J. Adv. Res
Antibacterial activity of parsley and celery aqueous extract on the isolated bacteria from children UTI in Erbil city‏
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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 Sep 03 2018
Journal Name
Al-academy
Simplicity and complexity in the visual layout of the designs Children magazine covers
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The magazine covers the subjects of (simplicity and complexity in the visual layout of the designs of magazine coverings of children) Chapter I The problem and importance of the goal and limits of research and addition to Terminology. In the second chapter the theoretical framework in which the first topic the role of simplicity and complexity in the design and the second section Visual design and design relations and the third research design in magazine covers and the third chapter includes the methodology of research and analysis and the results and conclusions and sources and the most important result of the research is (simplicity and complexity of design, Continuity and vitality and attract the attention of the receiver through the

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