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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
Sun May 22 2022
Journal Name
International Journal Of Early Childhood Special Education
A training program based on integrating futuristic thinking skills with classroom interaction patterns and its effect on the academic self- efficacy of mathematics teachers
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The research aims to identify the effect of the training program that is based on integrating futuristic thinking skills with classroom interaction patterns on mathematics teachers in order to provide their students with creative solution skills. The research sample consisted of 31teachers (15 teachers for the experimental group and 16 for the control groups). The researcher developed a measure for the academic self-efficacy consisting of (39) items. Its validity, reliability, coefficient of difficulty and discriminatory power were estimated. To analyze the findings, the researcher adopted the Mann-Whitney (U) test and the effect size, and the findings were as follows: There is a statistically significant difference at the significance leve

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Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Efficacy & safety of Desmopressin in the treatment of pediatric nocturnal enuresis
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Back ground: primary nocturnal enuresis (PNE) is a socially distressing condition that can be troubling for children & their families. It affects 15-26% of five years olds. Several approaches are used to treat PNE including behavioral modification, alarms & drug therapy. Aim of the study: to determine the efficacy and safety of nasal desmopressin treatment in children with PNEPatients : fifty-four children with primary nocturnal enuresis with a mean age of ( 8.2) years ( range 6-15), underwent a 2 week observation period followed by entrance into a randomized controlled study, comparing desmopressin & placebo, lasting 4 weeks. The efficacy of the drug was measured in reduction of the number of wet nights per week. The enureti

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Publication Date
Mon Jul 19 2021
Journal Name
Surgical Neurology International
Efficacy of Gamma Knife radiosurgery in the management of pituitary prolactinoma
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Background:

Gamma Knife radiosurgery (GKR) has been widely used in the management of a variety of intracranial tumors, including pituitary adenomas. Pituitary prolactinoma (Prs) is one of the most common types of these adenomas.

Methods:

This prospective study included 50 patients with pituitary Prs over a period from June 2017 to June 2018 at the Neurosciences Hospital, Baghdad/Iraq. The GKR procedure was performed using the Leksell Gamma Knife® Perfexion™, 192 beams of Cobalt 60 radiation were delivered through the intact skull to the pituitary Prs.

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Tue Jan 01 2019
Journal Name
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Facial Fractures in Preschool- and School-aged Children
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Aim: The purpose of this study was to analyze the patterns of facial fractures in children and to compare them between preschool- and school-aged children. Materials and methods: This retrospective observational study included 57 children with facial fractures. The variables analyzed were the age of the patients—divided into a preschool-aged group (0–5 years) and a school-aged group (6–12 years)—gender, cause of trauma, the facial bones involved, the pattern of fracture, the modality of treatment used, the time between injury and treatment, and the postoperative complications. Results: The incidence of facial fractures in children ≤12 years was 30.2%. The patients consisted of 40 (70.2%) males and 17 (29.8%) females, and most pati

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Contribute to the pivotal thinking skills in performing the transmission skill from Volleyball Fourth preparatory grade adolescents
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The aim of this study was to identify the level of critical thinking skills among fourth-grade middle school students and to determine the performance level of the underhand volleyball pass, with the assumption that there is a positive relationship between critical thinking and skill performance. The study population included 281 students from Basra Preparatory School for Girls under the Second Baghdad Education Directorate for the 2024/2025 academic year, of whom 275 students were intentionally selected as the research sample (97.865% of the population). The experimental procedure involved applying a critical thinking scale and a technical performance test for the underhand pass on 25 students per day over 11 days, from February 9

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Journal Name
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Self-Efficacy of English Language Teachers and Its Effect On their Pupils' AchievementIn Baghdad Secondary Schools/Karkh2
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Teachers' self-efficacy plays a very important role in the process of teaching English language, and teachers have primary role in determining what is needed or what would work best with their students. The sample consists of eighty-seven English language teachers in secondary schools in Baghdad/Kaarkh2. Self-efficacy questionnaire of fifteen items was constructed. Face, content validity and reliability were verified. Then, pupils' marks for the first semester were taken as their achievement.The main finding of the study indicates that:
English language teachers' self-efficacy has effect on their pupils' achievement.
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Thu Feb 01 2018
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Comparing Different laboratory Methods for Measuring the Feed Pellet Durability
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The experiment aimed to compare different methods of measuring the Feed pellet durability through the effect of pellet die speeds and the particle size (mill sieve holes diameter). Feed pellet durability was studied in four different ways: pellet direct measurement (%), pellet lengths (%), pellet water absorption (%), pellet durability by drop box device (%), pellet durability by air pressure device (%). Three pellet die speeds 280, 300, and 320 rpm, three mill sieve holes diameter 2, 4, and 6 mm, have been used. The results showed that increasing the pellet die speeds from 280 to 300 then to 320 rpm led to a significant decrease in the feed pellet durability by direct measurement, drop box device, and air pressure device, while pel

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