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bijps-974
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 Oct 01 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Growth Indices among Children and Adolescents with Type 1 Diabetes - Baghdad – Iraq, 2013
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Background: Type 1 diabetes mellitus is one of the most common chronic endocrine disorders of childhood, growth impairment is one of its long−term consequences

Objective: To study the anthropometric indices among children with type 1diabetes.
Results:
A total of 253 children with type 1diabetes were studied, 51.8% were females, 47.9% developed the disease at 5-9 years of age, and 52.6% presented with classical signs and symptoms. Stunting /sever stunting was 15% with male predominance, higher among older age group (10-20 y), wasting/ sever wasting was 19.4% with male predominance, higher among older age group (10-20 y), over weight/ obese was 3.6% with females predominant an

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Publication Date
Mon Dec 23 2024
Journal Name
Journal Of Baghdad College Of Dentistry
Oral health status, dental knowledge and behaviors among children and adolescents (8-15) years old in the cities of Baghdad and Thamar
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Background: Investigating dental health knowledge among children is important. Knowing what behaviors are right in relation to dental health does not guarantee that children will practice those behaviors. However, lack of knowledge and misconceptions about dental health may lead to behaviors that are harmful to teeth and gum. Baseline data on knowledge levels are required to determine which particular areas of dental health education are in need of improvement for high-risk children living in different geographical areas. This research was conducted to study the oral health status, dental knowledge and behavior in relation to two different cities, among children in Baghdad and Thamar (republic of Yemen) governorate. Materia

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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
Laparoscopic versus open appendectomy in patients with acuteappendicitis
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Background: Laparoscopic surgery for
appendicitis is now a well established and
advanced method of performing general surgical
procedures.
Objectives: To compare the outcome of
laparoscopic and open appendectomies in terms
of operative time, analgesic requirement,
postoperative complications, hospital stay, return
to normal activity and condition of scar.
Methods: This prospective study was carried
out from 1stMay 2008-1st January 2010, involving
110 patients (45 male and 65 female) with
features suggestive of acute appendicitis were
divided into 45 patients laparoscopic
appendectomy (LA) group and 65 patients open
appendectomy (OA) group, after taking informed
consent. LA was done with the

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Publication Date
Mon Mar 13 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Oral health status in relation to nutritional status among institutionalized autistic children and adolescents in Baghdad city, Iraq
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Background: The autism spectrum disorder (ASD) describes a wide range of symptoms, including difficulty with social interaction and communication skills. Controversial thinking about oral health of children with ASD, in general may have a lower hygiene level than healthy individuals, low caries rate and high body weight in comparison to healthy children. This study was conducted to assess the oral health status in relation to nutritional status among institutionalized autistic children and adolescents. Materials and methods: From 12 institutes in Baghdad, the study group contained 364 child and adolescent with ASD (Male= 294, Female=70), while control group included 441 normal child and adolescent (Male=357, Female=84) from primary and seco

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Sat Oct 05 2019
Journal Name
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Personalised Warfarin Dosing in Children Post-cardiac Surgery
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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Growth of diabetic children in post conflict Baghdad, Iraq
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Tue May 01 2018
Journal Name
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Publication Date
Sun Jun 07 2015
Journal Name
Baghdad Science Journal
Spectrophotometric Determination of Paracetamol in bulk and Pharmaceutical Preparations
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A simple, and rapid spectrophotometric method for the estimation of paracetamol has been developed. The methods is based on diazotisation of 2,4-dichloroaniline followed by a coupling reaction with paracetamol in sodium hydroxide medium. All variables affecting the reaction conditions were carefully studied. Beer's law is obeyed in the concentration range of 4-350 ?gml?1 at 490 nm .The method is successfully employed for the determination of paracetamol in pharmaceutical preparations. No interferes observed in the proposed method. Analytical parameters such as accuracy and precision have been established for the method and evaluated statistically to assess the application of the method.

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Publication Date
Wed Jan 01 2020
Journal Name
International Journal Of Pharmaceutical Research
Spectrophotometric Evaluation of Paracetamol in Bulk and Pharmaceutical Preparations
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Publication Date
Thu Jan 20 2022
Journal Name
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Comparison of the Safety and Efficacy of Laser Versus Pneumatic Intracorporeal Lithotripsy for Treatment of Bladder Stones in Children
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This study aimed to compare the safety and efficacy of laser lithotripsy and pneumatic lithotripsy, the two most commonly used transurethral lithotripsy methods for treating bladder stones in children in Iraq. Between January 2013 and December 2016, 64 children with bladder stones were included in this prospective randomized study, after ethical committee approval and written consent from the children’s parents or caregivers were obtained. Patients were assigned randomly by computer software to two groups treated with either pneumatic cystolithotripsy or laser lithotripsy. A 9 Fr. semirigid ureteroscope was used to pass the lithotripter through and fragment the stone. A catheter of 8–12 Fr. was then introduced and kept in place

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