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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
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
Sat Oct 05 2019
Journal Name
Pediatric Cardiology
Personalised Warfarin Dosing in Children Post-cardiac Surgery
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Abstract<p>Warfarin dosing is challenging due to a multitude of factors affecting its pharmacokinetics (PK) and pharmacodynamics (PD). A novel personalised dosing algorithm predicated on a warfarin PK/PD model and incorporating CYP2C9 and VKORC1 genotype information has been developed for children. The present prospective, observational study aimed to compare the model with conventional weight-based dosing. The study involved two groups of children post-cardiac surgery: Group 1 were warfarin naïve, in whom loading and maintenance doses were estimated using the model over a 6-month duration and compared to historical case-matched controls. Group 2 were already established on maintenance therapy a</p> ... Show More
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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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Publication Date
Tue May 01 2018
Journal Name
Practice Periodical On Structural Design And Construction
Hazards and Risk in Construction and the Impact of Incentives and Rewards on Safety Outcomes
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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
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
Thu Jan 20 2022
Journal Name
Journal Of Clinical Medicine
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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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Review of Histopathological Diagnoses of One Year Appendectomy Specimens in Sulaimani City
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Objective: To review and see the pattern of histopathological diagnoses of one year appendectomy specimens.
Methodology: This retrospective study was carried in Sulaimani Teaching Hospital over the period of one year (from 1st
of January to 31st of December 2009). All pathological reports were reviewed retrospectively for patient’s age, sex,
histopathological diagnosis and operative findings (if present). Histopathological diagnoses then were classified into
either positive or negative for acute inflammation. Any associated findings or any surgical specimen removed with the
appendix was recorded. The obtained data were analyzed by using the statistical package social sciences (SPSS) version
19; with Chi square to test

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Publication Date
Thu Jan 01 2015
Journal Name
International Journal Of Scientific Research In Knowledge
The Impact of Teenage Pregnancy on Maternal, Fetal and Neonatal Outcomes
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Adolescent pregnancy is common health problem still found in both developed and developing countries; as adolescent may have early sexual practice or early marriage. Adolescent mothers face substantially higher maternal and perinatal morbidity and mortality than adult women. This is a randomized prospective clinical study conducted at Al-Elwiya Maternity Teaching Hospital, Baghdad, Iraq. The objective of this work is to assess the adverse maternal, fetal and neonatal outcomes in early and late teenage pregnant mothers. Study sample consisted of 220 primigravid women with a singleton, cephalic, viable fetus and no congenital abnormality that gave birth at Al-Elwiya Maternity Teaching Hospital, Baghdad, Iraq. The 1stgroup: early teenage (46 w

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Publication Date
Wed Jun 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Person-Organization's Environment Fit and it's Reflection on the Work Outcomes
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This study aims to studying of Person and organization’s environment fit in a sample of Private bank’s reflection in its basic dimensions (Person-organization fit ,Person-Job fit, Person-group fit and Person- Person-fit )in the Work Outcomes (job satisfaction, the intention to leave the job, Job Engagement, and organizational  citizenship behavior ).

The questionnair’e has been used as a basic  instrument to gather data , As well as personal interviews with some of the staff of the research sample of private banks which were represented by (5) and included banks (Bank of Assyria for investment, the North Bank for Finance and Investment , Bank of the Tigris

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