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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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Publication Date
Sat Dec 11 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Study the Distribution of Rotavirus Genotypes in Vaccinated and non Vaccinated Children in Babylon Province
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Rotaviruses, a major cause of gastroenteritis in children worldwide accounts for around half a million deaths annually. Vaccine against the virus has been recommended by the WHO to be involved in the national immunization program.To evaluate the genetic characterization of rotavirus among children with acute gastroenteritis in Babylon province is warranted. Children complained of diarrhea with rotavirus infection detected in their stool were involved in the study. The age range was 10 months to 60 months and with retrogradechecking of rotavirus vaccine history. Rotavirus genotypes were detected by reverse transcription-polymerase chain reaction (RT-PCR).A total number of 40 children with rotavirus gastroenteritis were used to examine the

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Publication Date
Fri Jul 01 2022
Journal Name
Iranian Journal Of Neonatology
Maternal Risk Factors and Outcomes of Premature Neonates Admitted to the Neonatal Care Unit in AlElwiya Pediatric Teaching Hospital in Baghdad, Iraq
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Background: Prematurity and its complications are the major causes of neonatal and infant morbidity and mortality. Although the cause of preterm labor is often unknown, numerous etiological risk factors may be implicated. To identify the risk factors that lead to prematurity and assess the neonatal outcomes that preterm neonates may develop. Methods: This case-control study was conducted at AL-Elwiya Pediatric Teaching Hospital, Baghdad, Iraq, from the 1st of June to the 31st of December 2019. A non-randomized sample of 700 neonates admitted to the neonatal care unit was included in this study and divided into two groups of preterm full-term neonates as the experimental and control groups, respectively (n=350 each). The same questionnaire w

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Publication Date
Sun Jan 01 2006
Journal Name
Smj
Treatment of alopecia areata by topical diclofenac sodium gel in comparison with benzoyl peroxide gel
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Wed Mar 24 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
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Sat Apr 16 2022
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Post Fire Residual Concrete and Steel Reinforcement Properties
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he paper presents the results of exposure of normal concrete to high temperatures (400 and 700°C). In addition to the exposure of steel reinforcement bar Ø 12 mm, where two types of steel reinforcement burning situations were performed. Directly exposed to high temperatures (400 and 700°C) and others were covered by concrete layer (15 mm). From the experimental results of fire exposure for 1 hour of 400 and 700°C and gradually cooled, it was found that the residual average percentage of compressive strength of concrete was 85.3 and 41.4%, while the residual average percentage of modulus of elasticity of concrete was 75 and 48%, respectively. The residual average percentage of yielding tensile stress (Ø 12 mm) after burning and cooling

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Publication Date
Sun Apr 04 2010
Journal Name
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Effective an instructional in program in the development of some of the moral values on the children of kindergarten
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The research aims to
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2 - Building an educational program designed to develop moral values on the children of
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Publication Date
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
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Herpes labialis is an infection caused by the herpes simplex virus, characterized by an eruption of small and usually painful blisters on the skin of the lips, mouth, gums, or the skin around the mouth. Although there is no successful treatment available, the local use of compounds with effective anti-inflammatory and cytoprotective effects may be of value in this respect. This project was designed to evaluate clinically the local use of silymarin, a group of flavonoids with powerful antioxidant, anti-inflammatory and cytoprotective activity, in the treatment of herpes simplex ulcer. Fifty three patients with herpes labialis ulcers (HLU) were enrolled in this randomized, single blinded, placebo controlled clinical study, and they were al

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