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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
Wed Mar 24 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
Evaluating the anti- Pseudomonas Aeroginosa Efficacy and Potential Cytotoxicity of Nerium Oleander Alcoholic Extract
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Nerium oleander known as oleander has belonged to the poisonous plants its habitat in a tropical andsubtropical region. The chemical analysis with GC-Mass of the alcoholic extract of oleander leaves revealedthat this plant has many chemical compounds more than 80 compounds and high-peaks about 29 compoundswhich are represented by alkaloids, phenol, terpenes, and fatty acid. HPLC analysis showed many essentialoils that have many biological effects.To evaluate the antibacterial activity of the alcoholic extract of N. oleander against locally isolatedPseudomonas aeroginosa the broth micro-dilution method was adapted to different concentrations werestarted from 3.9 to1000 mg/ml. The results revealed that the alcoholic extract has antiba

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Publication Date
Thu Mar 30 2023
Journal Name
Iraqi Journal Of Science
Evaluation of the Efficacy of Different Serological Methods (rK39 dipstick, ELISA and IFA) Techniques in the Diagnosis of Visceral leishmaniasis.
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The objective of this study was to compare the sensitivity and specificity of rK39,
ELISA and IFA tests for the diagnosis of visceral leishmaniasis using blood
samples. Samples were collected from 146 suspected patients and 30 healthy
individual as control. The results showed 52 (35.62%), 58 (39.73%) and 71
(48.64%) positive samples by rK39, ELISA and IFA , respectively. IFA test showed
a higher sensitivity (48.63%) than ELISA and rk39 dip stick (39.72%) and (35.61%)
respectively. The highest sensitivity of agreement (K: 0.912) was found between
rK39 dipstick and ELISA. Therefore, we suggest the application of rK39 dipstick
and ELISA methods in endemic areas of visceral leishmaniasis for early and
accurate diag

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Publication Date
Wed Apr 01 2009
Journal Name
Journal Of Educational And Psychological Researches
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.
In the light of the findings of the present study, several conclusions, recommendations and suggestions for further

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Publication Date
Thu Dec 01 2022
Journal Name
Journal Of Medicine And Life
Renal stone density on native CT-scan as a predictor of treatment outcomes in shock wave lithotripsy
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Extracorporeal shock wave lithotripsy (ESWL) is considered a standard treatment for nephrolith or kidney stones measuring less than 20 mm. Anatomical, machine-related, and stone factors play pivotal roles in treatment outcomes, the latter being the leading role. This paper examined the relationship between stone density on native CT scans and ESWL treatment to remove renal stones concerning several treatments. One hundred and twenty patients (64 males and 56 females) were enrolled and completed the study from April 2019 to September 2020. Inclusion criteria were a single renal pelvis stone of 5–20 mm to be treated for the first time in adult patients with no urinary or musculoskeletal anatomical abnormalities. We assessed patients

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Publication Date
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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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
Sun Oct 09 2022
Journal Name
Journal Of Research In Medical And Dental Science
Efficacy of Locally Applied K-Carrageenan on the Healing of Thermal Burn in Rat-Experimental Model: Histological Study
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ABSTRACT Wound is damage or disruption to the normal anatomical structure and function. Carrageenan is sulphated polysaccharide found in Gigartina, Chondrus and Eucheuma species in the red algal family. Having anticancer, anti-inflammatory and renewal of tissues. Our study aimed to detect the role of kappa carrageenan in the burned skin wound repair. Skin burn were performed in the right and left cheek of 20 male rats (aged 7-8 weeks weighing 300-350 g). Burned skin rats were categorized into two equal groups. Burned areas of right side were treated with a local application of 1 ml of kappa carrageenan solution once daily (treatment group) and the left side receive no treatment (control group). After 5, and 10 days, 5 rats from each

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Publication Date
Sun Sep 02 2018
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Etiology and clinical pattern of liver diseases in children
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Background: liver diseases may not be recognized by clinicians, who can lead to a subsequent delay
in the initiation of effective therapies, the commonest presenting signs and symptoms of pediatric liver
diseases include hepatomegaly, jaundice, coagulopathy or elevation of the liver enzymes or waste
products as ammonia.
Objectives: To highlight the etiologies, pattern of presentations and the route of diagnosis of all liver
diseases in children less than 10 years referred to the Gastroenterology and Hepatology Unit in
Children Welfare Teaching Hospital over a six months period.
Patients and methods: A prospective study was conducted in the Gastroenterology and Hepatology
Unit in the Children Welfare Teaching Hospi

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Comparing Some Methods of Estimating the Parameters and Survival Function of a Log-logistic Distribution with a Practical Application
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The Log-Logistic distribution is one of the important statistical distributions as it can be applied in many fields and biological experiments and other experiments, and its importance comes from the importance of determining the survival function of those experiments. The research will be summarized in making a comparison between the method of maximum likelihood and the method of least squares and the method of weighted least squares to estimate the parameters and survival function of the log-logistic distribution using the comparison criteria MSE, MAPE, IMSE, and this research was applied to real data for breast cancer patients. The results showed that the method of Maximum likelihood best in the case of estimating the paramete

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