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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
Tue Jul 01 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The Monosynaptic H-reflex excitability in post-Stroke patients.
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Backgrond: One of the major causes of impaired movements post-stroke is the abnormal phasing of paralytic muscles. Many studies suggested that inappropriate muscle phasing may be associated with enhanced transmission in the monosynaptic Group Ia afferent pathway in the affected limb of post-stroke patients and Group Ia reflexes are abnormally elevated and fail to decrease in amplitude during locomotion.

Objectives: This study was conducted to identify the changes in the Soleus muscle H-reflex excitability at rest in the affected lower limb of post-stroke patients as compared to the contra lateral side and of normal controls.

Patients and methods: The excitability of the m

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Publication Date
Sun May 12 2019
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Study of hypocalcemia and its risk factors in post thyroidectomy in Al-Karama Teaching Hospital
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Background: Hypocalcemia is a well-recognized complication of thyroid surgery. The aim of this study was to determine the incidence of hypocalcemia after thyroid surgery and find out the risk factors involved regarding the patient’s age, gender, muscular build, clinical diagnosis, extent of surgery, ligation of the inferior thyroid artery, and pathology report.

Patients and Methods: This case series study was carried out on 50 patients who have undergone thyroid surgery for various thyroid diseases at the surgical department of Al-Karama Teaching Hospital for the period between January 2016 and July 2017. Serial serum calcium measurements were recorded as well as details of the operation, patie

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Comparing Several Nonlinear Estimators for Regression Function
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The aim of this paper is to estimate a nonlinear regression function of the Export of the crude oil Saudi (in Million Barrels) as a function of the number of discovered fields.

 Through studying the behavior of the data we show that its behavior was not followed a linear pattern or can put it in a known form so far there was no possibility to see a general trend resulting from such exports.

We use different nonlinear estimators to estimate a regression function, Local linear estimator, Semi-parametric as well as an artificial neural network estimator (ANN).

The results proved that the (ANN) estimator is the best nonlinear estimator am

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
Personal Efficacy And Its Relationship With Mindfulness Among University Students
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The study seeks to examine the level of personal efficacy and its relation to mental alertness among university students. Besides, the statistically significant differences in regard of students' gender, and the correlation between male and female. To do this, the researcher adopted two scales: one to measure the personal efficacy which was made up by (abed al-jabaar, 2010) included (26) items, and the other to measure the mental alertness that designed by (abed Allah, 2012) included (36) items. A total of (120) student were selected randomly from three-different colleges at the Al-Mustansiriyah University for the academic year 2016-2017. The findings revealed there are no significant differences among students in regard of the personal

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Publication Date
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
The natural courses of keratometric, pachymetric and visual acuity outcomes during 1year follow up after corneal collagen cross-linking
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Background: As photochemical reaction that can stiffen the cornea, CXL is the only promising method of preventing progression of keratectasia such as KC and secondary ectasia following refractive surgery. The aim of CXL is to stabilize the underlying condition with a small chance of visual improvement. Objective: To show the sequences of changes in visual acuity and topographic outcomes during 1 year post CXL for patients with progressive Keratoconus.Type of the study: Cross sectional studyMethods: CXL procedure was done for 45 eyes with progressive KC. The following parameters had been monitored pre operatively, 1, 3, 6 and 12 months postoperatively: K apex, K2, corneal thickness at thinnest location, anterior and posterior elevation po

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Publication Date
Fri Sep 27 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Antimicrobial efficacy of silver, zinc oxide, and titanium dioxide nanoparticles incorporated in orthodontic bonding agent
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Background: One of the most important complications of fixed orthodontic treatment is formation of white spots, which are initial carious lesions. Addition of antimicrobial agents into orthodontic adhesive material might be wise solution for prevention of white spots formation. The aim of this study was to evaluate the antibacterial properties of orthodontic adhesive primer against S. Mutans after adding the three different types of nanoparticles (Ag, ZnO, or TiO2). Materials and methods: Discs were prepared using empty insulin syringe approximately 2 mm×2 mm rounded in shape specimens (40 discs) were divided into four groups (ten discs for each group): The first group was the control (made from primer only), the second group (10 dis

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Publication Date
Wed Oct 31 2018
Journal Name
Al-kindy College Medical Journal
Efficacy Of Hyaluronic Acid And Corticosteroid Intra-Articular Injection In Knee Joint With Primary Osteoarthritis
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Background: Osteoarthritis OA is the most common joint disorder in the world. Injection of high molecular weight hyaluronic acid intra-articular with steroid is a one of the used therapeutic option for patients with (OA)knee.

Objectives: Objective of this study was the evaluation the efficacy, safety, pluse duration of action of viscosupplementation of the  HMWHA( high molecular weight hyluranic acid ).

Type of the study: Cross-sectional study.

Methods: From 81 patients with sever knee pain due to OA (grades 3–4) were recruited from Al-Yarmouk teaching hospital  & a private clinic during the period from January 2014 till July 2016.

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Publication Date
Mon Aug 02 2021
Journal Name
International Journal Of Dental Hygiene
Efficacy of erythritol powder air‐polishing in active and supportive periodontal therapy: A systematic review and meta‐analysis
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Abstract<sec><title>Objective

This systematic review aimed to analyse available evidence to answer two focused questions about the efficacy of erythritol powder air‐polishing (EPAP) (i) as an adjunctive during active periodontal therapy (APT) and (ii) as an alternative to hand/ultrasonic instrumentation during supportive periodontal therapy (SPT). Additionally, microbiological outcomes and patient's comfort/perceptions were assessed as secondary outcomes.

Methods

PubMed, Cochrane and Medline were searched for relevant articles published before February 2021 following PRISMA guidelines. The search was conducted by three indep

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Publication Date
Thu Oct 07 2021
Journal Name
Rimak International Journal And Humanities And Social Sciences
children were exposed to animation on specialized satellite channels and verified gratifications
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Publication Date
Wed Jan 02 2008
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Epidemiological, Clinical Profiles and Outcome of Bronchiolitis in Iraqi Children
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Background:
Bronchiolitis is the first episode of wheezing associated with low-grade fever, rhinitis, tachypnea, and increase respiratory effort in a previously healthy infant during the winter
months. It is the most common disease of the lower respiratory tract.
Methods:
This is a case control study carried out on one hundred infants with a mean age of 3.9 months ± 2.2 months admitted to Children Welfare Teaching Hospital in Medical City –
Baghdad with acute bronchiolitis during the period from 1st January 2006 to 1st April 2006. epidemiological risk factors, clinical presentations, chest X-ray findings, treatment,
complications and outcome were analyzed. Another one hundred infants (age and sex 

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