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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
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Clinical and Refractive Outcomes of Toric Phakic Implantable Collamer lens Implantat for correction of myopic astigmatism
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Background: Currently there are four general approaches to correct refractive errors: refractive corneal surgery, crystalline lens surgery and implantation of an intraocular lens in anterior or posterior chamber.

Objective: To evaluate the predictability, safety and stability of toric phakic implantable collamer lens implantation to correct moderate to high myopic astigmatism. in  Eye Specialty Private Hospital, Baghdad, Iraq.

Type of the Study: a prospective non randomize intervention study.

Methods: 60 eyes of 40 patients underwent implantation of a toric implantable collamer lens (V4c design).Mean spherical refraction was ₋11.32 diopter

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Publication Date
Thu Dec 16 2021
Journal Name
Kufa Medical Journal
Clinical and Refractive Outcomes of Toric Phakic Implantable Collamer Lens Implantation for correction of myopic astigmatism
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Background: Currently there are four general approaches to correct refractive errors: refractive corneal surgery, crystalline lens surgery and implantation of an intraocular lens in anterior or posterior chamber. Aim: To evaluate the predictability, safety and stability of toric phakic implantable collamer lens implantation to correct moderate to high myopic astigmatism. Methods: Sixty eyes of 40 patients underwent implantation of a toric implantable collamer lens (V4c design) in the Eye Specialty Private Hospital, Baghdad, Iraq were studied. The mean spherical refraction was -11.32±3.17 diopter (D) with a range of -6.00 to -18.00 D and a mean cylinder of -2.61±1.16 with range of -1.00 to -5.50 D. The outcome measures that evaluat

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Publication Date
Thu Sep 18 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of nutritional status on arch width and length of primary teeth among five years old kindergarten children
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Background: In human life, malnutrition may adversely affect various aspects of growth at different stages of life. Teeth are particularly sensitive to malnutrition. Malnutrition may affect odontometeric measurement involving arch width and length of primary dentition. The aim of this study is to estimate the effect of nutrition on arch width and length dimension measurements among children aged 5 years old. Material and methods: This study was conducted among malnourished group in comparison to well-nourished group matching with age and gender. The present study included 158 children aged 5 years (78 malnourished and 80 well-nourished). The assessment of nutritional status was done by using three nutritional indicators, namely Height-for-a

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Publication Date
Sun Aug 07 2022
Journal Name
Engineering, Technology & Applied Science Research Etasr
The Combined Strengthening Effect of CFRP Wrapping and NSM CFRP Laminates on the Flexural Behavior of Post-Tensioning Concrete Girders Subjected to Partially Strand Damage
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The studies on unbonded post-tensioned concrete members strengthened with Carbon Fiber Reinforced Polymers (CFRPs) are limited and the effect of strengthening on the strain of unbonded pre-stressed steel is not well characterized. Estimating the flexural capacity of unbound post-tensioned members using the design methodology specified in the design guidelines for FRP strengthening techniques of bonded post-tensioned members does not provide a reliable evaluation. This study investigates the behavior of unbonded post-tensioned concrete members with partial strand damage (14.3% and 28.6% damage) and strengthened with CFRP laminates using a near-surface mounted technique with and without U-wrap anchorages. The experimental results show

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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
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Study on Candida spp. infection oral thrush and bacteria accompanied it from children
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Oral swab samples were collected from 120 children (ages between one month- 10 years) who were infected with oral thrush and 30 healthy children. The percentages of isolated yeasts and Bacteria were 66.6% and 96.6% respectively. The dominate yeast and bacteria were Candida albicans and Staphylococcus aureus with of 78.7% and 34.4% respectively. Results revealed that the highest percent of infection with oral thrush disease was 32.5% in children within the age of 1-2 months.

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Publication Date
Fri Oct 28 2022
Journal Name
Political Sciences Journal
Recruitment of Children in African Armed Conflicts and its International Dimensions
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       African countries are among the countries in the world that suffer from the phenomenon of child recruitment in wars and conflicts. There are many reasons behind it, including the nature of the human formation of children, the societal violence to which they are exposed, lack of access to education, economic hardships, as well as the role of African wars and conflicts and other reasons that compelled children to join armed groups and participate in military operations. The recruitment of children is divided into two types, compulsory and voluntary, and this leads to many humanitarian and security repercussions that are not limited to a specific period of time but extend to subsequent generations, and due to its seriousness, t

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Publication Date
Fri Dec 22 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Clinical Characteristics and Therapeutic Management of Osteogenesis Imperfecta in Iraqi Children
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Background: Osteogenesis imperfecta (OI) is a rare congenital condition that results in bone fragility, recurrent fractures, and various extra-skeletal manifestations. Currently, intravenous bisphosphonate is the mainstay of medical treatment in OI. Objective: To identify the effect of current management strategies on Iraqi children diagnosed with OI. Methods: A retrospective study enrolled OI patients who were registered in Central Child Teaching Hospital, Baghdad, Iraq, from January 2015 to December 2022. We enrolled confirmed OI cases (either clinically and/or radiologically) who received cyclic pamidronate therapy for at least 3 cycles. They neither received other types of bisphosphonates nor underwent surgical intervention. Res

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Publication Date
Thu Aug 01 2024
Journal Name
Al-kindy College Medical Journal
Efficacy of Gamma Knife Stereotactic Radiosurgery in the Treatment of Primary Trigeminal Neuralgia
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Background: Trigeminal neuralgia (TN), or Tic Douloureux, is one of the most common neuropathic pains. Gamma knife stereotactic radiosurgery (GNSRS) has been considered one of the procedures for treating primary TN. Objective: This study evaluates the effectiveness of GNSRS in treating primary TN in patients who are unresponsive to medical treatment in a single-center experience. Subjects and Methods: This study was conducted on 180 patients from January 2018 to October 2021. The study utilized the Barrow Neurological Institute (BNI) pain intensity score to assess pain before and after GNSRS treatment. Results: A total of 180 patients with primary TN were included in this study, 108 female with a 1.5:1 female: male ratio.  Results

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Publication Date
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
The Reality of Alternative Assessment for Teachers of the First Cycle of the Basic Education in the Sultanate of Oman: Use, Self-Efficacy, and Attitude
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This study aims at identifying the reality of alternative assessment for teachers of the first cycle of the basic education in the Sultanate of Oman with respect to the degree of teachers' use of alternative assessment strategies, level of self-efficacy for alternative assessment strategies, and attitude towards alternative assessment, and their relationship with other variables. To achieve the aims of the study, a descriptive research approach was utilized. A 5-point self-rated questionnaire was developed. It consists of three sections: Actual use of alternative assessment strategies (21 items), self-efficacy for alternative assessment strategies (21 items), and attitude towards alternative assessment (27 items). The psychometric proper

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