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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 10 2021
Journal Name
Baghdad Science Journal
Health Assessment and unhealthy eating habits for children nurseries in the city of Baghdad
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This study was conducted to identify the health status of children's nurseries in the city of Baghdad and to identify improper dietary habits practiced by these children have shown the results of this study that the same proportion of childhood diarrhea disease research and infections

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Publication Date
Thu Oct 20 2022
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Investigation of the ADA Enzyme and Lipid Profile in Children Infected with Enterobius Vermicularis
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Adenosine deaminase (ADA) and lipid profile may be associated with some diseases. Parasitic diseases have also been reported to be associated with ADA and lipid profiles. This study aimed to evaluate ADA, lipid profile, and total protein among children infected with E.vermicularis. This research was carried out in Baghdad province from October 2021 to the end of March 2022. One hundred samples were collected from both sexes, ranging in age from (3-16) years. They all underwent examination for ADA, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and total protein levels. Results showed no significant differences between E.vermicularis positive group and E.vermicularis negative group regarding ADA, LDL, and trig

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Publication Date
Mon Jan 02 2006
Journal Name
Journal Of The Faculty Of Medicine Baghdad
protien energy malnutrition in Iraqi children before and after five years of the san
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Background:

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Publication Date
Fri Jan 01 2021
Journal Name
Academy Of Strategic Management Journal
Prospects and Challenges for Iraqi SMES Sector Post-Isis
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Iraq faces significant economic challenges, owing in part to its reliance on oil revenue and the country's overburdened public sector. The supremacy of State-Owned Enterprises (SOEs), obstructive rules, a lack of access to finance, a shortage of skilled labor, and inadequate infrastructure all impede private sector growth. This research relied mainly on information from global development organizations, most markedly the World Bank, as well as policy documents, and it discovered a scarcity of pertinent educational writings. The following are the key findings of this research: Recent economic growth has not resulted in poverty reduction; the stretched history of war and insecurity in Iraq has hampered progress and development; the private se

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Publication Date
Mon Jan 01 2024
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Prevalence of Anxiety and Depression Symptoms among Post Bariatric Surgery Patients in Baghdad-Iraq
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Background: Obesity is a major public health concern and is on the rise worldwide. Numerous studies revealed that the best method for treating morbid obesity is bariatric surgery, which has indicated its effectiveness in controlling weight. Published studies reported that patients who had undergone bariatric surgery may have psychiatric illnesses when compared to other obese individuals with similar preoperative characteristics.

Objectives:  Estimate the rates of anxiety and depression among post-operative bariatric surgery patients.

J. Fac. Med. Baghdad

2023. Vol 65, No. 4

 

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Publication Date
Fri Dec 29 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Efficacy of Some Formulations of the Insecticide Chlorpyrifos against Microcerotermies diversus Silv. On Citrus Tree Orchards
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The eflicacy  of six formula from chloropyrifos against tem1ite

Microterotermes - diversus on citrus tree orchards has been

tested years .

Data!rom field trials confirmed that Dursbau 4TC, chlorpyrifos -

500 EC and Talaban 40,8 TC at rate 100 mL L protected citrus trees for two years.  While ch1orfate. 40.8 TC, Dormate 40,8TC, Yamasban

40,8 TC protected  them for 16,16 and 12 months respectively at the same concentration.

But the rate of 5m1/ L of Dursban, chropyfros 500 EC , Chlorfat,

Tafabun yamashan and Dormate protected the trees tor 24,16,4,4,2

and 4 months  , respectively .

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Publication Date
Sun Dec 22 2024
Journal Name
Journal Of Baghdad College Of Dentistry
An Assessment of the Efficacy of Sinus Balloon Technique on Transcrestal Maxillary Sinus Floor Elevation Surgery
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Background: A minimally invasive antral membrane balloon elevation (MIAMBE) has been introduced to overcome the invasiveness of modified Caldwell-Luc (lateral approach) and the drawbacks of the osteotome (summers' technique) in maxillary sinus floor elevation surgery. Materials and methods: A total of 13 adult Iraqi patients aged 28-55 years, 4 males and 9 females underwent sinus floor elevation surgery via crestal approach by using sinus balloon technique. A panoramic radiograph and (Cone beam computed tomography (CBCT)/or medical CT scan) were obtained before and after surgery. Postoperative gained bone was assessed and the patient reactions including pain, nasal bleeding, and ecchymosis were recorded. The whole follow up period was 1yea

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Publication Date
Fri Mar 01 2019
Journal Name
Archives Of Plastic Surgery
Surgical outcomes of 14 consecutive bilateral cleft lip patients treated with a modified version of the Millard and Manchester methods
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Background Bilateral cleft lip deformity is much more difficult to correct than unilateral cleft lip deformity. The complexity of the deformity and the sensitive relationships between the arrangement of the muscles and the characteristics of the external lip necessitate a comprehensive preoperative plan for management. The purpose of this study was to evaluate the repair of bilateral cleft lip using the Byrd modification of the traditional Millard and Manchester methods. A key component of this repair technique is focused on reconstruction of the central tubercle.

Methods Fourteen patients with mean age of 5.7 months presented with bilateral cleft lip deformity and were operated on using a mod

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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 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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