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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 Jun 11 2025
Journal Name
Al–bahith Al–a'alami
Cultural and educational values for children
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Programs directed to children through the media in general and in television in particular are among the main factors that help in forming the cultural and educational values of this important segment of society, and in light of this the study problem was identified in answering a major question: What are the cultural and educational values that Ajyal channel seeks Space planted in children through my program, Iftah Ya Simsim (in its new season) and Friends of Ajyal? , While the objectives of the study were evident in identifying the most prominent cultural and educational values that the Ajyal satellite channel worked to instill in children, and identifying the nature of the techniques used by Ajyal channel in providing the value conten

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Publication Date
Wed Jun 11 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Enamel defect of primary and permanent teeth in relation to nutrients daily intake among Down's syndrome children in comparison to normal children
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Background: Any child with Down's syndrome does not develop in the same manner as normal child. Therefore, the child should not be viewed as being like everyone else. Developmental enamel defects in primary teeth have been found at least twice as frequently in disabled children as in control children. Down's syndrome consumed protein more than the recommended daily allowance compared to other disabled groups. Therefore, the aim of this study was to investigate developmental defects of enamel and their relations to nutrient intake among Down's syndrome children in comparison to normal children. Materials and Methods: A sample consisted of fifty institutionalized Down's syndrome children (study group) and 50 normal children (control group)

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Publication Date
Tue Dec 01 2020
Journal Name
Al-khwarizmi Engineering Journal
Studying the Radial and Tangential Velocity Components of the Epithelization Healing Post Photorefractive Keratectomy Surgery of the Human Eye
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Photorefractive keratectomy (PRK) is the refractive technique that began with a physical scraping of the epithelial layer of cornea subsequent by laser treatment. Post this procedure to about 48 hours the removed epithelial layer regenerated to protect the eye again. The regeneration process (called re-epithelization) started from the limbus of the cornea toward the central part of it. The re-epithelization mechanism consists of a change in cell density (mitosis) and cell concentration (migration) with a velocity in two directions: radial and tangential. In the present study, an estimation for both radial (responsible for the overlapped layers toward the outward direction of the cornea) and tangential comp

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Publication Date
Sun Oct 06 2013
Journal Name
Journal Of Educational And Psychological Researches
Awareness of children 's rights from the perspective of parents and educators kindergarten in the city of Baghdad
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The subject of children's rights in the modern era of the priorities of educators , because the child in the community is the future , which is held by the hope which is the basis for society in the renaissance and progress so quickly communities to prove these rights through its various institutions and issued legislation and held numerous conferences and taking specialists the field of childhood Aatron aspects of this rights and Aasalunha including a benefit for children until tomorrow for the rights of children , psychological and social health and educational . Therefore, the current study focused on the awareness of parents and educators of children's rights as individuals most closely satisfying their needs and rights. The

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Publication Date
Fri May 01 2020
Journal Name
Civil Engineering Journal
Post-Fire Behavior of Post-Tensioned Segmental Concrete Beams under Monotonic Static Loading
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This paper presents a study to investigate the behavior of post-tensioned segmental concrete beams that exposed to high-temperature. The experimental program included fabricating and testing twelve simply supported beams that divided into three groups depending on the number of precasting concrete segments. All specimens were prepared with an identical length of 3150 mm and differed in the number of the incorporated segments of the beam (9, 7, or 5 segments). To simulate the genuine fire disasters, nine out of twelve beams were exposed to a high-temperature flame for one hour. Based on the standard fire curve (ASTM – E119), the temperatures of 300◦C (572◦F), 500◦C (932◦F), and 700◦C (1292◦F) were adopted. Consequently,

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Publication Date
Fri May 01 2020
Journal Name
Civil Engineering Journal
Post-Fire Behavior of Post-Tensioned Segmental Concrete Beams under Monotonic Static Loading
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This paper presents a study to investigate the behavior of post-tensioned segmental concrete beams that exposed to high-temperature. The experimental program included fabricating and testing twelve simply supported beams that divided into three groups depending on the number of precasting concrete segments. All specimens were prepared with an identical length of 3150 mm and differed in the number of the incorporated segments of the beam (9, 7, or 5 segments). To simulate the genuine fire disasters, nine out of twelve beams were exposed to a high-temperature flame for one hour. Based on the standard fire curve (ASTM – E119), the temperatures of 300◦C (572◦F), 500◦C (932◦F), and 700◦C (1292◦F) were adopted. Consequently,

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Publication Date
Fri Jan 15 2010
Journal Name
Joijrnal Of College Ofeducation
Association between Insulin Resistance and Mellitus type 1 in children
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Aim of the study is to find any correlation between obesity (insulin resistance) and type I diabetes in children. Obesity and diabetes mellitus are the common health problems, and obesity is common cause of the insulin resistance. The results revealed marked increased in glucose, insulin, HbAlc and insulin resistance in obese diabetic type I patients comparing to control group they were obese and non-obese found to be within normal values for glucose, insulin, FIbAlc , and insulin resistance.

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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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
Wed Aug 31 2022
Journal Name
Al-kindy College Medical Journal
Health-Related Quality of Life in Diabetic Women with Comparing Obese & Normal weight
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Background: The prevalence of both obesity & diabetes are increasing all over the world & more in women.  They have a negative impact not only on morbidity & mortality but also on quality of life.

Objectives: To assess the HRQoL with a specific comparison between obese & normal weight among wo

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