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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
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Comparing the Sequential Nonlinear least squared Method and Sequential robust M method to estimate the parameters of Two Dimensional sinusoidal signal model:
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Estimation of the unknown parameters in 2-D sinusoidal signal model can be considered as important and difficult problem. Due to the difficulty to find estimate of all the parameters of this type of models at the same time, we propose sequential non-liner least squares method and sequential robust  M method after their development through the use of sequential  approach in the estimate suggested by Prasad et al to estimate unknown frequencies and amplitudes for the 2-D sinusoidal compounds but depending on Downhill Simplex Algorithm in solving non-linear equations for the purpose of obtaining non-linear parameters estimation which represents frequencies and then use of least squares formula to estimate

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Publication Date
Wed Apr 15 2020
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Aggression is a dominant behavior among adolescents in Al-Sadr city, Baghdad-Iraq
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Background: Aggression is any behavior intending to harm another living being that desires to avoid such harm. Aggression is considered as a public health problem worldwide. Exposure to violence is a determinant of aggression. Al-Sadr city, which is an overcrowded residential area in Baghdad, was exposed to violence through wars, civil war, and widespread inter-personal violence). This situation was an impetus to study aggression in this city.

Objectives: To estimate the prevalence of aggression among secondary school students in Al-Sadr city, Baghdad.

Methodology: A cross-sectional study was carried out in Al-Sadr city in Baghdad. A total of 720 adolescent secondary scho

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Publication Date
Sun Dec 22 2024
Journal Name
Journal Of Baghdad College Of Dentistry
Prevalence of Pacifier Sucking Habit and Its Effect on Occlusion in Children Aged 1-5 Years in Baghdad City
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Background: Non-nutritive sucking habits are common in infants and toddlers. One of the most common non-nutritive sucking habits is pacifier; its prevalence varies from one population to another. This study was conducted to determine the prevalence of pacifier sucking habit among children aged 1-5 years old in Baghdad city and to assess its effect on the occlusion of primary dentition concerning posterior crossbite. Materials and methods: The study was carried out among 1222 children aged 1-5 years old, from which 50 children with continues pacifier sucking habit were chosen to be the study group, compared to 50 children without any sucking habit (control group) matching the study group in age and gender. Children were examined clinically t

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Publication Date
Tue Sep 08 2015
Journal Name
Journal Of The Faculty Of Medicine
Sciatic nerve injection injury in children: Management and outcome
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W Tarik A, AW Ali T, Journal of the Faculty of Medicine, 2015 - Cited by 2

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Publication Date
Wed Jan 02 2008
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Genetic characteristics and β-cell Autoimmunity in T1DM Children
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Background: TIDM is known to be polygenic disease that appears from the interaction of mutation in multiple genes including HLA. The autoimmune mediated destruction of
pancreatic β-cells is reflected by the presence of autoantibodies against prominent antigens in the pancreatic β-cells.
Objective: This study was designed to investigate the role of HLA-class I and class II antigens in the etiology of type 1 diabetes mellitus (T1DM) and also assessment of
glutamic acid decarboxylase (GAD65) autoantibodies in the patients at the onset of the disease.
Patients & Methods: Sixty T1DM patients who were newly onset of the disease (diagnosed less than five months) were selected. Eighty apparently healthy

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Sciatic nerve injection injury in children: Management and outcome
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Background: Sciatic nerve injury is a common complication following IM gluteal injection in children. A controversy still exists regarding management and outcome.
Objective: To find the outcome of conservative and surgical treatment and compare it with other studies.
Patients and Methods: This is a retrospective study of 24 children( less than 15 years old) with sciatic nerve injection injury at the gluteal region. The child age, gender, type of injection drug, time of injury with complete neurological examination and EMG study were recorded. Conservative treatment including physiotherapy and surgical treatment including surgical exploration and neurolysis at the buttock region were done with follow-up 6 months to one year.
Resu

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Publication Date
Mon Jul 01 2013
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Suppression of Insulin Secretion by Ghrelin and The Deterioration of Glucose Tolerance in Healthy Children
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Background: Ghrelin, identified as an endogenous ligand for the growth hormone secretagogue receptor, functions as a somatotrophic and orexigenic signal from the stomach. The secretion of ghrelin increases under conditions of negative energy balance, such as starvation, cachexia, and anorexia nervosa, whereas its expression decreases under conditions of positive energy-balance such as feeding, hyperglycemia, and obesity. In addition to having a powerful effect on the secretion of growth hormone, ghrelin stimulates food intake and transduces signals to hypothalamic regulatory nuclei that control energy homeostasis. Thus, it is interesting to note that the stomach may play an important role in not only digestion but also a

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Publication Date
Mon Jun 27 2022
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn: 2789-3219 )
Self-Reported Sleep Disorder, Anxiety and Depression in Iraqi Patients Post-Myocardial Infraction
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Background: Myocardial infarction (MI) is distinguished by the necrosis of myocardial cells as a result of substantial and prolonged ischemia. Anxiety, problems sleeping, and feelings of depression are some of the most common psychosocial consequences of having a myocardial infarction. Aim: The purpose of this study is to evaluate the effects of post-myocardial infarction on patients' levels of anxiety, depression, and quality of sleep. Method: The collection of data from 94 individuals with MI was carried out according to a descriptive cross-sectional design. Sleep quality, depression, and anxiety were evaluated using standard questionnaires. Results: 69.1% of the participants reported having trouble getting quality sleep. The perc

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Publication Date
Fri Sep 27 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The effects of thumb sucking habit on the development of malocclusions in preschool age children in Hilla city
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Background: habit is any purposeless action repeated unconsciously. It is a sign of lack of harmony between the subject and the surrounding environment. Deleterious oral habits such as finger sucking could be one of the etiological factors for altered oro-facial growth development. This study conducted to explore the association between finger sucking habit and malocclusion in deciduous dentition. Materials and method: Totally 40 chronic thumb sucker and 40 controls matching in age and gender were enrolled in the study. A study conducted by verifying different occlusal trait through the intra-oral examination. Thumb sucking habit diagnosed using data gathered from parents. Results: The statistical analysis showed a highly significant dif

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Publication Date
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Etiology of Bloody Diarrhea among Children Admitted to Maternity and Children ’ s Hospital-Erbil
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Background: Bloody diarrhea plays a major role in
morbidity and mortality especially in developing
countries, it is usually a sign of invasive enteric
infection, there is a thought that amoebic dysentery is
more common than bacillary dysentery in Iraq, and
from 1989 to 1997 amoebic dysentery increase from
20000to 550000 patients.
Objectives: This study aims to:
1. Outline the incidence of various infectious causes of
bloody diarrhea in Erbil district.
2. Assess the effect of multiple factors like age, sex,
source of water supply, etc... On the incidence of
amebic and bacillary dysentery.
3. To provide baseline data for making strategic plan to
reduce the diarrhoeal mortality and morbidity.
Met

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