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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 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Person-Organization's Environment Fit and it's Reflection on the Work Outcomes
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This study aims to studying of Person and organization’s environment fit in a sample of Private bank’s reflection in its basic dimensions (Person-organization fit ,Person-Job fit, Person-group fit and Person- Person-fit )in the Work Outcomes (job satisfaction, the intention to leave the job, Job Engagement, and organizational  citizenship behavior ).

The questionnair’e has been used as a basic  instrument to gather data , As well as personal interviews with some of the staff of the research sample of private banks which were represented by (5) and included banks (Bank of Assyria for investment, the North Bank for Finance and Investment , Bank of the Tigris

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Publication Date
Sun Jul 30 2023
Journal Name
Pakistan Heart Journal
Evaluation of nurses Practice toward Children Safety Post Cardiac Catheterization Procedure
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Publication Date
Wed Jun 01 2011
Journal Name
Al Mustansiriyah Journal Of Pharmaceutical Sciences
Comparing the clinical efficacy and safety of high doses of beclomethasone inhaler with medium doses of beclomethasone inhaler combined with oral aminophylline or montelukast tablets in persistent asthmatic Iraqi patients.
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Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. The treatment guidelines recommend theuse of a second controller drug in addition to medium doses of inhaled corticosteroids (ICSs) rather than the use of high doses ICS alone in the treatment of moderate-severe persistent asthma. This study was conducted to compare the clinical efficacy and safety of three treatment regimens in Iraqi patients with moderate-severe persistent asthma.The study included three groups; each group included 15 patients. Patients were administered beclomethasone inhaler alone 1500-2000 μg/day, beclomethasone inhaler 750-1000 μg/day plus oral controlled release aminophylline tablets 450 mg/day or

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Publication Date
Thu Dec 13 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effect of Obesity and Socioeconomic Status on Adolescents' High School Students' Intelligence Quotient in Baghdad City
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Objective(s): To determine the effect of obesity and socioeconomic status upon adolescents' high school students' intelligence quotient in Baghdad City. Methodology: A descriptive design is carried throughout the study to determine the effect of obesity and socioeconomic status on adolescents' high schools students' intelligence quotient in Baghdad City for the period of January 7th 2017 to May 29th 2017. A non-probability, purposive sample, of (120) high school students, is selected. The sample is comprised of (12) students from 7th grade, (26) students from 8 th grade, (14) students from 9th grade, (3

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Publication Date
Sat Oct 01 2022
Journal Name
The Egyptian Journal Of Hospital Medicine
The Impact of rs767455 and rs1061622 Polymorphisms ‎on ‎Treatment Outcomes in Iraqi Ankylosing Spondylitis ‎Patients Taking ‎Etanercept
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Background: Ankylosing spondylitis (AS) is inflammation of the sacroiliac joints and spine, associated with clinical symptoms such as pain and stiffness in the vertebral column, after which, in a considerable number of individuals, new bone growth occurs. Objective: The current research study attempted to find out whether the presence of SNPs in TNF receptor [TNFRSF1A (rs767455), TNFRSF1B (rs1061622)] encoding genes could influence patients' outcomes to etanercept in a specimen of Iraqi AS patients. Patients and methods: Sixty patients with established AS receiving only etanercept were selected to be enrolled in this research with a mean age of 40.75 ± 8.67 years, 51 patients of them were males and only 9 patients were females. Patients we

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Publication Date
Sat Jul 01 2023
Journal Name
Analytical Science & Technology
A Review: Synthesis and characterization of metals complexes with paracetamol drug
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In this review, previous studies on the synthesis and characterization of the metal Complexes with paracetamol by elemental analysis, thermal analysis, (IR, NMR and UV-Vis (spectroscopy and conductivity. In reviewing these studies, the authors found that paracetamol can be coordinated through the pair of electrons on the hydroxyl O-atom, carbonyl O-atom, and N-atom of the amide group. If the paracetamol was a monodentate ligand, it will be coordinated by one of the following atoms O-hydroxyl, O-carbonyl or N-amide. But if the paracetamol was bidentate, it is coordinated by atoms (O-carbonyl and N-amide), (O-hydroxyl and N-amide) or (O-carbonyl and O-hydroxyl). The authors also found that free paracetamol and its complexes have antimicrobial

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Publication Date
Thu Dec 01 2022
Journal Name
Baghdad Science Journal
Simultaneous Ratio Derivative Spectrophotometric Determination of Paracetamol, Caffeine and Ibuprofen in Their Ternary Form
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A new, accurate, precise and economic two spectrophotometric methods for determination of Paracetamol (Par), Ibuprofen (Ibu), and Caffeine (Caf) were suggested. Those methods were the first and second ratio derivative spectrum using a double devisor. Par, Ibu, and Caf showed many useful peaks for their quantified determination. The validity of all analysis modes for determination of the three compounds, peak to baseline, peak area and peak to peak were according to ICH. The linearity of two methods was between 5 µg/ml as a lower concentration and 50 µg/ml as the highest concentration for three compounds. Recovery percentage was around 100% and relative standard deviation was less than 2.6%. The methods were applied successfully in the

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Publication Date
Sat Dec 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
The impact of an Oral Health Education (OHE) program by teachers and mothers on adolescents' oral health
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Background: Adolescence is one of the most dynamic stages of human development. However, Oral health is an integral part of public health, significantly impacts on the quality of life. OHE program is an important issue that should be given to them. The aim of this study was to evaluate oral health outcomes on adolescents' oral health by teachers and mothers Materials and Methods: The study was carried out in seven schools of Diyala - Baquba city. This 14-weeks duration study assessed the effectiveness of school OHE program on oral hygiene status, gingival health, and halitosis assessment of 80, 12 year-old, both genders of school adolescents. From the selected schools, one group was supervised by the teachers and the other was supervised

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Publication Date
Tue Jun 15 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Comparing the Effects of Lavender Oil and Olive Oil Massage on Pain due to Muscular Cramp during Hemodialysis
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Background: Pain due to muscular cramp during hemodialysis is one of the most common problems experienced by patient undergoing hemodialysis, and is associated with poor outcomes of patients. The main aim of this study was to comparing the effects of lavender oil and olive oil massage on Pain due to muscular cramp during hemodialysis.

Methods: In this random clinical trial, 60 hemodialysis patients were enrolled randomly and allocated to two groups with 30 members in Lordegan and Brojen hospitals, Shahrekord, Iran. The intervention included flora massage on the lower leg muscles so that the first group received olive oil massage (10 drops) and the second group received lavender oil massage (10 dr

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Publication Date
Sat Mar 31 2018
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Adsorption of Diclofenac Sodium and Ibuprofen by Bentonite Polyureaformaldehyde Thermodynamics and Kinetics Study
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An increasing number of emerging contaminants have been detected in surface waters, sediment, soil and ground water in different locations in the world, which is a new environmental challenges need an actual concern for international scientific and legislative communities. 

   The nonprescription and huge used pharmaceuticals ibuprofen and diclofenac sodium will be focused in this study. New adsorbent developed using cheap inorganic clay material (bentonite) and organic polymer polyureaformaldehyde (PUF), the combination of these two materials gave the surface more roughness with wide active site distribution. Batch adsorption experiment performed to each pharmaceutical individually to determine the optimum separat

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