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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 May 18 2016
Journal Name
Al-academy
Industrial design in the era of post-modernism: لبنى اسعد عبد الرزاق
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Linked to the post-modern historical transformations sociological which raided the developed Western societies since the middle of last century, which consisted mainly in the emergence of what he called Alsosiologion (consumer society a) and (Affluent Society), as it appeared the new social lifestyle is not only characterized by the provision of the accumulation of capital and sparingly in spending, but rather a kind of extravagance and encourage consumption, prompting some to say that consumption is a community postmodern engine, and other labels for this period of economic backgrounds, such as the new capitalism and the system of the new capitalist Alseperntiqi technical and labels purist such as industrial post-society emerged, some a

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Publication Date
Sun Dec 22 2024
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
Mon Apr 01 2024
Journal Name
Iraqi Postgraduate Medical Journal
7 SMAS Plasty in Face Lift with Fat Graft: Evaluation of Aesthetic Outcomes
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ABSTRACT: BACKGROUND: The main goal of facelift surgery is to reduce the effect of aging by reposition of face soft tissue in to more youthful orientation. There are many methods for SMAS plication which had different design and vector of pull. AIM OF STUDY: To evaluate the effectiveness and longitivity of 7 shaped SMAS plication in facelift. PATIENT AND METHODS: From January 2020 to march 2021, 10 female patients with age (45-60) years were presented with facial sagging, those patients were subjected to subcutaneous facelift with 7 shaped SMAS plication with fat greft in Al-Shaheed Ghazi Al-Harri Hospital and Baghdad burn medical center at Baghdad medical complex. RESULTS: The average follow up period was 6 to 12 months. The mean operative

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Publication Date
Thu Jun 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Comparing Some of Robust the Non-Parametric Methods for Semi-Parametric Regression Models Estimation
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In this research, some robust non-parametric methods were used to estimate the semi-parametric regression model, and then  these methods were compared using the MSE comparison criterion, different sample sizes, levels of variance, pollution rates, and three different models were used. These methods are S-LLS S-Estimation -local smoothing, (M-LLS)M- Estimation -local smoothing, (S-NW) S-Estimation-NadaryaWatson Smoothing, and (M-NW) M-Estimation-Nadarya-Watson Smoothing.

The results in the first model proved that the (S-LLS) method was the best in the case of large sample sizes, and small sample sizes showed that the

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Efficacy, safety and Cardiovascular Disease Risk Lowering Ability of ACE Inhibitors, B-Blockers and Combination Antihypertensive Drug Regimes in Iraq
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Hypertension is a major health problem throughout the world because of its high prevalence and its association with increased risk of cardiovascular diseases. It is defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. The aim of this study was to compare the efficacy, safety and cardiovascular disease risk lowering ability, of three antihypertensive drug regimens.

A retrospective study was carried out on 66 hypertensive patients, divided in to three groups based on their antihypertensive drug regimens (ACE inhibitors, β-blockers treated and combination antihypertensive therapy, the combination therapy consist of two or more of the following antihypertensive drugs ACE inhibitor di

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Publication Date
Sun Jan 19 2020
Journal Name
Biochemical And Cellular Archives
Isolation and characterization of phosphate solubilizing Pseudomonas species and assess its efficacy as plant growth promoter
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Publication Date
Sat Dec 24 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Prevalence of AGER gene polymorphism in post menopause Iraqi sample with Osteoporosis and osteopenia in type 2DM
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Osteoporosis (OP)is one of the most important metabolic disorder also affected by interaction of genetic and environmental factors by almost 70% and 30% respectively. Genetic components are identified to strongly effect bone mineral density, bone building and turnover, so they play an important role in determining risk of OP and fragility fractures. This study consists of patient and control group; Group A: (70) postmenopausal women with OP and osteopenia, Group B: (20) control group.  five milliliters of blood sample were divided into three tubes; one tube (1ml) contain gel for obtain serum to measure glucose level, the others tubes containing ethylene-diamine-tetra-acetic acid (EDTA), in 2 tube 2ml stored in deep freeze at (–40

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Structural Model of the Relationship between Emotional Creativity and Self-Efficacy among Students at the Preparatory Year Tabuk University
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This research aimed to identify the structural model of the relationship between emotional creativity and self-efficacy among male and female students of the preparatory year at Tabuk University. The current study adopted the descriptive correlational approach, as it is appropriate to the nature of the study. The study tools contained (60) items that measure the relationship between emotional creativity and self-efficacy among the male and female students of the preparatory year at Tabuk University. The study sample was chosen by the stratified random method of the study community, where the study sample reached (183) male and female students of the preparatory year at the University of Tabuk. The results of the study showed that there a

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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
Fri Sep 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
An Analysis of the Efficacy of Platelet-Rich Plasma Injections on the Treatment of Internal Derangement of a temporomandibular Joint
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Background: A Temporomandibular joint (TMJ) internal derangement (TMJID) is a disruption within the internal aspects of the TMJ in which the disc is displaced from its normal functional relationship with the mandibular condyle, after which the articular portion of the temporal bone causes joint dysfunction, joint sound, malocclusion, and locking of the mouth. Conservative and invasive techniques can be used for the treatment of TMJID. A platelet-rich plasma (PRP) injection is a simple, less invasive surgical procedure for the treatment of internal derangement. The objective of this study was to evaluate the efficacy of PRP injections in decreasing or eliminating pain, clicking, and limitation of mouth opening in patients with TMJID after th

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