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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
Sun Dec 29 2024
Journal Name
Plant Protection
Efficacy of silver nanoparticles from Fusarium solani and mycorrhizal inoculation for biological control of Fusarium wilt in tomato
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The present study investigates the characterization of silver nanoparticles (AgNPs) synthesized using Fusarium solani and their impact on tomato seed germination, plant growth, and disease resistance. A visible color change from yellow to dark smoky indicated the formation of AgNPs, while UV-visible spectrophotometry revealed an absorbance peak at 437 nm, confirming their presence. Atomic force microscopy analysis showed that the AgNPs ranged from 0 to 39.27 nm in size, with an average height of 5.772 nm, while scanning electron microscopy highlighted their diverse surface morphology. The application of AgNPs and mycorrhizal fungi significantly improved tomato seed germination rates, plant height, and dry weight compared to untreate

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Publication Date
Fri Jan 01 2010
Journal Name
Journal Of The College Of Languages (jcl)
The Abuse of Children In Emily Bronte's Wuthering Heights
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Emily Bronte is born in Yorkshire on 30 July 1818. Her father, Rev. Patrick Bronte, is a man of intelligence and determination which enables him to gain an admission as a sizar to 81. John's Cambridge in 1802. He has six children where Emily is the fifth. The mother is a young beautiful girl who belong to an important family. Both Emily's parents try to teach

                       Their children well, support them all the time and elevate them to

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high levels. This causes an eagerness towards reading and writing, but the happiness of the children is affected by the sickness and later on by the death of their mother in 1821. After that things would

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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Prevalence of Tonsillitis caused by Streptococcus spp. Among children and the effect of some Lactic acid bacterial (LAB) strain on it
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In this study 100 samples were collected from infected children with acute and chronic tonsillitis who attended to Al-Yarmook Teaching Hospital (ENT consultation clinic) from 5/12/2013 to 1/3/2014. The result of laboratory culture was positive in 67 samples. Depending on their cultural, morphological and biochemical characterization of bacterial isolate of them were identified as (37.31%) belonged to Streptococcus pyogenes and the diagnosis is confirmed by the use of Remel Rapid STR System, (34.32%) belonged to S.parasanguinis, (11.94%) S.mitis, (11.94%) S.oralis and (4.47%) S.thoraltensis . Results confirmed that cup assay gave highest inhibition zone after 24 hrs compare with well diffusion methods for suspension of L.

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Publication Date
Thu Sep 18 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of Nutritional Status on Mesiodistal and Bucco-Lingual (Palatal) Diameters of Primary Teeth among Five Years Old Kindergarten Children
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Background: Malnutrition in human life may adversely affect various aspects of growth at different stages of life. Teeth are particularly sensitive to malnutrition. Malnutrition may affect odontometric measurement involving tooth size dimensions. The aim of this study is to estimate the effect of nutrition on teeth size dimension measurements among children aged 5 years old. Materials and methods: This study was conducted among malnourished group in comparison to well-nourished group matching with age and gender. The present study included 158 children aged 5 years (78 malnourished and 80 well-nourished). The assessment of nutritional status was done by using three nutritional indicators, namely Height-for-age, Weight-for-age and Weight-fo

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Publication Date
Sun Nov 01 2009
Journal Name
Iraqi J Comm Med
Clinical Presentations and CT-Scan findings in children with Cerebral Palsy
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Background: Cerebral palsy is non-progressive disorder of posture or movement due to a lesion of the developing brain. It is the commonest physical disability in childhood. Objective: To study the clinical, neurological abnormalities, prevalence of convulsion (epilepsy) & to asses the value of CT scans of brain in patients with cerebral palsy.

Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
Obesity in kindergarten children and its relation with some variables Family
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Obesity is a common disease that resulted from over-nutrition in adults and children. It rarely causes damage to the centers of food in the brain. Obesity is defined as an increased body weight from its natural limit which is resulted from the accumulation of excessive amounts of fatty tissue incredibly up to 20% in males, 30 % in females unless this increase is not due to an increase in muscles as in athletes or accumulation of water in the body which is resulted from Mesothelioma or the magnitude of the skeleton.Obesity is the increase of the total average of fat in the body compared to other tissues, which causes an increasing body weight, thereby increasing body mass. The fatty child has an increase in the stored fatty layer under th

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Publication Date
Wed Apr 01 2020
Journal Name
Biochemical & Cellular Archives
INVESTIGATION OF VITAMIN D, ESTRADIOL AND C-REACTIVE PROTEIN LEVELS IN PRE AND POST-MENOPAUSAL IRAQI TYPE 2 DIABETES MELLITUS IN WOMEN.
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Diabetes mellitus is a metabolic chronic disease, with global estimation increase in patient (around 100 million in 2030).The aim of the current study is to investigate vitamin D, C-reactive protein and estradiol levels in pre and postmenopausal Iraqi women with type 2 diabetes (T2MD).A total of 176 female distributed into two groups: the first included 90 women withT2MD (43 pre and 47 post-menopausal); the second group included 86 healthy subjects (41 pre and 45 postmenopausal) considered as control. This study has shown that women in premenopausal (20-40 years) had highly significant difference in the estradiol and vitamin D levels in diabetes subjects (62.192 ± 17.643pg/ml, 10.522 ± 1.958ng/ml) compared with healthy (131.793 ± 1

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Publication Date
Mon May 29 2023
Journal Name
Rawal Medical Journal
Comparison of functional and radiological outcomes of lower third closed tibia fractures treated by nail VS plate osteosynthesis
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Objective: To determine the functional and radiological outcomes of lower third tibia closed fractures fixed by nail or plate osteosynthesis. Methodology: This randomized controlled trial included 20 patients presenting with closed fracture lower third tibia in Al-Kindy teaching hospital, Baghdad, Iraq. The patients were divided as every other one into two equal groups; group I had fractures fixed by 3.5 mm locked plate and group II by intramedullary locking nail. We followed all patients for 24 weeks to assess surgical complications, fracture union, alignment and functional outcome based on Knee society score (KSS). Results: The mean union time in both groups was 10.2 ± 1.48 and 9.3 ± 1.77 weeks, respectively (p = 0.003). Mean KSS in bot

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Publication Date
Sun Feb 25 2024
Journal Name
Baghdad Science Journal
Prioritized Text Detergent: Comparing Two Judgment Scales of Analytic Hierarchy Process on Prioritizing Pre-Processing Techniques on Social Media Sentiment Analysis
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Most companies use social media data for business. Sentiment analysis automatically gathers analyses and summarizes this type of data. Managing unstructured social media data is difficult. Noisy data is a challenge to sentiment analysis. Since over 50% of the sentiment analysis process is data pre-processing, processing big social media data is challenging too. If pre-processing is carried out correctly, data accuracy may improve. Also, sentiment analysis workflow is highly dependent. Because no pre-processing technique works well in all situations or with all data sources, choosing the most important ones is crucial. Prioritization is an excellent technique for choosing the most important ones. As one of many Multi-Criteria Decision Mak

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Publication Date
Sun Jan 01 2012
Journal Name
مجلة بحوث كلية التربية الاساسية
Essence - Appearance and it’s Relation with Self -efficacy and Scholastic Achievement for Preparatory School Students
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الذات والتحصيل الدراسي . وقد استخدمت الباحثة المنهج الوصفي التحليلي، وبلغت عينة الدراسة (500) طالبًا وطالبة، تم اختيارهم بالطريقة الطبقية العشوائية وهي تمثل (15%) من مجتمع الدراسة البالغ (3328) طالباً وطالبة من طلبة المرحلة الإعدادية واستخدمت الباحثة مقياسين تم بناء مقياس لقياس الجوهر والمظهر وتبني مقياس فاعلية الذات بعد إن قامت بترجمته وتعريبه وجعله ملائم للبيئة العراقية، كم تم استخراج درجات التحصيل الدراسي للع

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