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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 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
Fri Oct 31 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
Tue Jun 24 2025
Journal Name
Medicina Moderna - Modern Medicine
Prevalence of Prematurity Outcomes of Overweight Adolescent Pregnancy in One Thousand Premature Neonates in Baghdad
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Background: With the increasing trends of global culinary boom and food revolution, and since adolescents are one of the most important age groups that intereact actively with new emerging waves, the health impacts of overweight adolescent pregnancy could be an evolving issue. Additionally, prematurity has different risks of disease and fatality in different areas and nations. Objectives: We aimed to measure the prevalence of complications of prematurity in 1000 neonates in Baghdad city born to overweight adolescent mothers and general maternal characteristics. Methods: Data of 1000 premature (case) and full-term (control) neonates were collected from hospital records in Baghdad over 12 years. The mothers of our samples were overwei

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Engineering
Serviceability of Post-fire RC Rafters with Openings of Different Sizes and Shapes
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This study deals with the serviceability of reinforced concrete solid and perforated rafters with openings of different shapes and sizes based on an experimental study that includes 12 post-fire non-prismatic reinforced concrete beams (solid and perforated). Three groups were formed based on heating temperature (room temperature, 400 °C, and 700 °C), each group consisting of four rafters (solid, rafters with 6 and 8 trapezoidal openings, and rafter with eight circular openings) under static loading. A developed unified calculation technique for deflection and crack widths under static loading at the service stage has been provided, which comprises non-prismatic beams with or without opening exposed to flexure concentra

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
The Contribution of Behavioral Disorders to Predicting Bullying Patterns in a Sample of Adolescents with Autism Spectrum Disorder: College of Education and Arts - Northern Border University - Kingdom of Saudi Arabia.
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The present study aims to identify the role of behavioral disorders (anxiety disorder, behavior disorder "behavior", confrontation and challenge disorder, aggressive behavior) in predicting bullying patterns (verbal, physical, electronic, school) in a sample of adolescents with autism spectrum disorder. For this purpose, the researcher developed scales to measure the behavioral disorders and the bullying patterns among adolescents with autism spectrum disorder. The researcher adopted the descriptive survey approach. The study sample consists of (80) adolescents with autism spectrum disorder with ages range from (15-19 years) and (45-53 years old) in association with israr association for people with special needs in the northern borders

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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
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Patients' Knowledge and adherence to Clopidogrel Therapy post Percutaneous Coronary Intervention
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Abstract

Objectives: To assess patients’ knowledge and their adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention, and to find out the relationship between patients’ knowledge and their adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention

Methodology: A descriptive design was carried out at Al- Nasiriyah Heart Center in Thi-Qar Governorate for the period between May 19th, 2022 to October 25th, 2022. A non-probability sampling was used among (50) patients after their Percutaneous Coronary Intervention. The study instrument that used to collect data was composed of three parts namely: sociodemographic charac

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Publication Date
Wed Jul 01 2020
Journal Name
Campos En Ciencias Sociales
Leadership and Post-Conflict State Rebuilding: Iraq after 2003 Case Study
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The Iraqi political and social arena has been characterized, subjectively and objectively, by the weakness of leadership building. This has led to a leadership crisis, which is reflected in the quality of the outcome of the process of rebuilding the state in Iraq. Thus, this building process has lacked the simplest requirements and conditions of success. It has suffered from a major and obvious failure: the situation in Iraq has raised conflict leaders, not constructive leaders, and this confirms the existence of a cultural crisis in the production of conscious, aware leadership compatible with democratic action. The weakness of leadership in Iraq is reflected in a series of ongoing crises that require radical solutions in accordance with l

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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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