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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
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Impact of Brix 3000 and conventional restorative treatment on pain reaction during caries removal among group of children in Baghdad city
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Background: Pain and the usage of local anesthetic agents are still real problem in pediatric dentistry, for these reasons, the use of minimal invasive dentistry (MID) in regard to the patient comfort is important especially for children, anxious and uncooperative patients. Chemomechanical caries removal (CMCR) methods involve the selective removal of the carious dentine hence it avoided the painful removal of the sound dentine and the anxiety resulted due to the vibration of the hand piece which is also decreased thus it appears to be more acceptable and comfortable to the patient. Aims of this study: This study was conducted among group of children to assess and compare the anxiety rating scale (during and after treatment) between the

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Publication Date
Tue Oct 04 2022
Journal Name
Cureus
The Impact of Angiotensin Converting Enzyme-2 (ACE-2) on Bone Remodeling Marker Osteoprotegerin (OPG) in Post-COVID-19 Iraqi Patients
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Publication Date
Sun Dec 04 2011
Journal Name
Baghdad Science Journal
Effect of Laser Irradiation on the Optical Properties of SnO2 films Deposited by Post Oxidation of metal Films
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Tin oxide films (SnO2) of thickness (1 ?m) are prepared on glass substrate by post oxidation of metal films technique. Films were irradiated with Nd:YAG double frequency laser of wavelength (532 nm) pulses of three energies (100, 500, 1000) mJ. The optical absorption, transmission, reflectance, refractive index and optical conductivity of these films are investigated in the UV-Vis region (200-900) nm. It was found that the average transmittance of the films is around (80%) at wavelength (550 nm) and showed high transmission (? 90 %) in the visible and near infrared region. The absorption edge shifts towards higher energies, which is due to the Moss-Burstien effect and it lies at (4 eV). The optical band gap increased with increasing of ene

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Publication Date
Mon Aug 03 2020
Journal Name
Rawal Medical Journal
Functional outcomes of sandwich reconstruction technique for giant cell tumor around the knee joint
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Objective: To evaluate the functional outcomes after extended curettage and reconstruction using a combination of bone graft and bone cement (sandwich). Methodology: In this prospective case series 16 skeletally mature patients with primary giant cell tumor around the knee were included. Patients with previous surgically treated, malignant transformation, degenerative knee changes and those presenting with pathological fracture were excluded. The tumor was excised with bone graft filling space beneath the articular cartilage and a block of gel foam was placed over the cortical surface of picked bone graft. Remaining cavity was filled with polymethylmethacrylate cement (sandwich) with or without internal fixation. The func tional evaluation

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Publication Date
Wed Sep 07 2011
Journal Name
International Journal Of Pharmacy And Pharmaceutical Sciences
CLINICAL EFFICACY OF LOCALLY INJECTED CALCITRIOL IN ORTHODONTIC TOOTH MOVEMENT
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Orthodontic treatment has two major problems: being lengthy and costly procedure. The present study was designed to evaluate the clinical efficacy of locally injected vitamin D3 Keywords: Orthodontic, Calcitriol, Local injection, OTM (calcitriol) in accelerating orthodontic teeth movement (OTM) and reducing treatment time and cost in humans. The study was performed on 15 Iraqi adult orthodontic patients within the age range 17-28 years, they are randomly allocated into three groups, each of five patients and treated with either 15 pg, 25 pg, or 40 pg/0.2ml calcitriol diluted with 10% dimethylsulfoxide (DMSO). The maxillary arch of every patient was divided into control (right) and experimental (left) sides. In addition to force application,

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Publication Date
Thu Dec 30 2021
Journal Name
Al-kindy College Medical Journal
Knowledge, Attitude, and Practice of Nurseries' Workers toward Infection Prevention among the Children
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Background: Infections are common in the children attending daycare centers how act as predisposes to it. Hygienic interventions have a fundamental role in infection control and disease prevention in child care settings.

Objective: - To evaluate the knowledge, attitude, and practice of nurseries workers in infection prevention and control among the children.

Subjects and Methods: A cross-sectional study using the researcher-developed questionnaire validated by two experts and piloted and 100 nurseries-workers had participated in it.

Result: the mean age of participants was 37.5 years±12.1, (37%) aged 18-30 yrs, 58% married, and 57% with higher education, 54% of n

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Breakfast and its relationship to the curriculum daily diet of school-age children
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The breakfast key components of good nutrition and a large proportion of pupils to Ataatnol her breakfast at home and increase the failure rate breakfast increase the child's age research aims to study the importance of breakfast and emphasize the need to contain aggregates of basic food and its relationship to the curriculum daily diet and its impact on the balance of proteins, fats in food daily as well as the effect of some relevant factors such as the mother's level of education and the number of family members and summarized the most important results in that the percentage of 15.6% Neglected children eating breakfast as well as afternoon that Almaah percentages of calories coming from protein and fat at breakfast .....

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Publication Date
Mon May 01 2023
Journal Name
Wiadomości Lekarskie Medical Advances
EVALUATION OF VEST-OVER-PANT TECHNIQUE IN THE TREATMENT OF POST-HYPOSPADIAS URETHROCUTANEOUS FISTULA
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The aim: In this study, we present and evaluate the vest-over-pants technique as a simple way to correct urethrocutaneous fistulas after hypospadias. Materials and methods: Between October 2018 and June 2020, twenty male patients aged 5 to 20 years came to us with post hypospadias repair fistula, these patients underwent vest-over-pant repair of their fistula. The size of fistula was ranging between 2.5-5 mm. The distribution of fistula was coronal (3 patients), distal penile (9 patients), midshaft (2 patients) and proximal penile (6 patients). In 14 patients there were single fistula and 6 patients had more than one fistula. Eleven of patients were exposed to a previous failed fistula repair procedure. Results: Six months after the operati

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Publication Date
Thu Jan 01 2004
Journal Name
Ipmj-iraqi Postgraduate Medical Journal
Changes in alkaline phosphatase activity in rat mammary glands from virgin through pregnancy, lactation and post–lactation
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The aim of this investigation is to study the rote of alkaline phosphatase in mammogenesis and lactogenesis. A total of fortyfemalealbino rats were used and divided according to their physiological states into four groups [ten rats each]. From each deeply ether anesthetized rat, the mammary gland was removed, fixed, quenched in liquid nitrogen and sectioned using SLEE cryostat. The sections were employed for routine haematoxylin and eosin stain and alkaline phosphatase demonstration using the calcium–cobalt method. The obvious finding in the mammary glands of pregnant rat was the presence of thick black rings indicating strong alkaline phosphatase activityaround the basal part of the secretory epithelium of the alveoli. In lactating mamma

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Publication Date
Wed Jan 01 2003
Journal Name
Ipmj-iraqi Postgraduate Medical Journal
Changes in acid phosphatase activity in rat’s mammary tissue from virginity, through pregnancy, lactation and post–lactation
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Purpose: Studying the activity of acid phosphatase, which is the marker of lysosomal activity in the mammary glands of rats at different stages of the physiological maturation [virgih, pregnancy, lactation and Post lactation] Methods: Forty, female, albino rats were used in this study. They were divided into four groups according to their physiological states [virgin, pregnancy, lactation and post lactation]. The mammary glands, after suitable fixation and sectioning, were employed for routine haematoxylin and eosin stain and for acid phosphatase demonstration Results: Acid phosphatase activity was weakly diffuse in the secretory tubules of virgin rats, the diffuse and granular activity of this enzyme was increased during pregnancy in the s

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