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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
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
The effect of inhaled corticosteroid on salivary cytokine level in relation to Candida albicans among asthmatic children
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Background: Asthma is a common chronic disease in children in which the body’s airways swell, preventing the lungs from filling with air, there are many different inflammatory cells involved in asthma which can synthesize and release cytokines which are recognized to be important in chronic inflammation and play a critical role in the inflammatory response. Objectives: to assess the local effect of ICS on oral tissue by measuring Interlukine-12 level and Candida albicans colony in saliva among12 year's old asthmatic children who were collected from AL- Zahra Center Advisory for Allergy and Asthma, and compares them with non-asthmatic children of the same age and gender.Type of the study: Cross –sectional study.Methods: The total samp

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Publication Date
Sun Apr 07 2013
Journal Name
Journal Of Educational And Psychological Researches
Role the media to limit from get games children instigator on the violence
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Violence is a very serious phenomenon affecting the upbringing and culture kids, are playing the most violent forms of development of these Phenomenon, the research aims to determine the role of the media in reducing violence, and conducted a field study on parents Children by 200 form, the results revealed the importance of the media in raising awareness of the risks of violence on the child  Especially television, which hugely increased Show features, as well as the role of parents in guiding the child to buy Useful because the game to play negative impact of violence on children's health, and the media play an important role in raising awareness of these Risks through educational programs and television commercials, and o

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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
Fri May 30 2025
Journal Name
Surabaya Medical Journal
Exploring Dental Students' Perspectives: The Impact of Hybrid Learning in a Post-Pandemic World
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Background: The pandemic crisis prompted the world to adopt unexpected approaches to continue life as normally as possible. The education sector, including professors, students, and the overall teaching system, has been particularly affected. Objective: This study seeks to evaluate the benefits, challenges, and strategies related to COVID-19 from the perspectives of college students, particularly those in higher education in Iraq. Method: The online survey questionnaire was distributed via Google Forms and specifically aimed at undergraduate dental students. Results: A total of 348 students participated in the survey. There was a significant correlation (P > 0.01) between student satisfaction with hybrid learning and their experi

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Publication Date
Sun Dec 30 2018
Journal Name
Journal Of Global Pharma Technology
Employing the Physicochemical, Spectroscopy, Antimicrobial and Antifungal Efficacy Studies of P-Hydroxy Acetophenone Based Azo Schiff Base Complexes
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The azo Schiff base [Reaction of 4-aminoanypyrine and P-hydroxy acetophenone] and O-Phenylene diamine have been prepared. One azo Schiff base chelate of Co(Il), Ni(II), Cu(II) and Zn(II)ion was also prepared. The chemical frameworks of the azo Schiff base and like elemental analyses (CHN), determinations of molar conductance, 1 H &13C NMR, IR mass and electronic spectroscopy .The elemental analyses exhibited the combination of [L: M] 1:1 ratio. Established on the values IR spectral, it is showed that the azo Schiff base compound acts as neutral hexadentate ligand bonded with the metal ion from two hydroxyl, two azomethine and two azo groups of the azo Schiff base compound in chelation was confirmed by IR , 1Hand 13CNMR spectral outco

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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
Thu Sep 30 2021
Journal Name
International Journal Of Research In Social Sciences And Humanities
The Anonymous Identity of Forced Migrants: A Post-Colonial Study
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Colonialism invades the Third World countries, physically and psychologically. This article exposes but sample of the physical and psychological consequences of colonialism. The Beekeeper of Aleppo (2019) by the British novelist, Christy Lefteri is a typical novel to diagnose the harsh circumstances of individuals within and after the disaster. Since it depicts characters from Asian countries, it would be a best representative for all Asian people who suffer colonialism. Migration toward anonymity is the mere option for the colonized people. Aftermath, they experience displacement, trauma, and the loss of identity.

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Publication Date
Sun Jan 31 2016
Journal Name
International Journal Of Research In Humanities, Arts, And Literature
THE PROBLEMS FACING IRAQI CHILDREN IN LEARNING ENGLISH
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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
A study of Nutritional and Chemical Content in One Kind Chamomile Tea for Infant and Children
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This study has been performed for knowing the nutritional and chemical content of one kind chamomile tea for infant and children available in the pharmacy. The results have been showed that the percentage of essential compounds which represented with moisture, protein, fat, carbohydrate, ash and calories as 7.09%,0.01%,0.01%,92,81%, 0.08% and 371,37 Kal./100g, respectively of dry weight. Also the results have been showed that the percentage of chamomile plant extract that added to the tea as 5.74%. And the result of chemical test for effective materials in alcoholic extract showed consist Tannis, Glycosides, Flavonoids, Alkialoids,and Resins.

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Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Public Health Research & Development
Body image and Physical Perception of children with Precocious Puberty in Baghdad city
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