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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 Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
The Culture of mother in the selection clothes of children in the Early Childhood
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Early childhood Is the of the important stages in the life of man and initiated full on others
reliability has been rise in growth toward independence and self-reliance, as is the transition
from the home environment to the kindergarten environment (kindergarten) (4-6) years where
starts in the interaction with the external environment, it is an essential stage in the
construction of sound personal to the child, and choose proper clothes at this age is one of the
important aspects in building the child's personality, as it reflects the clothing behavior and
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her children. Children at this stage are dependent the mothers in

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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
Mon Oct 19 2026
Journal Name
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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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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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Fri Jun 01 2012
Journal Name
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Sat Apr 01 2017
Journal Name
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Structural and optical characteristics of pre- and post-annealed sol-gel derived CoCu-oxide coatings
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Sol-gel derived CuCo-oxide coatings as solar selective surfaces, synthesized onto aluminium substrates at various annealing temperatures, are analysed by correlating their structural, chemical bonding states, and surface morphological topographies. As the annealing progressed, all the coatings displayed a Cu0.56Co2.44O4 (ICSD 78-2175) phase with preferential orientation along (400) reflection plane. Rietveld refinement of X-ray diffraction (XRD) data indicate that residual stress and microstrains developed around the coating surfaces are reduced resulting in mechanically stable thin films. Enhancement of the crystallite size and preferred orientation of the surface were confirmed via XRD, field emission scanning electron microscopy (FESEM),

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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.

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Thu Jan 31 2019
Journal Name
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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
Thu Sep 09 2021
Journal Name
International Scientific Congress Of Pure, Applied And Technological Sciences (minar Congress)
Antimicrobial susceptibility pattern and the antagonistic effect of lactobacillus in fighting shigella spp. Isolated from diarrheic children
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Sun Feb 25 2024
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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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