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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 03 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Assessment of Adherence and Self-Efficacy in a Sample of Iraqi Patients Receiving Warfarin or Direct Oral Anticoagulants
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Background: While warfarin and direct oral anticoagulants (DOACs) are used to manage thromboembolic events, they possess several features that impact adherence. Objective: To assess medication adherence and self-efficacy in patients receiving warfarin or DOAC treatment. Methods: A cross-sectional study was performed at Ibn Al-Bitar Hospital in Baghdad from December 2022 to May 2023 on patients receiving either warfarin or DOACs. The Arabic version of the Adherence to Refills and Medications Scale (ARMS) questionnaire and the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6C) questionnaire were used to assess adherence and self-efficacy. Results: 181 patients were enrolled in the study, of whom 56.9% received warfarin an

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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
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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DBN Rashid, IMPAT: International Journal of Research in Humanities, Arts, and Literature, 2016 - Cited by 5

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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
Sat Dec 31 2016
Journal Name
Al-kindy College Medical Journal
CLINICAL PRESENTATIONS AND COMPLICATIONS OF GUILLAIN BARRE SYNDROME IN CHILDREN WELFARE TEACHING HOSPITAL
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Background: Guillain Barré syndrome is an acute inflammatory demyelinating disease of the peripheral nerves. Its synonyms are: acute inflammatory demyelinating polyradiculoneuropathy, idiopathic polyneuritis, acute infective polyneuropathy and post infections polyneuritis. Objectives: We attempt to study the clinical presentations and complications in patients with GBS who were admitted to children welfare Teaching Hospital and to compare the results with the other studies.Type of the study: A retrospective study.Methods: A study done on seventy patients with GBS who were admitted to children Welfare Teaching Hospital in Medical City-Baghdad from different parts of Iraq between January 2002-December 2006.Results: Forty (57.14%) of them

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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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Fri May 30 2025
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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
Wed Jan 30 2019
Journal Name
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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
taste his parents, especially his mother, she is the first responsible for providing clothes for
her children. Children at this stage are dependent the mothers in

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Publication Date
Fri Mar 03 2023
Journal Name
World Journal Of Biology Pharmacy &health Science
Ventricular septal defect in children and adults by echocardiography study in Iraqi patients
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A ventricular septal defect (VSD) is defined as a communication between the left and right ventricles or between the left ventricle and the right atrium. VSDs are amongst the most common abnormalities of the heart. They can be present in isolation or in association with other congenital cardiac abnormalities. This is study done with the aim to evaluate the types, size, associated CHD with ventricular septal defect in children and adolescent in two cardiac centers (Medical City Complex cardiac clinics, Ibn Al Nafaes teaching hospital) in Baghdad - Iraq

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Thu Sep 30 2021
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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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