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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 Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
Search for Identity in Michael Ondaatje's Post colonial Novel In the Skin of a Lion
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In his post colonial novel, In the Skin of a lion, the Canadian/Sri Lankan writer,
Michael Ondaatje is so interested in the term "Post colonialism" because he wants to show
that the term doesn't only refer to a period of time that comes after colonialism. In other
words, post colonialism is not only referred to as a literal description of formerly colonial
societies. He deals with the termas a literary genre and an academic construct that describes
the global conditions of a man after a period of colonialism. He shows that post colonialism is
a theory that tries to examine and explore the different styles and faces of European authority
to control the colonized. Ondaatje's attempt through such term is to unmask Europ

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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
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
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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Publication Date
Wed Oct 21 2020
Journal Name
British Journal Of Cancer
Epigenome-wide analysis reveals functional modulators of drug sensitivity and post-treatment survival in chronic lymphocytic leukaemia
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Abstract<sec> <title>Background

Chronic lymphocytic leukaemia (CLL) patients display a highly variable clinical course, with progressive acquisition of drug resistance. We sought to identify aberrant epigenetic traits that are enriched following exposure to treatment that could impact patient response to therapy.

Methods

Epigenome-wide analysis of DNA methylation was performed for 20 patients at two timepoints during treatment. The prognostic significance of differentially methylated regions (DMRs) was assessed in independent cohorts of 139 and 1

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
The Degree of Availability of Moral Values in the Arabic Language Textbook (Al-Mu’nes) For Grades Eleven and Twelve For Post-Basic Education in The Sultanate of Oman
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          The current study aimed to reveal the moral values available in the Arabic language textbook (Al-Mu’nes) for   grades eleven and twelve for post-basic education in the Sultanate of Oman. The researcher adopted the descriptive approach using the sentence as measuring unit in the analysis process. The five fields of moral values and their subcategories values represented the categories of the analysis. Iterations of values and the percentages of iteration were calculated in those textbooks. Moreover and the analysis and stability of the process were confirmed.

         After referring to previous studies, it was possible to de

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Publication Date
Thu Dec 06 2018
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Comparing the Quality of Life among Patients with Relapsing Remitting Multiple Sclerosis in Iraq Using Different Disease Modifying Therapies
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Multiple sclerosis (MS) is a chronic, inflammatory, immune mediated disease of the central nervous system, mostly affecting young adults with mean age of 30 years, twice as high in women compared to men. The etiology of MS is not fully elucidated. MS symptoms are directly related to demyelination and axonal loss, along with other psychological symptoms, can result in functional limitations, disability and reduced quality of life (QoL).  The QoL assessments in patients with a chronic disease may contribute to improving treatment and could even be of prognostic value. The goals  of this study were  to  compare the QoL of  Iraqi patients with relapsing remitting multiple sclerosis (RRMS),using three different diseas

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