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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 Jul 15 2021
Journal Name
University Of Samarra
Preparation, Diagnosis and Biological ‎Efficacy of new Ligands Derived from ‎Succinyl Chloride and Their Metal ‎Complexes and non metallic
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The purpose of my thesis is to synthesis two new bidentate ligands ‎which were used to prepare series of metal complexes by reacting the ‎ligands with (M+2 = Mn, Co, Ni, Cu, Cd and Hg) ‎ ‎ Succinyl chloride was used as starting material to synthesis two ‎bidentate ligands (L1) and (L2) by reaction it with 4-chloroaniline ‎‎(L1) and ‎ ‎ (4-aminoacetophenone) (L2) in dichloromethane as a solvent, that ‎are:‎ ‎(L1) = N1,N4-bis (4-chloro phenyl ) succinamide ‎(L2) =N1,N4-bis(4-acetylphenyl)succinamide ‎ The new ligands were characterize by using spectroscopic study ‎‎(Fourier-transform infrared spectroscopy (FT-IR), electronic spectra ( ‎UV-Vis) ,nuclear magnetic resonance(1H,13C-NMR), Mass spectra ‎

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Publication Date
Sun Sep 06 2009
Journal Name
Baghdad Science Journal
Estimation of cellular immune response by evaluation of some cytokines in immunopathogenesis of chronic hepatitis B and C pre- and post- treated Iraqi patients (in vivo and in vitro)
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Two groups of chronic hepatitis B and C virus patients were divided into Pre-treated patients (25 CHB patients with positive HBs Ag for more than 6 months and 40 CHC patients), and post-treated patients [12 CHB patients (4, 6, and 2 were treated with lamivudine, IFN-? and combination of LMV + IFN-? respectively), and 27 patients for CHC (3, 13 and 11 patients were treated with Ribavirin, IFN-? and combination therapy (RBV+ IFN-?) respectively].These patients were followed up for 6 months. By using ELISA technique, levels of IL-6, IL-10, IFN-? and TNF-? were measured in vivo and in vitro (supernatant of PBMCs stimulated with PHA) and compared with healthy control. The mean level of IL-6, IL-10 and TNF-? in CHB patients showed significant dif

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
The speaking Skill the Children of Kindergartens
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Language is fundamental and important for the development of various skills especially in the kindergarten stage where the child begins to approach others and interact with them linguistically listen to them and make sentences to communicate his ideas to them and without the ability to talk and expression, the child's benefit of his experiences in the kindergarten remains limited.

       And that children at any stage of early education are subject to different stages of linguistic development, and these stages are a fundamental feature in learning, especially for the skills of speaking, listening and reading,  Therefore, the researcher chose the speaking skill the

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Publication Date
Tue Nov 06 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Factors Contributing to Abdominal Post-Operative Wound Infections in Sulaimani Teaching Hospital
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Objectives: The study aims to assess some of the contributing factors to abdominal postoperative wound infection and
to find out the relationship between postoperative wound infections and some socio-demographic characteristics such as
age, gender, level of education, occupation and residential area.
Methodology: A descriptive study was carried out in Sulaimani Teaching Hospital (Kurdistan Region). The study has
started from January 15th up to October 31th, 2009. To achieve the study objectives, a purposive "non probability"
sample of (100) patients who have abdominal postoperative wound infection, Adult female and male patients who were
admitted to Sulaimani Teaching Hospital was selected.
The data were collected th

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Publication Date
Wed Dec 30 2020
Journal Name
Al-kindy College Medical Journal
Iraqi women Attitude towards Immediate Post-partum/ Post-abortion Contraception: a multi-institutional study
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Background: Immediate postpartum contraceptive and post abortion contraception methods are effective safe methods and are becoming a standard practice in many countries, yet it is not widely used in Iraq.

Aims: this study: is designed to assess the attitude and willingness of women to immediate contraception after giving birth or abortion and their satisfaction to previous use.

Methods and Material: Four hundred thirty-four women were surveyed in the labor word immediately after giving birth/ abortion. Their knowledge, attitude and contraception use were assessed according to the response they reported to a given questionnaire.

Results: women were not sure abo

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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
T-Cells Proliferation and Serum Cytokine levels in Type 1 Diabetic Children
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Background: There is plenty of evidence
suggesting that involvement of several groups of
viruses in the development and / or acceleration of
Type 1 Diabetes Mellitus (T1DM).
Objective: To analyze the T- cell proliferation in
the presence of Coxsackie virus B5 (CVB5), Polio
and Adenovirus antigens in addition to assessment
of Interferon- gamma (IFN-γ), Interleukins (IL-10
and IL-6).
Methods: In 60 Iraqi T1DM children with recent
onset of T1DM, Lymphocyte proliferation was
analyzed using Methylthiazol tetrazolium (MTT)
assay by culturing Peripheral Blood Lymphocytes
(PBLs) with Coxsackie Virus B5 (CVB5),
Adenovirus, and Polio vaccine. Serum Interferon-γ,
IL-10 and IL-6 were quantified by sandw

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Publication Date
Mon Jan 01 2018
Journal Name
Opción
Abnormal emotional behavior in children and its rela- tionship to televised violence
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Publication Date
Sun Oct 01 2023
Journal Name
Baghdad Science Journal
Ghrelin and Obestatin Levels as a Novel Marker in Iraqi Obese Children
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Obesity is an escalating health problem in developing countries. One to ten children worldwide are overweight in a report showed by the International Obesity Task Force. Ghrelin, orexigenic peptide, has 28 amino acids, it is considered the greatest remarkable promotion in the last two decades for understanding the physiological changes of action regu­lating food intake and hunger. Obestatin is a 23-amino acid peptide nearly connected to ghrelin that secures from substitutio

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Publication Date
Sat Dec 03 2016
Journal Name
Journal Of Genetic And Environmental Resources Conservation
Examination the efficiency of NDVI index by comparing with STVI-4 index to recognize the vegetation cover
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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
Fear of Intimacy and its Relationship with Post-Traumatic Stress Disorder among Yazidis Women
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The current research aims to identify the fear of intimacy and post-traumatic stress disorder among Yazidi women and the correlation between them. To achieve the objectives of the research, the researcher adopted the Descutner, 1991 & (Thelen) scale, which consisted of (35) items. The researcher also adopted the post-traumatic stress disorder scale for (Davidson, 1995) translated by (Abdul Aziz Thabet), which consists of (17) items. These two scales were administered to a sample of (200) individuals. Then, the researcher analyzes the data using the Statistical Package for Social Sciences (SPSS). The results showed that the research sample of Yazidi women has a fear of intimacy. The research sample of Yazidi women is characterized by

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