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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
Sun Dec 02 2018
Journal Name
Journal Of The College Of Education For Women
Poverty and its Relations to Some Social Variables (Children in the Primary Stage as a Model)
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The phenomenon of poverty is one of the most important phenomena facing the world at large. Despite the tremendous technological progress witnessed by mankind and despite the unprecedented high levels of world economic production, poverty remains the greatest challenge facing the world. Statistics and studies have shown that poverty is caused by several problems: (health, social, economic, educational, etc.) These problems are obstacles to the ability to obtain employment opportunities, which leads in the beginning to the growth phenomenon of unemployment, and ultimately to the growth of poverty.

The results of a range of research in the field of psychology have confirmed that children from poor homes suffer from a high level of

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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
Wed Oct 10 2018
Journal Name
Al-kindy College Medical Journal
Microfracture Arthroscopy Efficacy In Treatment Of Articular Cartilage Insult Of Knee
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Background: The treatment of articular cartilage defects is one of the most clinical challeng for orthopedic surgeons. Articular cartilage is a highly organized tissue with complex biomechanical properties and substantial durability. However, it has a poor ability for healing, and damage from trauma or degeneration can result in morbidity and functional impairment. debilitating joint pain, dysfunction, and degenerative arthritis                                                 &nbs

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Publication Date
Wed Oct 10 2018
Journal Name
Al-kindy College Medical Journal
Microfracture Arthroscopy Efficacy In Treatment Of Articular Cartilage Insult Of Knee
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Background: The treatment of articular cartilage defects is one of the most clinical challeng for orthopedic surgeons. Articular cartilage is a highly organized tissue with complex biomechanical properties and substantial durability. However, it has a poor ability for healing, and damage from trauma or degeneration can result in morbidity and functional impairment. debilitating joint pain, dysfunction, and degenerative arthritis                                                                           Objectives: The purpose of study is to show effectiveness of micro fracture arthroscopy as a method of treatment for such problem . Type of the study: Cros

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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Efficacy of atorvastatin in treatment of Iraqi obese patients with hypercholesterolemia
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ABSTRACTBackground: dyslipidemia plays a crucial rule in the development of cardiovascular disease, which has become the leading cause of death in most developed countries as well as in developing countries (1). The effects of reducing low density lipoprotein – C (LDL-C) concentrations on the prevention of cardiovascular events and stroke have been well reported in many clinical trials.Objectives: Evidence supports the use of statins for lipid modifications in the primary prevention of coronary artery disease, morbidity and mortality. This study aims to determine the effectiveness of atorvastatin in treating dyslipidemia in Iraqi obese patients.Methods: 200 overweight and obese patients with hypercholesterolemia, according to NCEP ATP

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Comparing Bayesian methods to estimate the failure probability for electronic systems in case the life time data are not available
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In this research, we find the Bayesian formulas and the estimation of Bayesian expectation for product system of Atlas Company.  The units of the system have been examined by helping the technical staff at the company and by providing a real data the company which manufacturer the system.  This real data include the failed units for each drawn sample, which represents the total number of the manufacturer units by the company system.  We calculate the range for each estimator by using the Maximum Likelihood estimator.  We obtain that the expectation-Bayesian estimation is better than the Bayesian estimator of the different partially samples which were drawn from the product system after  it checked by the

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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
Thu May 05 2022
Journal Name
Al-kindy College Medical Journal
Spinal Tuberculosis in Children
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Tuberculosis continues to be the leading cause of morbidity and mortality, with an estimated annual incidence of 10.4 million worldwide. It has been estimated that 10% of patients with extrapulmonary tuberculosis have musculoskeletal involvement, with the spine being the most common. Spinal tuberculosis (TB) accounts for 50% of cases of musculoskeletal tuberculosis.

Spinal tuberculosis is the result of infection with Mycobacterium tuberculosis. It is a secondary infection, the primary lesion of which is in the lungs, genitourinary system, or gastrointestinal tract and can be active or latent. Involvement of the vertebral segment is the result of hematogenous spread of infection along the arterial pathway or Batson's vei

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Publication Date
Thu Sep 27 2012
Journal Name
Journal Of Physiological And Biomedical Sciences
The promising anticancer efficacy of parsley seeds flavonoid (apigenin) in induced mammary adenocarcinoma (AMN3) mice
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Extraction and identification of parsley (Petroselinum sativum) seeds flavonoids (apigenin), as well as evaluation its anticancer efficacy was the main aim of the current study. Thin layer chromatography results clarified that apigenin is the major flavonoid in parsley seeds. The cytotoxic effect of apigenin in mammary adenocarcinoma (AMN3) bearing mice was manifested through significant (P ≤ 0.01) reduction in tumor volume and growth rate inhibition (90.8 %) after 24 days of oral administration at a dose of 300 mg/kg body weight. The volume of tumor in the treated group reached 1354.8 mm³ while the recorded size of the control was 14758 mm³. Transplanted cancer mice showed a significant (P ≤ 0.01) elevation in concentration of liver,

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Publication Date
Mon Mar 15 2021
Journal Name
Egyptian Journal Of Chemistry
Assessment of follicular fluid paraoxonase activity with pregnancy outcomes in women undergoing IVF/ICSI
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