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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 Jan 01 2023
Journal Name
Biomed Research International
Efficacy of Autogenous Dentin Biomaterial on Alveolar Ridge Preservation: A Randomized Controlled Clinical Trial
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Background. After tooth extraction, alveolar bone resorption is inevitable. This clinical phenomenon challenges dental surgeons aiming to restore esthetic and function. Alveolar ridge preservation can be applied to minimize dimensional changes with a new socket grafting material, an autogenous dentin graft, produced by mechanically and chemically processing natural teeth. This study assessed the safety and efficacy of using autogenous dentin biomaterial in alveolar ridge preservation. Materials and Methods. Patients with nonrestorable maxillary anterior teeth bounded by natural sound teeth were included in this study. After a detailed clinical and tomographic examination, eligibl

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Publication Date
Tue Aug 31 2021
Journal Name
Iraqi Journal Of Science
Biochemical and Genetic Study in Blood of β– Thalassaemia Children in Mosul City, Iraq
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The present study aimed to demonstrate the extent to which the activity of a number of enzymes and genetic variation of β-globin genes were affected in the blood of 65 children with β - thalassemia major of both sexes. The patients, with an age range of 2 – 15 years, were registered in the Thalassemia Center at Ibn Al-Atheer Teaching Hospital for Children in the city of Mosul / Iraq. They were under continuous treatment after being diagnosed by specialist doctors. The study also involved 30 healthy children of both sexes with the same age range who were considered as a control group.

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Delayed Recovery of Contrast Induced Kidney Injury Post Angiography: Rate and Risk Factors
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Background: Exposure to Contrast media is the third leading cause of hospital acquired acute kidney injury. It follows a predictable time of onset and a less predictable scenario in recovery. This is related to certain factors, but at the end there will be asubstantial association with increased mortality, morbidity, and length of hospitalization.
Objectives: To define the Incidence of persistent contrast induced renal impairment a month after angiography and to define the risk factors for such persistence
Patients and Methods: One hundred and one patients (101) were enrolled in this study. All were referred to the Iraqi Center for Heart Diseases in Baghdad/ Iraq for coronary and/or peripheral vascular angi

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Publication Date
Sun Dec 04 2011
Journal Name
Baghdad Science Journal
Effect of Laser Irradiation on the Optical Properties of SnO2 films Deposited by Post Oxidation of metal Films
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Tin oxide films (SnO2) of thickness (1 ?m) are prepared on glass substrate by post oxidation of metal films technique. Films were irradiated with Nd:YAG double frequency laser of wavelength (532 nm) pulses of three energies (100, 500, 1000) mJ. The optical absorption, transmission, reflectance, refractive index and optical conductivity of these films are investigated in the UV-Vis region (200-900) nm. It was found that the average transmittance of the films is around (80%) at wavelength (550 nm) and showed high transmission (? 90 %) in the visible and near infrared region. The absorption edge shifts towards higher energies, which is due to the Moss-Burstien effect and it lies at (4 eV). The optical band gap increased with increasing of ene

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of Research In Medical And Dental Science
The Efficacy of 4% Articaine Infiltration Anesthesia in the Extraction of Mandibular Molars: A Randomized Controlled Study
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Introduction: Articaine was developed in 1969, with reported advantages which are increased potency, increased duration of its anesthetic effect and superior diffusion through bony tissue. The effectiveness of using 4% articaine infiltration for extraction of mandibular molar teeth in comparison to 2% lidocaine inferior alveolar nerve block is not settled yet. Aim: The aim of this study was to evaluate the effectiveness of using 4% articaine infiltration for extraction of mandibular molars by comparing it to the use of 2% lidocaine inferior alveolar nerve block in terms of success, the volume of local anesthetic agents and the pain experienced during the procedure. Materials and methods: A prospective randomized controlled study included

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Publication Date
Sun Jan 01 2017
Journal Name
Rsc Advances
Investigation of the post-annealing electromagnetic response of Cu–Co oxide coatings via optical measurement and computational modelling
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The annealing temperature (200–500 °C) effects of optical frequency response on the dielectric functions of sol–gel derived CuCoOx thin film coatings: experimental and modelling.

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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Impact of Brix 3000 and conventional restorative treatment on pain reaction during caries removal among group of children in Baghdad city
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Background: Pain and the usage of local anesthetic agents are still real problem in pediatric dentistry, for these reasons, the use of minimal invasive dentistry (MID) in regard to the patient comfort is important especially for children, anxious and uncooperative patients. Chemomechanical caries removal (CMCR) methods involve the selective removal of the carious dentine hence it avoided the painful removal of the sound dentine and the anxiety resulted due to the vibration of the hand piece which is also decreased thus it appears to be more acceptable and comfortable to the patient. Aims of this study: This study was conducted among group of children to assess and compare the anxiety rating scale (during and after treatment) between the

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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
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
Tue Oct 04 2022
Journal Name
Cureus
The Impact of Angiotensin Converting Enzyme-2 (ACE-2) on Bone Remodeling Marker Osteoprotegerin (OPG) in Post-COVID-19 Iraqi Patients
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