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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
Sat Dec 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
The impact of an Oral Health Education (OHE) program by teachers and mothers on adolescents' oral health
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Background: Adolescence is one of the most dynamic stages of human development. However, Oral health is an integral part of public health, significantly impacts on the quality of life. OHE program is an important issue that should be given to them. The aim of this study was to evaluate oral health outcomes on adolescents' oral health by teachers and mothers Materials and Methods: The study was carried out in seven schools of Diyala - Baquba city. This 14-weeks duration study assessed the effectiveness of school OHE program on oral hygiene status, gingival health, and halitosis assessment of 80, 12 year-old, both genders of school adolescents. From the selected schools, one group was supervised by the teachers and the other was supervised

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Publication Date
Tue Sep 28 2021
Journal Name
Journal Of The College Of Education For Women
The Commonest Negative Behavioral Manifestations among Kindergarten Children in the Post-Terrorist Phase: شيماء حارث محمد , امل داود سليم
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Behavioral and emotional disorders represent one of the commonest problems facing children in particular and disturbing their parents and educators in general. This is because Iraqi people have long been living in difficult conditions and faced various terrorists’ operations, such as killing, destruction, robbery, and looting. Such operations are said to be one of the reasons that leads to the development of such disorders, and may negatively affect the psyche of the child and be reflected on his behavior as represented by playing with the IPad for hours, and suffering from nightmares. Accordingly, the current research aims to examine specifically the commonest negative behavioral disorders among kindergarten children during the post-t

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Publication Date
Sat Mar 31 2018
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Adsorption of Diclofenac Sodium and Ibuprofen by Bentonite Polyureaformaldehyde Thermodynamics and Kinetics Study
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An increasing number of emerging contaminants have been detected in surface waters, sediment, soil and ground water in different locations in the world, which is a new environmental challenges need an actual concern for international scientific and legislative communities. 

   The nonprescription and huge used pharmaceuticals ibuprofen and diclofenac sodium will be focused in this study. New adsorbent developed using cheap inorganic clay material (bentonite) and organic polymer polyureaformaldehyde (PUF), the combination of these two materials gave the surface more roughness with wide active site distribution. Batch adsorption experiment performed to each pharmaceutical individually to determine the optimum separat

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Publication Date
Wed Jul 21 2010
Journal Name
Veterinary Medical Journal Giza
Efficacy of some drugs and pathological studies on Toxoplasma gondii infection in mice.
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The study was conducted to determine the effect Toxoplasma gondii and the efficacy of azithromycin and garlic tablets on the treatment of acute murine toxoplasmosis and observe the histopathological changes due to infection. 60 Albino mice were divided into six groups, and their survival rate, pathology, bioassay trial and immunofluorescence were observed. Results revealed that azithromycin (250 mg/kg/day) given to infected mice increased the survival rate (90% on day 7 PI) and decreased the histopathological changes when compared with the control groups. Garlic tablets (500 mg/kg/day) had lesser effect on infected mice, and the survival rate (40% at days 6 and 7 PI) was lower than the groups treated with azithromycin. The group treated wit

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Comparing parameters and Reliability of two-parameters exponential
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One of the most important problems in the statistical inference is estimating parameters and Reliability parameter and also interval estimation , and testing hypothesis . estimating two parameters of exponential distribution and also reliability parameter in a stress-strength model.

This parameter deals with estimating the scale parameter and the Location parameter µ , of two exponential distribution   ,using moments estimator and maximum likelihood estimator , also we estimate the parameter R=pr(x>y), where x,y are two- parameter independent exponential random variables .

Statistical properties of this distribution and its properti

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Emotional deprivation and its relation with the behavioral and nervous problems for adolescents
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Publication Date
Sun Oct 19 2025
Journal Name
Lecture Notes In Networks And Systems
The Use of Artificial Intelligence Tools in Analyzing the Impact of Social Media on Adolescents’ Mental Health
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Thu Oct 01 2020
Journal Name
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EXTRACTING PECTIN FROM TOMATOES AND BEET PEELS AND USING IT IN THE MANUFACTURE OF YOGURT AND COMPARING THEM
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Pectin is available in many plants and in this study, the peels of tomatoes and beet were used to be an economical source of pectin production instead of dumping it with waste or using it as animal feed. The pectin extracted from the peels using different solutions, namely citric acid (2 M), oxalic acid (2%) and hydrochloric acid (0.5 M) the outcome of the extraction methods, 7. 1%, 6% and 11% respectively for tomatoes peels, while the pectin of beet peels were 8%, 6.5%, and 8.3%, and the highest percentage obtained in the manner of hydrochloric acid adopted in the manufacture of yogurt.Yogurt was manufactured with four treatments, in the first treatment standard pectin was added and the second treatment in addition to the pectin extracted

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Scopus
Publication Date
Tue Mar 05 2024
Journal Name
The Journal Of Obstetrics And Gynecology Of India
Obstetric and Neonatal Outcomes in Overweight Adolescent Pregnant Mothers
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Background The escalating global concern over increased body weight in adolescents, coupled with the rising rates of adolescent pregnancy worldwide, presents a significant challenge to healthcare systems. We plan to identify the maternal and neonatal consequences associated with pre-pregnancy overweight in adolescent women. Methods Throughout five years, all singleton adolescent pregnant women with pre-pregnancy self-reported body mass index (BMI) of 18.5– ≤ 29.9 were involved during the first-trimester visit. Two groups were generated: overweight and appropriate-weight (BMI 25–29.9 and 18.5–24.9, respectively). Obstetric and neonatal outcomes were observed prospectively and statistically adjusted for the confounding factors.

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Publication Date
Tue Mar 05 2024
Journal Name
The Journal Of Obstetrics And Gynecology Of India
Obstetric and Neonatal Outcomes in Overweight Adolescent Pregnant Mothers
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Background The escalating global concern over increased body weight in adolescents, coupled with the rising rates of adolescent pregnancy worldwide, presents a significant challenge to healthcare systems. We plan to identify the maternal and neonatal consequences associated with pre-pregnancy overweight in adolescent women. Methods Throughout five years, all singleton adolescent pregnant women with pre-pregnancy self-reported body mass index (BMI) of 18.5– ≤ 29.9 were involved during the first-trimester visit. Two groups were generated: overweight and appropriate-weight (BMI 25–29.9 and 18.5–24.9, respectively). Obstetric and neonatal outcomes were observed prospectively and statistically adjusted for the confounding factors.

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