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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 May 28 2020
Journal Name
Iraqi Journal Of Science
Theoretical Investigation on Reaction Pathway, Biological Activity, Toxicity and NLO Properties of Diclofenac Drug and Its Ionic Carriers
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The present study included the use of the approximate semi-experimental method, the time-independent density function theory (unrestricted), the time-dependent density function theory, and Hartree-Fock method to calculate the reaction pathway of the anti-inflammatory drug diclofenac with its common ionic carriers (sodium and potassium). The basis sets used were STO-3G, 3-21G, 6-31G, and 6-311G. The drug was studied with two new proposed carrier ions (lithium and calcium) which were compared with common carriers. The calculations included the optimized geometrical structure and some physical properties such as standard heat of formation, dipole moment, total energies, and analytical spectra of IR, UV-VIS and 1H NMR. The biologi

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Publication Date
Tue Jun 15 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Comparing the Effects of Lavender Oil and Olive Oil Massage on Pain due to Muscular Cramp during Hemodialysis
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Background: Pain due to muscular cramp during hemodialysis is one of the most common problems experienced by patient undergoing hemodialysis, and is associated with poor outcomes of patients. The main aim of this study was to comparing the effects of lavender oil and olive oil massage on Pain due to muscular cramp during hemodialysis.

Methods: In this random clinical trial, 60 hemodialysis patients were enrolled randomly and allocated to two groups with 30 members in Lordegan and Brojen hospitals, Shahrekord, Iran. The intervention included flora massage on the lower leg muscles so that the first group received olive oil massage (10 drops) and the second group received lavender oil massage (10 dr

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Publication Date
Sat Jul 01 2023
Journal Name
Analytical Science & Technology
A Review: Synthesis and characterization of metals complexes with paracetamol drug
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In this review, previous studies on the synthesis and characterization of the metal Complexes with paracetamol by elemental analysis, thermal analysis, (IR, NMR and UV-Vis (spectroscopy and conductivity. In reviewing these studies, the authors found that paracetamol can be coordinated through the pair of electrons on the hydroxyl O-atom, carbonyl O-atom, and N-atom of the amide group. If the paracetamol was a monodentate ligand, it will be coordinated by one of the following atoms O-hydroxyl, O-carbonyl or N-amide. But if the paracetamol was bidentate, it is coordinated by atoms (O-carbonyl and N-amide), (O-hydroxyl and N-amide) or (O-carbonyl and O-hydroxyl). The authors also found that free paracetamol and its complexes have antimicrobial

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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
Thu Apr 23 2020
Journal Name
Al-qadisiyah Journal Of Pure Science
The ESTIMATING MARRIAGE AND DIVORCES AND COMPARING THEM USING NUMERICAL METHOD. . .
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In this paper, we describe the cases of marriage and divorce in the city of Baghdad on both sides of Rusafa and Karkh, we collected the data in this research from the Supreme Judicial Council and used the cubic spline interpolation method to estimate the function that passing through given points as well as the extrapolation method which was applied for estimating the cases of marriage and divorce for the next year and comparison between Rusafa and Karkh by using the MATLAB program.

Publication Date
Thu Dec 01 2022
Journal Name
Baghdad Science Journal
Simultaneous Ratio Derivative Spectrophotometric Determination of Paracetamol, Caffeine and Ibuprofen in Their Ternary Form
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A new, accurate, precise and economic two spectrophotometric methods for determination of Paracetamol (Par), Ibuprofen (Ibu), and Caffeine (Caf) were suggested. Those methods were the first and second ratio derivative spectrum using a double devisor. Par, Ibu, and Caf showed many useful peaks for their quantified determination. The validity of all analysis modes for determination of the three compounds, peak to baseline, peak area and peak to peak were according to ICH. The linearity of two methods was between 5 µg/ml as a lower concentration and 50 µg/ml as the highest concentration for three compounds. Recovery percentage was around 100% and relative standard deviation was less than 2.6%. The methods were applied successfully in the

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Publication Date
Sun Jul 03 2005
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Renal Cell Carcinoma in Adolescents
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Malignant renal neoplasm: Because benign tumors of kidney are rare, so it is a good rule that all neoplasm of kidney which are recognized clinically should be treated as malignant. They are uncommon between the ages of 7&40(l).Rcna! cell carcinoma is the most common tumor of the kidney in adult. It arises from renal tubular cells.. It is rare in children &is more frequent in men than women. It is an adenocarcinoma &is the most common neoplasm(75%) of kidney. The tumor may invade loca!Iy& metastasize by way of blood stream &the lymphatics. Regional lymph nodes are involved in approximately 30% of patients, unfortunately sign &symptoms are usually meager until the disease is advanced. Gross haematuria is the most fr

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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
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
Tue Mar 14 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Spectrophotometric Determination of Diclofenac sodium Using 2,4-dinitrophenylhydrazine in Pure Form and Pharmaceutical Preparations
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A simple and sensitive spectrophotometric method is described for the determination of diclofenac sodium (DCL), in pure form and pharmaceutical formulations. The method is based on the oxidation of 2,4-dinitrophenylhydrazine (2,4-DNPH) and coupling of the oxidized product with DCL in alkaline medium to give intensively colored chromogen which exhibits maximum absorption (λmax) at 600 nm, and the concentration of DCL was determined spectrophotometrically. The optimum reaction conditions and other analytical parameters were evaluated. In addition to classical univariate optimization, modified simplex method (MSM) has been applied in optimization of the variables affecting the color producing reaction. Beer’s law is obeyed in the

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