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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 Jan 06 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Self-Regulation Fluid Program on Patients with Hemodialysis Self-Efficacy for Fluid Adherence in Al-Diwaniyah Teaching Hospital
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Objectives: to evaluate patient knowledge with hemodialysis and to determine the effectiveness of Self-regulation Fluid Program on Patients with hemodialysis self-efficacy for fluid adherence in Al-Diwaniyah Teaching Hospital.

Methodology: A quasi-experimental design (two group design: pre-test and post-test) was used. This study was conducted in Al-Diwaniya Teaching Hospital for the period from (15th of October 2018 to 20th of May 2019) on a non-probability (purposive) sample consisting of (60 patients) treatment in hemodialysis units. A questionnaire was built as a data collection tool and consisted of four parts:

First part: Demographic characteristics of the pati

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Publication Date
Wed Oct 16 2019
Journal Name
Journal Of Research In Medical And Dental Science
Evaluation of the Antibacterial Efficacy of Silver Nanoparticles as an Irrigant against Enterococcus faecalis In vitro Study
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Background: Successful root canal therapy depends on thorough chemo mechanical debridement of pulpal tissue, dentin debris and infective microorganisms. Objective: This study aimed to investigate the antibacterial effect of silver nanoparticles, sodium hypochlorite and chlorhexidine in reducing the bacterial infection of the root canals. Materials and Methods: The root canals of 55 single-rooted teeth were cleaned, shaped, and sterilized. All the teeth samples were inoculated with Enterococcus faecalis and incubated at 37°C for 2 weeks. Then, the teeth were divided into four groups. Group I (n=15): 100 ppm silver nanoparticles, Group II (n=15): 2.5 sodium hypochlorite, Group III (n=15): 2% chlorhexidine, IV (n=10): Normal saline as a contr

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Publication Date
Sat Jan 01 2022
Journal Name
Annals Of Parasitology
Evaluation the therapeutic efficacy of different concentration of amphotericin B drug in mice infected with visceral leishmaniosis
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Liposomal amphotericin B (Amph B) has been used effectively to treat leishmaniosis, in spite of its high toxicity appeared in some patients. In our study, Amph B was administered in Leishmania donovani that infected BALB/c male mice using different concentrations to evaluate its efficacy challenge against infection as well as its effect in modulating immunity of the host. We observed that low doses with short duration of Amph B as a therapy regime significantly enhanced the induction of Th1 cytokine (INF-γ), but suppressed Th2 cytokine (IL-10) production. Groups of mice infected with L. donovani and treated with Amph B showed clearly increasing in INF-γ level and reduction in IL-10 level in concentration (3, 4, 5 mg/ml/kg) with best resul

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Measuring the Historical Concepts of Kindergarten Children
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Historical concepts are among the concepts that are difficult to present to the pre-school child except by using modern techniques, as well as the difficulty of making visits to all historical monuments and going back to antiquity and the lack of studies in this area, therefore, we need an attractive medium that children love which is able to convey some abstract concepts that are difficult to teach to children using traditional methods, and among these activities that the kindergarten provides to children are the stories through which they develop their linguistic wealth, consolidate their religious and spiritual inclinations, refine their correct morals, and form their proper attitudes, knowledge and life concepts.

The

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of caries experience, enamel defects and selected salivary biomarkers in children with nutritional rickets
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Background: Nutritional Rickets is a condition produced by an absence of Vitamin D, calcium or phosphate. It clues to relaxing and fading of the bones. Dental expression of children with rickets contains enamel hypoplasia and delayed tooth eruption. This study was conducted in order to assess caries experience (dmfs) and enamel defects among study and control groups, and to evaluate and compare the levels of selected salivary biomarkers between children with nutritional rickets and apparently healthy children. Material and methods: Assessment of caries according to WHO in 1987, and assessment of enamel defects according to enamel defect index EDI of WHO in 1997. In addition a stimulated saliva samples were collected according to Palone e

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Publication Date
Sun Apr 01 2012
Journal Name
Journal Of Educational And Psychological Researches
Perceived Self-efficacy for university students
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Research was: 1- known as self-efficacy when students perceived the university. 2- know the significance of statistical differences in perceived self-efficacy according to gender and specialty. Formed the research sample of (300) students were chosen from the original research community by way of random (150) male specialization and scientific and humanitarian (150) females specialized scientific and humanitarian. The search tool to prepare the yard tool to measure perceived self-efficacy based on measurements and previous literature on the subject of perceived self-efficacy. The researcher using a number of means, statistical, including test Altaúa and analysis of variance of bilateral and results showed the enjoyment of the research s

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Publication Date
Sat Jun 19 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Role of Ginkgo biloba Extract as Monotherapy in Improving the Outcomes of Patients with Metabolic Syndrome: A Pilot Comparative Study with Metformin
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The present study evaluates the effects of Ginkgo biloba extract as monotherapy on the glycemic status, insulin resistance (IR), body mass index (BMI), and visceral adiposity index (VAI), in addition to the inflammatory markers, oxidative status and leptin level in patients with metabolic syndrome in comparison with metformin.

The study is a randomized, double-blind pilot study conducted during the period May to September, 2020. Fifty patients were recruited in the study and they were allocated into two groups (25 per each group): Ginkgo biloba and Metformin groups, they received (120 mg Ginkgo biloba extract/ capsule) and (500 mg Metformin/ capsule) respectively; orally as a single dose for 90 days. Blood samples were taken at z

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The impact of strategic innovation components of the application Business process re-engineering: A survey Study of the consultant of a sample of managers and their assistants and consultants in the General Company for Post & Telecommunications
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Abstract:

        Organizations need today to move towards strategic innovation, which means the analysis of positions, especially the challenges faced by the change in the external environment, which makes it imperative for the organization that you reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures. Now this research dilemma intellectual two-dimensional, yet my account in not Take writings and researchers effect strategic innovation in re-engineering business processes, according to science and to inform the researcher, and after the application represented in the non-application of such resear

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Publication Date
Wed May 11 2022
Journal Name
Journal Of Economics And Administrative Sciences
Comparing Some Methods For A single Imputed A missing Observation In Estimating Nonparametric Regression Function
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In this paper, we will study non parametric model when the response variable have missing data (non response) in observations it under missing mechanisms MCAR, then we suggest Kernel-Based Non-Parametric Single-Imputation instead of missing value and compare it with Nearest Neighbor Imputation by using the simulation about some difference models and with difference cases as the sample size, variance and rate of missing data.      

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Publication Date
Thu Sep 16 2021
Journal Name
International Journal Of Clinical Practice
An overview of post‐COVID‐19 complications
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