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bijps-974
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
Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Comparison of Immunoglobulin IgA Level in the Stimulated Saliva of Caries-Free and Caries-Active Children Aged 7-10 Years
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Background: Salivary immunoglobulin IgA plays an essential role in the immune response against dental caries. This studywas conducted to compare the salivary IgA levels and flow rate of stimulated saliva in caries active and caries free children. Materials and methods: The present study included sixty healthy children age 7-10 yearswho were divided into two groups. They were caries free and caries active children (30 children in each group). Assessment and recording of caries – experience were through the application of Decayed, Missing and Filled Tooth Index (DMFT) and (dmft) index, for permanent and deciduous teeth respectively. After dental examination, stimulated saliva samples were collected from the subjects and performed und

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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.

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Publication Date
Tue Apr 01 2003
Journal Name
Abhath Al- Yarmouk [basic Sciences And Engineering]
Methodology for selecting Nonprestressed Steel in Post- Tensioning Beams
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Publication Date
Wed Oct 16 2019
Journal Name
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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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Sat Jan 01 2022
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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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Scopus
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Fri Nov 01 2013
Journal Name
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Strengthening and Closing Cracks for Existing reinforced Concrete Girders Using External Post-Tensioning
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Sun Apr 01 2012
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Perceived Self-efficacy for university students
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Publication Date
Sun Jun 30 2013
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Day Case Tonsillectomy in Children
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Background: Day case surgery has become widely accepted as a safe alternative to the inpatient care in up to 70% of the cases at a children’s hospital. It has the advantage of minimizing the psychological trauma of hospitalization, decreasing nosocomial infection, less costly and frees up hospital beds.Objectives: To assess the advantages and disadvantages of this type of surgery.Methods: this is a prospective study, in which two hundred thirty childhood tonsillectomies were performed as a day-case in the department of otolaryngology at Al Shaheed Gazi hospital, Medical City Complex during the period from October 2009 to September 2010. The patients age range from 3-12 years (Mean 7.2 years).Results: 46.08% males and 53.91% females wer

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Publication Date
Sat Oct 01 2011
Journal Name
Iraqi Journal Of Physics
Stand-Alone PV Generator Comparing with Conventional Systems for Electrification of Small Social Centres in Remote Area
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Many isolated rural communities are located in regions where there is an abundant and reliable supply of solar energy, but where the distance to the nearest power station is many tens or even hundreds of kilometre. It is therefore mainly in these areas that rural electrification is now being provided by PV generators. since Stand-Alone PV generator can offer the most cost-effective and reliable option for providing power needed in remote places. Accordingly these isolated rural canters are fitted with PV for lighting, a refrigerator, a television and socket to supply kitchen appliances

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Publication Date
Wed Mar 30 2022
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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.

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