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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
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Awareness of the problem technological poisoning Media of parents of kindergarten children and their teachers
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The childhood stage is considered the most important stage of all the stages through
the human being’s life. In this stage the human being will be more affected by the various
factors that surround him/her. The first five years of his/her life leave a great impact not only
on the human being personality, but also on his/her whole life. Therefore, it is worthwhile tobe concerned with and focus at the raising up and the teaching of the child during the
childhood stage.
The mission of raising up children in this era - the era of globalization and information
bursting or news flooding – has become a very difficult or even an impossible mission.
Furthermore, not only in the Arabic world, but also all over the world, t

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Publication Date
Sat Jan 12 2019
Journal Name
Journal Of The College Of Education For Women
Self- Awareness of Emotions and its Relation to the Way of Helping of Kindergardens' Children
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The self-awareness interactions reflects with emotions,assess the child in respect to its relations with the social standards; they are not merely simply reactions , but rather they connect with his moral behavior and other 's thinks. When the self- awareness gets developed with emotions within the child , the latter become highly sensitive, causing him prone to be blamed . AS a result , the children test the self –awareness interactions with emotions and in age 3 years , where the self –awareness interactions with emotion clearly link to the self- assessment. The children in stage of kindergarten could not describe the self-awareness interactions accurately ; they test it under different circumstances in comparison to the youngest o

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Publication Date
Fri Jan 01 2021
Journal Name
Systematic Reviews In Pharmacy
A COMPARATIVE STUDY OF CHEMICAL COMPOUNDS AND ANTI-BACTERIAL EFFICACY OF DIFFERENT ALLIUM CEPA PLANT EXTRACTS
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Publication Date
Wed Jan 20 2021
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Study of Efficacy Adsorption of Methyl Green by Attapulgite and Modified Attapulgite Clay from Aqueous Solution
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    This paper includes the modification of the attapulgite  by precipitation of iron and aluminum compounds . Attapulgite (Atta) and modified attapulgite (Atta-m) clays are characterized by many  techniques ( FTIR , XRD ,SEM  with EDX ) .The  attapulgite clay before and after modification were used as the adsorbents for adsorption of methyl green (MG) . The results Indicate ,that the percentage of removal (MG) at equilibrium by using (Atta) and (Atta-m) clay were reached to  94% and 97% respectively. Indicating that the clay modification process was in addition to a relative improvement in the adsorption potential of the clay after modification.

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Publication Date
Wed Aug 17 2022
Journal Name
Al–bahith Al–a'alami
Digital addiction and its Relationship to social isolation among children in the autism Spectrum frome the viewpoint of their parents
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 This study titled “digital addiction and its relationship to social isolation among children in the autism spectrum from the point of view of their parents” in which the
researcher addressed an important topic which is knowledge of digital addiction in a
child with autism spectrum and its relationship to social isolation in them.
The study aimed to dhed the light on the digital addiction in a spectrum child Autism
from the point of view of their parents، by knowing the extent of addiction of children
in the autism spectrum، and identifying the relationship between electronic addiction and the social isolation of children in the autism spectrum.The study presented
several hypotheses،

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Publication Date
Tue Dec 24 2024
Journal Name
Journal Of Education For Pure Science
EFFECT OF PLANT GROWTH REGULATOR IN INCREASING THE EFFICACY OF HERBICIDES IN COMMON REED(Phragmites communis Trin.) CONTROL.
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This study was carried out in epidemically field with common reed (Phragmites communis Trin.) plants in the Nassiriah cityThiQur governorate ,during 2009/2010 to investigate the influence of plant growth regulator gibberellin (GA3)and cytokinin (CK) in increasing the efficacy of glyphosate and Fluazifop-butyl in common reed control . Factorial experiment in RCBD was used with three replications in tow Factors . Glyphosate 3500mg .l־¹ gave the higher mean of injury score of common reed and lower mean of common reed shoots , shoots dry weight and rhizome dry weight(3.59,22.01 shoot /0.5m² ,0.57Kg / 0.5m² and 250.50gm /0,5m² ),respectively. All plant growth regulators gaves the higher means of common reed shoots and rhizome dry weight com

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Publication Date
Sun Jul 01 2007
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Post-Surgical Loco Regional Recurrence Of Breast Carcinoma In Iraq
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Background : From the standpoint of mortality &morbidity, cancer is by far the most important clinical problem that concerns the breast today .The age adjusted incidence of new cases has been increasing steadily with increase in the incidence among the Iraqi women during the last few years .
Materials &method : A prospective study was arranged to assess the occurrence of postsurgical loco-regional recurrence of breast carcinoma in the Iraqi female patients , a total
number of 91 female patients were assessed during period from Dec.2000 to Dec.2002, the 
median period of follow up was two years.
Result : Loco-regional recurrence developed in 20 patients (22%). Chest wall and axilla were th

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The role of monetary policy in reducing inflation in Iraq through monetary sterilization mechanism. post-2003
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The main objective of the central bank is to achieve price stability and target in fractionates. Therefore, the bank sought to use modern tools and policies in order to reduce the negative effects of the accumulation of foreign reserves represented by monetary sterilization, similar to developed and developing countries alike, but with different available tools that are possible and imposed by the local financial and monetary environments, such as the window for buying and selling foreign currency, open market operations and deposit facilities. And lending existing. Because any in crease in the monetary base resulting from the accumulation of foreign reserves will affect price stability directly due to the consumer nature of the

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Publication Date
Tue Dec 24 2024
Journal Name
Journal Of Baghdad College Of Dentistry
Efficacy of arthrocentesis with injection of hyaluronic acid in the treatment of internal derangement of temporomandibular joint
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Background: Temporomandibular joint disorders refer to a group of heterogeneous pain and dysfunction conditions involving the masticatory system, reducing life quality of the sufferers. Arthrocentesis is simple and less invasive surgical procedure for the treatment of internal derangement than arthroscopy and better than other conservative procedures such as drugs, occlusal appliances and physiotherapy. The aim of the study was to evaluate the effect of arthrocentesis with injection of hyaluronic acid in the treatment of internal derangement of temporomandibular joint for the restoration of its function, reducing pain and preventing further deterioration of the temporomandibular joint dysfunction. Materials and methods: This study was perfo

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Publication Date
Wed Dec 30 2020
Journal Name
Journal Of Planner And Development
The preferences of planning bridges of Al-Mosul city post war
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The study started from the problems of wars and the damage that result from deterioration and destruction of infrastructure and the absence of planning and urban reconstruction. The study aims to address the condition of the bad destroyed bridges that have paralyzed traffic from the right and left sides of the city of Mosul. The study is based on the assumption that the reconstruction of bridges will improve the transportation network in the city of Mosul. The study relied on several approaches, including: the historical approach by reviewing global and local experiences and the descriptive approach to review the reality of the state of Mosul after the liberation process, through maps and the analytical approach through statistics and da

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