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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 Jun 30 2010
Journal Name
Al-kindy College Medical Journal
Human Leukocyte Antigens class II influence the expression of Glutamic Acid Decarboxylase auto antibodies in Type Diabetic children and their Siblings
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Background: The immunogenetic predisposition
may be considered as an important factor for the
development of Type 1 Diabetes Mellitus (T1DM)
in association with the HLA antigens.
Objective:This study was designed to investigate
the role of HLA-class II antigens in the etiology of
type T1DM and in prediction of this disease in
siblings, and its effect on expression of glutamic
acid decarboxylase autoantibodies (GADA).
methods:Sixty children who were newly diagnosed
type 1 diabetes (diagnosed less than five months)
were selected. Their age ranged from 3-17 years.
Another 50 healthy siblings were available for this
study, their ages range from 3-16 years. Eighty
apparently healthy control subjects,

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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
Patterns of parental care for mothers and kindergarten children at social fear
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That the child in the early years of his life learns a lot of experiences that help him
grow properly, and if the availability of the child family atmosphere full of love and affection
and trust he was able to grow healthy growth and is in accordance with itself and with the
community in which they live, and stop method of the child in the expression of fear on the
nature of situation and on the theme of fear and the reaction of those around the child as well
as the vague positions that can not a child from its interpretation raises his fear, and its lead in
life are the kindergarten of the growing concerns him, causing his social concern, therefore,
targeted current research to identify patterns of parental care(mot

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Publication Date
Sun Apr 30 2023
Journal Name
Iraqi Journal Of Science
Evaluation of Hematological Factors and Micronutrients Among Children Infected with Enterobius vermicularis
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     Malnutrition, anemia, and micronutrient deficits may be associated with Enterobius vermicularis infection. Hence, the subject has recently received a lot of attention. The goal of this study was to analyse the nutritional, hematological and micronutrient status of children infected with E. vermicularis. This research was carried out in Baghdad from October 2021 to the end of March 2022. The study comprised 100 children of both sexes, ranging in age from 3-16 years. All individuals nutritional status was assessed using the weight-for-age Z score and the height-for-age Z score. As well as cellophane tape samples and blood samples were collected from all individuals. The cellophane tape samples were examined under microscope f

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Publication Date
Tue Dec 15 2020
Journal Name
Journal Of Baghdad College Of Dentistry
Gingival health condition among children of inbreeding parents compared to children of outbreeding parents in Babylon governorate / Iraq
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Background: Consanguineous marriage is a relationship between biologically related individuals. Genetic factors have a role in gene environment interactions that takes the center stage. The evidence of oral disease (gingivitis and periodontitis) may depend on genetic syndromes, inherited diseases, familial studies etc. The present study aims at assessing dental plaque and gingival health condition in children of inbreeding parents compared with children of outbreeding parents among primary schools in Al-Qasem city/ Babylon governorate in Iraq. Materials and methods: this comparative study included three hundred ninety eight (398) students, 6-12 years old, from 4 primary schools; 199 children had their parents of inbreeding marriage with

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Publication Date
Sun Sep 07 2014
Journal Name
Baghdad Science Journal
Detection of RAF fusion transcripts in FFPE samples of Medullablastoma and Ependymom in Iraqi children with RT-RQPCR assays
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Medulloblastomas and ependymomas are the most common malignant brain tumors in children. However genetic abnormalities associated with their development and prognosis remain unclear. Recently two gene fusions, KIAA1549–BRAF and SRGAP3–RAF1 have been detected in a number of brain tumours. We report here our development and validation of RT-RQPCR assays to detect various isoforms of these two fusion genes in formalin fixed paraffin embedded (FFPE) tissues of medulloblastoma and ependymoma. We examined these fusion genes in 44 paediatric brain tumours, 33 medulloblastomas and 11 ependymomas. We detected both fusion transcripts in 8/33, 5/33 SRGAP3 ex10/RAF1 ex10, and 3/33 KIAA1549 ex16/BRAF ex9, meduloblastomas but none in the 11 ep

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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Dentistry
New functional and aesthetic composite materials used as an alternative to traditional post materials for the restoration of endodontically treated teeth
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Objectives To tailor composites of polyethylene–hydroxyapatite to function as a new intracanal post for the restoration of endodontically treated teeth (ETT). Methods Silanated hydroxyapatite (HA) and zirconium dioxide (ZrO2) filled low-density polyethylene (LDPE) composites were fabricated by a melt extrusion process and characterised using infrared spectroscopy (FTIR), differential scanning calorimetry (DSC) and dynamic mechanical analysis (DMA). The flexural strength and modulus were determined in dry state and post ageing in simulated body fluid and fractured surfaces analysed by SEM. The water uptake and radiographic appearance of the experimental composites were also measured and compared with a commercially known endodontic fibre

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Publication Date
Sun Sep 06 2015
Journal Name
Baghdad Science Journal
Preparation of Some Culture Media Locally from leaves and stems of Purslane plant (Portulaca oleracea oleracea L.) and Assessment of Their Efficiency Comparing with Culture Media of Oxoid Company
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The leaves and stems of the local Purslane plant ( Portulaca oleracea oleracea L. ) were used to preapare the extract of two types ( wet and dried extractions) the extracts were prepared by weighting of 60grams of the wet and the dried plant individually, then boiled in 500ml of distal water. Finally the volume was completed to1 liter, then we used these extracts to prepare of 8 types of the culture media contained basic, selective and enrichment media for growing a group of pathogenic bacteria. 8 types of bacteria were used for this purpose: Escherichia coli, Pseudomonas flouresence, Staphylococcus aureus , Staphylococcus epidermidis, Bacillus subtilis , Klebsiella pneumoniae , Proteus mirabilis and Proteus vulgaris. The stastica

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Publication Date
Tue Oct 24 2017
Journal Name
International Journal Of Science And Research
Incidence Rate of Infectious Diseases in Hospitalized Children
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Objective: The incidence of infectious diseases among hospitalized children remains high. This study describes the environmental health indicator diseases and differences between gender and age of the affected children. Patients & Methods: A review of hospitalization and death causes among children admitted to the Child Teaching Hospital for Pediatrics in Baghdad, Iraq was performed. Medical records of children admitted throughout three years period were collected for demographics data and statistical analysis using Chi-square test. Results: A total of 4,272 admissions and 309 deaths were recorded. Infectious diseases remain the primary cause of hospitalization among children and frequently lead to death; which recorded (56%) followed by ac

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Publication Date
Tue Dec 01 2020
Journal Name
International Journal Of Research In Pharmaceutical Sciences
Iraqi Experience of Factor VII use in Children
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Bleeding disorders in pediatrics is an important issue and can be lifethreatening if not diagnosed and treated appropriately. We aimed to evaluate Iraqi pediatric practice (as an example of resource-limited settings) about the use of Recombinant Activated Factor VII (RFVIIa) in bleeding disorders, with emphasis on its effectiveness and safety, in comparison with adjuvant therapy. Budget restrictions may affect the availability of even lifesaving drugs such as (RFVIIa). Therefore, we tried to investigate the local experience of pediatric bleeding, with the evaluation of the potential ability of adjuvant therapy of blood products and vitamin K to substitute RFVIIa in case of non-availability. During a complete one year‘s period, 35 patients

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Publication Date
Wed Jan 01 2025
Journal Name
Medical Journal Armed Forces India
Efficacy of hypochlorous acid solution in comparison with povidone iodine solution for the management of infected diabetic foot ulcers
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