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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
Tue Aug 30 2022
Journal Name
Pakistan Journal Of Medical & Health Sciences
Association between Digital Addiction and Sleep Habits for Preschool Children
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Publication Date
Fri Aug 05 2022
Journal Name
International Journal Of Language And Literary Studies
Literature and Ecology: Promoting an Eco-Consciousness through Children Literature
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The study scrutinises intermingled relations between children literature and some ecological issues. Such interwoven relationships would be highly recommended to encourage children to explore and identify themselves with nature from early ages to avoid facing an extreme experience later on.  The research limits its scope to two novels Suzanne Collins’ (1962) The Hunger Games trilogy (2003-2007) and William Golding’s (1911-1993) Lord of the Flies (1954), and both novels have no direct connections with Ecology and the Eco-consciousness, yet it offers an insightful description about Man’s experience with Nature. Moreover, it raises serious moral questions, raises awareness, heals wounds and suggests solutions for the problems th

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Publication Date
Wed Sep 29 2021
Journal Name
College Of Islamic Sciences
Factors affecting the upbringing of good children Lect
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Raising children occupies a prominent place in Islam as a step paving the way for the success of reform projects on the level of diverse human life, and for this reason the recommendation for education was mentioned in the mission entrusted to the Prophet (PBUH), the Almighty said:

(( هُوَ الَّذِي بَعَثَ فِي الْأُمِّيِّينَ رَسُولًا مِّنْهُمْ يَتْلُو عَلَيْهِمْ آيَاتِهِ وَيُزَكِّيهِمْ وَيُعَلِّمُهُمُ الْكِتَابَ وَالْحِكْمَةَ وَإِن كَانُوا مِن قَبْلُ لَفِي ضَلَالٍ مُّبِينٍ))  Jumaa verse /38

The topic of the research that is in your hands deals with the

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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
Mon Oct 06 2014
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Increased Correction in Modifying Some Improper Eating Habits in Malnourished Children
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Not necessarily to be malnutrition is a result of poverty and lack of food, it may be the outcome of the wrong food practices; and the lack of knowledge in nutrition basis and chronic diseases. Some studies have confirmed that the more the knowledge in nutrition basis increased, the more the child has well-balanced food.

Unhealthy eating habits spread among children at an early age, which is one of the negative factors affecting the nutritional status they have causing various disorders as a result of lack or increase of food or lack of balance. The signs and symptoms of these disorders can be simple or can lead to deadly diseases.

Training children on proper eating habits in different fields of life is considered the mos

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Publication Date
Sat Sep 21 2019
Journal Name
Journal Of The College Of Education For Women
Reading Readiness Skills in Preschool Children
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This research aims to identify the following :

  • The reading willingness skill to kindergarten children.
  • There is no statistical significance difference between average scores of reading willingness skill of the sample individuals as a whole, and the hypothetical average of the scale.
  • The difference in reading willingness skill to kindergarten children according to gender variable (male & female).
  • There is no statistical significance difference between average scores of reading willingness skill for kindergarten children according to gender variable (male & female).

   To achieve the research goals, the researc

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Publication Date
Sun Sep 27 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Parents' Efficacy for Child Healthy Weight Behavior in Elementary Schools in Hilla City
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Objectives: The study aims to (1) Assess the parents' efficacy for child healthy weight behavior. (2) Identify the difference in parents’ efficacy for child healthy weight behavior between the groups of parent’s gender, family’s socioeconomic status, child’s gender, and child’s birth order, (3) Find out the relationship between parents’ age, child’s age, child’s body mass index, family’s socioeconomic status, the number of children in the family and parents’ efficacy for child healthy weight behavior.
Methodology: A descriptive correlational study is conducted for the period from November 11th, 2018 to March 25th, 2019 to assess the parents' efficacy for child healthy weight behavior. The study was carried-out in (

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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
Mon Mar 23 2020
Journal Name
Journal Of Engineering
Post-buckling Analysis of Cold-form Steel Column
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For the time being, the cold-formed sections are widely used due to their simple manufacturing and construction processes. To be feasible, the strength of cold-formed columns should be determined based on their post-buckling behavior. Post-buckling relations are cumbersome and need design aids similar to those of American Iron and Steel Institute (AISI) to be applicable. These design aids have been developed to sections and materials other than those available in the local market. Therefore, this paper tries to develop a general finite element model to simulate the postbuckling behavior of cold-formed steel columns. Shell element has been used to discretize the web, flanges, and lips of the column. A linear bucking analy

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Publication Date
Sun Dec 27 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation the Risk Factors that are Associated with Osteoporosis in Post Kidney Transplantation in a Sample of Iraqi Patients
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Renal transplantation is a principal treatment option for end-stage kidney failure. Bone loss and fracture are serious complication of kidney transplantation, associated with morbidity and mortality. The pathogenesis of post transplantation bone loss is multifactorial and complex

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