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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 Nov 13 2025
Journal Name
Journal Mustansiriyah Of Sports Science
Self-Efficacy and its Relationship to Psychological Adjustment among Table Tennis Players with Disabilities Special Needs
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The introduction and importance of the research included that physical education and its various activities are important for the disabled. The exercise of physical activities by the disabled effectively contributes to raising their level of fitness and reducing diseases caused by lack of movement. Disabled people often suffer from psychological and social problems, and this feeling may be accompanied by a high level of anxiety, a lack of self-esteem and a loss of self-confidence. Psychological adaptation is one of the concepts of sports psychology interconnected with the psychological climate, as the process that the player seeks to meet his demands and needs. Adaptation includes the pursuit of emotional balance between the individual play

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Haemogloin Level, Blood Group, Chest X Ray Findings and Consanguinity in Thalassemic Children in AL Muthana Governorate
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Background: Thalassemia is characterized by the decrease or absence of the synthesis of one or more globin chains of hemoglobin. Thalassemia is distributed worldwide and is characterized by; regular blood transfusion which is creating alloimmunization to erythrocyte antigens is one of the major complications of regular blood transfusions in thalassemia, particularly in patients who are chronically transfused.Objectives: The aims of this study are to understand the immune system profile as the triggering factor for thalassemia.Methods: Thirty patients aging between one year and four months and twenty two years, twenty two of them were boys and eight were girls. Twenty nine patients, their parents are relative except one and studied in the

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Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Public Health Research & Development
Impact of Breast Feeding Duration on the Presence of <i>Candida</i> in Relation to Nonnutritive Sucking Habit among Group of Iraqi Children
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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Serum Levels of Total IgE, IL-12, IL-13 and IL-18 in Children Patients with Asthma
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T-cell activation and alteration of cytokine levels are involved in the pathogenesis of asthma. However, the profile of circulating T-lymphocyte subsets and related cytokines during asthmatic attacks is still unclear. We compared the serum concentrations of proinflammatory cytokines Interleukine-18( IL-18) and Interleukine-12(IL-12), T-helper 2 (Th2) cytokine Interleukine-13(IL-13 ) and Immunoglobuline-E ( IgE) in 27 asthmatic children and 21 sex and age matched healthy control subjects. Serum cytokines and IgE concentrations were measured by enzyme-linked immunosorbent assay. Serum IL-13 , IL-18 and IgE concentrations were significantly higher in asthmatic patients than normal control subjects ( IL-13: median 9.73 versus 4.43 pg/ml, P&l

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Publication Date
Sat Nov 01 2014
Journal Name
Journal Of Cosmetics, Dermatological Sciences And Applications
Genital Warts in Infants and Children&#8212;Re-Evaluation of Podophylline 15% as an Effective Topical Therapy
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Publication Date
Mon Dec 31 2018
Journal Name
Ibn Al-haitham Jour. For Pure & Appl. Sci
Comparative Study of Thymidine Kinase -1 and Total Antioxidant Capacity in Iraqi Children with Platelet Count Disorder
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This study aimed to find relationship between thymidine kinase-1 (TK-1) as tumor marker and total antioxidant capacity (TAC) in Iraqi children patients with thrombocytopenia and with thrombocytosis. The present study conducted 60 children patients (30 patients with idiopathic thrombocytopenia purpura (ITP) and 30 patients with thrombocytosis caused by leukemia) attending the Children Fever Hospital in the Medical City / Baghdad, and 30 healthy children as a control group. All study groups were with range ages (1-15) years, and they were diagnosed by assay of platelet count, Prothrombin Time (PT), and partial Thromboplastin Time (PTT). The results shown elevation in plasma TK-1 and TAC values in children patients with thrombocytopenia and w

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Publication Date
Thu Jan 13 2022
Journal Name
Journal Of Research In Medical And Dental Science
Impact of Bad Oral Habits on Dental Caries among 6-10 Years Old Children in Hilla City
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Background: There is a clear debate about the role of bad oral habits (thumb-sucking and biting nails) and on oral health and the state of the dental caries, but there is no doubt that continuing these bad habits until advanced ages will lead to deep and difficult problems to solve. Objective: The purpose of study was to evaluate the effect of bad habits, include finger sucking and nail biting on dental caries among children aged from 6 to 10 years old. Subjects and methods: In Al-Hilla city, Iraq, a comparative study was conducted in which (200) primary school students aged between 6 to10 years old were involved. A questionnaire filled out by their parents was used to gather information related to the bad oral habit, and then all the stude

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Foavedur mass media for children and modifyin Their behaviour from point of their parents view: Foavedur mass media for children and modifyin Their behaviour from point of their parents view
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Abstract:
The research aimed to know favoured mass media for children and
modifying their behaviour ,the child became aquires the information from
mass media that he exposure them without any guidance , where upon the
quidance proqrammes becomes real danger whereas qet out their civil

style and converting to deadly poisons,and because of little study for this
supject the two researchers opined to perform astudy to know the favoured
mass media to the children and what are the mass media that modify their
behavior according to ther parent points of view ,after propring the research
measurement and the suilable statical methods it has shown that there are
mass media affect in children behavior ,they are st

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Publication Date
Sun Jul 17 2022
Journal Name
Al–bahith Al–a'alami
Post-interactive communication A study to build a model for the flow of communication in social networking sites
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The issue of the research lies in the non-representation of the models developed for the communication process in the interaction and networking processes through social media, as the research sought to build a network model of communication according to the specific data and features of social media platforms in order to reach a special generalization to understand how the process of networking operates in cyberspace.

The researcher followed the analytical survey approach as she described the communication models outwardly in order to be able to build a networked communication model that represents the flow of post-reactive communication. Therefore, it has been named "Nebula - Sadeem" after the concept of post-space and cosmic g

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Publication Date
Sun Mar 01 2020
Journal Name
Baghdad Science Journal
The Efficacy of Poppy, Papaver nudicaule extract as an Anesthetic for the Common Carp, Cyprinus carpio
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Aqueous extract of poppy plant) Papaver nudicaule) with five concentrations (50, 100, 150, 200 and 250) mg/l were used to anesthetize fingerlings of the common carp Cyprinus carpio (Mean total length 8.91 ± 0.31 cm and mean total weight 7.72 ± 1.19 gm) instead of the traditional use of MS-222. Results showed that extracted solution of poppy have partial and overall anesthesia effect on these fishes with inverse relationship between the concentrations used and the time needed to reach partial and overall anesthesia, and also direct relationship between concentrations used and time needed for fish recovery. Best results were obtained by using a concentration of 250 mg/l, where time for partial anesthesia was 8 ± 1.52 m

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