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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
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Kindergarten Children Addiction to Tablet Devices and Its Negative Effects
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The characteristic of our time is the tremendous technological progress and the wide use of the Internet. Children have had a large share of this progress.as they are becoming fond of having the technological equipment of tablets and mobile phones which become indispensable for these children cannot do without them .
Recently, the phenomenon of using mobile phones and tablets by children has become more widespread, and the society in general and parents, in particular, have ignored the reasons for their health .Despite the many advantages and benefits for children who are well trained to use these devices properly that have enhanced their cognitive and social abilities, there are many disadvantages that could harm children's growth if

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Publication Date
Wed Feb 28 2024
Journal Name
Mosul Journal Of Nursing
Association between Digital Addiction and Eating Behaviors for Preschool Children
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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
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
Sat Dec 31 2022
Journal Name
Al-kindy College Medical Journal
The Youngest Palestinian Case of Multisystem Inflammatory Syndrome in children (MIS-C)
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The multisystem inflammatory syndrome in children (MIS-C) considers a post-infectious immunological response to coronavirus illness (COVID-19) that was originally identified in the United Kingdom and later identified in other countries.  A previously healthy 3-month-old boy was admitted to hospital context with -5-day history of fever, gastrointestinal symptoms [diarrhea, vomiting of normal gastric contents], hypoactivity, and poor oral intake, but so far no history of covid-19 active disease. The infant was dehydrated, with macular non-blanching skin rash everywhere over his body and widespread non-pitting edema. With supportive measures, methylprednisolone and IV immunoglobulin, the child improved, with his fever, skin rash, and labor

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Publication Date
Sun Dec 29 2019
Journal Name
Iraqi Journal Of Science
The prevalence of anemia among children infected with Entamoeba histolytica in Baghdad
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     The relation between Entamoeba histolytica and anemia has lately had much attention. The aim of this study was to determine the possible correlation between anemia and parasitic intestinal infection with E.histolytica in children from Baghdad-Iraq. This study was conducted from October 2018 to April 2019 in different hospitals, primary health care centers, and primary schools. Eighty-one children participated in this study and their ages were between 1 and 12 years. The participants were divided into two groups based on their general microscopic stool examination. The first group was diagnosed as E.histolytica infected group (n=47), while no pathogens were detected in the stool samples

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Publication Date
Sun Sep 02 2018
Journal Name
Journal Of The Faculty Of Medicine Baghdad
A Study of Early post-operative wound complications of spina bifida aperta repair “Incidence and Risk Factors”
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Background: Myelomeningocele is the single most common congenital anomaly that affects the CNS
and vertebral column. The third world countries having a higher incidence. The management is usually
surgical with relative high incidence of complications.
Objectives: to evaluate the possible risk factors that may predispose to early wound complications of
myelomeningocele.
Methods: This prospective study was carried out in the Surgical Specialization Hospital in Medical City
Complex - Baghdad from 2009-2012. 147 cases were included in the study. Requested data were
gestational age, type of delivery, gender, age at operation, type of suturing of the wound, tension of
suturing, duration of operation, site of the lesion,

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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
Mon Nov 27 2023
Journal Name
Journal Of Periodontal Research
Ability of gingival crevicular fluid volume, E‐cadherin, and total antioxidant capacity levels for predicting outcomes of nonsurgical periodontal therapy for periodontitis patients
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Abstract<sec><title>Objectives

To determine the potential of gingival crevicular fluid (GCF) volume, E‐cadherin and total antioxidant capacity (TAC) levels to predict the outcomes of nonsurgical periodontal therapy (NSPT) for periodontitis patients.

Background

NSPT is the gold‐standard treatment for periodontal pockets < 6 mm in depth, however, successful outcomes are not always guaranteed due to several factors. Periodontitis‐associated tissue destruction is evidenced by the increased level of soluble E‐cadherin and reduced antioxidants in oral fluids which could be used as predictors for success/failure of N

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Publication Date
Sun Jul 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Indications and complications of peritoneal dialysis in children with acute renal failure, a single center experience
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Background: Peritoneal dialysis (PD) is the preferred and convenient treatment modality for acute renal failure (ARF) in children and hemodynamically unstable patients, because of its inherent advantages: technique can be initiated simply and quickly, no highly trained personnel nor expensive and complex apparatus are required and systemic anticoagulation is not needed.
Objectives: is to highlight the role of peritoneal dialysis in management of children with acute renal failure and to determined its complications.
Patients and methods: A retrospective study was carried out from 20th April 2012 till1st May 2014 ,on children with acute renal failure admitted to nephrology unit in Child Welfare Teaching Hospi

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