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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
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Movement Skills in Diabetic children Kindergarten Department
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The current research aims at studying the precise and big movement skills and the ability
of the diabetic child to do them, The research sample consisted of ten diabetic children who
go to the Diabetes Center of Research that is apart of the Yarmook hospital. The sample was
chosen according to the intentional method and it wasn’t possible to have bigger sample
because the parents of the children didn’t agree for fear on the children’s health. It was
apparent through the research that the diabetic child performs the big movement skills better
than his ability to do the precise movement skills because they require accuracy,
concentration and high attention.
The most prominent recommendations and suggestions.

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Publication Date
Mon Mar 01 2021
Journal Name
Al-khwarizmi Engineering Journal
Hurst Exponent and Tsallis Entropy Markers for Epileptic Detection from Children
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The aim of the present study was to distinguish between healthy children and those with epilepsy by electroencephalography (EEG). Two biomarkers including Hurst exponents (H) and Tsallis entropy (TE) were used to investigate the background activity of EEG of 10 healthy children and 10 with epilepsy. EEG artifacts were removed using Savitzky-Golay (SG) filter. As it hypothesize, there was a significant changes in irregularity and complexity in epileptic EEG in comparison with healthy control subjects using t-test (p< 0.05). The increasing in complexity changes were observed in H and TE results of epileptic subjects make them suggested EEG biomarker associated with epilepsy and a reliable tool for detection and identification of this di

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
Leadership qualities among kindergarten children and its relationship to some variables
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There is no doubt that leadership is a social phenomenon , and human activity does not take place , but remained in the family cohesive have a common goal Alaho instil confidence in the same of her sons to be better , and the importance of this subject Arta researchers to identify the extent to which children in this phenomenon and to identify the causes and extent of its spread in the community , has been directing an open question (Appendix 1) to a group of kindergarten teachers , to learn about the characteristics of leadership that can be enjoyed by kindergarten children . The current research aims to:
1. Detect levels of leadership qualities among kindergarten children in the light of the characteristics of leadership skills
2

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Publication Date
Fri Nov 01 2013
Journal Name
Iraqi Postgraduate Medical Journal
Post Hair Epilation Acneiform Eruption Among Females
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KE Sharquie, HR Al-Hamami, IK Sharquie, AA Noaimi, HM Al-Karawy, Iraqi Postgraduate Medical Journal, 2013

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Publication Date
Wed May 18 2016
Journal Name
Al-academy
The Role of T.V. Shaws in Transmitting Violence in Children: An Analytic Study for T.V. Chanels for Children During 1/3/2014 – 1/9/2014: يوسف محمد حسين
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Our study comes up to clarify the role of television in spreading the culture of violence with a child. This study represents one of the important studies that have tried to highlight the impact of these programmes, particularly cartoons, on the child's behaviors, actions and acquired habits.Violence considers a common phenomenon among the people, as the role of the media, particularly TV has a vital role due to its properties, characteristics and its significant impact on different segments and groups in society and in children particularly through exposure to programmes of films.The results of the study have been affected by the rising proportion of females to males, and that the contribution of real life has a big role in the child ac

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Publication Date
Mon Mar 07 2022
Journal Name
International Journal Of Environmental Research And Public Health
Efficacy of MMP-8 Level in Gingival Crevicular Fluid to Predict the Outcome of Nonsurgical Periodontal Treatment: A Systematic Review
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Purpose: To explore whether baseline matrix metalloproteinase (MMP)-8 level in gingival crevicular fluid (GCF) (exposure) can predict the outcome (reduction in probing pocket depth (PPD) (outcome)) of nonsurgical periodontal therapy (NSPT) (manual or ultrasonic or both) in patients with periodontitis (population/problem) after 3 months. Methods: Six databases (PubMed, Cochrane library, ProQuest, Ovid, Scopus, EBSCO) were searched for relevant articles published until 30 July 2021. Retrieved articles were passed through a three-phase filtration process on the basis of the eligibility criteria. The primary outcome was the change in PPD after 3 months. Quality of the selected articles was assessed using Cochrane Risk of Bias tool (RoB2

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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Training Program to Improve some Aspects of Sensory Integration Disorder and Its Effect on Self-Direction Among a Sample of Children with Intellectual Disabilities
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The present research was conducted to investigate the effectiveness of a training program to improve some aspects of sensory integration disorder and its effect on self-direction among a sample of children with intellectual disabilities. The study sample consists of (10 subjects as an experimental group) were exposed to the training program، and the control group consists of (10 subjects as a control group) were not exposed to the training program. The study included the following tools: A scale of self-direction for intellectual disability (prepared by the researcher). Training program (prepared by the researcher). The Results of the study showed the following: There are no statistically significant differences between the means ranks

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Publication Date
Thu Sep 09 2021
Journal Name
International Journal Of Research In Pharmaceutical Sciences
Seroprevalence of celiac disease among children in Baghdad, Iraq
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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Using Cluster Analysis In Determining The Variables Affecting The Evaluation The Growth Of Children At Different Levels
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In light of the increasing interest in Child-rearing in nurseries and kindergartens and the most important experiences gained by the child at this stage that form the basis for the subsequent stages of her/his physical mental and social growth.

The significance of the research concentrates the need to asses the affecting variables on the child growth to create opportunities for her/him to have intact rearing.

The research also aims to classify these variables at each age level and highlight its moral role.

The problem of the research is the lack of clarity of different variables impact of the child growth in different age levels in nurseries and kindergart

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Publication Date
Sat May 17 2014
Journal Name
Immunologic Research
Applying biodegradable particles to enhance cancer vaccine efficacy
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