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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
Fri Apr 15 2022
Journal Name
Alustath Journal For Human And Social Sciences
The Intersectionality in I’ve Been Meaning To Tell You: A Letter to My Daughter: A Post-Colonial Perspective
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Intersectionality is a concept that focuses on social inequality towards black people and provides an analytical instruments for creating social justice issues in such a way in order to depict how social marginalization, or privilege occurs differently in various social positions. It does this by focusing on the interaction of multiple systems of oppression. Intersectionality is used to examines how the social factors; race, gender, and class can affect the people’s life especially the immigrants, black people, and refuges. This article will depicts how blacks in Canada are segregated and distinguished from white race. David Chariandy’s I’ve Been Meaning To Tell You: A Letter to My Daughter 2018 is analyzed through Kimberle Crenshaw

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Publication Date
Fri Jun 30 2023
Journal Name
Journal Of The College Of Education For Women
Knowledge purification of Kindergarten Children
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The research is concerned with the problems of knowledge purification of kindergarten children by verifying its aims, identifying of knowledge purification among the first level of kindergarten children and the second level of kindergarten children, and the differences between the males and females in the variable of knowledge purification. The research community included the children in the state and private kindergartens in Baghdad governorate, on its two sides, Karkh and Rusafa, for the six districts for the academic year 2022-2023. After making the knowledge purification test according to the scientific steps of test constructions, the test has been presented to a group of experts specialized in the field of kindergarten to ascertain

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Educational And Psychological Researches
Psychological and Health Risks of Children Toy-Related Injuries: Pellet-Gun as a Model
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The research aims to identify the psychological and health risks that a child might be exposed to by playing with hazardous toys such as pellet guns. To this end, the researcher has visited Ibn Al-Haytham Eye Hospital in Baghdad, the emergency department to figure out the rate of injuries in Children for the consecutive years (2017-2018) and the first Month of (2019). The psychological risks as a result of disability are represented by the inability to accommodate the surrounding environment well. Additionally, the child experiences a kind of tension, conflict, and going in psychological crises through introversion, isolation, withdrawal tendencies, and poor conformity with himself and the Society.

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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Rational Emotional Behavioral Program in Developing Self-Efficacy to Reduce the Burnout among Teachers of Students with Autism Disorder
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The aim of this study is to identify the effectiveness of a rational, emotional, behavioral program in developing self-efficacy to reduce the level of Burnout in 20 teachers of students with autism disorder in Jazan, Saudi Arabia. The proposed program included 12 training sessions. The researcher found that the proposed program has contributed significantly to the development of self-efficacy and reduce the level of Burnout for the targeted subject in this study.

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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of Educational And Psychological Researches
Parents Role in Social Personality Formation for Children
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Experts of Psychology and education emphasized that childhood is one of the most important stages in the formation of human personality, and the most influential in his public life, especially the stage in which he lives within his family, which must provide him with the requirements of healthy growth of physical, emotional, moral and social. Emotional-social connection of the child to his family, is especially important in determining the characteristics of his social character, in accordance with the norms and values ​​prevailing in society. This requires the child to be cared for and cared for, and to deal with him in a healthy social manner. So as to achieve positive growth and harmony in the process of social control in internal

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Anger in Kindergarten Children as Seen by Teachers
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Anger is one of the problems of scientific importance that psychologists and education scientists are interested in, especially societies and educational environments, because if a child’s anger continues to develop into violence, then it becomes an unusual behavior, and an indication of the child's lack of adaptation to his family and his environment (Moses, 2013: 4)                                                               &n

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Risk Factors for Recurrent Febrile Convulsions in Children
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Background: Febrile convulsions are the most frequent type of seizures in children under 6 years of age. Significant percentage of these children will later suffer from recurrence of febrile convulsion.Objectives: To identify the main risk factors for recurrent febrile convulsions in children.Methods: we carried out a case control study involving 89 children those who experienced first attack of febrile convulsions and 92 children with recurrent attack of febrile convulsions. The study was conducted in Central Children Teaching Hospital, Baghdad during the period 2006- 2007. Results: Compared to children with first attack of febrile convulsion, children with recurrent seizures were younger at onset (4- 12m) (67% vs. 44%), mainly male (70

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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
Behavioral Disturbances among School Children in Baghdad Province
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Background: Mental health of children has recently been
receiving increased attention in many parts of the world.
However, such attention has been lacking in developing
countries, particularly in the form of systematic research
Aim: The study aimed to find out the frequency of
behavior disorders in a sample of primary school children
and the different social and demographic factors that might
be related to this disorder.
Methods: The study is a cross-sectional one that included
918 primary school pupils in both urban and rural areas of
Baghdad. Rutter's questionnaire teacher's version was used
to assess the pupils, and the demographic data was obtained
by special questionnaire sent to the parents to be

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Publication Date
Mon Feb 08 2021
Journal Name
Public Works Management & Policy
Causes of Problems in Post-Disaster Emergency Re-Construction Projects—Iraq as a Case Study
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This study examines the causes of time delays and cost overruns in a selection of thirty post-disaster reconstruction projects in Iraq. Although delay factors have been studied in many countries and contexts, little data exists from countries under the conditions characterizing Iraq during the last 10-15 years. A case study approach was used, with thirty construction projects of different types and sizes selected from the Baghdad region. Project data was gathered from a survey which was used to build statistical relationships between time and cost delay ratios and delay factors in post disaster projects. The most important delay factors identified were contractor failure, redesigning of designs/plans and change orders, security is

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Publication Date
Thu Jul 01 2021
Journal Name
Mustansiriya Medical Journal
Evaluation of some biomarkers in diagnosis of bacterial bloodstream infection in children
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Background Bloodstream infection (BSI) is a life-threatening condition caused by the presence of microorganisms, generally caused by a range of bacteria in the blood. Objectives The aim of this study was to evaluate the possible role of procalcitonin (PCT) and C-reactive protein (CRP) as biomarkers of pediatric BSI. Methodology The study was conducted on 150 blood samples collected from the patient who admitted to Children Welfare Teaching Hospital, Medical City, Baghdad. During the period from November 2020 to March 2021, ninety blood samples from them were positive culture and 60 blood samples were negative culture (control group). The isolates were identified depending on the morphological, microscopic examination, and biochemical tests.

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