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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 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
Thu Nov 22 2018
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
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

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Publication Date
Wed Jan 02 2008
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Investigation of Circulating anti- Coxsackie B, anti- Polio and anti- Adeno IgG in newly diagnosed T1DM Children
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Back ground: Viruses may be involved in the pathogenesis of Type 1 Diabetes Mellitus (T1DM), either through direct β-cell infection or as triggers of
autoimmunity.
Objective: To investigate the presence of specific anti- viral IgG antibodies for Coxsackie virus type B (CVB5), Poliovirus, and Adenovirus which proposed to be
involved in the etiology of T1DM.
Subjects & methods: A total of 60 Iraqi T1DM children were included in the presents study. They were new onset of the disease (diagnosis was from one week up
to five months). For the purpose of comparisons, 50 apparently healthy control subjects were selected. Serum IgG against Coxsackie virus type B5, Adenovirus type
3, 4, and 7, and Poliovac

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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
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
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
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Financial technology as one of the recovery strategies of the Iraqi banking sector in the post-Covid-19 stage: An exploratory study
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The research aims to employ one of the most important strategies for recovery from the crisis of the Covid-19 pandemic, which ravaged the economies of the entire world and its various sectors, including the banking sector, through financial technology that is based on digital transformation to achieve financial sustainability and the creation of innovative financial value chains in light of the decline in the banking sector as a result of The negative effects of the Covid-19 pandemic, be guided by the relevant international accounting standards to control the risks associated with financial technology. To recover from the Covid-19 crisis, the research came out with a set of recommendations, most notably financial technology from

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The Efficacy of Solifenacin Added to Α-Adrenergic Antagonists in the Treatment of Lower Urinary Tract Symptoms in Males with Benign Prostate Hyperplasia (The Iraqi Experience)
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symptoms/Benign prostate hyperplasia (LUTS/BPH) raises the possibility that a combination of α-adrenergic blocker therapy with anticholinergic therapy could both reduce the risk of retention or deteriorating bladder function and also add to the treatment of the remaining obstructive symptoms of LUTS/BPH.
Objective: Is to investigate the efficacy and tolerability of 5mg solifenacin in the treatment of lower urinary tract symptoms in patients with benign prostatic hyperplasia in combination with an alpha-blocker.
Patients and methods: This is a prospective study of 29 patients with benign prostatic hyperplasia already on alpha-blockers, given solifenacin 5mg once daily. International prostate symptom score (IPSS), patient micturitio

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Publication Date
Mon Sep 30 2024
Journal Name
Medical Journal Of Babylon
Effectiveness of Deep Breathing Technique on Pain Level of School Children during Catheterization
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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
The Role of Education in Enhancing the Value of Citizenship in Children through the Interactive Life Process in Educational Institutions
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The aim of the research is to diagnose the methods of enhancing the value of citizenship in children through the interactive life process in educational institutions; the descriptive approach was used to achieve the objective by identifying social theories that corresponded to the national value or the theoretical principles of citizenship education. The study focused on educational activities and their role in establishing values, national educational philosophy in interactive activities, as well as the presentation of previous studies on the subject of citizenship, and maps of each of the strategies of active learning, skills in the process of interactive life in the field of education, Institutions that have the responsibility to prom

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