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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 Oct 28 2024
Journal Name
Anggaran : Jurnal Publikasi Ekonomi Dan Akuntansi
The Role Of Emotional Intelligence in The Board Of Directors and Its Impact On The Performance and Value Of Institutions and Conservative Practices In Light Of Crises (Applied Research On a Sample Of Banks Listed On ISX)
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This research aims to underscore the significance of women's emotional intelligence in enhancing the effectiveness of the Board of Directors, a crucial component of internal governance, particularly during crises. Despite strides made in recent decades in appointing women to senior roles in government, business, and education, challenges persist in improving women's leadership opportunities, especially in developing countries. The study utilizes statistical methods, including Pearson's correlation, to analyze the relationships between variables within a sample of banks listed on the Iraqi securities market, comparing periods before and during the COVID-19 pandemic (2019 and 2020). The goal is to measure the impact of female emotiona

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Publication Date
Sun Jan 01 2017
Journal Name
Al–bahith Al–a'alami
Advertises of Advertising Mail Post of Emirate of Dubai as a sample
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                The advertising mail is considered as one of potential tools that followed to transfer the printed messages to the consumers and public customers whom are located at homes or works. This type of advertising is preferable due to the zero expense to receive the announcements of products, which became recently one of the successful procedures to create new customers and keep them in touch with direct communication. It is also possible to send them to specific group of people who can be classified by the advertisers to select even by name their own clients to give the personality to the clients for a long term of communication.

&

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Publication Date
Sat Jan 01 2022
Journal Name
Ssrn Electronic Journal
The Prospective of Artificial Neural Network (ANN’s) Model Application to Ameliorate Management of Post Disaster Engineering Projects
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Currently and under the COVID-19 which is considered as a kind of disaster or even any other natural or manmade disasters, this study was confirmed to be important especially when the society is proceeding to recover and reduce the risks of as possible as injuries. These disasters are leading somehow to paralyze the activities of society as what happened in the period of COVID-19, therefore, more efforts were to be focused for the management of disasters in different ways to reduce their risks such as working from distance or planning solutions digitally and send them to the source of control and hence how most countries overcame this stage of disaster (COVID-19) and collapse. Artificial intelligence should be used when there is no practica

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of Global Pharma Technology
Auto-antibodies Profile in Children Infected with Visceral Leishmaniasis
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Visceral leishmaniasis (VL) is a parasitic infection caused by an intracellular growth of Leishmania spp. in macrophage cells. The autoimmune disorder is a condition takes place when the immune system produces antibodies which incorrectly attacked its own body tissues. VL has been involved as an effect or on the autoimmune aspect. This study was conducted to identify the auto antibodies profile in patients infected with VL. The presences of auto antibodies in 21 Iraqi children infected with VL were tested for laboratory autoimmune aspect. The highest percentage of seropositive in Leishmania patients was observed for anti-ds DNA, anti-Mi-2, anti-Ku and anti-PCNA antibodies (90.5%, 90.5%, 90.5% and 61.9%) respectively, while the lowest percen

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Scopus
Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Creative skills in solving environmental problems among kindergarten children
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Acquires this research importance of addressing the subject (environmental problems) with
age group task, a category that children pre-school, and also reflected the importance of
research, because the (environmental problems) constitute a major threat to the continuation
of human life, particularly the children, so the environment is Bmchkladtha within
kindergarten programs represent the basis of a hub of learning where the axis, where the
kindergarten took into account included in the programs in order to help the development of
environmental awareness among children and get them used to the sound practices and
behaviors since childhood .
The research also detected problem-solving skills creative with kids Riyad

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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
Addiction of electronic games for children
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Childhood is characterized by ahigh privacy in the life of the child overall educational institutions in the world. Based on this specificity, modern education begins with a holistic vision of the child through all developmental aspects (moral, religious, emotional, social, linguistic, physical, health, and mental). This integration could be achieved through taking into consideration the needs and rights of children and developing curricula that consider these needs and capacities to provide opportunities for developing and supporting the developmental aspects of the child. The contemporary technological developments in the field of computer and the Internet have brought with it new forms, ideas, and problems for children in recent years

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Publication Date
Thu Oct 31 2019
Journal Name
Al-kindy College Medical Journal
Behavior Management of Children with Autism
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Background: Pervasive Developmental Disorder (PDD) is a term refers to the overarching group of conditions to which autism spectrum disorder (ASD) belongs .

Objective: This study was designed to determine the existing behavior of children with autism in dental sitting, the behavior improvements in recall dental visits and evaluate the improvement in oral hygiene with using specific visual pedagogy chart.

Type of the study: Cross-sectional study.

Methods: Forty children of both genders, ages ranged from 4 – 6 years having primary teeth only were selected whose medical history included a diagnosis

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Publication Date
Mon Dec 19 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of NursesPractice Regarding Poisoning Children
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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Fine motor skills of kindergarten children
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The deprivation Some of the children to exercise some fine motor activities a big problem , as a consequence, this problem plays of the delay in motor development during early childhood , Usually it happens to be the reasons for the lack of the right place to play , and the lack of the presence of the tools needed to play motor, or fear excessive protection by parents for their children as a result of lack of awareness of the importance of physical activity for the child to use his fingertips and fine his muscles . In addition to that small percentage of children spend most of their time in the daily activities and skills of non-motor , Such aswatching television, or play video games or they tend to play computer and mobile but they are

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Publication Date
Tue Mar 07 2017
Journal Name
Journal Of Pharmacy And Pharmacology
Personalised dosing of medicines for children
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Abstract<sec><title>Objectives

Doses for most drugs are determined from population-level information, resulting in a standard ?one-size-fits-all’ dose range for all individuals. This review explores how doses can be personalised through the use of the individuals’ pharmacokinetic (PK)-pharmacodynamic (PD) profile, its particular application in children, and therapy areas where such approaches have made inroads.

Key findings

The Bayesian forecasting approach, based on population PK/PD models that account for variability in exposure and response, is a potent method for personalising drug therapy. Its potential utility is eve

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