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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
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Anemia among Lactating Mothers and their Children Under Two Years of Age
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Objective: The aim of this study is to evaluate anemia among lactating women and their children less than 2 years of
age.
Methodology: The study was done on (148) lactating mothers and their children under 2 years of age in the primary
health care center at AL-Salam Quarter/Baghdad from l/10/2009 to 15/10/2010.
Result: This study recommends that there is a significant relationship between anemic mothers and their children. The
study also revealed that there is (77.8%) from nursing mothers in the age groups (25-29) who suffered from anemia,
while (23.1%) for the age group (20-24) did not have anemia
Recommendation: We encourage the use of breast milk or iron-fortified infant formula only for any milk-based part
of

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Publication Date
Sun Oct 27 2019
Journal Name
Iraqi Journal Of Science
Pre and Post-Stack Imaging of 2D Seismic Data Using Time Migration for Ajeel Oil field, Central of Iraq
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Kirchhoff Time migration was applied in Pre and Post-Stack for 2D seismic survey for line AJ-99N, that is located in Ajeel oilfield in Salah Al-Din Governorate, Central Iraq. The process follows several accurate steps to reach the final time migration stage. The results of applied time migration give an accurate image for the Ajeel anticline reservoir and to improve the signal to noise ratio. Pre-Stack shows a clearer image for the structure in the study area, and the time-frequency analysis insure the result.

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Publication Date
Tue Sep 01 2020
Journal Name
Key Engineering Materials
Push-Out Test of Steel-Concrete-Steel Composite Section for Pre-Installation and Post-Installation Techniques of Shear Connectors
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Composite steel-concrete sections have a broad benefit through increasing structural strength as well as minimizing the self-loads. All past researches were concerned with pre-installed shear connectors (PRSC) in the manufacturing of composite sections. A new fabrication technique for steel-concrete-steel composite sections were presented in the current study by the post-installation shear connectors (POSC) passed-through an embedded polymerizing vinyl chloride (PVC) pipes. The performance of normal strength concrete prisms with a specified strength of 32 MPa connected to square steel tubes (SST) was investigated. Six specimens were fabricated in both methodologies, PRSC and POSC were experimentally tested by Push-out test. The spac

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Publication Date
Wed Jan 01 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Congenitally missing and supernumerary teeth among a group of 3-12 years old children with cleft lip and/ or palate in Iraq
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Background: There are many congenital anomalies associated with cleft lip and/or palate. This research is to study the prevalence of congenitally missing teeth and supernumerary teeth in this population group. Materials and Method: One hundred eight cleft lip and/or palate Iraqi patients had participated in this study (57 male, 51 female), 3-12 years of age. 26 of them had orthopantomogram were within (6-12) years of age were inspected for congenitally missing teeth and supernumerary teeth. Patients whom age range 3-5 years were checked for the congenitally missing teeth by clinical examination with strongly insisting the teeth were not missed due to caries or trauma. Results: There were 19(73.076%) patients with 41 congenitally missing tee

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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
Sun Sep 03 2023
Journal Name
Al-mansour Journal
Biometrics Systems Challenges in a Post-COVID-19 Pandemic World: A review
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One of the most serious health disasters in recent memory is the COVID-19 epidemic. Several restriction rules have been forced to reduce the virus spreading. Masks that are properly fitted can help prevent the virus from spreading from the person wearing the mask to others. Masks alone will not protect against COVID-19; they must be used in conjunction with physical separation and avoidance of direct contact. The fast spread of this disease, as well as the growing usage of prevention methods, underscore the critical need for a shift in biometrics-based authentication schemes. Biometrics systems are affected differently depending on whether are used as one of the preventive techniques based on COVID-19 pandemic rules. This study provides an

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Publication Date
Thu Jun 15 2023
Journal Name
Journal Of Population Therapeutics And Clinical Pharmacology
Detection the Phylogenetic groups of E. coli that isolated from diarrheal in children under five years and study their relationship of common serotypes in Baghdad hospitals.
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Publication Date
Wed Apr 01 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Incidence of Haemophilus influenzae type b among children less than 5 years and resistance to antibiotics in Iraq.
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Back ground: Meningitis is an inflammation of the protective membranes covering the brain and spinal cord that known as meninges. It is the major cause of morbidity and mortality among infants and children less than the age of 5 years.
Objectives: To determine Haemophilus influenzae type b meningitis incidence in children aged less than 5 years and choice a drug for treatment
Patients and methods: During period from Febraury 2012 to first March 2013 ,250 Cerebrospinal fluid (CSF) specimens were collected from children less than 5 years ,which clinically diagnosed with meningitis ,in several hospitals of Iraq.Microbiological, biochemical, latex agglutination test and antibiotics sensitivity were used to identify and choice the antib

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Publication Date
Fri Sep 30 2022
Journal Name
Iraqi Journal Of Science
Isolation and Identification of Novel Streptococcus pluranimalium Isolated from Children with Upper Respiratory Infections in Mosul Hospitals, Iraq
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    Streptococcus pluranimalium was first isolated in 1999. Recently, several case reports have been published that have revealed that S. pluranimalium can infect humans as well. The pathogenicity and pathophysiology of this pathogen is poorly studied and its characteristics are not well known. In this study, S. pluranimalium was first isolated and then identified from infants and children who suffered from upper respiratory infections. 90 samples were collected from nasopharyngeal cavity. Among them, 83 Streptococcus spp. isolates were identified. 3 out of which were biochemically and molecularly identified as S. pluranimalium. 16S rRNA sequencing based identification revealed that all iso

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