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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 Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Mothers Knowledge and Practices with Hemophilic Children type A at Azadi Teaching Hospital in Kirkuk City
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Objective: The study aims to assess the knowledge and practices of mothers with hemophilia children type - A - ,
socio-economic status and association between mother demographic information with their knowledge and practices
toward their children in Azadi Teaching Hospital in Kirkuk.
Methodology: Descriptive study no probability (purposive) sample. Selected Fifty-five of mothers having hemophilia
children, started from November 2012 to May 2013. Study was carried out in the Azadi teaching hospital in
Kirkuk. By using questionnaire which consists from five parts include demographic characteristics for mother and
children, socio-economic, Knowledge and practices data gathered, by direct interview with the mothers in the

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Publication Date
Sun Apr 01 2007
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Relation between Behavioral Factors, Malnutrition and Persistent Diarrhea in Children Under Two Years of Age. A Hospital Study
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Background A high prevalence of Behaviors which is related to persistent diarrhea and the prevalence of moderate to sever malnutrition in patients with persistent diarrhea in children.
Objectives To asses the prevalence of negative behaviors that causes the persistent diarrhea and to asses the prevalence of malnutrition among children with persistent diarrhea and to
compare prevalence of malnutrition due to persistent diarrhea to that of national figures.
Patients and Methods This study was carried out at the Central Teaching Hospital for Children in Baghdad, a total number of 200 cases of persistent diarrhea (lasting more than 14
days)"with no more than 48 hour normal bowel motions in this period" in children

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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
Tue Jan 02 2024
Journal Name
Turkish Archives Of Pediatrics
Evaluation of Decayed, Missing Due to Caries, and Filled Teeth Index in Children with Phenylketonuria in Comparison to Normal Population
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Publication Date
Sun Apr 01 2012
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Bacterial Isolates in Blood Culture of Children with Septicemia.
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Background: Septicemia is a common condition in children with a resultant high morbidity and mortality. It’s defined as the presence of bacteria in the blood and is often associated with severe infections, the alternative names (Blood poisoning, Bacteremia with sepsis, systemic inflammatory response syndrome).
Objective: To study the etiological agents and antibiotics susceptibility of septicemia in children admitted to Central Teaching Hospitals of Pediatric.
Patients and Methods: A total of 80 patients having signs and symptoms of Septicemia who were admitted to Central Teaching Hospital of Pediatric in Baghdad city. Samples were obtained during the period from the 1st January till the 30 th of Feb

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Publication Date
Sun Apr 01 2007
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Relieving Symptoms of Chronic Sinusitis in Children By Adenoidectomy
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Background: To determine the efficacy of adenoidectomy in relieving symptoms of chronic sinusitis in children.
Patients and methods :A prospective study carried out on 35 patients who underwent adenoidectomy or Adeno-tonsillectomy between May 2004 and October 2005.The patient ages ranged from 3 to 12 years. Five patients were unavailable for follow-up and did not complete the study so they are excluded from. The pre-operative symptoms were Rhinorrohea, Nasal congestion, Headache, Postnasal drainage, Cough, Halitosis and Irritability.
Also recorded was Mouth breathing, Fever and Frequent antibiotic use. Telephone interviews with the patient's caregivers were conducted to collect information followi

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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
Wed Jan 01 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of post-pressing times on adaptation of maxillary heat cured acrylic denture base at posterior palatal seal area
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Background: The purpose of this study was to verify the influence of post- pressing time of acrylic resin (immediate, 6, 12 and 24 hour) on the dimensional accuracy of denture base whish is a critical factor in the retention and stability of the complete denture that may occur during polymerization shrinkage. Materials and Methods: Forty maxillary stone casts were poured in plastic mold (Columbia Dentoform corp. NEW YORK, type III dental stone (Geastone, Zeus Sri Loc.Tamburine Roccastrada, GR, Italy). The stone casts were randomly assigned into 4 groups of 10 specimens each according to the post-pressing times into (immediate, 6, 12 and 24 h.). Heat cure acrylic resin denture base was constructed according to the previously mentioned pressi

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Publication Date
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluations of Intervention Program on Nurses` Practices about Care of Children with Diabetic Ketoacidosis
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Objective(s): To assess the adequacy of mediation program on medical attendants practice toward care of kids with diabetic's ketoacidosis. Methodology: A quasi-experimental design that applied at teaching hospitals for pediatric in AL Ramadi city to establish the Effectiveness of Intervention Program on Nurses` Practices about Care of Children with Diabetic Ketoacidosis from 3th of March 2022 till 20 of March 2023. Non-probability (purposive) sample of (50), likewise was alienated into the study (experimental) group. The study group included (50) nurses non-randomly selected from AL-Ramadi Teaching Hospital.

A preliminary study has conducted in AL-Ramadi Teaching Hospital The whole number of nurse

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Publication Date
Mon Jan 30 2023
Journal Name
Iraqi Journal Of Science
The Influence of Entamoeba histolytica Against Some Gut Microbiota in Children with Acute Amoebic
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       This study aimed to evaluate the relationship between the microbiota number of some common bacterial species in children's gut with Entamoeba histolytica infection. To achieve that,49 samples of stool were collected, 29 from children with acute amebiasis and 20 from healthy children, children's ages ranging from 1 month to 12 years from both genders. Counting three types of bacteria Lactobacillus spp., Bifidobacterium spp. and Escherichia coli, using the standard curve obtained from Real-Time PCR was accomplished. The standard curve was made from decimal serial dilution of samples containing an unknown number of bacteria. The results showed that E. histolytica infection creates co

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