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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 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
Thu Dec 31 2020
Journal Name
College Of Islamic Sciences
: Islamic law; perfection The rule of perfection in Islamic law and its impact on the creative construction of the individual and society: The rule of perfection in Islamic law and its impact on the creative construction of the individual and society
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This research explains to us the role of the Islamic religion in the issue of accuracy in speech and work, and how it is closely related to human production in his life, and Islam affirms that his idea is mainly reflected in his production, and how it affects the perception of the meaning of creativity. Therefore, our Islam affirmed the accuracy in every word or work we do to build a society in which people enjoy high quality in ethics and dedication in their work so that the Islamic system depends on humanity to preserve our rights on the other hand the research discusses the deliberate default and how it reflects on our production and how it makes it less good.

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Publication Date
Sat Jan 27 2024
Journal Name
Caspian Journal Of Environmental Sciences,
Morphological study on the form and number of eyes in scorpions and spiders
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Scorpions and spiders belong to the class Arachnida in phylum Arthropoda. Scorpions are easily distinguished by median eyes on obvious the center of the carapace and have one pair, and lateral eyes have 2-8 in some species. Scorpions do not have good eyesight so the median eyes have always been simple and they are more sensitive than the lateral pairs. They have anterior median eyes (AME) with narrow field of view and pairs of lateral eyes (LE) with more sensitivity and response to light. Family Buthidae have 2-6 lateral eyes in Compsobuthus Mesobuthus, Hottentotta, while Vaejovidae, Chactidae and Chaerilidae have 2 pairs of lateral eyes. In addition, 3 pairs are found in Orthochirus and Androctonus. Spiders have six eyes in family Pholicid

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Publication Date
Mon Jan 01 2018
Journal Name
Al–bahith Al–a'alami
News website Analytical: study of news sites (Iraqi Media network, The Seventh Day,Huffington Post Arabic
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This research focuses on the services provided by news websites (IMN, Youm7, Huffington Post Arabic) to its audience of Internet users, as well as materials posted through its pages, trying to monitor and explain them to identify their types & features, and it›s functions, whether informational or non-informational, to know the technical potential of each of the news sites, with the entry of the latest technology information. The research used the analysis method to achieve the research objectives within the period from 1/1 to 31/1/2017. The researchers used the content analysis tool as a research tool to analyze the news sites and to know the services they provide through their pages. The research was divided into three parts, the

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Publication Date
Fri Oct 01 2021
Journal Name
Journal Of Al-rafidain University College For Sciences ( Print Issn: 1681-6870 ,online Issn: 2790-2293 )
Nutritional Status of Children below Five Years in Iraq for 2018
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In this article we analysis the data of Iraqi children aged 0-9 months covered in Multiple Indicator Cluster Survey (MICS6-2018) to evaluate the nutritional status . Weight for-age z-score (WAZ), height-for-age z-score (HAZ) and BMI-for-age z-score were compared with the z-scores WHO standards. The overall prevalence of underweight and stunting of the children were 4 % and 11% respectively. Prevalence of overweight based on BMI-for-age for the sexes combined was 21%. Comparing the results obtained from MICS-6 with the results obtained from MICS-4, we find that there is an improvement in the nutritional status of Iraqi children concerning weight, but as for height, we find that there is an increase in the percentage of children who suffer fr

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of Educational And Psychological Researches
Installing Quality of Gratitude in Children from an Islamic Educational Perspective
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The study aimed to identify how to raise grateful children from an Islamic educational perspective. For that objective to be achieved, the researcher used both of deductive and descriptive approaches using the method of documentary research. The study's results show that children are the real wealth of the community and the foundation of cultural building; therefore, paying attention their raising is a responsibility that must be shared by everyone; gratitude is part parcel of the Islamic doctrine, which is one of the greatest virtues; the virtue of gratitude is the attitude of the believers which in turn strengthens the bonds and expands the network of positive social relationships; It is also considered a cultural significance

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Publication Date
Wed Sep 30 2020
Journal Name
Indian Journal Of Forensic Medicine And Toxicology. Vol 14 (2
Psychosocial Consequences of Children with Idiopathic Growth Hormone Deficiency in Baghdad
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Scopus
Publication Date
Sun Dec 05 2010
Journal Name
Baghdad Science Journal
Study of Humoral Immune Response In Children Infected With Visceral Leishmaniasis
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40 blood sample were taken from children infected with kala-azar at age less than ten years, who were admitted to El-Eskan child hospital, and central health laboratory in Baghdad. At the same time 15 sample collected from healthy child for comparing. During research estimated immunoglobulins level ( IgG, IgM, IgA) and (IFAT) IFAT test recorded a higher indicate antibodies level witch was synergistic with infected severity, the stander level of antibodies arrange between 1/16, 1/32 and 1/64 that means it graduate from the lowest one 1/16 into the highest one 1/64 within groups. During infectious the IgG ,IgM level recorded the higher level (2012.9 mg/dl) and (154.3 mg/dl) compared to the control group (874.3 mg/dl),

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Publication Date
Mon Mar 15 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Feeding Behaviors of Children with Autism Spectrum Disorder in Baghdad City
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Objective(s): To assess the behavior that impedes the eating of children with autism spectrum disorders in Baghdad city, and find out the relationships between the behaviors that impede eating of autistic children and their demographic characteristics.
Methodology: The study started from the period of 16th September 2019 to the 16th of March 2020. A non-probability (purposive) sample of 80 children with autism spectrum disorders was selected. The questionnaire was designed and composed of two parts: the first part includes the autistic children demographic data, the second part includes scales of behavior that impede eating followed by parents towards autistic child. The reliability of the questionnaire was determined through a pilot

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Publication Date
Sun Mar 04 2012
Journal Name
Baghdad Science Journal
Evaluation of cellular immune response in Golden Hamsters experimentally infected with Leishmania donovani comparing with cellular immune response against chicken Red Blood Cells.
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The Evaluation of the immune response in Golden Hamsters experimentally infected with Leishmania donovani was determined in this study, particularly, the cellular immune response. Follow up has maintained to determine the Delayed Type of Hypersensitivity using skin test both in infected and control lab animals. Chicken red blood cells were used as a parameter to evaluate the immune system; they are dull and have the ability of immunization. Two concentrations of chicken R.B.C were examined to determine which gives the higher titration in Hamsters and those were 1.5 X 109 cell/ml and 3 X 109 cell/ml , the second concentration gave the maximum titration where then used in this work. After sensitization with Chicken R.B.C for both infected a

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