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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
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
Wed Jul 05 2017
Journal Name
International Journal Of Science And Research (ijsr)
Pacifier Sucking Habit and its Relation to Dental Caries and Type of Feeding Habits among Group of Children (Comparative Study)
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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
Forms of post-modernism in performance of Iraqi theatre "dream of Baghdad exam": عمار عبد سلمان محمد
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  The effects of postmodernism on theatrical form was managed by the director (Anas Abdul Samad) to be employed in the Iraqi play (Dream in Baghdad) and the researcher sought to study this problem and divided it into four chapters dealt with in the first chapter the problem of research and its need, the importance of research, As well as the definition of terminology, either Chapter II theoretical framework divided by the researcher to the first two is the postmodernism in the theater is the most prominent reference references and the second most important postmodern applications in the world play and then the researcher concluded the second chapter of the most important indicators. In the third chapter, the researcher identified th

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Publication Date
Fri Dec 15 2023
Journal Name
Bionatura Journal. Ibero-american Journal Of Biotechnology And Life Sciences
Efficacy of the entomopathogenic fungus, Metarhizium anisoplae, against Khapra beetle Trogoderma granarium (Coleoptera: Dermestidae) under laboratory conditions
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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
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
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
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
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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