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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
Social Medical Care for the Deformed Children: A Field Study in Baghdad City
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The Child is the first sedum for the human society performing, and we deal in our
research to explain the nature of the mutual relations in between the form and the medicine
social caring foundation. So the motherhood and the childhood nowadays become the most
dedicated in the researchers works, whom interesting in the social affairs, and that whom
work in the medicine field as scientists.
So the child is the future man and must be in wright body construction that need to great
care and interest to make him wright mind through capability of performing anything support
to him.
In our research we deal with the main factors in which lead to infect the child by the
creative malfunction, like the environmental and m

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Publication Date
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
Impact of short term intervention on mother knowledge, attitude and practice to improve oral hygiene of their children aged(4-7) Years Old in Al-Shaab Area - Baghdad City
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Background: Mothers are considered as the key role in effect on child's dental behavior. So it is important to involve her in oral health promotion program to prevent early childhood dental caries from occurring in early age. Objectives: To identify the knowledge, practice and attitude of mothers about the oral health of their children. And to measure the change in oral hygiene of children aged (4-7) years old after one month of interventional program on their mothers. Type of study: Non-randomized interventional.Methods: Non-randomized interventional study for one month in Al Shaab area in Baghdad to 65 mothers who have children aged (4-7) years .A modified administrated questionnaire is given to assess mothers’ knowledge, practice an

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
The shapes of adjacent structures for informing the stage show for children
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This research talked about the importance of adjacent structures for informing the stage show for children. The researcher began from the importance of adjacent structures for informing the show to introduce the various and different proofs, on the level of creativity and artistic shape of the accomplishment over it’s shifts that contribute to formation the show and it's intellectual, artistic, technical and cognitive Marks that contribute in dynamism the interactive show and contact the idea that connect with the design and directional vision for the beauty and cognitive. Lead to the eager operation in attention, sensitive and attractive the child. The research consist of four chapters: The first chapter include methodological framewo

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Publication Date
Sun Oct 07 2018
Journal Name
Al-kindy College Medical Journal
Risedronate as a therapeutic trial post-hysterectomy in premenopausal women to prevent osteoporosis
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Background: Osteoporosis is a skeletal defect manifested by a reduction of bone strength as a result of reduced bone mass to the extent that there is a higher risk of fracture even on minor trauma. Hysterectomy in a premenopausal woman is a well known cause of ovarian failure resulting in an increased risk of osteoporosis.

Objective : To clarify bisphosphonate's preventive effect on osteopenia and osteoporosis in premenopausal women after hysterectomy.

Type of the study: Cross –sectional study.

Method:  84 premenopausal females post hysterectomy aged between 40 – 50 years, were enrolled in this randomized controlled double blinded trail a

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Publication Date
Thu Oct 12 2017
Journal Name
Iraqi Journal Of Laser
A Comparative Evaluation of Post-Operative Pain and Function after Gingival Depigmentation Using 940 Nm Diode Laser And Conventional Bur Method: 6 Months Study
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The aim of the study was to evaluate the efficacy of diode laser (λ=940 nm) in the management of gingival hyperpigmentation compared to the conventional bur method. Materials and methods: Eighteen patients with gingival hyperpigmentation were selected for the study with an age between 12-37 years old. The site of treatment was the upper gingiva using diode laser for the right half and the conventional method for the left half. All patients were re-evaluated after the following intervals: 3 days, 7 days, 1 month and 6 months post-operation. Pain and functions were re-evaluated in each visit for a period of 1 day, 3 days and 1 week post-operation. Laser parameters included 1.5 W in continuous mode with an initiated tip (400 μm) placed in

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Publication Date
Thu Jul 01 2021
Journal Name
Mustansiriya Medical Journal
Evaluation of some biomarkers in diagnosis of bacterial bloodstream infection in children
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Background Bloodstream infection (BSI) is a life-threatening condition caused by the presence of microorganisms, generally caused by a range of bacteria in the blood. Objectives The aim of this study was to evaluate the possible role of procalcitonin (PCT) and C-reactive protein (CRP) as biomarkers of pediatric BSI. Methodology The study was conducted on 150 blood samples collected from the patient who admitted to Children Welfare Teaching Hospital, Medical City, Baghdad. During the period from November 2020 to March 2021, ninety blood samples from them were positive culture and 60 blood samples were negative culture (control group). The isolates were identified depending on the morphological, microscopic examination, and biochemical tests.

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Publication Date
Mon Oct 01 2007
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Malnutrition among first year school children in Iraq
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Background: Iraqi people have endured an excess burden of morbidity’ and mortality during the last two decades due to wars and sanctions. This report M’as carried out to assess the nutritional status of first year primary school children.
Methods: A total of3881 school children in Balad district in Salahadin govemorate was included in the study. Age, height and weight were recorded. Malnutrition was regarded as value of less than 2 SD of the reference value.
Results: Among the total sample, 16.5%, 20.06% and 15.3% were underweight, stunted and wasted, respectively. No significant difference was detected in malnutrition rates between both sexes. Conclusion: High rates of malnutrition were detected among school children.

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Anger in Kindergarten Children as Seen by Teachers
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Anger is one of the problems of scientific importance that psychologists and education scientists are interested in, especially societies and educational environments, because if a child’s anger continues to develop into violence, then it becomes an unusual behavior, and an indication of the child's lack of adaptation to his family and his environment (Moses, 2013: 4)                                                               &n

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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of Educational And Psychological Researches
Parents Role in Social Personality Formation for Children
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Experts of Psychology and education emphasized that childhood is one of the most important stages in the formation of human personality, and the most influential in his public life, especially the stage in which he lives within his family, which must provide him with the requirements of healthy growth of physical, emotional, moral and social. Emotional-social connection of the child to his family, is especially important in determining the characteristics of his social character, in accordance with the norms and values ​​prevailing in society. This requires the child to be cared for and cared for, and to deal with him in a healthy social manner. So as to achieve positive growth and harmony in the process of social control in internal

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Risk Factors for Recurrent Febrile Convulsions in Children
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Background: Febrile convulsions are the most frequent type of seizures in children under 6 years of age. Significant percentage of these children will later suffer from recurrence of febrile convulsion.Objectives: To identify the main risk factors for recurrent febrile convulsions in children.Methods: we carried out a case control study involving 89 children those who experienced first attack of febrile convulsions and 92 children with recurrent attack of febrile convulsions. The study was conducted in Central Children Teaching Hospital, Baghdad during the period 2006- 2007. Results: Compared to children with first attack of febrile convulsion, children with recurrent seizures were younger at onset (4- 12m) (67% vs. 44%), mainly male (70

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