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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 Sep 27 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Health Education Program on Health Care Providers’ Knowledge toward Immunization of Children at Primary Health Care Centers in Kirkuk City
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Objectives: The study aims to evaluate effectiveness of health education program on health care providers’ knowledge toward immunization of children at primary health care centers in Kirkuk city.

 

Methodology: A quasi –experimental study design two- group (pre-test, post-test 1 and post-test 2) conducted at primary health care centers in Kirkuk city during the period from 28 October 2019 to 10 August 2020. By collecting (50) samples divided into two groups, each one (25) participant as control & study group. The study group exposed to the education program only.

 

Results: Results showed a clear positive

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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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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 in

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Publication Date
Sat Dec 02 2023
Journal Name
International Journal Of Applied Engineering & Technology
ASSESSING THE CONCENTRATIONS OF SOME HEAVY METALS IN BLOOD SAMPLES OF CHILDREN DIAGNOSED WITH AUTISM SPECTRUM DISORDERS IN BAGHDAD CITY
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Publication Date
Fri Apr 01 2016
Journal Name
Pediatric Dental Journal
Retrospective analysis of 1286 oral and maxillofacial biopsied lesions of Iraqi children over a 30 years period
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Objectives To determine the prevalence of oral lesions by age and gender among the pediatric population in Iraq. Materials and methods A review of the archives of the oral pathology department of Baghdad University from, 1970 Materials and Methods: A review of the archives of the oral pathology department of Baghdad University from 1970 to 2013 for all biopsies from children aged 0–15 years old. Results A total of 1286 child specimens represented 11.98% of all biopsied lesions. The pyogenic granuloma was the most frequent lesion in children, and the periapical cyst was the most frequent lesion from an odontogenic origin. The incidence of malignant lesions was higher in the 0–3 age group than other groups. Conclusions The majority of les

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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Applying Social Stories in Developing Social Interaction Skills among Children with Autism Spectrum Disorder
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Abstract

The current research aims to identify the effectiveness of social stories in increasing social interaction among children with an autism spectrum disorder. The researcher used the single-subject design methodology (Single Subject Designs, SSD) with

 (A-B) design to answer the research questions. The study sample consisted of (3) children with autism spectrum disorder enrolled in a transit daycare center in the Asir region, Saudi Arabia. The results of the study showed that there is a positive functional relationship between social stories and play to increase social interaction among children with autism spectrum disorder, which contributed to the acquisition and generalization of this behav

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of Educational And Psychological Researches
Early marriage for the minors: a phenomenon of family violence against children
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It is certain that marriage has the favor of the continuity of human kind since the Prophet Adam till now. But this important event is threatened by some justifications which lead to its delay or abandonment. In the West, sexual relations, illegal friendships, and disrespect of marriage sacredness lead to this delay. While the reasons behind the delay of marriage in the Arab world refer to high dowries, women go out to work, and the religious and scientific ignorance of the need and importance of marriage. The problem also differs according to the difference between the rural and urban regions. On one hand, we find that early marriage is a necessity in the rural regions; on the other hand, the delay of marriage is a clear and nat

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Publication Date
Wed Sep 30 2015
Journal Name
College Of Islamic Sciences
Break in the bond And its impact on the difference of scholars
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Break in the bond and its impact on the difference of scholars

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Publication Date
Tue Dec 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
The importance of improved forests in Iraq and their impact on the economic and social future
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عانت الغابات في العراق قصوراً واضحاً في مجال إشباع حاجة السكان لمنتجاتها الرئيسية المتمثلة بالأخشاب ومنتجاتها الثانوية المتمثلة بالأغصان والأوراق والنباتات الطبيعية والحيوانات البرية ونواتجها الأخرى، مما يتطلب التفكير بمحاولة إيجاد سبل جديدة لحل هذه المشكلة الاقتصادية المرتبطة بعنصريها الحاجة للأخشاب والأموال المخصصة لتطويرها عموماً.

لقد دمرت مساحات كبيرة من الغابات وحرقت وقطعت من

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Publication Date
Wed Mar 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Correlation of Insulin Like Growth Factor-1 and Insulin-Like Growth Factor Binding Protein with LH, FSH and Testosterone in Iraqi Children with Growth Hormone Deficiency
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Insulin like growth factor-1 has metabolic and growth-related roles all over the body and is strongly associated and regulated by growth hormone. It is produced by almost any type of tissue, especially the liver. The study aimed to measure insulin like growth factor in growth hormone deficient patients and find its relation with other studied parameters. The Subjects in the study were 180 studied in the National Diabetic Center for Treatment and Research/Al-Mustansiriya University in Baghdad/Iraq for the period from November 2021 to April 2022. Blood was drawn and investigated for the levels of IGF-1, IGFBP-3, LH, and FSH. Also testosterone and statistical analysis was carried out to find the potential correlations. The results relived t

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