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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
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
Sun Mar 02 2008
Journal Name
Baghdad Science Journal
A study of analysis and comparison to the low nutrient density foods that more normality for children age (3 –5 years)
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Through the early childhood and after the ablactating the child learns acquired food habbits that might studying with him throughout his life. Here the parents role arises: teaching the child the sound food habits and hygienic styles and whatever beneficial to the health and with the sufficient quantities for the body. In this way the experiences the child learns at home will be of great help in his future life in choosing the suitable food after becoming more dependent in making his decisions and choices away from his parents. The results in this study showed that the averages of the children’s consumption of the high energy foods in comparison with the other highest consumption average , after that comes the con sumption of soft drills

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Publication Date
Wed Dec 30 2015
Journal Name
Al-kindy College Medical Journal
Estimation of post- mortem interval by some biochemical changes of vitreous humor.
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Background:No previous Iraqi study was done on the estimation of post mortem interval (PMI) from the medico-legal point of view; depending on the biochemical changes of vitreous humor.Objectives:To find out the relationship between some biochemical changes in vitreous humor and post mortem interval.To find out a new formula for estimation of PMI from some biochemical changes in vitreous humor.Method:The study was conducted on one hundred twenty two cases referred to the medico-legal institute in Sulaimani province during the period between 1st of February and 30th of July 2012.Complete classical autopsy was performed for each case and vitreous humor was collected at autopsy from the posterior chamber of the eye and the samples after coll

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Publication Date
Tue Jul 01 2008
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
TESTING THE EFFICACY OF SOME METHODS RECOMMENDED ABROAD FOR CONTROLLING THE ORIENTAL HORNET, VESPA ORIENTALIS L., ATTACKING HONEY BEE, APIS MELLIFERA L., COLONIES IN IRAQ
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Some methods recommended abroad to control the oriental hornet, Vespa orientalis L., attacking the honey bee, Apis mellifera L., colonies were tested, with some modifications, for the first time under the Iraqi conditions. One of these methods was carried out by covering the hive entrance with a piece of queen excluder to prevent the hornet from entering the hive. Also, the position of hive stand was reversed to deprive the hornet from using the flight board as a stage for waiting and creeping toward the defending bees. The second method was carried out by fixing a cardboard cone as a bee passage at the hive entrance to hinder the entry of the hornet into the hive. Both of these methods were found to be unsuccessful to

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Publication Date
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
Adenoidectomy with Myringotomy and Tympanostomy Tube Versus Adenoidectomy with Myringotomy in Treatment of Otitis Media with Effusion in 5-7 Years Old Children
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Background: Adenoiditis is a common cause of otitis media with effusion (OME) in children & perhaps OME is one of the most common diseases leads to hearing impairment in children with subsequent impairment of speech development & learning difficulties , however, treatment remains controversial. Objectives: To evaluate if there is a significant advantage of tympanostomy tube insertion in association with adenoidectomy over adenoidectomy in association with myringotomy alone in treatment of children with OMEType of the study: This is a prospective study. Patients & methods: The study consisted from 63 children diagnosed as cases of bilateral OME & variable degrees of adenoid hypertrophy. The patients were divided randomly i

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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
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
Sun Jun 27 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Mothers’ Knowledge about Their Children with Sickle Cell Anemia and Non-Pharmacological Approaches to Pain Management in Basra Center for Hereditary Blood Diseases
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Objective(s): To assess mothers’ knowledge about their children with sickle cell anemia and non-Pharmacological approaches to pain management and found some relationship between mothers knowledge and their demographic data of age, level of education, and occupation.
Methodology: A descriptive design used in the present study established was for a period from September 19th, 2020 to March 30th, 2021. The study was conducted on a non-probability (purposive) sample of (30) mother their children with sickle cell anemia was chosen. The data were analyzed through the application of descriptive and inferential statistical approaches which are applied by using SPSS version 22.0.
Results: The findings of the study indicated that moderate

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Publication Date
Sun Jun 01 2008
Journal Name
Baghdad Science Journal
The Minimum Inhibitory Concentration (MIC) and Minimum fungicidal concentration(MFC) of extracted oil of lemon grass and thyme against Candida spp. and Bacteria Spp. Isolated from children with oral thrush
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120 samples were collected from children (ages between new born and 10 years) who infected with oral thrush. The results revealed that the Minimum Inhibitory Concentration (MIC) and Minimum Fungicidal Concentration (MFC) of extracted oil of lemon grass against C.albicans, C.tropicalis, C.keyfr, C.glabrata and C.guilliermondii were 1.25,1.25,1.25,2.5 and 2.5µl/ml and 2.5, 2.5, 2.5, 5 and 5 µl /ml respectively. while the (MIC) and (MFC) for the extraction oil of thyme against C.albicans, C.tropicalis, C.keyfr, C.glabrata and C.guilliermondii were 0.6, 0.6, 1.25, 1.25, and 1.25µl/ml and 1.25, 1.25, 2.5, 2.5, and 2.5µl/ml respectively . While the value of (MIC) and (MFC) for Nystatin against Candida species were 32 and 64 µg

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