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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
Fri Dec 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Oral health status among kindergarten children in Karbala city\Iraq
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Back ground: Dental caries and periodontal disease followed by enamel defect were the most common and widely spread diseases affecting children. Aim of this study is the assessment of the occurrence and severity of dental caries, dental plaque, gingivitis and enamel anomalies among 4-5 years old children in Karbala city-Iraq. Materials and methods: A sample of 658 children (350 males, 308 females) aged four and five years old was selected randomly from the fourteenth kindergartens in Karbala city. Diagnosis and recording of dental caries and enamel anomalies were followed the criteria of WHO 1987, WHO1997 respectively. Dental plaque was assessed using plaque index of Silness and Loe,1964. Gingival health condition was assessed using gingiv

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
5'-nucleoridase activity in sera from iraq children with leukemia
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Enzyme activity were studied in the sera of children with leukemia than healthy children, where 31 cases were studied, including 21 cases of patients with acute lymphatic leukemia

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Publication Date
Sun Jan 02 2011
Journal Name
Journal Of Educational And Psychological Researches
CONSTRACION SCALE FOR AUTISTIC CHILDREN
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Autism is considered as one of the most developmental  problems  in the world that interfere with children growth and affect their social ,emotional and cognitive development child with autism used to be normal in his growth but in his development parents started to notice that their child characterize by loneliness and withdrawal himself from the surrounding world with some mannerism behaviors these characteristics used to be manifested children during the 1st  three year of their life .  It appears, one in every 500 birth (The American International Institution for child health 1997. and it would be less in females than makes at 1/4 percent .

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Publication Date
Sun Feb 08 2009
Journal Name
Ibn Al- Haitham J. For Pure & Appl. Sci.
Evaluation of Dot. ELISA test for Diagnosis Visceral Leishmaniasis in Infected Children
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Evaluation of Dot. ELISA test for Diagnosis Visceral Leishmaniasis in Infected Children

Publication Date
Sun Jun 07 2015
Journal Name
Baghdad Science Journal
Study of Some Biochemical Parameters in Iraqi Children with Acute Lymphoblastic Leukemia
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Leukemia or cancer of the blood is the most common childhood cancer, Acute lymphoblastic leukemia (ALL), is the most common form of leukemia that occurs in children. It is characterized by the presence of too many immature white blood cells in the child’s blood and bone marrow, Acute lymphoblastic leukemia can occur in adults too, treatment is different for children. Children with ALL develop symptoms related to infiltration of blasts in the bone marrow, lymphoid system, and extramedullary sites, such as the central nervous system (CNS). Common constitutional indications consist of fatigue (50%), pallor (25%), fever (60%), and weight loss (26%). Infiltration of blast cells in the marrow cavity and periosteum often lead to bone

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Publication Date
Wed Jun 30 2010
Journal Name
Al-kindy College Medical Journal
Assessment of workplace hazards among working children in al amen city, Baghdad
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Back ground: One out of six children in the
world today is involved in child labor, doing
work that is damaging to his or her mental,
physical and emotional development.
Objective: Assessment of some health
problems among the studied working children.
Method; A cross-sectional study was
conducted in Al Amen Primary Health Care
(PHCC) during the period from January to
August 2009, a sample of 6048 children were
selected randomly(3218girls and2866 boys age
between 5-17 years ) and interviewed to collect
information using a structured questionnaire
form, information related to different aspects
of child labor prevention were included in the
form as well as a general medical examination
and lab

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of The College Of Education For Women
Conservation of Concept among Children: Semantic Study
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Conservation of Concept among Children: Semantic Study

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Publication Date
Mon Feb 21 2022
Journal Name
Journal Of Pure And Applied Microbiology
Microbiological Identification of Bacteria with Leukemic Children
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The most common form of childhood cancer is leukemia, Calculation for more than one third of all childhood cancers among those ages 1 day – 14 years. The diseases of leukemia are worldwide, it occurred in both genders from male and females and in all age. A total of 80 different samples of patient children were collected from the central teaching hospital of pediatric in Baghdad. Obtained during the period from 1st Sept. 2019 till the 31 th of Aug. 2020. Each isolates identification by using Vitek 2. Isolated organism in leukemic children show 18 (22.5 %) gram positive and 62 (77.5 %) gram negative from the total sample 80 (100.0 %). The percent of male is 45 more than female which represents 35 in most age groups between age (1 d

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Publication Date
Mon Jan 16 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Nurses` Practice Regarding Poisoning Children
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Objectives: Assess nurses` practices for children with chemical poisoning, and find out relationship between nurses` socio- demographic data and their practices for children with chemical poisoning.

Methodology: A descriptive correlational design used to achieve the purpose of the study, the study was conducted at Al-Basrah Hospital for Maternal and Children throughout the period 12th of September 2021 to 10th of October 2022. A non- probability sample of (30) nurse at emergency department was selected. The instrument of the study was constructed based on previous literatures that related to study project, which include nurses` socio-demographic data and questionnaire format

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Publication Date
Thu Oct 25 2018
Journal Name
Al-kindy College Medical Journal
Infectious Causes of Diarrhea Among Neutropenic Children
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Background: Intestinal infections are frequently occur among children with cancer who receive chemotherapy. On the other hand, diarrhea is especially common and severe among cancer patients that develop neutropenia, either due to the disease itself or due to the intensive chemotherapy. There are many causes of diarrhea among those patients, but intestinal infections still an important etiology among them.

Objectives: to study the frequency of diarrhea among neutropenic children, with its infectious etiologies, especially the bacterial, fungal and parasitic causes.

Type of the study:Cross-sectional study.

Methods: the study was done in the Oncology

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