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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
Tue Jun 01 2021
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Gene Expression of NLRP3 Inflammasome in Celiac Disease of Iraqi Children
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Celiac disease (CD) is an autoimmune disorder characterized by chronic inflammation that essentially affects the small intestine and is caused by eating gluten-containing foods. This study sought to determine gene expression of NLRP3 Inflammasome in peripheral blood of Iraqi CD children using quantitative real-time PCR (qRT-PCR) assay. Thirty children with CD (12 males and 18 females) were enrolled in the study and their age range was 3-15 years. The diagnosis of the disease was confirmed by serological examinations and intestinal endoscopy. A control sample of 20 age-matched healthy children was also included. The children were stratified for age, gender, body max index (BMI), histological findings, and marsh classification. Fu

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Publication Date
Wed Jan 08 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Nutritional Status among a Group of Preschool Children in Relation to Concentration of Selected Elements in Saliva and Caries Severity (A Comparative Study)
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Background: Nutritional status during childhood is very important for individual development and growth. Nutrition has local and systemic effect on the oral health by affecting dental health and salivary composition. This study was aimed to determine effect of iron, sodium and potassium ions in saliva on the nutritional status and to determine the effect of nutritional status on caries severity among preschool children. Material and Methods: The sample consists of 90 children aged 4 and 5 years of both genders, selected from 6 kindergartens in Al-Resafa aspect of Baghdad province. Children classified according to their nutritional status into three groups (normalweight, underweight and overweight). Nutritional status was determined by usi

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Publication Date
Mon Dec 31 2018
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Detection of Thiopurine S-Methyltransferase (TPMT) Polymorphisms TPMT*3A, TPMT*3B and TPMT*3C in Children with Acute Lymphoblastic Leukemia
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Background: Thiopurines are essential medications in Acute Lymphoblastic Leukemia (ALL) treatment protocols as anti-cancer agents since long time; however, their use might result in unexpected toxicities in ALL children due to the low thiopurine S-methyltransferase (TPMT) activity, a major enzyme involved in 6- mercaptopurine metabolism, which strongly correlates to the genetic polymorphism of the TPMT gene in those patients.

Objective: To identify the most common TPMT polymorphisms in children with ALL and its frequencies.

Methods: A cross sectional study enrolling eighty-one ALL children receiving mercaptopurine drug during their maintenance course of treatment accordin

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
The Effect of Age and occupation on the Type and the Number of workers injuries in construction sector in Iraq
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World statistics proved that the most of work dangerous accidents, which causes death, are occurred in the construction works. These accidents related to many causes such as loss of workers experience and ignoring rules of safety requirements, especially young workers. Due to the risk of accidents that may occur in the site of work, the idea of this study crystallized to show the relationship between the age of worker and number of injuries and accidents, to identify the causes of these injuries, and to put the appropriate solutions to avoid or reduce the risk of work injuries. Also, the research shows the main principles of safety requirements to forming a clear picture about the subject of the study. A questioner form was prepared to c

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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
Sun Jul 02 2006
Journal Name
Journal Of The Faculty Of Medicine Baghdad
assessment of skeletal maturation of Iraqi children during the years of sanctions
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background:

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Publication Date
Mon Oct 28 2024
Journal Name
Anggaran : Jurnal Publikasi Ekonomi Dan Akuntansi
The Role Of Emotional Intelligence in The Board Of Directors and Its Impact On The Performance and Value Of Institutions and Conservative Practices In Light Of Crises (Applied Research On a Sample Of Banks Listed On ISX)
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This research aims to underscore the significance of women's emotional intelligence in enhancing the effectiveness of the Board of Directors, a crucial component of internal governance, particularly during crises. Despite strides made in recent decades in appointing women to senior roles in government, business, and education, challenges persist in improving women's leadership opportunities, especially in developing countries. The study utilizes statistical methods, including Pearson's correlation, to analyze the relationships between variables within a sample of banks listed on the Iraqi securities market, comparing periods before and during the COVID-19 pandemic (2019 and 2020). The goal is to measure the impact of female emotiona

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Publication Date
Mon May 01 2023
Journal Name
Clinical And Experimental Dental Research
Atypical clinical features of post COVID‐19 mucormycosis: A case series
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Abstract<sec><title>Objectives

This case series aims to evaluate patients affected with post COVID‐19 mucormycosis from clinical presentation to surgical and pharmacological treatment to improve the disease prognosis.

Material and Methods

This case series was conducted at a specialized surgery hospital in Baghdad Medical City for over 10 months. Fifteen cases who had mild to severe COVID‐19 infections followed by symptoms similar to aggressive periodontitis, such as mobility and bone resorption around the multiple maxillary teeth, were included in this case series.

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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
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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