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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 Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Feeding Problems in Children with Congenital Heart Diseases in Nasiriya Heart Center
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Objective: To identify feeding problems of children with congenital heart disease.
Methodology: Non probability (purposive) sample of (65) were selected of 225 children who visit Al Nasiriya
heart center during the period of conducting the pilot study, previously diagnosed with congenital heart
disease.
Results: The study results indicated that children with congenital heart disease have feeding difficulties, low
birth weight , repeated diarrhea , more than half of the sample taking medication for heart disease which cause
repeated vomiting, difficulty taking liquids and refusal of feeding or eating.(64.6%) of study sample suffered
from wasting. (78.5%) suffered from stunting. Almost half of the study sample suffered

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Publication Date
Mon Jun 01 2020
Journal Name
Pjmhs Jun
Non-polio Enterovirus Isolation in children with acute Flaccid Paralysis in Iraq
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Aim This study is an overview of NPEV investigated during AFP surveillance programs for the period 2010–2017 in Iraq. Methods Stool samples from 4296 AFP cases and 2933 healthy contacts among children less than 15 years of age were processed for virus isolation as a part of AFP surveillance for the Global Polio Eradication Program in Iraq at National Polio Laboratory. NPEV detection was performed by virus isolation on cell culture according to WHO recommendations. Results The NPEV isolation rate was 14% of total AFP cases and 14.5% of healthy contacts. The infection rate was higher in males than females with a male/female ratio of 1.5: 1. The highest NPEV infection rate was observed among the children aged 1-2 years and decrease significa

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Publication Date
Fri Dec 28 2018
Journal Name
Iraqi Postgraduate Medical Journal
Recurrent Pneumonia in Children at a Tertiary–Pediatric Hospital in Baghdad
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MK Al-Janabi, NA Nasir, RK Jaber, AO Oleiwe, Iraqi Postgraduate Medical Journal, 2018 - Cited by 7

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Publication Date
Sat Apr 01 2023
Journal Name
Baghdad Science Journal
Physiological and Hormonal Effects of Titanium Dioxide Nanoparticles on Thyroid Function and the Impact on Bodyweight in Male Rats
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Fifty-four Sprague-Dawley albino adult male rats were classified into three main groups each of 18 rats treated for a particular duration (1,2, and 4) weeks respectively. Each group was subdivided into three subgroups each of six rats treated as follows; group (1) serve as normal control, group (2, and 3) intra-peritoneal treated with TiO2NPs (50,200) mg/kg respectively, body *weight of all rats was measured before and after the experiment, then rats were dissected at the end of each experiment and the weights of the thyroid was measured. The result showed a highly significant decrease (p<0.01) in thyroid gland weight, a highly significant increase (p<0.01) in body weights and TSH, while a highly significant decrease (p&

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Publication Date
Wed Aug 16 2017
Journal Name
Journal Of Health, Medicine And Nursing
Prevalence of Congenital Heart Disease in Infants of Diabetic Mothers in Children Welfare Teaching Hospital
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Women with diabetes in pregnancy (type 1, type 2 and gestational) are at increased risk for adverse pregnancy outcomes which also include infant development of congenital heart disease and even fetal death. Adequate glycemic control before and during pregnancy is crucial to improve outcome

Publication Date
Sun Oct 01 2017
Journal Name
مجلة القادسية للعلوم الرياضية
The impact of leverage in two different environments on the development of weapons and arms explosion strength on some physiological indicators and the accuracy of the performance of the service and crushing volleyball skills
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ھدف البحث الـــــى : ١ -إعداد تدریبات القوة الارتدادیة في وسطین متباینین على بعض المؤشرات الفسیولوجیة لتطویر القوة الانفجاریة ودقة مھارتي الأرسال والضرب الساحق بالكرة الطائرة . ٢ -التعرف على تأثیر تدریبات القوة الارتدادیة في وسطین متباینین على بعض المؤشرات الفسیولوجیة لتطویر القوة الانفجاریة.. ٣ -التعرف على تأثیر تدریبات القوة الارتدادیة في وسطین متباینین على دقة مھارتي الأرسال والضرب الساحق بالكرة الطائرة

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Publication Date
Mon Jul 30 2018
Journal Name
Civil Engineering Journal
Performance of Post-Fire Composite Prestressed Concrete Beam Topped with Reinforced Concrete Flange
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The performance of composite prestressed concrete beam topped with reinforced concrete flange structures in fire depends upon several factors, including the change in properties of the two different materials due to fire exposure and temperature distribution within the composition of the composite members of the structure. The present experimental work included casting of 12 identical simply supported prestressed concrete beams grouped into 3 categories, depending on the strength of the top reinforced concrete deck slab (20, 30, and 40 MPa). They were connected together by using shear connector reinforcements. To simulate the real practical fire disasters, 3 composite prestressed concrete beams from each group were exposed to high t

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Publication Date
Wed Oct 09 2019
Journal Name
Engineering, Technology &amp; Applied Science Research
Numerical Analysis of Segmental Post Tensioned Concrete Beams Exposed to High Fire Temperature
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The main objective of this study is to characterize the main factors which may affect the behavior of segmental prestressed concrete beams comprised of multi segments. The 3-D finite element program ABAQUS was utilized. The experimental work was conducted on twelve simply supported segmental prestressed concrete beams divided into three groups depending on the precast segments number. They all had an identical total length of 3150mm, but each had different segment numbers (9, 7, and 5 segments), in other words, different segment lengths. To simulate the genuine fire disasters, nine beams were exposed to high-temperature flame for one hour, the selected temperatures were 300°C (572°F), 500°C (932°F) and 700°C (1292°F) as recomm

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Publication Date
Sat Dec 11 2021
Journal Name
Engineering, Technology &amp; Applied Science Research
Post-Fire Behavior of Non-Prismatic Beams with Multiple Rectangular Openings Monotonically Loaded
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The main objective of this paper is to study the behavior of Non-Prismatic Reinforced Concrete (NPRC) beams with and without rectangular openings either when exposed to fire or not. The experimental program involves casting and testing 9 NPRC beams divided into 3 main groups. These groups were categorized according to heating temperature (ambient temperature, 400°C, and 700°C), with each group containing 3 NPRC beams (solid beams and beams with 6 and 8 trapezoidal openings). For beams with similar geometry, increasing the burning temperature results in their deterioration as reflected in their increasing mid-span deflection throughout the fire exposure period and their residual deflection after cooling. Meanwhile, the existing ope

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Publication Date
Sat Dec 11 2021
Journal Name
Engineering, Technology &amp; Applied Science Research
Post-Fire Behavior of Non-Prismatic Beams with Multiple Rectangular Openings Monotonically Loaded
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The main objective of this paper is to study the behavior of Non-Prismatic Reinforced Concrete (NPRC) beams with and without rectangular openings either when exposed to fire or not. The experimental program involves casting and testing 9 NPRC beams divided into 3 main groups. These groups were categorized according to heating temperature (ambient temperature, 400°C, and 700°C), with each group containing 3 NPRC beams (solid beams and beams with 6 and 8 trapezoidal openings). For beams with similar geometry, increasing the burning temperature results in their deterioration as reflected in their increasing mid-span deflection throughout the fire exposure period and their residual deflection after cooling. Meanwhile, the existing ope

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