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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 28 2022
Journal Name
College Of Islamic Sciences
The impact of sins and disobedience on the individual and society in the Holy Quran objective study
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     The Noble Qur’an is the book of God, the Blessed and Exalted, in which is the teachings of God Almighty’s religion, which is Islam, in order for people to unite it and establish servitude to it. The individual and the society alike saw it appropriate to make my opinion alerting the seriousness of this matter, so the research was entitled (The Impact of Sins and Disobedience on the Individual and Society in the Holy Qur’an - Objective Study), knowing that we touched upon some of the effects, which we found it appropriate to mention in this research in the service of the good. Its details came in the Holy Qur’an without referring to others, noting their arrangement in the Holy Qur’an..

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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
Fri Jun 30 2023
Journal Name
Pakistan Heart Journal
Music Medicine Intervention--Based Program for Reducing Pain and Anxiety of Children Undergoing Bone Marrow Aspiration and Lumber Puncture Procedures
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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
Mon Jan 01 2018
Journal Name
Journal Of Global Pharma Technology
Auto-antibodies Profile in Children Infected with Visceral Leishmaniasis
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Visceral leishmaniasis (VL) is a parasitic infection caused by an intracellular growth of Leishmania spp. in macrophage cells. The autoimmune disorder is a condition takes place when the immune system produces antibodies which incorrectly attacked its own body tissues. VL has been involved as an effect or on the autoimmune aspect. This study was conducted to identify the auto antibodies profile in patients infected with VL. The presences of auto antibodies in 21 Iraqi children infected with VL were tested for laboratory autoimmune aspect. The highest percentage of seropositive in Leishmania patients was observed for anti-ds DNA, anti-Mi-2, anti-Ku and anti-PCNA antibodies (90.5%, 90.5%, 90.5% and 61.9%) respectively, while the lowest percen

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Creative skills in solving environmental problems among kindergarten children
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Acquires this research importance of addressing the subject (environmental problems) with
age group task, a category that children pre-school, and also reflected the importance of
research, because the (environmental problems) constitute a major threat to the continuation
of human life, particularly the children, so the environment is Bmchkladtha within
kindergarten programs represent the basis of a hub of learning where the axis, where the
kindergarten took into account included in the programs in order to help the development of
environmental awareness among children and get them used to the sound practices and
behaviors since childhood .
The research also detected problem-solving skills creative with kids Riyad

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Publication Date
Sun Apr 03 2011
Journal Name
Journal Of The Faculty Of Medicine Baghdad
H-reflex excitability in children with spastic cerebral palsy
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Background: Cerebral palsy is a disorder of movement and posture resulting from permanent, nonprogressive defect or lesion of the immature brain. Spastic cerebral palsy is a common clinical type which is difficult to diagnose clinically in the early years of life. This study was conducted to identify the changes in the H-reflex excitability in children with spastic cerebral palsy as compared to normal children.
Methods: The excitability of the monosynaptic H-reflex pathway was tested in 36 children with spastic cerebral palsy during waking by calculation of the H-reflex wave amplitude with the ratio of maximal H /maximal M response amplitudes and compared with 32 normal children of the matching age.

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Publication Date
Sun Jan 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Aortic root dilatation among children with unoperated Fallot tetralogy. A clinical and echocardiographic study.
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Bacground: Tetralogy of Fallot (TOF) is a commn congenıtal heart disease and it may be associated with aortic root dilation (ARD ) before or even years after the surgical repair. To the best knowledge this is the first study in Iraq dealing with this issue.
Objectives : To dtermine the frequency of aortic root dilatation among sample of children with Fallot teralogy in Mosul-İraq and to asses its associated risk factors.
Patients and methods : A total of 110 children ,54 with TOF compared to 56 normal chıldren by echocardiography for determining the frequency of aortic root dilatation among both groups. Among TOF children different factors like age and sex, size of the ventricular sptal defect (VSD) ,degree of overrıdıng of ao

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Crossref
Publication Date
Mon Oct 17 2022
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Focus Assessment of Transthoracic Echocardiography post septostomy Procedure in Patients Undergoing Ablation of Left Atrial Supraventricular Tachycardia
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Background: Echocardiography has an important role to follow up patients with Iatrogenic atrial septal defect (IASD) and after Catheter ablation during electro-physiological study.

Objectives: evaluating the impact of non-invasive Transthoracic Echocardiography (TTE) parameters (LAVI, LVEF, ASD size and E/e`) post radiofrequency ablation of left atrial arrhythmia.

Patients and methods: for the evaluation of the atrial septal defect, a transthoracic echocardiography (TTE) was used   in patients who underwent left atrial arrhythmia ablation, enrolled in prospective study in the Iraqi center for cardiac diseases, in cooperation with university of Baghdad /college of m

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Crossref
Publication Date
Mon Oct 17 2022
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Focus Assessment of Transthoracic Echocardiography post septostomy Procedure in Patients Undergoing Ablation of Left Atrial Supraventricular Tachycardia
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Background: Echocardiography has an important role to follow up patients with Iatrogenic atrial septaldefect (IASD) and after Catheter ablation during electro-physiological study.Objectives: evaluating the impact of non-invasive Transthoracic Echocardiography (TTE) parameters(LAVI, LVEF, ASD size and E/e`) post radiofrequency ablation of left atrial arrhythmia.Patients and methods: for the evaluation of the atrial septal defect, a transthoracic echocardiography(TTE) was used in patients who underwent left atrial arrhythmia ablation, enrolled in prospective studyin the Iraqi center for cardiac diseases, in cooperation with university of Baghdad /college of medicineResults: The outcomes of the present study were assessed according to

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