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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
Sun Jun 27 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Level of Depression and Anxiety among School Age Children with Acute Lymphoblastic Leukemia under Chemotherapy Treatment at Pediatric Teaching Hospitals in Baghdad City
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Objective(s): To assess the level of depression and anxiety among school age children with acute lymphoblastic leukemia under chemotherapy treatment and to find out the relationship between the level of depression and anxiety among the affected children and their demographic characteristics.
Methodology: A cross-sectional study was conducted on school age children both gender having acute lymphoblastic leukemia under chemotherapy treated and their age between 6 years to 12 years. The study started from the period of September, 19th 2020 to March,1st 2021. Non-probability (Purposive) sample of (114) children with acute lymphoblastic leukemia under chemotherapy was selected in attending hospital wards, outpatient and counseling clinics

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Publication Date
Sun Jan 01 2023
Journal Name
Rawal Medical Journal
Efficacy of lumbar interlaminar epidural steroid injections for lumbar spinal stenosis: A prospective study
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Objective: To study the effect of epidural spinal injection over one year in case of spinal stenosis. Methodology: This prospective study included 566 patients with spinal stenosis seen at Al-Kindy Teaching and Al-Sader, Hospitals who were treated by local epidural steroid injection. They were followed up for at least five subsequent visits after seven days, one month, three months, six months, and one year to assess efficacy. Result: Mean age of patients was 49.5 years, with a predominance of females (65%). L4/L5 was the most involved level in the spinal stenosis (70%). Grade II stenosis accounted for (45.4%) of cases. The pairwise comparison revealed that there was significant decrease in proportions of patients with pain in day

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Publication Date
Tue Mar 14 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Enterpathogen Associated With Diarrheal Cases in Children Aged ( >1-15) Years in Baghdad
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The goal of this study is to determine interior pathogen that causes Diarrhea state to chidren between (1-15) years old, theirs patient from (learn hospital of alemamen alkadoman) in the city of Baghdad from 25/4/2014 to 1/10/2014 period of time, the study represents 103 sample of stool, the result represents that highest ration of infected by 48.545%, Rotavirus 39.80%, mix infected(parasite + Rotavirus) 8.73%, with record of lowest infection ration 2.91%, found during the study that the age group 1-5 years showed the highest percentage of injury Rotavirus by also reached 60.98% case common injury (Rotavirus and parasitic) where this age group, the highest recorded percentage of injuring 66.67%, As for parasitic infected which represente

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Publication Date
Fri Dec 14 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Women's Self-care Instructions concerning Wound, Perineal & Urinary System Care post cesarean section in Baghdad teaching hospital
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Aim: to determine the effectiveness of women's self-care instructions on their post cesarean section care in Baghdad
teaching hospital.
Methodology: The present study used quasi-experimental study design in maternity words in Baghdad teaching
hospital. The sample was collected and follow up for the period (15) January 2014 until 15 May 2014 Nonprobability
(purposive sample) of (100) women post cesarean section divided in to two groups (50) women post
cesarean section considered as a study group, and another (50) women post cesarean section considered as the
control one, A questionnaire designed as a tool to collect data fit the purpose of the study a questionnaire include
demographic variables, Reproductive variables

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Publication Date
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact of spastic cerebral palsy upon the quality of life of children under the age of 12 years in Erbil City: parents’ reports
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Objectives: This study aims to assess the quality of life of cerebral palsy children less than 12 years old reported by
parents in Erbil city/Iraq.
Methodology: A descriptive study was conducted during 2014, to describe the quality of life of cerebral palsy
children. One hundred mothers have cerebral palsy children were participated in this study. The study took place at
Helena Center for handicapped children in Erbil City. Questionnaire was used to collect data, which consists of two
main parts. The first part is divided into two sections; section one was described the mothers’ demographic
characteristics, while the second section was for identifying the demographical characteristics of cerebral palsy
children. Th

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Phenomena (submission delays) and (deletion) and Dalalthma on the social meanings in part (28) of the Holy Quran
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Arabic language , like any other living languages grow and evolve ; social phenomenon
it is subject to the law of life ; therefore resemble organism also touted as the most eloquent
language and the ability to meet the needs of people in every time and place.
The contemplation of the verses of the Koran reveals a lot of means of expression
leading to the grammatical meaning of the social.
I have tried in this research that investigated the social meanings through the phenomena
of deletion and delivery delays and capture semantic landing through the meanings that lead
to psychological persuasion to comply with the orders after the rights of the divine in which
social directives.
It remains the greatest mystery o

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Publication Date
Wed Apr 28 2021
Journal Name
Journal Of Engineering
Post-occupancy evaluation Correlated with Medical Staffs' Satisfaction: A Case Study of Indoor Environments of General Hospitals in Sulaimani City
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This study aims at identifying the notion of Post-Occupancy Evaluation (POE) pertinent to the performance of three general hospitals constructed inside the Sulaimani City, tracing the relationship between the quality of the indoor environments and medical staff (doctors and nurses) satisfaction level. Using some indoor environment elements in the right way will positively influence the mood, stress level of the medical staff, and patient recovery as a result. The POE toolkits (AEDET and ASPECT) have been implemented on targeted wards at the selected hospitals. AEDET and ASPECT questionnaires were distributed among 152 medical staff to obtain their perspectives. In total, 112 valid questionnaires were received. The medica

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Crossref (4)
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Publication Date
Fri Dec 23 2022
Journal Name
F1000research
Association between polymorphisms within the gene coding for tumor necrosis factor (TNF)-alpha with outcomes of treatment in a sample of Iraqi patients with ankylosing spondylitis taking etanercept: an observational study
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Background:Ankylosing spondylitis (AS) is a progressive, chronic inflammatory illness with an unclear etiology that explicitly targets the vertebral column, peripheral joints, and extraarticular tissues. The purpose of this research was to investigate if the existence of single nucleotide polymorphisms (SNPs) in the promoter region of the tumor necrosis factor-alpha (TNF-α) gene at positions -1031T/C (rs199964), -857C/T (rs1799724) and -806C/T (rs4248158) in a sample of Iraqi AS patients could influence the patients' outcomes with etanercept.

Methods:Sixty patients with established AS receiving only etanercept were selected to enroll in this study, with a mean age of 40.75±8.6

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Crossref (2)
Crossref
Publication Date
Sun Oct 02 2011
Journal Name
Journal Of Educational And Psychological Researches
The Effect of a consulting program for decreasing withdrawal behavior of the children with autism of kindergarten
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       unacceptable social behaviors, particularly withdrawal behavior that appears in children with autism represent a major problem hindering the process of communication with those around them and therefore the process of mergence  with them be difficult.

     The withdrawal causes a real affect deficit for children with autism limits the possibility of development of their intellectual and mental growth due to their solitude and the weakness of their focus in the acquisition of pedagogical skills and lack the necessary social skills to maintain the relations of friendship and enjoyment of them.

      withdrawal children fail to participate

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Publication Date
Thu Dec 24 2020
Journal Name
Psychology And Education
A Proposed Programme Based On Sensory Integration Theory For Remediating Some Development Learning Disabilities Among Children
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The current research aims to prepare a proposed Programmebased sensory integration theory for remediating some developmental learning disabilities among children, researchers prepared a Programme based on sensory integration through reviewing studies related to the research topic that can be practicedby some active teaching strategies (cooperative learning, peer learning, Role-playing, and educational stories). The Finalformat consists of(39) training sessions.

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