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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 Jan 01 2019
Journal Name
Indian Journal Of Public Health Research & Development
Maximum Bite Force among Iraqi Primary School Children in Mixed dentition
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Publication Date
Fri Jun 11 2021
Journal Name
Journal Of Baghdad College Of Dentistry
Traumatic dental injuries in relation to quality of life among school children in Baghdad /Iraq
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Background: One of the significant public health problems is the traumatic dental injury to the anterior teeth, it has a great impact on children’s daily. Physical and psychological disturbance, pain and other negative impacts, such as tendency to avoid laughing or smiling may be associated with traumatic dental injuries, that may affect the social relationships. To determine the occurrence of traumatic dental injuries in relation to quality of life, this study was established among children of primary schools. Material and Methods: A cross-sectional study was conducted among private (574) and governmental (1026) primary school children in Baghdad city. Dental trauma was assessed according to Ellis and Davey classification in1970

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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 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 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 May 05 2022
Journal Name
Al-kindy College Medical Journal
Safety profile of immediate post-partum intrauterine device insertion during caesarean delivery – a clinical trial with three years of follow up: Utility of Immediate Post Placental Insertion of Intrauterine Device During Cesarean Delivery
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Background: Many countries recommend the use of long-acting reversible contraceptive intrauterine device immediately after cesarean delivery. The cesarean delivery rate in Iraqi public hospitals is 32.2% and may reach 85.8% in private hospitals. Immediate post-partum intrauterine device insertion at cesarean is rarely done in Iraq.

Objectives: To assess the safety and practicality of immediate post-partum intrauterine device insertion during cesarean delivery for family planning and pregnancy spacing in Iraqi women.

Subjects and Methods: A single arm clinical trial included 150 eligible women who attended Al-‎Elwiyah Maternity Teaching Hospital or Al Hayat Rahibat Hospita

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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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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
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
Sat Nov 08 2025
Journal Name
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The Pattern Of Skin Diseases Among Kindergarten Children In Baghdad. A Comparative Study Between Two Surveys Five Years Apart
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