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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 Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Analysis The Consistency Between The Tariff And The Exchange Rate And Their Reflection On The Trade Balance In Iraq
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       The trade balance is considered as a way to join the national economy with the world, So it is the mirror that reflect the economic center of the country and it is point to competitive ability of it, The tariff and the exchange rate perform a great role to motivate the domestic production and improve the trade balance if we direct them to achieve the same purpose. The Iraqi economic has trade balance which achieve overabundant during the years of studying because of the oil exports, while the other exports represent a small percentage it is hardly remember, and expansion in imports from other side causes exhaustion in oil revenues, and this make the trade balance in permanent

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Publication Date
Thu Apr 01 2021
Journal Name
Annals Of The Romanian Society For
Relation Study between Chromogranin a and Other Clinical Biomarker in Iraqi Children with Growth Hormone Deficiency Undergo Treated Via Recombinant Growth Hormone
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Growth hormone deficiency is a condition that occurs when a limited volume of growth hormone is released by the pituitary gland since growth hormone deficiency causes growth delays, short stature, and overall physical development delays. symptoms differ based on the age at which they occur .Aim of this study Estimating the level of growth hormone serotonin ,IGF-1 and Chromogranin A before and after with treatment recombinant growth hormone and It is the first study in Iraq that sheds light on the relationship between Chromogranin and other variables ( somatostatin, IGF-1,GH) ,also the prediction of Chromogranin A as a newly biochemical marker in children with growth hormone deficiency. In this study, 30 samples were collected from children

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Information and communication technology and its impact on the quality of service of the tourism sector and hotel: An analytical study in selected hotels in the Iraqi capital Baghdad
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Publication Date
Tue Aug 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
The Water Footprint and Virtual Water and Their Effect on Food Security in Iraq
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Publication Date
Fri Dec 01 2023
Journal Name
Agbioforum
The Role of the Digital Economy, Business Synergy, and Trade Policies on Global Economic Prosperity in India and China
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The necessity of addressing global economic prosperity has garnered significant attention from recent studies and policymakers. This article analyses the effects of the digital economy, business synergies, and trade policies on the economic prosperity of China and India. The study examines the impact of political support on the digital economy, business synergies, trade policies, and global economic prosperity in China and India. The study collects data from prominent economists in India and China using questionnaires. The article utilised the SPSS-AMOS software to analyse the relationship between variables. The results showed that the digital economy, business synergies, and trade policies are positively linked to global economic prosperit

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Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
Value of random urinary calcium to creatinine ratio in diagnosing hypercalciuria in children with nocturnal enuresis
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Background:Nocturnal Enuresis is a common problem affecting 20% of five years old children and up to 2% of adolescent and young adult. Although it is a self limiting benign condition, it has social and psychological impact on the child and his family. Many pathophysiological theories had been suggested, but none is confirmed. Hypercalciuria has been suggested to be associated with higher incidence of nocturnal enuresis. Objectives:The aim of our study to test the value of Ca/Cr ratio, on random urine sample, in diagnosing hypercalciuria in enuretic children. Type of study: Cross sectional study.Methods:Forty four enuretic children were enrolled in this study and forty five children without nocturnal enuresis were taken as control group.

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Publication Date
Mon Nov 05 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Bacteriological and Chemical Study on the Effect of Lead in Blood and Saliva of Workers at Batteries Industry in Baghdad
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Objectives: The study aims at:
1- Measuring the level of lead in workers’ saliva and blood in the factory.
2- Studying the correlation between the saliva lead level and the infection that caused by microorganisms, isolation and
identification.
3-Studying the influence of high blood lead level on the total white blood cells.
Methodology: This study has been conducted for the period from March 15th, 2010 to May, 20th
, 2010. A total of (60)
saliva and blood samples were collected from workers in batteries industry factory in Baghdad and another (20) samples
were collected as a control group. Lead level had been measured in blood and saliva samples, then microorganisms were
isolated the from the saliva samples.

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Publication Date
Wed May 01 2019
Journal Name
The Iraqi Journal For Information And Documentation Studies
The role and importance of scientific research in creating new knowledge and its impact on developing the cognitive capabilities of information and librarians and their Employees
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The research aims at identifying the importance of scientific research for researchers and in creating new knowledge، development and utilization of mental and cognitive energies and developed them with the ability to research، extrapolation، meditation and then conclusion. The information was collected by interviewing the Secretary-General of the Central Library and by distributing questionnaire forms to the (33) teaching staff of the College of Higher Education. The responses of the society were analyzed the result and the recommendations were the most important 1. Information specialist and all employees of the administrators and technicians in the centers of information sources (libraries) and in the field are considered scientific r

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Publication Date
Mon Feb 13 2023
Journal Name
Journal Of Educational And Psychological Researches
Challenges Facing Blended Education from the Point Of View of Teachers Teaching Children with Disabilities
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The current research aims to identify: 1) the challenges facing blended education from the point of view of teachers of students with disabilities. 2) The challenges facing blended education from the point of view of teachers of students with disabilities according to the gender variable (males-females). 3) The challenges facing blended education from the point of view of teachers of students with disabilities, according to the academic qualifications of graduates

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Publication Date
Mon Jul 07 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The Electrophoretic Deposition of Nano Al2O3 and AgNO3 on CpTi Dental Implant (An in vitro and in vivo study)
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Background: Even the wide use of dental implants, still there is a proportion of implants are failed due to infection. Much considerable attention has been paid to modify the implant surface. Coating of dental implant with a biocomposite material of suitable properties can improve osseointegration. And this is the main concern of this study. The aim of present study was to evaluate the use of a biocomposite coating of dental implant with (ceramic nano Al2O3 and metalic AgNo3) on the bond strength at bone – implant interface and tissue reaction. Materials and methods: A total number of forty-eight screws, CpTi dental implant used in this study. Half of these screws were coated with a biocomposite material of nano (Al2O3and AgNo3), thi

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