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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
Mon Dec 29 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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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

(institute-bachelors-masters). 4) The challenges facing blended education from the point of view of male and female teachers, according to the functional service period with students with disabilities (less than 8 years - from 9 to 15 years - 16 years and above). 5) the

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Publication Date
Wed Jun 30 2021
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
A COMPARATIVE STUDY OF THE CONSUMERS ATTITUDE ON THE MEAT HYGIENE SLAUGHTERED IN AND OUTSIDETHE SLAUGHTER HOUSEES: A COMPARATIVE STUDY OF THE CONSUMERS ATTITUDE ON THE MEAT HYGIENE SLAUGHTERED IN AND OUTSIDETHE SLAUGHTER HOUSEES
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The study was conducted to assess the attitude and awareness of a sample of people regarding the indiscriminate slaughter and its effects on health and the environment compared with slaughtering  in a slaughterhouse. The sample consisted of 120 persons from six equal professional groups contacted with the butchery labour (livestock keeper, truck driver, butcher, veterinarian, shopkeeper and consumer). The age ranged 22-76 years old, mean 52±10  years, lived ≥ 5 years in the Baghdad city. The results showed that there is a preference for slaughtering inside the slaughterhouse due to the presence of veterinary examination, slaughtering and preparing meat in a healthy, easy-to-clean places, unlike the indiscriminate sla

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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
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
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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Publication Date
Fri Jun 30 2023
Journal Name
The International Tinnitus Journal
Is Topical Nasal Steroid Useful for Treatment of Otitis Media with Effusion in Children?
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Background: Otitis media with effusion is a common and important pediatric clinical problem; it is the leading cause of hearing impairment in children. Medical treatment remains controversial. Aim: To evaluate the usefulness of using topical nasal steroids in the treatment of otitis media with effusion. Patients and Methods: Between November 2019 and October 2022, a prospective controlled clinical study was carried out in the department of otolaryngology at Al-Jerrahat Teaching Hospital in Medical City, Baghdad, Iraq. This study comprised 40 patients with bilateral otitis media with effusion (23 males, 17 females). Two groups were created for the patients. Patients in group A (20 patients) were treated with mometasone furoate nasal spra

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Publication Date
Mon Dec 29 2025
Journal Name
Journal Of Baghdad College Of Dentistry
An Oral Health Status and Treatment Needed in Relation to Dental Knowledge, Among a Group of Children Attending Preventive Department, College of Dentistry, University of Baghdad
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Background: Oral health represents an important base for human well-being; the heath of the body begins from oral cavity. Great deal has been applied to increase knowledge in the field of oral health in order to develop appropriate preventive program. This study was conducted in order to estimate the percentage and severity of dental caries and gingivitis among children attending Preventive Department in Collage of Dentistry, University of Baghdad and to determine dental treatment need for those patients, further more to study the relation of these variables with dental knowledge. Materials and Methods: The study group consists of 163 children with an age ranged from 6 to 14 years, who attended the preventive clinic for the first time to be

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Publication Date
Sun Jun 10 2018
Journal Name
Annals Of Clinical And Analytical Medicine
Lead among children with autism in Iraq. Is it a potential factor?
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Abstract Aim: Autism is a neurodevelopmental disorder which affects communication and social interaction of children. It is a heterogeneous disease with various clinical presentations. Some genes are involved in its pathogenesis. It has been suggested that environmental exposure to lead can increase the risk of autism. The aim of our study was to compare blood lead levels among autistic and non-autistic children. Material and Method: This retrospective study included 107 children (60 with autism and 47 without autism) referred from the different Iraqi provinces, in the years 2015, 2016 and 2017, to the poisoning consultation center in Baghdad. Data collection including age, gender, residence, referral source, family history and blood lead l

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Publication Date
Wed Sep 25 2024
Journal Name
Dentistry 3000
Maximum mouth opening measurement in relation to maximum bite force among children
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Objective: This research aimed to study the relation between maximal bite force (MBF) and maximum mouth opening among 12-year-old school children. Methods: In this cross-sectional study, a total of 400 children aged 12 years (194 boys and 206 girls) were examined. The MBF for the right and left side, as well as the anterior region, were evaluated for all children. The MMO was measured using an electronic digital caliper. To analyze the data path analysis method was used. Results: Boys showed a higher MMO of 48.797 ± 6.500 than girls (46.710 ± 5.926 mm). The MMO increased with increasing MBF, with significant differences between females and males. Conclusion: The MMO was higher in boys than in girls. Gender plays a significant ro

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