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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
Sat Jul 20 2024
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
FABP and Some Related Diabetic Parameters Among Adolescents with Toxoplasma gondii
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Recently, it has been revealed that Toxoplasmosis may be associated with some factors related to type 2 diabetes, such as glucose, insulin, the Homeostatic Model Assessment for Insulin Resistant (HOMA-IR), and Fatty acid binding protein (FABP). Therefore, the current study aimed to specify how Toxoplasma gondii (T.gondii) infection affects glucose, insulin, HOMA-IR, and FABP among adolescents. From October to December 2022, this study was carried out at Al Madain Hospital in Baghdad. For a group of adolescents visiting the hospital, an ELISA test was performed to check their anti-T.gondii antibodies. Ninety adolescents were selected to participate in the study on the basis of this examination. They were divided into two groups: those who te

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Publication Date
Wed Feb 22 2023
Journal Name
Iraqi Journal Of Science
Miltefosine Efficacy on Leishmania Donovani Promastigote
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In the current study, different concentrations of miltefosine drug, which is the first effective and safe oral treatment for visceral leishmaniasis, was evaluated against L. donovani promastigotes in comparison with pentosam drug. Direct counting microscopic assay was used to find 50% inhibitory concentration (IC50) of miltefosine and pentostam against L. donovani promastigotes. The IC50 of miltefosine drug was 45.42μg/ml, 46.76μg/ml and 36.68μg/ml after 24 hr, 48hr and 72hr respectively, In comparison with IC 50 of pentostam drug was 75.39 μg/ml after 72hr. There were significant differences (P˂0.05) between IC50 values of miltefosine and pentostam drugs from first day to third day.

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Publication Date
Thu Sep 01 2022
Journal Name
Prepodavatel Xxi Vek
Metaphor and Genre of Family Chronicle (On the Example of L. Ulickaya’s "Medea and Her Children”)
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The article deals with the role of metaphors in forming the plot of L. Ulitskaya’s family chronicle “Medea and Her Children”. The author of the article describes the results of the next stage of research related to the works of Lyudmila Evgenievna Ulitskaya, a representative of modern Russian prose. The analysis of tropes and figures in the works written at the turn of the XXth – XXIth centuries is of importance for the study of the modern state of Russian language as an independent system. “Medea and Her Children” is one of the works by L. Ulitskaya (written in 1996), which, like her other works, is characterized by a unique style of narration, rich in vocabulary, lexical, semantic and stylistic diversity of the author’s word

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Manufacturing an Organic Solar Cell and Comparing with Different Dyes
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A solar cell was manufactured from local materials and was dyed using dyes extracted from different organic plants. The solar cell glass slides were coated with a nano-porous layer of Titanium Oxide and infused with two types of acids, Nitric acid and Acetic acid. The organic dyes were extracted from Pomegranate, Hibiscus, Blackberry and Blue Flowers. They were then tested and a comparison was made for the amount of voltage they generate when exposed to sunlight. Hibiscus sabdariffa extract had the best performance parameters; also Different plants give different levels of voltage.

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Publication Date
Thu Jun 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Effects of vitamin D deficiency on bone and root re-sorption post-orthodontic retention in rats
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Background: Orthodontic therapy often causes external root resorption. Serum vitamin D (VD) level is important for tooth mineralization and bone remodeling. This study aimed to test the impact of vitamin D (VD) supplements on bone and root remodelling in a vitamin D (VD) deficient rat model following orthodontic retention. Methods and Material: 30 male Wistar rats were divided into three groups: a control group of 10 rats and two experimental groups of 10 rats each with vitamin D deficiency (VDD) induced by a VD-free diet for 21 days. And a third group with VD supplementAll groups received orthodontic active treatment using a modified orthodontic appliance that applied 50 gm of force for 14 days to move the maxillary right first mol

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Publication Date
Thu Mar 19 2015
Journal Name
Al-academy
The technical and conceptional changing in post modern art: شيماء وهيب خضير
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The art has been turned its subject in the post modern thinking . this turning is aresult to the turning in the role of the art it self. Across its history the art was basing its subject on a universal unite it the phenomenenon which is the most elevated . that the artist try to activate the role of the subject as a axial which compose the plastic art them. Because of the history of art full with subjects which consider in alarg part of it, have relation ship with elite and aesthetics , and from the begening of renaissance the central activity of the art was based on opoint which has concentrated reaction or it going in away belong to the state in that time.so renaissance was in relegous axial and romantisim on a dream axial, classisisim

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Publication Date
Thu Oct 31 2019
Journal Name
Al-kindy College Medical Journal
Assessment of efficacy and safety of dapsone gel 5% in the treatment of acne vulgaris
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ABSTRACTBackground : Acne vulgaris is a
common skin disease, affecting more than 85% of
adolescents and often continuing into adulthood.
People between 11 and 30 years of age and up to
5% of older adults. For most patients acne remains
a nuisance with occasional flares of unsightly
comedones, pustules and nodules. For other less
fortunate persons, the sever inflammatory response
to Propionibacterium acnes (P.acnes) results in
permanent
Methods: Disfiguring scars. (1, 2) Stigmata of sever
acne cane lead to social ostracism, withdrawal
from society and severe psychologic
depression (1-4).
Result Pathogenesis of acne Traditionally, acne
has been thought of as a multifactorial disease of
the fo

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Publication Date
Sat Jun 18 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Development of novel paracetamol/naproxen co-crystals with an improvement in naproxen solubility.
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Co-crystals are new solid forms of drugs that could resolve more than one problem associated with drugs formulations like solubility, stability, bioavailability, mechanical and tableting properties. A preliminary theoretical study for estimating the possible bonding between the co-crystal components (paracetamol and naproxen) was performed using the ChemOffice program. The results revealed a high possibility for bonding between paracetamol and naproxen and indicated the ability of molecular mechanics study to predict the co-crystal design.

       In this work, four different methods were used for the preparation of three different ratios 1:1, 2:1, and 1:2 of paracetamol:naproxen co-crystals. The four

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Nutritional Status of Pregnant Adolescents in Baghdad City
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Objectives: The study aims to assess the nutritional status, identify nutrition-related health problems and
find out the relationships between nutritional status and demographic characteristics of the pregnant
adolescents in Baghdad City.
Methodology: A descriptive study was carried out from April/20/2009 to June/30/2009 through a "Nonprobability"
purposive sample of (196) pregnant adolescents their age between (13–19) years who attend (14)
primary health care centers in Baghdad City seeking for antenatal care. The data were collected by the
investigator who interviewed the pregnant adolescents and filled out the constructed questionnaire formats
which designed for the purpose of the study. Internal consistency of

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Publication Date
Mon Nov 05 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Health Education-oriented Program on Parents' Awareness towards Adolescents' Violence Control in Baghdad City
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Objective: This study aims to determine the effectiveness of health education oriented program on parents' awareness
towards adolescents' violence control.
Methodology: A quasi-experimental study was carried out in Baghdad city form 1st of April, 2008 to 1st of September,
2009. A purposive "non-probability" sample of 60 parents who have adolescents' violence in their families who were
selected according to specific criteria. The researcher divided the samples into two equal groups; the study and control
groups. The health education program, as well as a questionnaire was constructed as tools for data collection by the
researcher for the purpose of the study. Content validity was determined by a panel of experts in diffe

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