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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
Wed Jan 01 2020
Journal Name
Periodicals Of Engineering And Natural Sciences
Comparing traditional estimators and the estimators of (PSO) algorithm for some growth models of gross domestic product in Iraq
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Publication Date
Fri May 17 2019
Journal Name
Biochem. Cell.arch
THE EFFICACY OF GOLD NANOPARTICLES IN INHIBITING THE TOXICEFFECT OF TAMOXIFEN ON THE KIDNEYS OF MALE ALBINO MICE
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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
Challenges Faced by Families of Children with Intellectual Disabilities and Its Effect on the Psychological Health in the Asir
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Abstract

This research aims to identify the challenges faced by families of children with intellectual disabilities and to identify the impact of the challenges facing them on the mental health of their children with intellectual disabilities. Based on the following questions: What is the nature of the challenges faced by families of children with disabilities and how do these challenges affect the mental health of their children with intellectual disabilities? The study was conducted on a sample of four families of six children with intellectual disabilities, depending on the degree and type of disability. To achieve the study's objectives, the qualitative approach was used, Because of the importance of accessin

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Prevalence of obesity among adolescents at secondary schools in Kirkuk city
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Objective: to identify the secondary school adolescent's obesity, and to find out the relationship between
adolescents obesity characteristics and their family history.
Methodology: A cross-sectional study was carried out among 537 adolescents (270 boys and 267 girls) aged 12-15
years selected by means of a multistage stratified random sampling technique.
Results: the prevalence of obesity among adolescents was 22.3%. (55.8%) of the obese adolescents were male,
(42.5%) their age is (13) years old, and (79.2%) of them coming from middle level of socio economic status score.
There are a significant relationship between obese adolescents and their family history of obesity which indicated
that obese father, and obese br

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Medicinal And Chemical Sciences
An Evaluation of Activity of Prepared Zinc Nanoparticles with Extract Green Plant in Treatments of Diclofenac, Levofloxacin, and Tetracycline in Water
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Myrtle plant was washed, dried, and powdered after harvesting to produce a fine powder used in water treatment. An alcoholic extract was created from the myrtle plant using ethanol, which was then analyzed using GC-Mass, Fourier Transform Infrared spectroscopy, and ultraviolet-visible spectroscopy to identify the active components. Zinc nanoparticles were created using alcoholic extract. FT-IR, UV-Vis, SEM, EDX, and TEM were used to characterize zinc nanoparticles. Using a continuous processing procedure, zinc nanoparticles with myrtle extract and powder were employed to clean polluted water containing pesticides and antibiotic. First, 2 g of zinc nanoparticles was mixed with 20 ml of polluted water and the result was (Tetra 44%, Levo 32%),

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Publication Date
Sun Sep 02 2007
Journal Name
Iraqi Postgraduate Medical Journal
The Efficacy of Dextran 70 on Reticuloendothelial System in Systemically Infected Mice with Klebsiella Pneumoniae
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The reticuloendothelial system (RES) play an important role in immunity against bacterial infection and Klebsiella pneumoniae one of the most common causes of hospital-acquired infections. Dextran70 (D70), a polysaccharide, may alter functions of this system through changing many biological activities in the tissues.

Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Physics: Conference Series
Motivational efficacy of lasers on marrow haemopoetic cells
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Abstract<p>Lasers has been proved to increase tissue oxygenation, activate marrow progenitor cells, expanse the microcirculation, accelerate the restoration of functions, stimulate adaptation ability and stabilization of the hormonal status. The semisolid tissue present in the epiphysis of the bone where it’s structure is spongy or cancellous is bone marrow and it formed about 4% of body weight, the marrow is composed of hemopoietic cells, however, the structure of the marrow is of both cellular and non – cellular components. The hemopoietic stem cells are responsible of producing white blood cells, red corpuscles, platelets in addition to the fibroblasts, macrophages, adipocytes, osteoblast</p> ... Show More
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Publication Date
Thu Nov 01 2018
Journal Name
Al-kindy College Medical Journal
The Efficacy and Safety Of Using Hydrochlorothiazide As Adjuvant Therapy In Pediatric Urinary Tract Infections
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Background: Acute urinary tract infection is a common bacterial infection causing illness in infants and children. At age of seven, 8% of girls and 2% of boys will have at least one episode. Although drinking water and using home remedies are known to help to flush away bacteria and keeps them from sticking to the bladder wall, researches to test the efficacy and safety of hydrochlorothiazide's diuretic effect as adjuvant to the antibiotics in pediatric age groups are lacking, and so this research was to address this subject.

Objectives: To assess the effectiveness   and  the safety of hydrochlorothiazide as adjuvant therapy to the antibiotics in treating acute urinary tract infect

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Publication Date
Sun Mar 13 2011
Journal Name
Baghdad Science Journal
Effect of Diclofenac (Voltaren) in histological structure of kidney in male Rabbits (Oryctolagus cuniculus )
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This study was designed to know the effect of Diclofenac sodium (voltaren) drug on the histological composition of kidney in domestic rabbits . Twelve adult males with (1.4) kg weight . The first group of animals administrated orally by 1 ml of Voltaren with 6 mg/kg , while the second group with (1) ml of distal water (as control group ) . the administrated continue for (60) days sequentially. The treatment with voltaren showed pathological cases in tissues and cells of kidney including necrosis, infilteration ,congestion in blood vessels edema.Also epithelial separation in kidney tubules in comparison with control group Conclusion from the above results, revealed that voltaren had negative effects on the kidn

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Publication Date
Thu Jun 12 2025
Journal Name
Folia Medica 67(3): E149216
Impact of thumb sucking on salivary melatonin, Candida albicans, and dental caries in children
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Introduction: Salivary melatonin is a critical antioxidant that contributes to oral health by mitigating oxidative stress. Psychological stress linked to thumb sucking may disrupt oral homeostasis, leading to conditions such as dental caries and fungal infections. Aim: This study explores the relationships between thumb sucking, salivary melatonin levels, dental caries, and the presence of Candida albicans (CA) in children. Materials and methods: A case-control study was conducted with 60 children aged 4-5 years at the University of Baghdad’s College of Dentistry. Participants were divided into thumb-sucking (n=30) and non-thumb-sucking (n=30) groups. Salivary melatonin levels were measured using enzyme-linked immunoso

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