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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 Sep 03 2018
Journal Name
Al-academy
Simplicity and complexity in the visual layout of the designs Children magazine covers
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The magazine covers the subjects of (simplicity and complexity in the visual layout of the designs of magazine coverings of children) Chapter I The problem and importance of the goal and limits of research and addition to Terminology. In the second chapter the theoretical framework in which the first topic the role of simplicity and complexity in the design and the second section Visual design and design relations and the third research design in magazine covers and the third chapter includes the methodology of research and analysis and the results and conclusions and sources and the most important result of the research is (simplicity and complexity of design, Continuity and vitality and attract the attention of the receiver through the

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Publication Date
Mon Jan 01 2018
Journal Name
Al-kindy College Medical Journal
Metabolic Syndrome; Comparing the Results of Three Definition Criteria in an Iraqi Sample
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Background: Different diagnostic definition and criteria have been recommended by different expert groups for the diagnosis of metabolic syndrome, however, it’s prevalence in the same population could differ depending on the definition used yielding different results. In Iraq, there is a lack of research comparing these different diagnostic definitions. Objective: To find out the most suitable metabolic syndrome definition to be used for Iraqi people.  Methods: 320 participants were recruited for this study, 53.4% men and 46.6% women, aged between 25-85 years, visiting Baghdad Teaching Hospital, the prevalence of metabolic syndrome according to different definitions were compared and the agreement was assessed by the Kappa st

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Publication Date
Fri Feb 13 2026
Journal Name
Al-kindy College Medical Journal
Metabolic Syndrome; Comparing the Results of Three Definition Criteria in an Iraqi Sample
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Background: Different diagnostic definition and criteria have been recommended by different expert groups for the diagnosis of metabolic syndrome, however, it’s prevalence in the same population could differ depending on the definition used yielding different results. In Iraq, there is a lack of research comparing these different diagnostic definitions.

Objective: To find out the most suitable metabolic syndrome definition to be used for Iraqi people.

 Methods: 320 participants were recruited for this study, 53.4% men and 46.6% women, aged between 25-85 years, visiting Baghdad Teaching Hospital, the prevalence of metabolic syndrome according to different definition

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Publication Date
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Disease Patterns and outcomes of Neonatal Admissions at Raparin Pediatric Teaching Hospital in Erbil City
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Objectives: This study aims to determine the disease’s patterns and outcomes of admission among neonates hospitalized at the neonatal care unit in Erbil City, and using the findings as a baseline for neonate’s morbidity and mortality assessment in the future. Methodology: A retrospective study carried out at neonatal care unit of Raparin pediatric teaching hospital. An instrument for data collection developed by researcher included (age, gender, cause of admission, diagnosis and outcome upon discharge and causes of death). Content validity of the instrument was determined through the use of panel ex

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of The Turkish-german Gynecological Association
Maternal and neonatal outcomes in adolescent pregnant women with one prior Cesarean section in Baghdad
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Publication Date
Wed Jan 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
The role of electrolytes and inflammatory biomarkers in the development of febrile seizure in children
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Publication Date
Sun Jun 02 2024
Journal Name
Methods And Objects Of Chemical Analysis
Simultaneous Spectrophotometric Determination of Piroxicam, Naproxen, Diclofenac Sodium and Mefenamic Acid in Pharmaceutical Formulations by Partial Least Squares Method
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A chemometric method, partial least squares regression (PLS) was applied for the simultaneous determination of piroxicam (PIR), naproxen (NAP), diclofenac sodium (DIC), and mefenamic acid (MEF) in synthetic mixtures and commercial formulations. The proposed method is based on the use of spectrophotometric data coupled with PLS multivariate calibration. The Spectra of drugs were recorded at concentrations in the linear range of 1.0 - 10 μg mL-1 for NAP and from 1.0 - 20 μg mL-1 for PIR, DIC, and MEF. 34 sets of mixtures were used for calibration and 10 sets of mixtures were used for validation in the wavelength range of 200 to 400 nm with the wavelength interval λ = 1 nm in methanol. This method has been used successfully to quant

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Publication Date
Sun Dec 01 2013
Journal Name
Baghdad Science Journal
Bacterial Causes Tonsillitis in Children, Study the Resistance to Antimicrobials and the Effect of Clove Extracts on Selected Isolated Bacteria.
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In this study Isolated Pathogenic bacteria which causes Tonsillitis in Children with ages between 3-17 years. They are admitted to Central Children Hospital (Al-Karch) and Ebn-Albalady Hospital (Al-Rusafa). 200 cases were collected which include 120 Male and 80 Female. The result of the recent study shows that the isolation percentage was 40% from Male and 35% from Female. In this study Fifty six isolated were Identified, 20 were ?-hemolytic Streptococcus which was Streptococcus pyogenes, formed (36%) from all isolated.6 Pathogenic bacteria were ?- hemolytic Streptococcus which was Streptococcus pneumoniae formed (11%). The number of Moraxella catarrhalis bacteria was 12 formed (21%), the number of Haemophilus influenzae was 1

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Publication Date
Fri Feb 13 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of fracture strength of endodontically treated teeth restored by milled zirconia post and core with different post and core systems (An in vitro comparative study)
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Background: Restoration of root canal treated teeth with a permanent restoration affect in the success of endodontically treated teeth. This in vitro study was performed to evaluate and compare the fracture strength of endodontically treated teeth restored by using custom made zirconium posts and cores, prefabricated carbon fiber, glass fiber and zirconium ceramic posts. Materials and method: Forty intact human mandibular second premolars were collected for this study and were divided into five groups. Each group contains 8 specimens: Group1: Teeth restored with Carbon Fiber Posts; Group2: Teeth restored with Glass Fiber Posts; Group3: Teeth restored with Zirconium Ceramic prefabricated Posts; Group4: Teeth restored with Zirconium Posts

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Publication Date
Fri Feb 13 2026
Journal Name
Al–bahith Al–a'alami
THE ROLE OF WESTERN LEGISLATIONS AND LAWS IN PROTECTING CHILDREN FROM ADVERTISEMENT
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This study aims to identify the most important legislatures and legal frameworks pertaining to advertisement for children. It focuses on the western approach, which is characterized by the variety of its perspectives in presenting issues and in identifying problems. However, if studies show that there is a certain awareness about the advertisement impact on children, it is obvious that most of legislatures reject the laws restricting the broadcast advertising spots intended for children under 12 years of age, with the exception of the Swedish and the Canadian province of Quebec experiences, which opted for total ban on advertising spots broadcast messages targeting children.

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