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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
Fri Jul 26 2024
Journal Name
Surgical Neurology International
Orbital varices: Epidemiology, clinical presentation, and treatment outcomes – A scoping review
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Background:

Orbital varices are vein dilations in the orbit presenting various symptoms. This scoping review synthesizes existing evidence on their epidemiology, clinical features, and treatment efficacy.

Methods:

Literature was reviewed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed and Scopus were searched until April 31, 2024, for articles on clinically diagnosed ocular varices detailing diagnostic methods, treatments, and outcomes. Exclusions were reviews, animal studies, and incomplete case reports. Data on study characteristics, diagnosis, management, and o

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Publication Date
Mon Nov 05 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation and Comparison of Complete Dentures’ Complaints: Post-insertion
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Aims: This study aims to compare patients’ complaints and problems of wearing complete dentures.
Methodology: The sample included 40 Iraqi patients who are wearing complete dentures from about five years ago. They
were selected randomly with a age range between (55–65) years. The questions asked to the patients were listed according
to the recent classification of post-insertion problems.
Result: The results showed that the percentage of patient's complaint from adaptation problems (62.1%) was higher than
looseness problems (61.3%) and discomfort problems (39.3%) as followed.
Recommendation: Dentists need thorough knowledge of anatomy, physiology, pathology and psychology. The assessing
of the psyche and emotions

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Publication Date
Fri Dec 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Comparing the effectiveness of using three different re-mineralizing pastes on remineralisation of artificially induced white spot lesion
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Background: This study aimed to compare the surface microhardness (MH) and mineral content of white spot lesions(WSLs) after using bioactive glass (BAG)casein phosphopep-tides-amorphous calcium phosphate(CPP-ACP),and nanohydroxyapatite(Nano-HAP) under pHcycling. Material and method:18 sound maxillary first premolar were used for the study.10 were selected for the vickers microhardness test, For Energy-dispersive X-ray spectroscopy analysis (EDX), the remaining 8 premolar teeth were used, 40 sections of enamel blocks (Four from each tooth) were produced from the middle part of the buccal and palatal surfaces of teeth for MH test while 48 sections of enamel blocks (Six from each tooth) were produced for EDX analysis. Enamel slabs were divi

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Publication Date
Fri Dec 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Comparing the effectiveness of using three different re-mineralizing pastes on remineralisation of artificially induced white spot lesion
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Background: This study aimed to compare the surface microhardness (MH) and mineral content of white spot lesions(WSLs) after using bioactive glass (BAG)casein phosphopep-tides-amorphous calcium phosphate(CPP-ACP),and nanohydroxyapatite(Nano-HAP) under pHcycling. Material and method:18 sound maxillary first premolar were used for the study.10 were selected for the vickers microhardness test, For Energy-dispersive X-ray spectroscopy analysis (EDX), the remaining 8 premolar teeth were used, 40 sections of enamel blocks (Four from each tooth) were produced from the middle part of the buccal and palatal surfaces of teeth for MH test while 48 sections of enamel blocks (Six from each tooth) were produced for EDX analysis. Enamel slabs were

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Publication Date
Mon Jan 01 2024
Journal Name
Kafkas Universitesi Veteriner Fakultesi Dergisi
Assessment of In-vitro Cytotoxicity and In-ovo Virucidal Antiviral Efficacy of Various Plant Extracts and Bioactive Molecules
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Publication Date
Tue Dec 13 2011
Journal Name
Iraqi Journal Of Laser
The Efficacy of Er:YAG Laser on Intrapulpal Temperature Rise of Class V Cavity Preparation
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The objective of this study is to determine the efficacy of class V Er:YAG laser (2940 nm) cavity preparation and conventional bur cavity preparation regarding Intrapulpal temperature rise during cavity preparation in extracted human premolar teeth. Twenty non carious premolar teeth extracted for orthodontic purposes were used and class V cavity preparation was applied both buccal and lingual sides for each tooth .Samples were equally grouped into two major groups according to cavity depth (1mm and 2mm). Each major group was further subdivided into two subgroupsof ten teeth for each (twenty cavities for each subgroup). TwinlightEr:YAG laser (2940 nm) with 500mJ pulse energy, P.R.R of 10 Hz and 63.69 J/cm2 energy density was used. The ana

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Publication Date
Tue Oct 04 2022
Journal Name
Azerbaijan Medical Journal
Ultrasonic fetal Doppler and growth indices and their relation to immediate neonatal outcomes in different severities of maternal anemia
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Doppler assessment may lead to intervention that reduces the risk of fetal brain damage. Aim of thestudy: to assess the relation between ultrasonic hemodynamic Doppler indices of middle cerebral and umbilical arteries (PI, RI), growth indices to immediate neonatal outcomes (weight, head & abdominal circumference, APGAR scores at 1 and 5 minutes and neonatal unit admission) in women with mild, moderate and severe anemia during pregnancy. Present study is a clinical prospective study carried out in Al-Elwiya Maternity Teaching Hospital during (January-Jun) 2019, all anemic pregnant women presented to Obstetrical wards in hospitals for emergency cesarean section were the study population. The final sample selected was 120 pregnant women. Ultra

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Publication Date
Mon Jan 11 2021
Journal Name
2nd International Conference In Physical Science & Advanced Materials
Comparing the optical parameters for thin CAZTSe films prepared with various Ag ratios and annealing temperatures
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􀀑􀀃Pure Cu (CZTSe) and Ag dopant CZTSe (CAZTSe) thin films with Ag content of 0.1 and 0.2 were fabricated on coring glass substrate at R.T with thickness of 800nm by thermal evaporation method. Comparison between the optical characteristics of pure Cu and Ag alloying thin films was done by measuring and analyzing the absorbance and transmittance spectra in the range of (400-1100)nm. Also, the effect of annealing temperature at 373K and 473K on these characteristics was studied. The results indicated that all films had high absorbance and low transmittance in visible region, and the direct bang gap of films decreases with increasing Ag content and annealing temperature. Optical parameters like extinction coefficientrefractive index, and

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Publication Date
Wed Jul 10 2024
Journal Name
The Open Neuroimaging Journal
The Efficacy of Bedside Chest Ultrasound in the Detection of Traumatic Pneumothorax
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Background

Chest X-rays have long been used to diagnose pneumothorax. In trauma patients, chest ultrasonography combined with chest CT may be a safer, faster, and more accurate approach. This could lead to better and quicker management of traumatic pneumothorax, as well as enhanced patient safety and clinical results.

Aim

The purpose of this study was to assess the efficacy and utility of bedside US chest in identifying traumatic pneumothorax and also its capacity to estimate the extent of the lesion in comparison to the gold standard modality chest computed tomography.

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Publication Date
Mon Jul 03 2017
Journal Name
Iraqi New Medical Journal
Coarctation of aorta in pediatric age group: mode of presentation, early and intermediate outcomes of interventional treatment
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Although rare, coarctation of aorta is a treatable cause of hypertension, transcatheter dilatation by balloon with or without stent are a well-known treatment strategy