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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
Sun Dec 02 2018
Journal Name
Journal Of The College Of Education For Women
Poverty and its Relations to Some Social Variables (Children in the Primary Stage as a Model)
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The phenomenon of poverty is one of the most important phenomena facing the world at large. Despite the tremendous technological progress witnessed by mankind and despite the unprecedented high levels of world economic production, poverty remains the greatest challenge facing the world. Statistics and studies have shown that poverty is caused by several problems: (health, social, economic, educational, etc.) These problems are obstacles to the ability to obtain employment opportunities, which leads in the beginning to the growth phenomenon of unemployment, and ultimately to the growth of poverty.

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Publication Date
Thu Dec 06 2018
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Comparing the Quality of Life among Patients with Relapsing Remitting Multiple Sclerosis in Iraq Using Different Disease Modifying Therapies
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Multiple sclerosis (MS) is a chronic, inflammatory, immune mediated disease of the central nervous system, mostly affecting young adults with mean age of 30 years, twice as high in women compared to men. The etiology of MS is not fully elucidated. MS symptoms are directly related to demyelination and axonal loss, along with other psychological symptoms, can result in functional limitations, disability and reduced quality of life (QoL).  The QoL assessments in patients with a chronic disease may contribute to improving treatment and could even be of prognostic value. The goals  of this study were  to  compare the QoL of  Iraqi patients with relapsing remitting multiple sclerosis (RRMS),using three different diseas

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Publication Date
Wed Jan 01 2020
Journal Name
International Journal Of Engineering Business Management
Using ANN in emergency reconstruction projects post disaster
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The purpose of this study is to avoid delays and cost changes that occur in emergency reconstruction projects especially in post disaster circumstances. This study is aimed to identify the factors that affect the real construction period and the real cost of a project against the estimated period of construction and the estimated cost of the project. The case study is related to the construction projects in Iraq. Thirty projects in different areas of construction in Iraq were selected as a sample for this study. Project participants from the projects authorities provided data about the projects through a data collection distributed survey made by the authors. Mathematical data analysis was used to construct a model to predict change

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
The speaking Skill the Children of Kindergartens
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Language is fundamental and important for the development of various skills especially in the kindergarten stage where the child begins to approach others and interact with them linguistically listen to them and make sentences to communicate his ideas to them and without the ability to talk and expression, the child's benefit of his experiences in the kindergarten remains limited.

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Publication Date
Fri May 30 2025
Journal Name
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Exploring Dental Students' Perspectives: The Impact of Hybrid Learning in a Post-Pandemic World
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Background: The pandemic crisis prompted the world to adopt unexpected approaches to continue life as normally as possible. The education sector, including professors, students, and the overall teaching system, has been particularly affected. Objective: This study seeks to evaluate the benefits, challenges, and strategies related to COVID-19 from the perspectives of college students, particularly those in higher education in Iraq. Method: The online survey questionnaire was distributed via Google Forms and specifically aimed at undergraduate dental students. Results: A total of 348 students participated in the survey. There was a significant correlation (P > 0.01) between student satisfaction with hybrid learning and their experi

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Wed Jan 01 2020
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The Efficacy of 4% Articaine Infiltration Anesthesia in the Extraction of Mandibular Molars: A Randomized Controlled Study
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Introduction: Articaine was developed in 1969, with reported advantages which are increased potency, increased duration of its anesthetic effect and superior diffusion through bony tissue. The effectiveness of using 4% articaine infiltration for extraction of mandibular molar teeth in comparison to 2% lidocaine inferior alveolar nerve block is not settled yet. Aim: The aim of this study was to evaluate the effectiveness of using 4% articaine infiltration for extraction of mandibular molars by comparing it to the use of 2% lidocaine inferior alveolar nerve block in terms of success, the volume of local anesthetic agents and the pain experienced during the procedure. Materials and methods: A prospective randomized controlled study included

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Publication Date
Thu May 05 2022
Journal Name
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Spinal Tuberculosis in Children
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Tuberculosis continues to be the leading cause of morbidity and mortality, with an estimated annual incidence of 10.4 million worldwide. It has been estimated that 10% of patients with extrapulmonary tuberculosis have musculoskeletal involvement, with the spine being the most common. Spinal tuberculosis (TB) accounts for 50% of cases of musculoskeletal tuberculosis.

Spinal tuberculosis is the result of infection with Mycobacterium tuberculosis. It is a secondary infection, the primary lesion of which is in the lungs, genitourinary system, or gastrointestinal tract and can be active or latent. Involvement of the vertebral segment is the result of hematogenous spread of infection along the arterial pathway or Batson's vei

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Wed Dec 27 2023
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Efficacy of Autogenous Dentin Biomaterial on Alveolar Ridge Preservation: A Randomized Controlled Clinical Trial
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Background. After tooth extraction, alveolar bone resorption is inevitable. This clinical phenomenon challenges dental surgeons aiming to restore esthetic and function. Alveolar ridge preservation can be applied to minimize dimensional changes with a new socket grafting material, an autogenous dentin graft, produced by mechanically and chemically processing natural teeth. This study assessed the safety and efficacy of using autogenous dentin biomaterial in alveolar ridge preservation. Materials and Methods. Patients with nonrestorable maxillary anterior teeth bounded by natural sound teeth were included in this study. After a detailed clinical and tomographic examination, eligible participants were randomly allocated into two groups

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Efficacy of Autogenous Dentin Biomaterial on Alveolar Ridge Preservation: A Randomized Controlled Clinical Trial
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Background. After tooth extraction, alveolar bone resorption is inevitable. This clinical phenomenon challenges dental surgeons aiming to restore esthetic and function. Alveolar ridge preservation can be applied to minimize dimensional changes with a new socket grafting material, an autogenous dentin graft, produced by mechanically and chemically processing natural teeth. This study assessed the safety and efficacy of using autogenous dentin biomaterial in alveolar ridge preservation. Materials and Methods. Patients with nonrestorable maxillary anterior teeth bounded by natural sound teeth were included in this study. After a detailed clinical and tomographic examination, eligibl

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Publication Date
Thu Jul 15 2021
Journal Name
University Of Samarra
Preparation, Diagnosis and Biological ‎Efficacy of new Ligands Derived from ‎Succinyl Chloride and Their Metal ‎Complexes and non metallic
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The purpose of my thesis is to synthesis two new bidentate ligands ‎which were used to prepare series of metal complexes by reacting the ‎ligands with (M+2 = Mn, Co, Ni, Cu, Cd and Hg) ‎ ‎ Succinyl chloride was used as starting material to synthesis two ‎bidentate ligands (L1) and (L2) by reaction it with 4-chloroaniline ‎‎(L1) and ‎ ‎ (4-aminoacetophenone) (L2) in dichloromethane as a solvent, that ‎are:‎ ‎(L1) = N1,N4-bis (4-chloro phenyl ) succinamide ‎(L2) =N1,N4-bis(4-acetylphenyl)succinamide ‎ The new ligands were characterize by using spectroscopic study ‎‎(Fourier-transform infrared spectroscopy (FT-IR), electronic spectra ( ‎UV-Vis) ,nuclear magnetic resonance(1H,13C-NMR), Mass spectra ‎

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