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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 Jun 18 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Some Pro and Anti-Inflammatory Cytokines in Children with Tonsillitis and their Correlations with Vitamin D Deficiency
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Inflammation of the tonsils could be described as acute tonsillitis, mainly due to infection. Recurrent tonsillitis could be defined as 3-7 episodes during the first 3 years of age. Vitamin D, which is a neuro-hormone with pleiotropic biological activities may modulate the immune response by alleviation, and stimulation of Th1 and Th2 cell proliferation, respectively, that influence the stimulation, synthesis, and secretion of both pro and anti-inflammatory cytokines. In this study we aimed to shed light on the levels of vitamin D in children with different episodes of tonsillitis in association with levels of interleukins (TNFα, IL-2, IL-4, IL-10). Blood samples were collected from 48 participants in 3 groups: control, acute tonsilliti

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Publication Date
Sun Dec 06 2015
Journal Name
Baghdad Science Journal
Efficacy of some local isolates of Beauveria bassiana(Bals.) and Metarhizium anisopliae (Met.) in control of mosquito larvae of Culex quinquefasciatus (Say)
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The main aim of this study is to investigate the ability of four local entomopathogenic isolates Beauveria bassiana (Bals.) and Metarhizium anisopliae (Met.) to control the mosquito larvae in the lab. The results revealed that the isolate (MARD48) B .bassiana reduced the survival rate of the mosquito larvae to (80%) followed by the isolate M. anisopliae (MARD10) to (90%) in the first two days of treatment, and 60 and 66% respectively in the third day. The results also showed that the isolate B. bassiana (MARD48) killed 50% of the population (LC50) with the concentration 1×104 conidia/ml compared to 1×107 conidia/ml for the isolates B. bassiana (MARD14) and M. anisopliae (MARD10), and 1×108 conidia/ml for the isolate B .bassiana (MARD76).

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Publication Date
Sat Dec 31 2022
Journal Name
Al-kindy College Medical Journal
The Youngest Palestinian Case of Multisystem Inflammatory Syndrome in children (MIS-C)
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The multisystem inflammatory syndrome in children (MIS-C) considers a post-infectious immunological response to coronavirus illness (COVID-19) that was originally identified in the United Kingdom and later identified in other countries.  A previously healthy 3-month-old boy was admitted to hospital context with -5-day history of fever, gastrointestinal symptoms [diarrhea, vomiting of normal gastric contents], hypoactivity, and poor oral intake, but so far no history of covid-19 active disease. The infant was dehydrated, with macular non-blanching skin rash everywhere over his body and widespread non-pitting edema. With supportive measures, methylprednisolone and IV immunoglobulin, the child improved, with his fever, skin rash, and labor

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Publication Date
Sun Jan 03 2010
Journal Name
Journal Of Educational And Psychological Researches
The non right behavior appearance for the kindergarten children and its relation with the kindergarten teaching style
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The kindergarten teacher play a role in fixing the children behavior so she must plant the value and the habits that make a positive behavior and accepted by the society so the teacher must know all the right educational psychological styles to fix the children behavior and make them accepted psychologically and socially so the problem of the research start from knowing the relation between the methods of dealing with the kindergarten’s teachers and the non right behavior appearance for the kindergarten children. The current research aims to measure the negative behavior appearance of the children of kindergarten and distinguish it according to (sex and levels) and to distinguish the most using styles by the teachers of kinderg

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Risk Factors influencing Post-Partum Depression Severity in Iraqi Women
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Background: Post-partum depression (PPD) is a form of postnatal depression that affects mothers. Clinical manifestations usually appear within six months after delivery. Risk factors that influence the severity of post-partum depression are not fully known in the Iraqi population.
Objectives: We aim to evaluate the risk factors and identify potential predictors that may influence the symptom levels (severity) of post-partum depression among Iraqi women from Baghdad.
Subjects and Methods: The current study is cross-sectional, and we used the Edinburgh Postnatal Depression Scale (EPDS) and a cut-off value of 13 to differentiate patients into two those with lower symptom levels (LSL) and higher symptom levels (HSL). We also explored p

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Publication Date
Mon Jul 04 2016
Journal Name
University Of Plymouth
‘History Engraved on his Shoulder’: A Comparative Study of the Influence of British First World War Poetry on Post 1980 Iraqi War Poetry "embargoed indefinitely"
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Abstract This study aims to compare British war poetry of the First World War with Iraqi poetry from the mid-20th century with special reference to Iraqi war poetry of the 1980’s Iraq-Iran War and the period that followed it. It will also investigate the influence of the designated British war poetry on the chosen body of Iraqi poetry. Through the comparison of sample poems the study presents, firstly, the direct influence of the British poetry of the Great War and its translation which formed the seeds of a more radical movement in Iraqi poetry during the 1980’s Iran/Iraq War and the period that followed it. The study also presents a comparison of the works of British and Iraqi civilian poets during and after the war time and their con

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
EFFECT OF SIX HATS IN THE DEVELOPMENT OF LANGUAGE SKILLS OF KINDERGARTEN CHILDREN
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Increasing need for day after day to find ways and innovative means of
helping to educate and give children the skills of different kind, has found a
researcher on the subject of hats, six room to give children language skills
through the experience of field reconnaissance conducted on the three
children found that language skills improved, he decided to make these study.
Objectives of the study:
Understand the differences between the experimental group first (the way the
debate) and second (six caps) depending on the test post administration.
to identify the language skills of the second group according to the pre and
post test
Differences between males and females in the second group (Six Hats)
Search T

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Publication Date
Thu Nov 14 2024
Journal Name
Journal Of Studies And Researches Of Sport Education
The Effect Of Suggested Exercises On Developing Some Mental Abilities For Children Aged 4-6 Years
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The purpose of the current article lies in determining  the impact of the suggestive  exercises on the development of  the mental capabilities of children. The researchers used the experimental method with a single-group design, which was appropriate for the core of the current article . The study samble  has been specified as children aged 4-6 years in Umm Al-Rabi'een Kindergarten, with a total of 95 children. The study samble  (15 children) was randomly selected.  . After the exercises were completed, the post-tests have been carried out  on the sample  with similar circumstances as that of  pre-tests.  Researchers used statistical methods in the SPSS program. After the results were presented, analyzed, and discussed, The resear

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Publication Date
Thu Jul 11 2024
Journal Name
Maaen Journal For Medical Sciences
Pharmacological Supplements Efficacy in Management of chronic pain associated with Sickle Cell Disease: A narrative review
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Sickle cell disease (SCD) is a hereditary ailment that can cause severe pain and suffering to people who are affected. However, with continued investment in research and treatment options, we can make progress towards improving the lives of those with SCD. Over 40% of patients experience painful vaso-occlusive crises (VOCs), so we must work towards finding solutions and providing support for those living with this condition, These episodes, a hallmark of SCD, significantly contribute to morbidity, mortality, and a diminished quality of life, while also incurring substantial healthcare costs. Chronic pain particularly affects older adolescents and adults with SCD, with over half reporting daily discomfort. Opioid-based analgesics, though sti

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Publication Date
Wed Jul 07 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
Impact of Pregnant Women’s Depression State upon their Pregnancy Outcomes at Maternity Hospitals in Baghdad City
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Objective: To assess the impact of pregnant women’s depression state upon their pregnancy outcome Methodology: A descriptive purposive study was used to assess the impact of pregnant women’s depression state on their pregnancy outcomes. The study was conducted from (22nd \ September \ 2020 to 15th \ February \ 2021). A non-probability sample (purposive sample) was selected from 100 women. Data were collected through an interview with the mother in the counseling clinic, during the third trimester of pregnancy, as well as after childbirth in the labour wards to assess the outcome of pregnancy. Data were analyzed through descriptive statistics (frequency and percentages). Results: The most important thing observed in this study was the ne

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