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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
Thu Oct 31 2019
Journal Name
Al-kindy College Medical Journal
Behavior Management of Children with Autism
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Background: Pervasive Developmental Disorder (PDD) is a term refers to the overarching group of conditions to which autism spectrum disorder (ASD) belongs .

Objective: This study was designed to determine the existing behavior of children with autism in dental sitting, the behavior improvements in recall dental visits and evaluate the improvement in oral hygiene with using specific visual pedagogy chart.

Type of the study: Cross-sectional study.

Methods: Forty children of both genders, ages ranged from 4 – 6 years having primary teeth only were selected whose medical history included a diagnosis

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Publication Date
Mon Dec 19 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of NursesPractice Regarding Poisoning Children
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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
Addiction of electronic games for children
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Childhood is characterized by ahigh privacy in the life of the child overall educational institutions in the world. Based on this specificity, modern education begins with a holistic vision of the child through all developmental aspects (moral, religious, emotional, social, linguistic, physical, health, and mental). This integration could be achieved through taking into consideration the needs and rights of children and developing curricula that consider these needs and capacities to provide opportunities for developing and supporting the developmental aspects of the child. The contemporary technological developments in the field of computer and the Internet have brought with it new forms, ideas, and problems for children in recent years

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Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Public Health Research & Development
Post-Traumatic Stress Disorder among Women with Breast Cancer in Iraq: A Preliminary Report
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Publication Date
Fri May 01 2015
Journal Name
Journal Of The Faculty Of Medicine
Gentamycin injection in disc space during lumbar discectomy (aiming to prevent post - operative discitis)
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AW Ali T, Journal of the Faculty of Medicine, 2015 - Cited by 3

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Publication Date
Mon May 01 2023
Journal Name
Clinical And Experimental Dental Research
Atypical clinical features of post COVID‐19 mucormycosis: A case series
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Abstract<sec><title>Objectives

This case series aims to evaluate patients affected with post COVID‐19 mucormycosis from clinical presentation to surgical and pharmacological treatment to improve the disease prognosis.

Material and Methods

This case series was conducted at a specialized surgery hospital in Baghdad Medical City for over 10 months. Fifteen cases who had mild to severe COVID‐19 infections followed by symptoms similar to aggressive periodontitis, such as mobility and bone resorption around the multiple maxillary teeth, were included in this case series.

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Publication Date
Fri Jun 20 1930
Journal Name
College Of Islamic Sciences
Prison and imprisonment   And their impact on the strengthening of power In the Qur'anic perspective
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Prison and imprisonment  
And their impact on the strengthening of power
In the Qur'anic perspective

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Publication Date
Sun Jan 01 2017
Journal Name
Al–bahith Al–a'alami
Advertises of Advertising Mail Post of Emirate of Dubai as a sample
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                The advertising mail is considered as one of potential tools that followed to transfer the printed messages to the consumers and public customers whom are located at homes or works. This type of advertising is preferable due to the zero expense to receive the announcements of products, which became recently one of the successful procedures to create new customers and keep them in touch with direct communication. It is also possible to send them to specific group of people who can be classified by the advertisers to select even by name their own clients to give the personality to the clients for a long term of communication.

&

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
The Effect of Age and occupation on the Type and the Number of workers injuries in construction sector in Iraq
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World statistics proved that the most of work dangerous accidents, which causes death, are occurred in the construction works. These accidents related to many causes such as loss of workers experience and ignoring rules of safety requirements, especially young workers. Due to the risk of accidents that may occur in the site of work, the idea of this study crystallized to show the relationship between the age of worker and number of injuries and accidents, to identify the causes of these injuries, and to put the appropriate solutions to avoid or reduce the risk of work injuries. Also, the research shows the main principles of safety requirements to forming a clear picture about the subject of the study. A questioner form was prepared to c

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Publication Date
Fri Oct 01 2021
Journal Name
Journal Of Al-rafidain University College For Sciences ( Print Issn: 1681-6870 ,online Issn: 2790-2293 )
Nutritional Status of Children below Five Years in Iraq for 2018
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In this article we analysis the data of Iraqi children aged 0-9 months covered in Multiple Indicator Cluster Survey (MICS6-2018) to evaluate the nutritional status . Weight for-age z-score (WAZ), height-for-age z-score (HAZ) and BMI-for-age z-score were compared with the z-scores WHO standards. The overall prevalence of underweight and stunting of the children were 4 % and 11% respectively. Prevalence of overweight based on BMI-for-age for the sexes combined was 21%. Comparing the results obtained from MICS-6 with the results obtained from MICS-4, we find that there is an improvement in the nutritional status of Iraqi children concerning weight, but as for height, we find that there is an increase in the percentage of children who suffer fr

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