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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 Mar 07 2010
Journal Name
Baghdad Science Journal
Lymphocyte phenotyping in untreated children patients with chronic allergic asthma
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This study aimed to isolate and phenotype lymphocytes in untreated children patients with chronic allergic asthma. To reach such aim the study involved (25) patients from children (17 male and 9 female) whom their ages where between (3-10) years, in addition to (15) apparently healthy children (9 male and 6 female) in the same ages involved as control group. The data demonstrated that there was a significant increase in the mean percentages of T-lymphocytes (CD3+ cells) in the peripheral blood of patients (66.75±0.29)**, in comparison with control group (43.58±0.19), a significant increase in the mean percentages of T-helper lymphocytes (CD4+ cells) in the pe

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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Oral health status among kindergarten children in Karbala city\Iraq
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Back ground: Dental caries and periodontal disease followed by enamel defect were the most common and widely spread diseases affecting children. Aim of this study is the assessment of the occurrence and severity of dental caries, dental plaque, gingivitis and enamel anomalies among 4-5 years old children in Karbala city-Iraq. Materials and methods: A sample of 658 children (350 males, 308 females) aged four and five years old was selected randomly from the fourteenth kindergartens in Karbala city. Diagnosis and recording of dental caries and enamel anomalies were followed the criteria of WHO 1987, WHO1997 respectively. Dental plaque was assessed using plaque index of Silness and Loe,1964. Gingival health condition was assessed using gingiv

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Publication Date
Fri Dec 30 2016
Journal Name
Al-kindy College Medical Journal
Congenital Thrombasthenia In Children Welfare Teaching Hospital: A Descriptive Study
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Background: Thrombasthenia is an inherited genetic disorder affecting platelets, which is characterized by spontaneous muco-cutaneous bleeding and abnormally prolonged bleeding in response to injury or trauma. Objectives: The aim of this study was to assess the diagnosis and treatment of thrombasthenia in Children Welfare Teaching Hospital. Type of the study: A cross-sectional study. Methods: This descriptive study was performed on 66 patients with thrombasthenia from the first of October 2013 till the first of July 2015.The diagnosis of the disease was done by a wide spectrum of characteristics including family history, clinical manifestations, laboratory tests.. Results: The common manifestations of the disease at time of diagnosis wer

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
5'-nucleoridase activity in sera from iraq children with leukemia
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Enzyme activity were studied in the sera of children with leukemia than healthy children, where 31 cases were studied, including 21 cases of patients with acute lymphatic leukemia

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Publication Date
Sun Apr 03 2016
Journal Name
Journal Of Educational And Psychological Researches
The effect of a counseling program to develop the skills of friendship among introverts children
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Some children are suffering from introversion in kindergartens , so it must be confront and obviated by specialists because it will inevitably lead to unsatisfactory results reflect negatively on the individual and the community together . And the introvert child is a miserable child incapable of social interaction or give - and - take with colleagues , lack of integration of the child to life leads to the obstruction of  participation with his peers in various activities.     Introversion  causes a real emotional deficit to the children of kindergartens which limits of possibility of their intellectual development and mental growth and that because of their isolation and poor focus in education

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Publication Date
Sat Aug 10 2019
Journal Name
Engineering, Technology & Applied Science Research
Performance of Segmental Post-Τensioned Concrete Beams Exposed to High Fire Temperature
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The present study illustrates observations, record accurate description and discussion about the behavior of twelve tested, simply supported, precast, prestressed, segmental, concrete beams with different segment numbers exposed to high fire temperatures of 300°C, 500°C, and 700°C. The test program included thermal tests by using a furnace manufactured for this purpose to expose to high burning temperature (fire flame) nine beams which were loaded with sustaining dead load throughout the burning process. The beams were divided into three groups depending on the precast segments number. All had an identical total length of 3150mm but each had different segment number (9, 7, and 5 segments), in other words, different segment length

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Engineering
Strengthening of Reinforced Concrete T- Section Beams Using External Post-Tensioning Technique
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This research is carried out to investigate the externally post-tensioning technique for strengthening RC beams. In this research, four T-section  RC beams having the same dimensions and material properties were casted and tested up to failure by applying two mid-third concentrated loads. Three of these beams are strengthened by using external tendons, while the remaining beam is kept without strengthening as a control beam. Two external strands of 12 mm diameter were fixed at each side of the web of the strengthened beams and located at depth of 200 mm from top fiber of the section (dps). So that the depth of strands to overall depth of the section ratio (dps

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Publication Date
Wed Jun 30 2010
Journal Name
Al-kindy College Medical Journal
Assessment of workplace hazards among working children in al amen city, Baghdad
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Back ground: One out of six children in the
world today is involved in child labor, doing
work that is damaging to his or her mental,
physical and emotional development.
Objective: Assessment of some health
problems among the studied working children.
Method; A cross-sectional study was
conducted in Al Amen Primary Health Care
(PHCC) during the period from January to
August 2009, a sample of 6048 children were
selected randomly(3218girls and2866 boys age
between 5-17 years ) and interviewed to collect
information using a structured questionnaire
form, information related to different aspects
of child labor prevention were included in the
form as well as a general medical examination
and lab

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Publication Date
Sun Jun 07 2015
Journal Name
Baghdad Science Journal
Study of Some Biochemical Parameters in Iraqi Children with Acute Lymphoblastic Leukemia
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Leukemia or cancer of the blood is the most common childhood cancer, Acute lymphoblastic leukemia (ALL), is the most common form of leukemia that occurs in children. It is characterized by the presence of too many immature white blood cells in the child’s blood and bone marrow, Acute lymphoblastic leukemia can occur in adults too, treatment is different for children. Children with ALL develop symptoms related to infiltration of blasts in the bone marrow, lymphoid system, and extramedullary sites, such as the central nervous system (CNS). Common constitutional indications consist of fatigue (50%), pallor (25%), fever (60%), and weight loss (26%). Infiltration of blast cells in the marrow cavity and periosteum often lead to bone

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Publication Date
Sun Feb 08 2009
Journal Name
Ibn Al- Haitham J. For Pure & Appl. Sci.
Evaluation of Dot. ELISA test for Diagnosis Visceral Leishmaniasis in Infected Children
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Evaluation of Dot. ELISA test for Diagnosis Visceral Leishmaniasis in Infected Children