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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
Thu Jan 01 2026
Journal Name
Malaysian Journal Of Nursing
Nursing Implications in Managing Oral Health among Children: Narrative Review
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Background: Oral health is an essential component of nursing care, and the maintenance of oral health, through both pharmacological and non-pharmacological management, is widely employed in clinical practice to support effective oral care. In children, oral health plays a crucial role in overall wellbeing, and nurses are often among the first healthcare professionals to identify, address, and prevent oral health problems. Objectives: This narrative review synthesizes and analyzes the historical evolution and available evidence regarding the nursing role in managing oral health in children, with a specific focus on nurse-led practices. It explores how nurses contribute to prevention, early detection, education, and the implementation

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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 Jun 28 2019
Journal Name
Journal Of The College Of Education For Women
The Effectiveness of an Educational Program For Early Intervention depending on Illustrative Pictures to Acquire some concepts For Children with Hearing impairment
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“Child of today is a man of the future" this slogan is one of the most popular logos of international organizations and institutions that dealing with human beings needs in general and children needs in particular, whether these needs are educational, health, social, or economic. Children require special care and extra legal protection, since the child-raising is not the Child’s own issue, but it's the issue of the society in which he/she would integrate.

As the education and language skillsacquisition primarily associated with hearing, because human being receives most of the skills and knowledge through the hearing; that imitate sounds and learn how to speak isacquired only by hearing, so therefore the hearing - impairedchi

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Publication Date
Fri Oct 01 2010
Journal Name
Iraqi Journal Of Physics
Investigation of plasma characteristics of center region of post cylindrical magnetron sputtering device
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A d.c. magnetron sputtering system was designed and fabricated. The chamber of this system is consisted from two copper coaxial cylinders. The inner one used as the cathode and the outer one used as anode with magnetic coil located on the outer cylinder (anode). The axial behavior of the magnetic field strength along the cathode surface for various coil current (from 2A to 14A) are shown. The results of this work are investigated by three cylindrical Langmuir probes that have different diameters that are 2.2mm, 1mm, and 0.45mm. The results of these probes show that, there are two Maxwellian electron groups appear in the central region. As well as, the density of electron and ion decreases with increases of magnetic field strengths.

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Publication Date
Tue Sep 28 2021
Journal Name
Journal Of The College Of Education For Women
Reasons for Lying in Kindergarten Children from the Kindergarten Teachers’ Point of View: A Comparative Study between Males and Females: سجلاء فائق هاشم , كلثوم عبد عون ردام
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Lying is considered a dangerous tendency among children if it has become a habit. It results in many social problems, such as child’s loss of confidence, lack of others’ respect to him, and his lack of respect to the desired values ​​of the society, such as honesty and trust. Consequently, he will be led to a deviation when he becomes old; especially if the child’s socially unaccepted behavior has not been directed. The research, thus, aims to examine the causes of lying in the most important stage of children’s life; that is, between (4-6) years. Such an aim helps to know about the individual reasons of lying among males and females from teachers’ perspectives. To meet the objective of the study, a number of (128) children

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Publication Date
Wed Aug 10 2016
Journal Name
Fourth International Conference On Genetics And Scientific Environment. Cairo / Arab Republic Of Egypt For The Period From July 23 To 30
Efficacy of Arbuscular mycorrhiza (AM) in inducing non-enzymatic antioxidants in tomato leaves infected with Fusarium oxysporum f. sp. Lycopersici.
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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 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

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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