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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
Wed Feb 22 2023
Journal Name
Iraqi Journal Of Science
Miltefosine Efficacy on Leishmania Donovani Promastigote
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In the current study, different concentrations of miltefosine drug, which is the first effective and safe oral treatment for visceral leishmaniasis, was evaluated against L. donovani promastigotes in comparison with pentosam drug. Direct counting microscopic assay was used to find 50% inhibitory concentration (IC50) of miltefosine and pentostam against L. donovani promastigotes. The IC50 of miltefosine drug was 45.42μg/ml, 46.76μg/ml and 36.68μg/ml after 24 hr, 48hr and 72hr respectively, In comparison with IC 50 of pentostam drug was 75.39 μg/ml after 72hr. There were significant differences (P˂0.05) between IC50 values of miltefosine and pentostam drugs from first day to third day.

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Publication Date
Tue Sep 01 2020
Journal Name
Asian Journal Of Pharmacy And Pharmacology
Clinical manifestations and maternal outcomes of COVID-19 in pregnancy: A systematic review
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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Synthesis and Preliminary Pharmacological Evaluation of New Analogues of Diclofenac as Potential Anti-inflammatory Agents
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         A group of amine derivatives [4-aminobenzenesulfonamide derivatives, 2-aminopyridine and 2-aminothiazole] incorporated to α-carbon of diclofenac a well known non-steroidal anti-inflammatory drug (NSAID) to increase bulkiness were designed and synthesized for evaluation as  a potential anti-inflammatory agents with expected COX-2 selectivity. In vivo acute anti-inflammatory activity of the selected final compounds (9, 12 and 13) was evaluated in rats using egg-white induced edema model of inflammation in a dose equivalent to (3 mg/Kg) of diclofenac sodium. All tested compounds  produced a significant reduction  in paw edema with respect to the effect of propylene glycol 50

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Publication Date
Thu Oct 31 2019
Journal Name
Al-kindy College Medical Journal
Assessment of efficacy and safety of dapsone gel 5% in the treatment of acne vulgaris
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ABSTRACTBackground : Acne vulgaris is a
common skin disease, affecting more than 85% of
adolescents and often continuing into adulthood.
People between 11 and 30 years of age and up to
5% of older adults. For most patients acne remains
a nuisance with occasional flares of unsightly
comedones, pustules and nodules. For other less
fortunate persons, the sever inflammatory response
to Propionibacterium acnes (P.acnes) results in
permanent
Methods: Disfiguring scars. (1, 2) Stigmata of sever
acne cane lead to social ostracism, withdrawal
from society and severe psychologic
depression (1-4).
Result Pathogenesis of acne Traditionally, acne
has been thought of as a multifactorial disease of
the fo

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Crossref (2)
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Publication Date
Tue Jun 30 2015
Journal Name
Al-kindy College Medical Journal
Effects of local Infiltration of Bupivacaine in total hip and knee replacement for post - operative analgesia
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Background: Pain is one of the most postoperative complications of surgical wound especially within first 24 hrs. leading to delay hospital discharge, stress gastritis and increasing blood pressure. As wound infiltration with long acting local anesthetic (bupivacaine) has been proved to be effective after orthopedic surgeries especially total hip and knee replacements.Objective: our study was designed to determine theeffectiveness of local infiltration of 0.5% of bupivacainebefore closure of surgical wounds in controllingpostoperative pain and improve patient’s outcome after totalhip and knee replacement surgeries in first 24hrspostoperative period.Methods: Twenty patients from class I (healthy patients) and class II (patients mild sys

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Tue Oct 06 2026
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Mycotoxins are secondary by-products of mold metabolism and are accountable for human and animal mycotoxicosis. The most serious trichothecenic mycotoxin is the fungal T-2 mycotoxin. T-2 mycotoxin impaired nutrient absorption, metabolism, and then, eliciting severe oxidoreductive stress. Diet plays a key role beyond the supply of nutrients in order to promote animal and human health. Organic acids have been commonly used to exert antioxidative stress capacity in the liver and gut ecosystem. This study is planned to explore, the competence of using (X-MoldCid®) during chronic T-2 mycotoxicosis course in rat. Rats were allocated into 4 main groups, (CN-Gr), negative control and was allowed for the free access to the normal rats chow and the

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Manufacturing an Organic Solar Cell and Comparing with Different Dyes
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A solar cell was manufactured from local materials and was dyed using dyes extracted from different organic plants. The solar cell glass slides were coated with a nano-porous layer of Titanium Oxide and infused with two types of acids, Nitric acid and Acetic acid. The organic dyes were extracted from Pomegranate, Hibiscus, Blackberry and Blue Flowers. They were then tested and a comparison was made for the amount of voltage they generate when exposed to sunlight. Hibiscus sabdariffa extract had the best performance parameters; also Different plants give different levels of voltage.

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Publication Date
Sun Mar 01 2026
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Comparing longitudinal and transverse wound closure methods for spina bifida
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Publication Date
Fri Nov 09 2018
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Iraqi National Journal Of Nursing Specialties
Prevalence of obesity among adolescents at secondary schools in Kirkuk city
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Objective: to identify the secondary school adolescent's obesity, and to find out the relationship between
adolescents obesity characteristics and their family history.
Methodology: A cross-sectional study was carried out among 537 adolescents (270 boys and 267 girls) aged 12-15
years selected by means of a multistage stratified random sampling technique.
Results: the prevalence of obesity among adolescents was 22.3%. (55.8%) of the obese adolescents were male,
(42.5%) their age is (13) years old, and (79.2%) of them coming from middle level of socio economic status score.
There are a significant relationship between obese adolescents and their family history of obesity which indicated
that obese father, and obese br

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