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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 Dec 19 2019
Journal Name
مجلة العلوم النفسية
Employment of the Roundhouse Strategy and its Impact on Academic Achievement and Core Thinking
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The aim of this research is to employ the roundhouse strategy to study its impact on the students achievement of the 10th grade in physics and their core thinking. After the application of the research experience and gaining data, which was processed statistically using the statistical packages program (SPSS). The results of the researcher revealed the superiority of the students of the experimental group who studied using the roundhouse strategy on the students of the control group who studied the usual method in the achievement test. As results showed that there were statistically significant differences between the average scores of the experimental group and the average scores of the control group students in the core thinking test and

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Publication Date
Sun May 08 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of the relationship between the internal auditor and the external auditor on the Earnings quality in Iraqi companies listed in the Iraqi Stock Exchange
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The changes that have occurred in the business environment and scientific and technological progress, as well as the complexity of administrative problems resulting from its practice of various activities, have led to an increase in the responsibilities entrusted to it, and for the purpose of achieving its strategic objectives, which has made the pillars of corporate governance an inevitable matter required by the nature of modern scientific management of the governorate, the success that companies seek is based on the fertile environment and the dialectical relationship between the individual and the company, and to achieve this success there must be a compatible and harmonious audit environment between the internal and external

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Publication Date
Mon May 19 2025
Journal Name
Retos
The effect of the cube model on visual-spatial intelligence and learning the skill of spiking in volleyball for female students
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Objective: To identify the effect of the cube model on visual-spatial intelligence and learning the skill of spikinging in volleyball for female students, The researchers used the experimental method by designing two equivalent groups with pre- and post-measurements. Research methodology: The main research sample of (30) female students was selected from the research community represented by second-stage students in the College of Physical Education and Sports Sciences - University of Baghdad for the academic year (2024-2025). The sample was divided equally into two control and experimental groups. The researchers conducted the sample homogenization process and the equivalence process between the two groups in the variables of visua

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Publication Date
Sun Sep 28 2025
Journal Name
Opción: Revista De Ciencias Humanas Y Sociales, Issn 1012-1587, Nº. Extra 21, 2019, Págs. 907-927
The Effect Of The Perkins’ And Blythe’s Model On Mathematical Communication Among Students Of The 5Th Bio Scientific Grade In Mathematics
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Autorías: Muayad Kadhim Raheem, Lina Fouad Jawad. Localización: Opción: Revista de Ciencias Humanas y Sociales. Nº. 21, 2019. Artículo de Revista en Dialnet.

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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
The Effect of Continuous Darkness and Continuous Light on the Reactivity of Smooth Muscles to Drugs in the Rat Vas Deferens
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Background: The vasoconstricting agents: nor-adrenaline and 5- hydroxytryptamine
(5-HT) have a stimulant action on smooth muscle contractility of the rat vas deferens.
Objective: This study aimed to investigate the effect of exposure to continuous
darkness and continuous light on the contractility of the vasa deferntia smooth
muscles from rats to applied nor-adrenaline and 5-HT.
Method: Male albino wistar rats were divided into 3 experimental groups. Group 1:
Control animals, were exposed to the ordinary photoperiod each day. Group 2: Rats
were kept in a dark room. Group 3: In a room under a bright artificial light.
All animals were killed after 4 weeks.
Results: Vasa deferentia preparations from continuous dar

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Publication Date
Tue Jul 14 2015
Journal Name
Ibn Al-haitham J. For Pure & Appl. Sci.
Effect of Annealing Temperature and Thickness on the Structural and Optical Properties of CdSeThin Films
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CdSe alloy has been prepared successfully from its high purity elements. Thin films of this alloy with different thicknesses (300,700)nm have been grown on glass substrates at room temperature under very low pressure (10-5)Torr with rate of deposition (1.7)nm/sec by thermal evaporation technique, after that these thin films have been heat treated under low pressure (10-2)Torr at (473,673)K for one hour. X-ray patterns showed that both CdSe alloy and thin films are polycrystalline and have the hexagonal structure with preferential orientation in the [100] and [002] direction respectively. The optical measurements indicated that CdSe thin films have allowed direct optical energy band gap, and it increases from (1.77- 1.84) eV and from

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Publication Date
Wed May 14 2025
Journal Name
Journal Of Applied Mathematics
Role of Wind and Fear on the Dynamic of a Prey and Two Competing Predators
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An essential tool for studying the web is its ability to show how energy moves through an ecosystem. Understanding and elucidating the relationship between species variety and their placement within the inclusive trophic dynamics is also beneficial. A food web ecological model with prey and two rival predators under fear and wind flow conditions is developed in this article. The boundedness and positivity of the system’s solution are established mathematically. The stability and existence constraints of the system’s equilibria are examined. The proposed system’s persistence limitations are established. Additionally, the bifurcation analysis of every potential equilibrium is examined using the Sotomayor theorem. To describe the

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Publication Date
Mon Jan 01 2018
Journal Name
Al–bahith Al–a'alami
Political Marketing and the Formation of Trends in Public Opinion on Social Networking Sites: An Analytical Study of the Two F.B. Pages: the Prime Minister and the Parliament President
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The social networking sites have become one of the most important promotional instruments for their characteristic of facilitation of communication and the creation of public platform for discussion and formation of new points of view. These sites were used in the political marketing process where politicians use Facebook pages to promote their ideologies and spread their programs for the purpose of an influencing public opinion.
This research deals with the way by which political products are the Iraqi parliament. We adopt the methodology for analyzing the contents of these pages during three months starting from September,12 2016 to March 1, 2017 characterized by a lot of changes and events, in particular the beginning of the war o

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Publication Date
Mon Jan 01 2024
Journal Name
Baghdad Science Journal
Acute Toxicity of Chlorpyrifos on the Freshwater Bivalves (Unio Tigridis) and Effects on Bioindicators
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A freshwater bivalve plays a crucial function in aquatic habitats as the filtered water and burrowing mussels mix the sediment, thus increasing oxygen content and making the ecosystem healthier. The aim of the study is to see how chlorpyrifos affects biochemical markers in freshwater mussel Unio tigridis. About 180 individuals per taxon and water samples were collected from the Qandil water resource on the Greater Zab River, Erbil Province, Iraq. Once arrived at the lab, the individuals were kept in aquaria with river water and an air-conditioned room Temperature: 25±2 and Light: 12h/12h and acclimatized to laboratory conditions for seven days in aged tap water. The mussel's identification molecularly and the DNA sequence of t

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Publication Date
Mon Jan 02 2023
Journal Name
Scripta Medica
The influence of socioeconomic status and general health on the fracture incidence
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Background/Aim There is an association between patient general health, socioeconomic status and fracture incidence. Aim of this study was to demonstrate the relation between the socioeconomic and health status and the occurrence of fractures in Al-Kindy Hospital residents. Methods A prospective cross-sectional study was performed by using data collected from fractured patients in Al-Kindy Teaching Hospital / Baghdad Orthopaedics Outpatient Clinic, between 12 December 2021 and 8 March 2022. A hundred patients aged 20 to 75 years were included in this study. The data were collected using a researcher-administered questionnaire, which included items to assess patient's socioeconomic status (accommodations, occupation, income status, level of e

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