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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 Sep 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
Servant Leadership and its Impact on the Effectiveness of Teamwork
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Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Causes and Effects of Earnings Management on Stock Prices
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This study uses the performance of the discretionary estimation models by using a sample of listed companies in the Netherlands and Germany. The actual accounting framework provides a wide opportunity for managers to influence data in financial reporting. The corporate reporting strategy, the way managers use their discretionary accounting, has a significant effect on the company's financial reporting. The authors contribute to the literature through enhancement to these models to accomplish better effects of identifying earnings management as well as to present evidence that is particular to the Dutch and German setting.

For this, we followed the methodology of Dechow, Sloan, and Sweeney (1995) and Chan

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Crossref (4)
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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Effect of frequency Chirp on the black and gray solitions
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the behavior of the first-order black and gray solitons propagtedin optical fiber in the presence of frequency chirp is studied analytically and numerically results show that phase profile of black solitons changes abruptly

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Publication Date
Sun Sep 30 2012
Journal Name
College Of Islamic Sciences
Customary marriage and the position of Islamic law on it
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Praise be to God, Lord of the worlds, and the best of prayers, and the completion of the blessing of our master Muhammad Al-Hadi Al-Amin, his family and companions, the righteous and those who followed his path and guided him to the day of judgment.
And after:
It is God's human honor that he has legalized marriage and made optimal goals and intentions for her:
1 establish a safe and reassuring life between the husband and his wife based on the tranquility and love and compassion is achieved through satisfying the instincts of the road project from the verse:  and that He created for you mates from among yourselves to find repose in them and put between you affection and mercy in this are Signs for those who reflect  ()

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Publication Date
Tue Jul 02 2019
Journal Name
Sudan Journal Of Medical Sciences
Positive and Negative Effects of the Commensal Bacteria on Carcinogenesis
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Background: Cancer is a lethal disease that results from a multifactorial process. Progression into carcinogenesis and an abnormal cell proliferation can occur due to the micro and macro environment as well as genetic mutations and modifications. In this review, cancer and the microbiota – mainly bacteria that inhabit the tumour tissue – have been discussed. The positive and negative impacts of the commensal bacteria on tumours being protective or carcinogenic agents, respectively, and their strategies have also been described. Methods: Related published articles written in English language were searched from Google Scholar, PubMed, Mendeley suggestions, as well as Google search using a combination of the keywords ‘Microbiota, commens

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
The role of governors and Arab workers in helping the needy and the poor in the eras Rashidin and Umayyad
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The research deals with financial and supplies support from the rulers and governors of the
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The prophet , senior Muslims and the rich cared a lot about this side . There was a large
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from the pve – Islamic society where there is no concern about helping the needy and poor .
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Publication Date
Wed May 09 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
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The Objective of the research is to identify the Strategic Vigilance and effect in the Managerial Decision Quality, by knowing the interest of the organization influence the Strategic Vigilance in the Managerial Decision Quality, adopted four dimensions of the Strategic Vigilance is (Environmental Vigilance, Commercial, Competitiveness & Technology) to indicate the extent individually and collectively impact in the Managerial Decision Quality, The questionnaire was used as a main tool to survey the views of a sample of 45 managers, was named Supreme Judicial Council society for research, and the statistical program SPSS, and research found a clear positive impact dimensions Strategic Vigilance in the Manageri

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Publication Date
Mon May 06 2019
Journal Name
Journal Of Physical Education
Designing Teaching Aids and Their Effects on Learning and Retaining Diving and Cartwheel on Floor Exercises in Women’s’ Artistic Gymnastics
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Designing Teaching Aids and Their Effects on Learning and Retaining Diving and Cartwheel on Floor Exercises in Women’s’ Artistic Gymnastics

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Crossref
Publication Date
Thu Oct 31 2019
Journal Name
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Contraception as a Risk Factor of Trichomonas vaginalis Infection Among Women Attending Outpatient of Al-Batool Teaching Hospital for Maternity and Children-Baqubah-Iraq
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Background:The effects of contraception on Trichomonas vaginalis have important implications for women who suffer from infections associated with disruptions in the vaginal ecology, such as bacterial vaginitis and urinary tract infections.

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Crossref (1)
Crossref
Publication Date
Wed Jun 29 2016
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Effect of adding the Flavonoids from Zizypus spina-christi leaves in redox indicators of the fat extracted from Cows, Sheeps bones and storage on defferent temperature and periods.: Effect of adding the Flavonoids from Zizypus spina-christi leaves in redox indicators of the fat extracted from Cows, Sheeps bones and storage on defferent temperature and periods.
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Flavonoids were extracted from Zizyphus spina-christi leaves by Ethyl acetate after acid digested and used as antioxidant. The dried extract was added separately to each sample of fat extracted from hallow cow and sheep bones as follows: T1 cow fat, T2 control for cow fat, T3 sheep fat and T4 control for sheep fat (the control T2 and T4 reffered to samples without added antioxidant).
Samples were stored at -18, 5, 25 and 55 °C for 28 days. The storage trials were conducted at -18, 5 and 25 °C for 28 days for T1, T2, T3 and T4. The chemical indices examined initially and at the end of storage period. PVs was 1.46, 1.46, 1.8 and 1.8 meq/ Kg oil respectively, FFA values were 0.245, 0.245, 0.244 and 0.244% respectively and TBA va

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