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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 Oct 31 2021
Journal Name
Iraqi Geological Journal
Stratigraphy and Nannofossil Biozonation of Sarmord Formation on the Qaywan Anticline in Sulaymaniyah Governorate, Northern Iraq
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The Sarmord Formation is one of the overlooked formations that require more investigations than that achieved before. There are many problems in its definition, age, stratigraphy and aerial distribution. Previously in most parts of the Sulaymaniyah, it is not mapped and its outcrops combined with Balambo Formation while in the present study it is differentiated, mapped in the field on the Qaywan anticline and its problems discussed in details with a suggestion of solutions. For laboratory studies, 31 samples are taken on the Qywan Mountain (anticline) at 23 km north of the Sulaimani city for nannofossils biozonation. This study identified 19 species of the recorded calcareous nannofossils, the studied section reveals three biozones

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Leadership Skills and their Impact on Strategic Planning: Applied Research in the Iraqi Ministry of Planning
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The present search addressed the " leadership skills and their impact on strategic planning " Where has the objective of leadership skills and strategic planning of increasing importance at the present time , for being fairly modern topics ,which have a tremendous impact on the success of organizations..                                                                        &n

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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
Focus groups strategy and its impact on the achievement of primary school students in art education
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Art education is one among the fundamental subjects for elementary school students, because it contributes to assembling learners’ personalities and developing their technical skills. For this reason, this research comes, which aims to understand the effect of the task groups’ strategy in developing the performance of elementary school students in art education. to realize the goal of the research, the researcher put the subsequent hypotheses:
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Publication Date
Wed Aug 30 2023
Journal Name
Baghdad Science Journal
Studying the Effect of COVID-19 on Liver Enzymes and Lipid Profile in Iraqi Recovering Patients
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  The Covid-19 virus disease has been shown to affect numerous organs and systems including the liver. The study aimed to compare lipid profiles and liver enzyme levels in individuals who had recovered from Covid-19 infection. To achieve the study objectives, liver Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Alkaline phosphatase (ALP),  Random Blood Sugar (RBS) and Lipid profile which include cholesterol, High-Density Lipoprotein (HDL), Triglycerides (T.G), Low-Density Lipoprotein (LDL), and Very low-density Lipoprotein (VLDL) were determined.

One hundred twenty serum samples were obtained, of which fifty samples were utilized as the control healthy persons (not affected by COVID) and seventy samples came f

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Publication Date
Sun Dec 31 2023
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
EFFECT OF PARTICLE SIZE AND DIE HOLES DIAMETER IN THE MACHINE ON BROILER FEED PELLETS QUALITY
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Due to the need for controlling and regulating of feed pellet. Pellet that is imported or locally manufactured is accompanied by cracking and crumbling percentage that occur during transporting and distributing to animals, using conveyors and mechanical feeders. This study aimed to determine the effect of particle size and die holes diameter in the machine on broiler feed pellets quality in pellet durability, pellet direct measurement, pellet expansion, and pellet length. Three particle size 2, 4, and 6 mm, and three diameters of die holes in the machine 3, 4, and 5 mm, have been used. The results showed that changing the particle size from 2 to 4 then to 6 mm led to a significant decrease in pellet durability and pellet lengths, pe

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Publication Date
Sun Jun 30 2024
Journal Name
Iraqi Journal Of Science
Study the Effects of Annona sp. Extract on Some Physiological Parameters and Fertility in Diabetic Mice
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     The current study was conducted to investigate Annona fruit pulp effects on the levels of various physiological biomarkers linked with insulin-dependent diabetes mellitus after disease induction in mice, as well as indications of oxidative stress and male hormones. The rats were separated into four groups, three of which were given Alloxan (90 mg/kg body weight) to induce diabetes, while the fourth served as a negative control. The first group of diabetic mice received no therapy, the second received metformin (600 mg/kg body weight) and the third received Annona fruit puree. The mice were sacrificed at the end of the experiment, to acquire blood and tissue samples from the liver, kidneys and spleen. The first untreated gro

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Publication Date
Fri Nov 07 2014
Journal Name
Chemistry And Materials Research
Synthesis and Charactrization of New Schiff Base Derived from PVA and Erythroascorbic Acid Derivative and Study Its Effect on the Activity of ACh Enzyme (In Vitro)
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Schiff base derived from PVA and Erythroascorbic acid derivative (pentulosono-ɣ-lactone-2, 3-enedianisoate) was synthesized and characterized by Thin Layer Chromatography (TLC) and FTIR spectra, aldehyde was also characterized by (U.V-Vis), 1HNMR, 13CNMR and mass spectra. The inhibitory effect of prepared polymer on the activity of human serum Cholinesrerase has been studied in vitro. The polymer showed a remarkable activity at low concentration (4.5*10-3 – 4.5*10-8 M).

Publication Date
Tue Jan 01 2019
Journal Name
Energy Procedia
Humidity effect on diffusion and length coefficient of radon in soil and building materials
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Publication Date
Thu Jul 21 2022
Journal Name
Journal Of Advanced Biotechnology And Experimental Therapeutics,
Effect of gentamicin and doxycycline on expression of relB and relE genes in Klebsiella pneumonia
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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Population Density and Susceptibility of Some Varieties of Potato to Infested by Aphid and Thrips on Spring Plantation in the Middle of Iraq
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Aphid Aphis spp (Hemiptera:Aphididae) and Thrips Thrips spp (Thysanoptera: Thripidae) an economically important pests on several crops in the world and Iraq, that transfer many viruses diseases to it. Field studies were conducted to assessment the population density of these insects and susceptibility of six varieties (Barin, Revera, Divela, Rudlph, Alazata and Pleny) to infestation during 2013 spring season. The results were showed that all Potato varieties were infested by Aphis and Thrips on spring plantation but with different percentage. The Divela variety was higher percentage of infestation and high population density of aphid which averaged 1.47 insect/ leaf while in Alazata was the lower population density which averaged 1.02 in

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