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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 Sep 27 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of the Genotoxicity of the Aerial Parts of Iraqi Euphorbia cyathophora on Bone Marrow and Spleen Cells in Mice
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The aim of the study was extraction of arial part of Euphorbia cyathophora constituents with methanol and evaluate its effect on mitotic index and total chromosomal aberration bone marrow cell and spleen cell in mice  200 gm of E. cyathophora fine powder was defatted then extracted by cold maceration 80% ethanol for seven days. The extract was filtered and dried in a rotary evaporator then the dried extract was suspended with water and consecutively extracted using chloroform, ethyl acetate for each. The aqueous layer was then mixed with 100ml methanol. These fractions are dried under reduced pressure to obtain the dry extract. Twenty-four Albino mice were used for the experiment. The animals were divided into four groups: Gr

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Publication Date
Thu Oct 31 2019
Journal Name
Al-kindy College Medical Journal
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.

Objective: To find the association of the common types of contraceptions with the Trichomonasvaginalis infection in women admitted to the Al-BatoolTeaching Hospital for Maternity and Children in Baqubah city.

Type of study: Cross-sectional study

Methods: This study consist of 75 women with contraception use and71 apparently healthy non contraception user women  admitted to outpatient in Al

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Publication Date
Sun Oct 21 2018
Journal Name
Al–bahith Al–a'alami
“Usages of the Youth in the Emirati Society for the Dubbed Turkish Series on the Arab Satellite Channels and the Satisfactions Achieved”
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The research topic is summarized in the importance of studying the measuring the extent of the university youth’s exposure in the Emirati Society to those series and the resulting achieved satisfaction. The most important results and recommendations of the study are as follows: a high rate of the respondents’, sample individuals, exposure to the dubbed Turkish series since it is evident that almost three-fourths of the study individuals watch the dubbed Turkish series,.”. The most significant positive aspects of the dubbed Turkish series are: “they focus on the most important tourist attractions in Turkey” and “ improving the audience›s knowledge and information on the traditions of the Turkish society”. The most apparent

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Ali Al Bazergan and its impact on the intellectual, political and administrative in Iraq 1887-1958 Historical Study
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The historical person study as a personality to the AL- Bazargan, one of the important
studies, is the shed light on the character had an effect of the political life in Iraq, an important
historical era involved many events, coincided with a national and historical by this personal
at the events successive positions that stage of the history of Iraq, especially if we know,
strongly his loyalty to the homeland and the earth, and intense hatred for any occupation or
colonization desecrate the land...
This was evident during his participation and his supervisor in 1920 liberal revolution
against the British occupation, and urged the need for adherence to the principles of
independence, and the emphasis on the nation

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Publication Date
Sun Jul 03 2016
Journal Name
Journal Of Educational And Psychological Researches
The Impact of the Constructive Scientific Stations Strategy on Achievement and Mind Habits for The Fourth Scientific students in biology
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The study aimed at ideutifying the impact of scieutific skills in strategy and liabits of mind amony stueuts in tenth grade . The study demanded to choose a sampie that coutaiun (42) student of the fourth grade of the secondary school who were dirided into tow groups , the first is experimental studied according to scieutific skill strategy , and the other controlling , studied according to the  usualway . An achievement test  has been taken that adopted  staudard for mind skills as research tools that are applid after ascertaining  sincerity proved at the end of the experiment .The study has reached to the conclusion that there are statistically significant differnces in farour of the experiment group in both

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Publication Date
Sun Sep 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Measuring the Social Responsibility and its Impact on the Financial Performance of Banks: Applied Research in the Iraqi National Bank
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The objective of the research is to measure the impact of social responsibility on the financial performance of the National Bank of Iraq for the period from 2014 to 2016 (3 years) through discussing and analyzing the level of practice of the Bank of Baghdad for social responsibility and the impact on their financial performance during the period. To measure the independent variable (CSR), the researcher used the CSR Disclosure Index and relied on the ROA as an indicator to measure the dependent variable (financial performance). The results of the research showed the main hypothesis of the research, which states that the social responsibility of the banks has no significant impact on the financial performance. In relation to the disclosu

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Publication Date
Sun Sep 06 2009
Journal Name
Baghdad Science Journal
Biological and chemical Study to evaluate the types of water used for drinking in the Al-youssiffiyah area and its effect on public health
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Election study included four sites for the waters in area of Youssifiyah south of Baghdad (river water, tank water, liquefactions water, and water filtrate and seethed and purifier by alum and chloride), the samples were collected during the month of June in 2007. Temperature, electrical conductivity and acidity are measured. Also , the concentration of chloride , sulphate , carbonate , nitrate , sodium , calcium , magnesium , hard total and total dissolved substances are determined , as well as heavy metals assess environmental risk (such as Cu, Pb, Zn, Fe). It was also a study of bacterial totals included both total Bacteria (TB) and Total Coliform Bacteria (TC) and Fecal Coliform (FC) and Fecal Streptococci (FS). The stu

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
THE EFFECT OF CHEMICAL AND BIOLOGICAL TREATMENTS ON IMPROVING THE NUTRITIVE VALUE OF CORN COBS AND WILD REED
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This study was conducted in Animal Resources Department , College of Agriculture to estimate the effect of chemical and biological treatments to improve the nutritive value of poor quality roughages ( corn cobs and wild reed ) . The feeds were treated chemically with 4% NaoH solution ,whereas Aspergillus niger was used to ferment corn cobs and wild reed samples . The chemical analysis showed that protein percentages of corn cobs and wild reed was increased significantly (P<0.05) from 6.05% to 10.51% and 17.70% and from 3.10 %to 6.50% and 9.96% for both chemical and biological treatments respectively. The crude fiber percentages decreased significantly (P<0.05) from 29.19% and 26.10% to 23.60% and 20.10% for chemical treatment and was 20

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Publication Date
Wed Nov 24 2021
Journal Name
International Journal Of Differential Equations
The Impact of Media Coverage and Curfew on the Outbreak of Coronavirus Disease 2019 Model: Stability and Bifurcation
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In this study, the spreading of the pandemic coronavirus disease (COVID-19) is formulated mathematically. The objective of this study is to stop or slow the spread of COVID-19. In fact, to stop the spread of COVID-19, the vaccine of the disease is needed. However, in the absence of the vaccine, people must have to obey curfew and social distancing and follow the media alert coverage rule. In order to maintain these alternative factors, we must obey the modeling rule. Therefore, the impact of curfew, media alert coverage, and social distance between the individuals on the outbreak of disease is considered. Five ordinary differential equations of the first-order are used to represent the model. The solution properties of the system ar

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Publication Date
Sat Dec 20 2014
Journal Name
International Journal Of Current Engineering And Technology
The Effect of Sb Dopant and Annealing Temperature on the Structural and Optical Properties of GeSe Thin Films
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The pure and Sb doped GeSe thin films have been prepared by thermal flash evaporation technique. Both the structural and optical measurement were carried out for as deposited and annealed films at different annealing temperatures.XRD spectra revealed that the all films have one significant broad amorphous peak except for pure GeSe thin film which annealed at 573 K, it has sharp peak belong to orthorhombic structure nearly at 2θ=33o . The results of the optical studies showed that the optical transition is direct and indirect allowed. The energy gap in general increased with increasing annealing temperature and decreased with increase the ratio of Sb dopant. The optical parameters such as refractive index, extinction coefficient and r

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