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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
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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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
On the design of the annexation experience between splintered and dissociated sectors
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The idea of the design of combination Between split – plot and split block means that an experiment conducted with a design

formed by combination Between split – plot and split block, and it presents a precise manner to analytic who aimed to make appropriate statistical analysis for the experiment because such design contains four random errors , it make a high precision rather than another designs. The plan and the theoretical analysis were presented with application   to show its idia and the ability to use it in many fields  especially in agricultural experiments field .

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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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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
Sun Jan 12 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 real and

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Publication Date
Sun Jun 04 2017
Journal Name
Baghdad Science Journal
The Effect of Variety and Gibberellic acid and Brassinolide and their Interaction on Some of The Chemical Characteristics and Total chlorophyll of the plant Dill Anethum graveolens L.
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The experiment was carried out to study the effect of variety and gibberellic acid in concentration (0 and 50)mg.lat-1 and BL in five concentration (0, 0.50 ,1 ,2 and 3)mg.ltr-1 and their interaction in some chemical Characteristics and total chlorophyll for Dill plant . the experiment designed according Randomized Complete Block Design (RCBD) and three replicates per treatment, compared to the average using less significant difference at the level of probability (0.05) , the results showed the following:- The effect of brassinolide with it,s concentrations led to obtain a significant increase in all the studied characteristics, so the superiority of the concentration of 2 mg.L-1 of brassinolide in each of Ca, Mg,Fe, and total chlorophyll T

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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
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
Sun Jun 02 2019
Journal Name
International Journal Of Multidisciplinary And Current Research
The security problem in the Gulf Cooperation Council countries Study on internal challenges and future prospects
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The importance of our research is that it examines the causes and sources of the security challenges in the internal security environment of the GCC countries, and aims to address the most important issues that are of great interest, namely, the issue of inter-GCC differences and addressing the issues of regional security for the Gulf region, After it is one of the most dynamic and more polarized areas for the emergence of threats and challenges because of the multiplicity of sources of threat and their complexity due to the specificity of the strategic environment and the negative repercussions it can have on the Gulf region, especially the issue of regional security of the Gulf Cooperation Council Which has become a magnet for competing i

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