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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
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
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
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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   The research problem stems from the suffering of organizations from the weakness of their organizing aspect and the weak influence of the leadership on the subordinates and their dispersion. Organizations today are in rapid development and therefore work relations are not dominated by the humanitarian aspect and the first goal has become productivity. The research aims to identify the influence of servant leadership and its dimensions as an independent variable on the effectiveness of work teams as an approved variable and their importance increases when these organizations are service organizations, and how their influence increases when this leadership is the servant leadership and its dimensions in the Health Depa

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Publication Date
Mon Feb 25 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Investment in higher education and its impact on the labor market: Applied Research in private colleges
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Publication Date
Wed Aug 30 2023
Journal Name
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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
Thu Mar 01 2012
Journal Name
Journal Of Al-nahrain University
Histopathological Studies of the Liver and Kidney in Mice Fed on Smut Wheat Infected with Tilletia
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The current study was designed to investigate the effect of Tilletia smut spores on histopathological changes in liver and kidney in mice. Twenty animals were divided into two equal groups, 10 mice each, control group fed on normal diet and the treated groups were fed on a mixture of 50% normal diet with 50% wheat infected with Tilletia for 30 days. Histopathological sections taken from liver and kidney treated with Tilletia revealed several alterations. The changes in liver included, multiple granulomatous lesions, area of coagulation necrosis, vacuolar degeneration in the cytoplasm of hepatocytes, proliferation of hepatocytes with formation of pseudolobull which initiates for procancer. Whereas in the kidney, the changes included

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Publication Date
Sun Dec 31 2023
Journal Name
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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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Sun Jun 30 2024
Journal Name
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Study the Effects of Annona sp. Extract on Some Physiological Parameters and Fertility in Diabetic Mice
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Publication Date
Wed Jan 01 2020
Journal Name
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The impact of JAK2V617F allelic burden on clinical and laboratory parameters in patients with myeloproliferative neoplasms
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Publication Date
Fri Sep 15 2023
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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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