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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
Sat Jul 19 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of in office bleaching on surface roughness and micro-hardness of newly developed composite materials (In vitro study)
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Background: Alterations in the microhardness and roughness are commonly used to analyze the possible negative effects of bleaching products on restorative materials. This in vitro study evaluated the effect of in-office bleaching (SDI pola office +) on the surface roughness and micro-hardness of four newly developed composite materials (Z350XT –nano-filled, Z250XT-nano-hybrid, Z250-mico-hybrid and Silorane-silorane based). Materials and methods: Eighty circular samples with A3 shading were prepared by using Teflon mold 2mm thickness and 10mm in diameter. 20 samples for each material, 10 samples for base line measurement (surface roughness by using portable profillometer, and micro-hardness by usingDigital Micro Vickers Hardness Test

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Publication Date
Wed Mar 28 2018
Journal Name
Indian Journal Of Natural Sciences
Detection of the Main Mycotoxins in Feed of Horses in Al-Zawra'a Park and Study their Effects on Hematological Feature
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Publication Date
Wed Jan 23 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Cancellation in the Life Insurance Policies and its Impact on the Financial Solvency of Insurance Companies: Applied Research in the Iraqi General Insurance Company
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This research cancellations in life insurance policies and their impact on the solvency of the insurance companies (Applied Research in the Iraqi general insurance company), The study was descriptive approach in identifying and addressing variables which consists of {cancellations in life insurance} independent variable, the financial solvency of insurance companies as the dependent variable, and for the purpose of achieving the objectives of the research were formulated one hypothesis has been tested in the Iraqi insurance company, the researcher used the financial statements in the collection data needed for the study and information . The research found a number of conclusions highlighted that inflation, as well as economic variables

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of The College Of Education For Women
Alternative Sanctions and their Impact on Societal Security: A Field Study in the Directorate of Juveniles Reformatory in Baghdad
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Crime is one of the most severe challenges facing States, and strives to find preventive measures, reduce its seriousness, and prevent them; due to developments, crimes have increased, and emerging new patterns of crimes, there is an urgent need to prevent crimes and reduce their effects. Modernizing its punitive system and diverting it to correctional rehabilitative justice to redress the prejudice caused by the crime and rehabilitate the convicted person by using alternative measures to short-term imprisonment. This research emphasizes alternative sanctions' value to minimizing short-term imprisonment penalties and their impact on societal security through several goals like, the negative consequences, justifications, and alternatives

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Publication Date
Wed Feb 28 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
The Effects of -806 T/C and -857 T/C Single Nucleotide Polymorphisms in the TNF-α Gene on Rheumatoid Arthritis Severity and Inflammatory Markers
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Background: Polymorphisms in the TNF-α gene affect the development and progression of rheumatoid arthritis. Objective: To investigate the associations between (-806 T/C) and (-857 T/C) SNPs with rheumatoid arthritis severity and susceptibility in a sample of Iraqi patients. Methods: A case-control study was conducted in Baghdad, Iraq. Twenty healthy controls and 63 patients confirmed to be newly diagnosed with rheumatoid arthritis were included. Those are divided into two groups (patients and controls), and the patients were further subdivided into severe and mild-moderate groups. Samples from those participants were analyzed for clinical and inflammatory parameter measurements. Genotyping by the Sanger method was performed to stu

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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Teaching Practices of Science and Mathematics Teachers Based on the National Framework for Future Skills in the Omani School
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Abstract

The research aims to identify the level of effectiveness of the teaching practices of science and mathematics teachers in light of the national framework for future skills in Omani schools. To achieve the objectives of the study, the researchers used the descriptive approach, as he designed a note card consisting of (30) phrases distributed on three axes: basic skills, practical skills, and technical skills. After verifying the validity and reliability of the tools, they were applied to a sample of (116) teachers. The results of the research revealed that the level of effectiveness of the teaching practices of mathematics teachers has recorded a medium degree with a mean (3.05). The results a

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Publication Date
Fri Jan 01 2016
Journal Name
Al–bahith Al–a'alami
The Influence of Turkish Soap Operas in the Behavior and Trends of the Iraqi Audience (A Field Study on Iraqi University's Students)
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This research seeks the effects of dubbed Turkish TV series on Iraqi audiences. The chosen sample is about 600 Iraqi students at Baghdad and al-Anbar Universities. This study consists of four sections: section one deals with the theoretical framework of the study. Section two studies the dubbed Turkish TV series. The third section explores the role of mass media in forming tendencies, and the last section seeks the field study by analyzing the tendencies if Iraqi viewers of these series.
The goal of this study is to know the role these series played in affecting the behavior and attitudes of Iraqi people and how it can change their morals.
The research ends with the number of results like the negative effect of these series on the

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of forensic accounting in winning compensation claims and its impact on the profits of the National Insurance Company: applied research
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                The research aims to shed light on the importance of forensic accounting and its role in winning compensation claims against the company because of the ability of the forensic accountant (the judicial expert) to interpret and analyze the data. The research community represents the insurance companies in Iraq. The research sample was represented by the National Insurance Company. Coverage of the theoretical and deductive approach in covering the practical side, based on the financial records of the National Insurance Company for years of research.One of the most important conclusions reached by the researchers was that forensic accounting has a role

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Publication Date
Wed Feb 22 2017
Journal Name
Geological Society, London, Special Publications
Role of facies diversity and cyclicity on the reservoir quality of the mid-Cretaceous Mishrif Formation in the southern Mesopotamian Basin, Iraq
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Publication Date
Fri Oct 28 2022
Journal Name
Political Sciences Journal
The political and economic repercussions of the Chinese Marshall Plan on the Arab world
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China is moving towards building the largest economic power in the world, so what does this mean economically and politically for Europe, America, the Middle East and the Arab world? This project is called the expansionist Chinese Marshall Plan which is a revival of the old Silk Road in a new way. It represents the aspirations of the Chinese people and their president, Xi Jinping, to build a transport route from Asia to Europe and a railway plan to transport goods. The purpose of this is to develop the economic growth model, expand into new markets, promote the Chinese currency, and expand economic and political influence in the areas covered by the Chinese initiative. Equal opportunities in distributing investments to these countries, a

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