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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
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effects of Melatonin On The Oxidative Stress , Protein Glycation , Microalbuminuria and Lipid Profile In Type II Diabetes Mellitus
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Previous studies indicated that supplementation with antioxidants has a protective effects against oxidative stress–induced damage in type 2 diabetes. In this study we evaluated the antioxidant effects of melatonin on the oxidative stress parameters and microalbuminuria in type 2 DM patients. 30 patients with type 2 DM were treated with 3mg/day melatonin for 90 days. Erythrocytes and plasma MDA and glutathione, fasting plasma glucose, %HbAIC, microalbuminuria, total plasma protein and lipid profile were measured each 30 days and compared with those obtained from 20 healthy controls.

A decrease in MDA levels associated with the elevation in GSH levels were observed, compared with the pre–treatment levels.

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Publication Date
Tue Mar 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
Employing the indicators of stereotypes and the dimensions of organizational clarity and their role in achieving the planned organizational behavior Analytical study on a sample of workers in some departments of the Faculties of Engineering, University of
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The current research examines the employment of indicators of stereotypes and the dimensions of organizational clarification to achieve planned organizational behaviour on a sample of employees in a number of departments of the Faculties of Engineering, University of Kufa, for a sample of (122) teaching staff. This research proposes the use of positive indicators of stereotypes for both the organization and employees and their awareness of what they want to obtain and what should be done for both parties and the removal of organizational clarity represented by the functional dimension that explores to what degree the employee's understanding of the internal strategy of the organization and the strategic dimension that searches fo

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Publication Date
Thu Jul 01 1999
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
New Records And Some Notes On The Broad Bean Root Aphids and Their Natural Enemies in Hammam Al-Alil
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In May 20th. 1985 two species of aphids were found on the roots of Vicia faba L. in Hammam region 30 Kilometer south of Mosul. Samples of these aphids were sent to the Commonwealth Institute of Entomology, London. ( No. 17002/9804 Asia ) and identified as being Smynthurodes betas westwood and Dysaphis crataegi (Kaltenbach) (APhididae : Homoptera). The first species was dominant. The latter species was also noticed on the roots of the common bishop's weed (Ammi majus L.) and on the wide carrot (Daucus carrota L.) of the family Umbelliferae (Bodenheimer & Swirski, 1957).

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Publication Date
Mon Sep 29 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
Thu Oct 31 2013
Journal Name
Al-khwarizmi Engineering Journal
Influence of the Applied Potential and Temperature on the Electrode position of the Lead Dioxide
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The excellent specifications of electrodes coated with lead dioxide material make it of great importance in the industry. So it was suggested this study, which includes electrodeposition of lead dioxide on graphite substrate, knowing that the electrodeposition of lead dioxide on graphite studied earlier in different ways.

In this work the deposition process for lead dioxide conducted using electrolytic solution containing lead nitrate concentration 0.72 M with the addition of some other material to the solution, such as copper nitrate, nickel nitrate, sodium fluoride and cetyl trimethyl ammonium bromide, but only in very small concentrations. As for the operating conditions, the effect of change potential and temperature as well

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Publication Date
Mon Oct 22 2018
Journal Name
Journal Of Economics And Administrative Sciences
Value system and its impact on the morals of the public job of the individual
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         Values ​​are penetrating or interfering in the lives of individuals and groups and are connected to them in the sense of life itself, because they are closely linked to the motives of behavior, hopes and goals, and can be said that values ​​are everything. The concept of values ​​is one of the concepts that have received the attention of researchers from different disciplines. This has resulted in a kind of confusion and variation in use from one specialization to the other, and uses multiple uses within one specialization. Therefore, there is no uniform definition of values ​​because they relate to individuals. Individuals differ in many things, such as perception,

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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
The preoccupations of the compressive references and their impact on the formations of postmodern art
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The artistic process operates whether in general in all arts or specifically in one type of arts or one of the genres of arts types on the preoccupations of the pressing artistic references as the founder of the artistic work in the material formulations on the one hand and on the other hand as a translator to understand the artistic achievement in general and plastic art in particular and for the importance The researcher chose the title of her research tagged (the preoccupations of the pressing reference and its impact on the formations of postmodern arts).
The first chapter of the methodological framework deals with the problem of research, importance, objective, limits, and then terminology and its definition, and then the secon

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Publication Date
Thu Dec 15 2022
Journal Name
Journal Of Juridical And Political Science
Civil Liability Arising from Children Abuse. A Comparative Study of American Law
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Researchers are interested in the issue of children abuse and they look for its cause in the past and present. Their interest is limited to identifying penal liability which is caused by children abuse away from focusing on civil liability. So, the study is going to clarify the parents' responsibility for children abuse rather than civil liability of the medic in case he wouldn’t notify the authorities about the case according to the American law rules and the attitude of Iraqi law rather than some judicial application of civil cases that were exposed to American judiciary concerning children abuse.

Crossref
Publication Date
Thu Dec 15 2022
Journal Name
Journal Of Juridical And Political Science
Civil Liability Arising from Children Abuse. A Comparative Study of American Law
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Researchers are interested in the issue of children abuse and they look for its cause in the past and present. Their interest is limited to identifying penal liability which is caused by children abuse away from focusing on civil liability. So, the study is going to clarify the parents' responsibility for children abuse rather than civil liability of the medic in case he wouldn’t notify the authorities about the case according to the American law rules and the attitude of Iraqi law rather than some judicial application of civil cases that were exposed to American judiciary concerning children abuse.

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