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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
Sun Dec 06 2009
Journal Name
Baghdad Science Journal
THE EFFECT OF RAMADI SEWAGE TREATMENT PLANT ON THE PHYTOPLANKTON AND SOME PHYSICO – CHEMICAL CHARACTERS IN EUPHRATES RIVER , IRAQ
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Four localities were selected in Euphrates River and Ramadi sewage treatment plant to collect water samples monthly during the period between October 2001 to July 2002 . Total cell count of phytoplankton and its physico- chemical concentrations were determined . The study aimed to demonstrate the effect of Ramadi sewage treatment plant on Euhprates River . It is concluded that the sewage had an dilution effect for the total hardness , total alkalinity , electrical conductivity and salinity of Euphrates River , but it is also caused in the presence of a contaminated area . This was cleared from the depletion of dissolved oxygen and high values of biological oxygen demand with lower valuse of pH in this area . The water of Euphrates

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Publication Date
Wed Dec 09 2020
Journal Name
Banks And Bank Systems
Cooperative decision-making on fiscal and monetary policy in Iraq using the prisoner’s dilemma
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This paper investigates the interaction between fiscal and monetary policy in Iraq after 2003 using the prisoner’s dilemma.The paper aims to determine the best form of coordination between these policies to achieve their goals; payoff matrix for both policies was constructed. To achieve the purpose, the quantitative approach was applied using several methods, including regression, building payoff matrices and decision analysis using a number of software.The results of the monetary policy payment function show that inflation rate has an inverse relationship with the auctions of selling foreign currency and a positive relationship with the government’s activity, while the fiscal policy function shows that real growth is positively

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
A Note on the Hierarchical Model and Power Prior Distribution in Bayesian Quantile Regression
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  In this paper, we investigate the connection between the hierarchical models and the power prior distribution in quantile regression (QReg). Under specific quantile, we develop an expression for the power parameter ( ) to calibrate the power prior distribution for quantile regression to a corresponding hierarchical model. In addition, we estimate the relation between the  and the quantile level via hierarchical model. Our proposed methodology is illustrated with real data example.

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Publication Date
Wed Aug 31 2022
Journal Name
Journal Of Positive School Psychology
Impact Of An Educational Program For Nursing Management About Care Of Children Treated With VP Shunt In Mosul City
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Publication Date
Thu Dec 13 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Study Some Parameters of HCV Isolated From Sample of Hemophilic Patients in Children Welfare Teaching Hospitalin Medical City/Baghdad
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Objective(s) : This study aimed at evaluating the seroprevalence of anti -HCV and studying the
correlation between hemophilia and risk factors for acquiring HCV such as age , marital status &
occupation among hemophilic patients .
Methodology : 210 hemophilic patients in children welfare teaching hospital/medical city/Baghdad–Iraq
(hemophilia center) were investigated using prepared questionnaire and tested for HCV infection, those
were measuring patient’s age, hemophilia types and severity, marital status, residency and history of
previous HCV infection .
Results : Most hemophilic patients were hemophilia A at severe , hemophilia was at age group 20 – 29
years , the majority of patients were unmarried a

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Effect Repetition of Anticyclone and on thermal characteristic in Iraq
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Anticyclone of synoptic studies that influence weather and climate of Iraq, The aim of
the study is to clarify the effect variation of repetition of Anticyclone and effect on thermal
characteristic in Iraq were pressure level has been analyzed (1000) millibars and that because
of pressure level is the closet to the earth surface and the clarity of climatic phenomenon
based on a systematic analysis of synoptic seeking maps and observation and (12:00)
according to timing GMT for five climatic stations which is (Mosul, Kirkuk, Baghdad, Rutba,
and Basra) and so far three consecutive climatic cycles which is first climatic cycle for period
(1986-1976). and second climatic cycle for period (1997-1987) and third climatic cy

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Publication Date
Sun Dec 05 2010
Journal Name
Baghdad Science Journal
Effect of vincristine and vinblastine on mice spermatozoa in vitro
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The aim of this project was to study the in vitro effect of antineoplastic drugs (vincristine and vinblastine) on mice spermatozoa. Eighteen adult (age 8-9 weeks) male mice were divided into three groups equally. The animals in each group were slain by cervical dislocation, the testes were removed and two tails of epididymides isolated. Spermatozoa were obtained from the two tails of epididymides by mincing in 500 µl TCM-199.The first group non-treated (unadded) as a control group, second group added 10 µg/ml of vincristine to TCM-199 and the third group added 10 µg/ml of vinblastine to TCM-199. After 10 minutes from added of vincristine and vinblastin measured the following test: spermatozoa activity, percentage dead spermatozoa and mor

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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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