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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 Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Social Responsibility initiatives in Financial Performance on economic unit and create value for it
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        Many of researchers have written about social responsibility and business strategy and competitive advantage, and they have given particular attention to the relationship between economic and social responsibility , but what is missing in this aspect is how the economic units that use their core competencies to advance social responsibility initiatives so that they can achieve a significant competitive advantage and create value for it ?

The current research aims to verify the view that "the economic and social objectives in the long term is not contradictory in nature but complementary objectives essential", as well as make sure that the s

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
strategic direction and its impact on institutional performance An exploratory study in the Directorate General of Curricula
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The objective of the research is to determine the nature of the strategic direction of the institution and its impact on enhancing the indicators of institutional performance. The strategic direction is the main purpose for which it was found. Therefore, it is the main engine for all activities and tasks that the institution can carry out to achieve its objectives within the environment in which it operates. The promotion of corporate performance indicators is one of the major challenges that senior management must address in order to help the organization invest its human resources in the best possible way.

The research problem was determined by means of the intentional sample, consisting of (33) members

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Publication Date
Mon Jul 01 2024
Journal Name
Civil Engineering Journal
The Effect of Oil Contaminated on Collapse Pattern in Gypseous Soil Using Particle Image Velocimetry and Simulation
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Gypseous soil covers approximately 30% of Iraqi lands and is widely used in geotechnical and construction engineering as it is. The demand for residential complexes has increased, so one of the significant challenges in studying gypsum soil due to its unique behavior is understanding its interaction with foundations, such as strip and square footing. This is because there is a lack of experiments that provide total displacement diagrams or failure envelopes, which are well-considered for non-problematic soil. The aim is to address a comprehensive understanding of the micromechanical properties of dry, saturated, and treated gypseous sandy soils and to analyze the interaction of strip base with this type of soil using particle image

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Effect of measurement and analysis of quality costs on continuous improvement: Applied research in the Directorate General for the distribution of electric power in the Middle Euphrates
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The research aims to identify the theoretical foundations for measuring and analyzing quality costs and continuous improvement, as well as measuring and analyzing quality costs for the Directorate of Electricity Supply / Middle Euphrates and continuous improvement of the distribution of electrical energy,The problem was represented by the high costs of failure and waste in electrical energy result to the excesses on the network and the missing (lost) energy,Thus, measuring and analyzing quality costs for the distribution of electrical energy and identifying continuous improvement leads to a reduction in missing and an increase in sales, as the research reached many conclusions, the most important of which is the high percentage o

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Publication Date
Thu Mar 20 2025
Journal Name
Tikrit Journal Of Engineering Sciences
Effect of Different Compressor Speeds on the Energy and Exergy of an Automobile Air-Conditioner Using R134a in the Absence and Presence of a Liquid-Suction Heat Exchanger
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Refrigerant R134a has been widely utilized in automotive air conditioning systems (AACSs); R134a has a high global warming potential (GWP) of 1430 despite having zero ozone depletion potential (ODP). Coming refrigeration systems must include refrigerants with low GWP and zero ODP. The aim of this experimental study is to evaluate the thermal performance of an (AAC) with different values of compressor speeds, i.e., (1000, 1700, and 2400 rpm) and two thermal loads, i.e., (500 and 1000 Watt) with the absence and presence of liquid suction heat exchanger (LSHX) using R134a. The results showed that adding LSHX enhanced the COP cycle by 7.18%, 10.7%, and 3.09% for the first, second, and third speed, respectively, at 500 Watt, while the en

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Publication Date
Mon Dec 20 2021
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY THE PHYSICAL AND CHEMICAL PROPERTIES AND DETERMINATION THE CYTOTOXICITY OF KOJIC ACID PRODUCED FROM THE LOCAL ISOLATE ASPERGILLUS FLAVUS WJF81 AND THEIR EFFECTS ON CONSUMER HEALTH.: STUDY THE PHYSICAL AND CHEMICAL PROPERTIES AND DETERMINATION THE CYTOTOXICITY OF KOJIC ACID PRODUCED FROM THE LOCAL ISOLATE ASPERGILLUS FLAVUS WJF81 AND THEIR EFFECTS ON CONSUMER HEALTH.
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Steps were taken to obtain the Kojic acid crystals from local fungal isolation A. flavus WJF81 by separating the fermentation products from the fungus mycelium from the production plant at the centrifuge at a speed of 5000 cycles for 10 minutes. The extraction was followed by ethyl acetate then supernatant concentrate by using rotary evaporator, and dried with heat oven 37ºC. Long, yellowish, pristine acid crystals were obtained that examined the optical microscope with a magnification force of 10x and 40x. The melting point of kojic acid was determined between 152.9-153.5 °C Results of the diagnosis of Kojic acid by applying High pressure liquid chromatography HPLC technique showed that the acid was at one peak, which was close to the

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Publication Date
Sun Mar 05 2017
Journal Name
Baghdad Science Journal
Positive and Negative Aspects of Copaxone ( Glatiramer acetate) Action on TC, TG HbA1c and Iron Levels in The Sera of Iraqi Women with Multiple Sclerosis in Baghdad
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The aim of the present study is to highlight the role of total cholesterol (TC), triacylglycerol (TG), Glycated hemoglobin A1c and iron in Iraqi women with multiple sclerosis and also to examine the biochemical action of copaxone (which is the most widely used in the 21st century to treat multiple sclerosis) on these biochemical parameters. This is the first study in Iraq which deals copaxone action on TC , TG , HbA1c and iron. Ninety women in their fourth decade suffering from multiple sclerosis were enrolled in this study. They were divided into: the first (group B) composed of (30) women without any treatment related to multiple sclerosis or any treatment linked with chronic or inflammatory diseases. The second (group A1) included (30)

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Publication Date
Sun Jul 21 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Assessment of the Knowledge and Practice on Safe Handling of Anticancer Drugs among Pharmacists in Iraqi Healthcare Settings
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Background: Occupational exposure to hazardous drugs occurs in all aspects of anticancer drug handling. Proper recommendations and guidelines should be applied to control and reduce exposure. Objective: To assess pharmacists' knowledge and practice regarding the safe handling of anticancer drugs. Methods: A cross-sectional study was conducted at seven major hospitals in Baghdad City, Iraq, from December 2023 to February 2024. A pre-designed questionnaire was given to pharmacists who handled anticancer drugs in chemotherapy units. The questionnaire comprises sociodemographic data, knowledge of the safe handling of cytotoxic drugs and thoughts about exposure and risk, practices for safely handling cytotoxic drugs, and challenges for s

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Publication Date
Fri Jul 01 2016
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
STUDY THE EFFECT OF DIFFERENT TYPES OF STRESS ON SOME BLOOD CONSTITUENTS AND PLASMA BIOCHAMICALS IN MALE RATS
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    The objective of this work was to determine and compare the physiological changes in some: blood components (packed cell volume and hemoglobin) and plasma biochemical parameters (glucose, total protein, albumin, cholesterol and triglycerides) under 3 day of different types of stress: water deprivation, starvation, overcrowding and handling stress. Twenty five male Wister rats weighted 100-120 gm, were divided randomly into five groups: control, water deprivation, starvation, overcrowding and handling stress. On the third day of stress the animals anesthetized for blood collection; the results of blood component revealed a significant increase in PCV and a significant decrease in Hb of water deprivation group and starva

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Publication Date
Sun Jul 03 2022
Journal Name
International Journal Of Health Sciences
effects of toxoplasmosis infection on the levels of IL-18 and anti-ds-DNA antibodies in SLE patients
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The present study was set to demonstrate the prevalence of toxoplasmosis infection and its effects on patients with systemic  lupus erythematosus (SLE) through determining their serum levels of anti-dsDNA and IL-18 antibodies. For this purpose, the sera from 132 SLE and/or toxoplasmosis patients and 30 healthy women, were collected. The study sample was divided into four groups of SLE, toxoplasmosis, SLE coinfected with toxoplasmosis, and healthy control. Anti-Toxoplasma IgG antibodies were examined for all the samples using ELISA kit. The results showed a high mean level of anti-Toxoplasma IgG among SLE patients coinfected with toxoplasmosis (104.8792±12.31585pg/ml) in comparison to that in toxoplasmosis patients (91.1705±12.577

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