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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
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Some Thoughts on Greetings in English and Arabic
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The present study examines the main points of differences in the subject of greetings between the English language and the Arabic language. From the review of the related literature on greetings in both languages, it is found that Arabic greeting formulas are more elaborate than the English greetings, because of the differences in the social customs and the Arabic traditions and the Arabic culture. It is also found that Arabic greetings carry a religious meaning basing on the Islamic principle of “the same or more so”, which might lead to untranslatable loopholes when rendered in English.

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Publication Date
Sun Jul 01 2018
Journal Name
Journal Of Educational And Psychological Researches
Slums and its implication on security in Baghdad
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The research team seeks to study the phenomena of random housing in Iraqi society in general and Baghdad city in particular by standing on the causes behind this phenomena and its relation with security situation in Baghdad. The researchers adopted a theoretical and practical framework. The main objective is to diagnose the risks caused by the escalation of slums in Baghdad city. 

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Publication Date
Thu Jan 01 2026
Journal Name
Journal Of Physical Education
Proposed Exercises Using Flexible Resisters And Their Effect On Developing Strength Endurance And The Performance of Some Offensive Skills In Youth Basketball
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Publication Date
Fri Jan 01 2021
Journal Name
Special Exercises For Offensive Tactical Skills And Their Impact On Developing The Speed And Accuracy Of Some Basic Skills In Youth Football
SPECIAL EXERCISES FOR OFFENSIVE TACTICAL SKILLS AND THEIR IMPACT ON DEVELOPING THE SPEED AND ACCURACY OF SOME BASIC SKILLS IN YOUTH FOOTBALL
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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Banking Liberalization and its impact on Attracting Customers: applied research in a sample of Iraqi banks listed on the Iraq Stock Exchange
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The research aims to shed light on banking liberalization and explain its impact on attracting customers, especially since Iraq adopted this policy after (2003) due to the changes that occurred, as the Central Bank of Iraq granted flexibility to banks in setting the interest rate on deposits and loans as well as allowing the entry of foreign banks in the local environment. The research relied on the analytical method for the dimensions of banking liberalization represented by (liberating interest rates, liberating credit, legal reserve requirements, entering foreign banks, privatization) as well as the factors affecting the attraction of customers, and a number of Iraqi banks listed in the Iraqi Stock Exchange were selected as a

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the relationship between Government spending compression and the window of the currency and its impact on the exchange rate of the Iraqi dinar
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The exchange rate is the backbone of  any economy in the world, whether  developed or developing, where most countries adopted  many policies, in order to ensure the stability of the exchange rate of the currency, because of its importance as a link between the local economy and the others ,And it contribute in the achievement of internal and external balance and despite the many different factors that affect it, but there is wide consensus on the effectiveness of the role of spending and the currency window in the exchange rate of the Iraqi dinar, especially in the Iraqi economy, effectiveness As the increase in government spending lead to an increase in the supply of money and increase domestic demand and high pr

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Publication Date
Thu Oct 12 1995
Journal Name
International Journal Of Environmental Studies
ON THE SPATIAL AND SEASONAL VARIATIONS OF HEAVY METALS OF THE RAZZAZAH LAKE, IRAQ
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Five heavy metals, namely Cd, Cu, Fe, Mn, and Pb in the surface water and through the water column were studied at 10 selected stations in the Razzazah lake and Karbala drainage canal for the period between November 1990 to October 1991*. pH and total hardness were also measured. Lead was found to be the highest in concentration as overall average values, followed by an manganese, iron, copper then cadmium at the surface as well as along the water column. All the studied metals were below or close to the maximum allowed limits of Iraqi standards for inland water. The spatial and seasonal variations were discussed.

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
The influence of temperature and size on the absorption coefficient of CdSe quantum dots
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Abstract<p>Because of Cadmium selenide quantum dots (CdSe quantum dots) has a tuning energy gap in the visible light range, therefore; it is provided a simple theoretical model for the absorption coefficient of CdSe quantum dots, where the absorption coefficient determines the extent to which the light of a material can penetrate a specific wavelength before it is absorbed. CdSe quantum dots have an energy gap can be controlled through two effects: the temperature and the dot size of them. It is found that; there is an absorption threshold for each directed wavelength, where CdSe quantum dots begin to absorb the visible spectrum at a size of 1.4 nm at room temperature for a directed wavelength 3</p> ... Show More
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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
Study the Effect of Ceramic Coating on the Performance and Emissions of Diesel Engine
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In this study, the effect of ceramic coating on the performance and gases emission on diesel engine was investigated. A four-stroke, direct injected, single cylinder, diesel engine was tested at constant speed and at different load conditions without coating. Then, the inlet and exhaust valves faces were coated by about 500µm with ceramic materials. Ceramic layers were made of YttriaStabilized Zirconia (YSZ), and NiCrAl as a bond coat. The coating technique adapted in this work is the flame spray method. The engine with valves ceramiccoated research was tested for the same operation conditions of the engine (without coating). The results indicate a reduction in both fuel consumption by about 7.6% and particulate emissions by about (13

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Engineering Science And Technology
THE INFLUENCE OF CHEMICAL COMPOSITION OF ASPHALT CEMENT ON THE PHYSICAL AND RHEOLOGICAL PROPERTIES
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Failure in asphalt mixture and distress in pavement are major issues to roads infrastructure. Selecting an appropriate chemical composition of asphalt cement is a key component in avoiding these issues. This work aimed to investigate the effect of the chemical composition of different polar fractions on the rheological and physical properties of asphalt cement. Four types of asphalt cement with penetration grades of 20/30, 40/50, 60/70 and 85/100 were divided into four fractions. Complex shear modules, rutting resistance and rotational viscosity of the asphalt cement were determined by using a Dynamic Shear Rheometer and a Rotation Viscometer, respectively. The results show that an increase in the asphaltene content and Gastel index resulte

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