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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
Mon Jun 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The phenomenon of negative behavior has studied as a social and psychological phenomenon that effect on the performance and life of workers inside and outside the organization. The adoption of this phenomenon is studied in terms of the role of the interna
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The phenomenon of negative behavior has studied as a social and psychological phenomenon that effect on the performance and life of workers inside and outside the organization. The adoption of this phenomenon is studied in terms of the role of the internal environment of the organization in addressing this behavior, being the variables belong to the field of organizational behavior to see the results of those variables on the Iraqi organizations, since the specificities of it differ from the rest of the Arab and foreign environments. Therefore, this study focused on testing the relationship of the internal environment of the organization and its role in addressing the negative behavior of the workers.

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Publication Date
Sat Jul 01 2023
Journal Name
The Egyptian Journal Of Hospital Medicine
Evaluation of the Antibiofilm Activity of Laurus nobilis Leaves Extract and Assessment of Its Effect on fimA and papC genes in Escherichia coli isolates
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Background: The beneficial gut bacterium E. coli can cause blood poisoning, diarrhoea, and other gastrointestinal and systemic disorders. Objective: This study amid to examines the antibiofilm activity of Laurus nobilis leaves extract on E. coli isolates and compares pre- and post-treatment gene expression of fimA and papC genes. Subjects and Methods: Ten isolates of E. coli were obtained from the Genetic Engineering and Biotechnology Institute, University of Baghdad, which was previously collected from Baghdad city hospitals and diagnosed by chemical tests, the diagnosis was confirmed using VITEK-2 System. The preparation of the aqueous and methanolic Laurus nobilis leaves extracts was done by using the maceration method and Soxhlet appara

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Publication Date
Fri Mar 01 2024
Journal Name
The International And Political Journal
Constitutional Amendments in Oman and Their Impact on Internal and Foreign Policy
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The Sultanate of Oman is located in the far southwest of the Arabian Peninsula and enjoys a distinctive geographical location as it overlooks the Arabian Gulf and the Gulf of Oman. The Sultanate has good relations with various countries of the world and enjoys an important regional position. At the beginning of 2020, Sultan Qaboos bin Said died, and Haitham bin Tariq assumed power after him, according to the will of his cousin, the late Sultan. The new Sultan had held some important positions before 2020, including: Minister of Heritage and Culture since February 2002, Chairman of the Supreme Committee for the Future Vision (Oman 2040), Secretary-General of the Ministry of Foreign Affairs, Undersecretary of the Ministry of Foreign Affairs f

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Publication Date
Fri Feb 20 2026
Journal Name
Sport Culture
Some bio-motor abilities and their relationship to the skill of standing on the hands followed by the forward roll on the mat of floor movements in artistic gymnastics for women
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The research consists of five chapters, and in the first chapter, it addresses the introduction and importance of the research, where the researcher explained the importance of bio-motor abilities and their role in achieving a high level through their connection to the skill performance of standing on the hands followed by the forward roll, and the research problem: Do these bio-motor abilities have an impact on the level of skill performance? Handstand followed by forward roll.

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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
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
A Proposed Training Program for School Leaders in the Sultanate of Oman on the Planning Practices of the Kaufman Model in Light of the Needs and Challenges of Reality
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The study aims to build a proposed training program for school leaders in the Sultanate of Oman on the planning practices of the Kaufman model in light of the needs and challenges of reality. It also aims to identify the challenges facing school leaders in practicing the stages of strategic planning. To achieve these objectives, the study adopted the descriptive approach due to its suitability to the nature of the study. A questionnaire was used to collect the needed data. The study sample included (225) individuals from school principals, their assistants and senior teachers in post-basic education in the Sultanate of Oman. After processing the data statistically, the study concluded that the reality of planning practices for school lea

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Publication Date
Mon Nov 05 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
EFFECT OF PLANT DENSITIES ON THE GROWTH AND YIELD OF SUNFLOWER Helianthus annuus L.: EFFECT OF PLANT DENSITIES ON THE GROWTH AND YIELD OF SUNFLOWER Helianthus annuus L.
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A field experiment was conducted at the experimental field of botanical garden, faculty of science, university of Baghdad, in order to study the effect of plant density on growth and yield of two local cultivars of sunflower (Sin Althieb and Shumose). The densities used were 4.4 and 8.8 plant/m2. The results showed difference between cultivars in their agronomic traits and their yields. There was a significant increase in plant height and leaf area index by increasing the plant density, while head diameter, number of seeds and leaf area decreased. But the most significant effect was the increasing in yield and biological yield by increasing the plant density. There was an increase by 72% and 58% in the yield and 79% an

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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
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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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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