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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 Dec 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
The Influence of Different Fabrication and Impression Techniques on the Marginal Adaptation of Lithium Disilicate Crowns (A comparative in vitro study)
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Background: The marginal adaptation has a key role in the success and longevity of the fixed dental restoration, which is affected by the impression and the fabrication techniques .The objective of this in vitro study was to evaluate and compare the marginal fitness of lithium disilicate crowns using two different digital impression techniques (direct and indirect techniques) and two different fabrication techniques (CAD/CAM and Press techniques). Materials and Methods: Thirty two sound upper first premolar teeth of comparable size extracted for orthodontic reason were selected in this study .Standardized preparation of all teeth samples were carried out with modified dental surveyor to receive all ceramic crown restoration with 1 mm deep

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Publication Date
Thu Jan 30 2020
Journal Name
Al-kindy College Medical Journal
The Impact of Prophylactic Dexamethasone, Metoclopramide or both on Nausea and Vomiting After Laparoscopic Cholecystectomy
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Background: Postoperative nausea and vomiting (PONV) are one of the most common complaints following laparoscopic cholecystectomy.

Objective: This study was designed to compare the effects of dexamethasone, metoclopramide, and their combination on preventing PONV in patients undergoing laparoscopic cholecystectomy.

Methods: A total of 135 patients enrolled in the study. American Society of Anesthesiologists (ASA) physical status I and II patients were included in this randomized, double blind, placebo-controlled study. Patients were randomly assigned to group A administered 8mg iv dexamethasone, group B received metoclopramide 10 mg, group C received combination of 8mg de

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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of Sport Science Technology And Physical Activities
The effect of using Daniel's model and Driver’s model in learning a kinetic chain on the uneven bars in the artistic gymnastics for female students
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The aim of this study to identity using Daniel's model and Driver’s model in learning a kinetic chain on the uneven bars in the artistic gymnastics for female students. The researchers used the experimental method to design equivalent groups with a preand post-test, and the research community was identified with the students of the third stage in the college for the academic year 2020-2021 .The subject was, (3) class were randomly selected, so (30) students distributed into (3) groups). has been conducted pretesting after implementation of the curriculum for (4) weeks and used the statistical bag of social sciences(SPSS)to process the results of the research and a set of conclusions was reached, the most important of which is t

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Engineering
Impact of the Weir Slit Location, the Flow Intensity and the Bed Sand on the Scouring Area and Depth at the Dam Upstream
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A total of 48 experiments were conducted to investigate the impact of slit weir dimensions and locations on the maximum scour depth and scour area created upstream. The slit weir model was a 110 mm slit opening, and it was installed at the end of the working section in a laboratory flume. The flume was 10.0 m long, 30 cm wide, 30 cm deep, and almost middle. It includes a 2 m working section with a mobile bed with 110 mm in thickness. In the mobile bed, two types of nonuniform sand (with a geometric standard deviation of 1.58 and 1.6) were tested separately. The weir dimensions and location were changed with flow rates. Then dimensions of the slit weir were changed from 60 x 110 mm to 60 x 70 mm (width x height), while th

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The strategic recovery of the insurance service and its reflection on achieving the strategic goals: research My application in the National Insurance Company
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The research topic dealt with the strategic recovery of the insurance service, which is one of the approaches that have an important role in providing solutions and remedies for the recession that affects companies and hinders them from achieving their strategic goals. The research also addressed the strategic objectives of the company as the rationale and actual guide for companies of all activities in order to protect their systems from deviation for its desired purpose. So the aim of the research is to demonstrate the repercussions of the strategic recovery of the insurance Service represented by (compensation, speed of response, apology, initiative (identifying the problem). The company's strategic goals are represented (prof

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Publication Date
Sun Oct 07 2012
Journal Name
Journal Of Educational And Psychological Researches
The Effect of KWL Strategy on the Achievement of the Students of the fourth class literary in the subject of History and the Development of Cognitive Thinking skills
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Whereas conventional methods of teaching history do not meet the sometimes purpose has suggested some educators strategies modern help to improve the level of students in the education process through activating prior knowledge and employed in positions of current learning, and focus attention on the points and the outstanding elements of the content and practice techniques Calendar criticof ideas and meanings and mental and linguistic activities used to verify the extent of reaching understanding.                                       &n

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Physical Environment and Crowded Classes on Academic Achievement
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The research problem can be summarized through focusing on the environment that surrounds students and class congestion, how these factors affect directly or indirectly the academic achievement of students, how these factors affect understanding the scientific material that the student receives in this physical environment, how classroom’s components such as seats, space With which the student can move, the number of students in the same class,  the lighting, whether natural or artificial, and is this lighting sufficient or not enough, the nature of the wall paint old or modern, is it comfortable for sight, the blackboard if it is Good or exhausted,  In addition to air-conditioning sets in summer and winter, this is on the on

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Publication Date
Tue Jul 22 2025
Journal Name
Advances In Life Science And Technology
The Effect of Preservatives and Freezing on Museum Saved Fish Samples
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Two means used for saving fish samples, namely Freezing and Preservatives represented by Alcohol and Formalin. The Freezing was used in saving samples collected newly, in addition to use Alcohol and Formalin with different concentrations 70% of Alcohol and 10% of Formalin. The concentrations of some heavy metal elements were examined, such as Potassium, Phosphorus, Calcium, Manganese, Magnesium, Zinc, Iron, Copper and Boron in samples saved in Formalin and Alcohol and frozen at different durations. The concentration of some elements has been changed during the saving duration. The study was performed on the concentration of heavy elements in the Liza abu muscles of saved and frozen fish.

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Publication Date
Tue Jul 22 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of cigarette smoking on salivary IgA and periodontal disease
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Background: Chronic periodontitis is an inflammatory disease of tissues supporting the teeth. Salivary compositions have been most intensely studied as a potential marker for periodontal disease. In this study, analysis of saliva provides a simple and non-invasive method of evaluating the role of salivary IgA (s-IgA) levels in periodontal disease by detecting the level of (s-IgA) in patients with chronic periodontitis smokers and non smokers patients and correlate the mean (s-IgA) levels with clinical periodontal parameters Plaque index (PLI) gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL). Materials and Methods: The study samples consists of (15) patients with chronic periodontitis who were non smokers (

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of Brucellosis on Lipid Profile and Oxidant-Antioxidants Status
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The activation of inflammatory cells, the release of their mediators, and the excessive production of free radicals may affect circulating lipids, but no evidence supports a role for peroxidation in the pathogenesis of Brucellosis disease. The aim of this work is to study the effect of Brucellosis on lipid profile concentration and oxidant-antioxidant status. We studied 20 Brucellosis patients (18 Females and 2 males) and 15 healthy controls (age average from 16 to 60 years old). Significant differences were noted between the serum lipids of Brucellosis patients and control group. Mean total cholesterol and low density lipoprotein cholesterol (LDL-cholesterol) concentrations were higher in patients than in control group (mean ± SE 197

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