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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
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
Fri Jan 02 2026
Journal Name
Journal Of Physical Education
The Effect Of Absolute Strength Training On Knee Injuries Rehabilitation And Special Strength In Muay Thai Fighters
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Publication Date
Sun Sep 06 2015
Journal Name
Baghdad Science Journal
The Bactericidal Effect of CO2 Laser on Pseudomonas aeruginosa Isolated from Wound and Burn Infections, In-Vitro
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A total of 60 cotton swabs are collected from patients suffering from burn wound and surgical site infections admitted to Baghdad Teaching Hospital and Burn Specialist Hospital in Baghdad city during 9/2013 to 11/2013. All cotton swabs are cultured initially on blood agar and MacConkey agar and subjected for standard bacteriological procedures for bacteriological diagnosis. Twenty samples out of sixty are identified as Pseudomonas aeruginosa by conventional methods. The results of antibiotic susceptibility test illustrate that the antibiotics resistance rate of Pseudomonas aeruginosa isolates is as follows:100% (2020) for ceftriaxone, cefepime and carbencillin, 70% (14/20) for amikacin, 65%(13/20) for tobramycin, ceftazidim and gentamycin,

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Publication Date
Sun Jul 12 2020
Journal Name
International Journal Of Research In Social Sciences And Humanities
RISK MANAGEMENT AND ITS REFLECTION ON THE QUALITY OF MUNICIPAL SERVICE, CASE STUDY IN SALAHALDDIN SEWERAGE DIRECTORATE
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The current research aims to identify the risk management and its impact on the quality of service in the Salahalddin Sewerage Directorate, This is due to the great impact that the service provided by this institution plays in preserving health and the environment in the community, which has faced many administrative challenges, problems and issues as a result of the rapid and continuous environmental changes, and therefore, the adoption of administrative concepts such as risk management and knowledge of their impact on the quality of the municipal service is necessary to reach this service To the required levels. To achieve the research objectives, two main hypotheses have been formulated, the first of which is to find the extent of the li

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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
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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Publication Date
Fri Jan 02 2026
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
Fri Jan 02 2026
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
Fri Sep 01 2023
Journal Name
Iraqi Journal Of Physics
Influence of NiTi Spring Dimensions and Temperature on the Actuator Properties
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Nitinol (NiTi) is used in many medical applications, including hard tissue replacements, because of its suitable characteristics, including a close elastic modulus to that of bones. Due to the great importance of the mechanical properties of this material in tissue replacements, this work aims to study the hysteresis response in an attempt to explore the ability of the material to remember its previous mechanical state in addition to its ability to withstand stress and to obtain the optimal dimensions and specifications for the manufacturer of NiTi actuators. Stress-strain examination is done in a computational way using a mutable Lagoudas MATLAB code for various coil radii, environment temperatures, and coil lengths. The computational m

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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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