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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
Sat Mar 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The exercise of citizenship behaviors and their impact on customer loyalty: Analytical study from the standpoint of employees in the National Insurance Company
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The exercise of citizenship behaviors and their impact on customer loyalty (An analytical study from the perspective of workers in the National Insurance Company).

The Research aims to find out the degree of customers National Insurance company for customer citizenship behavior and its impact on the level oh loyalty from the perspective of employess in the company, as well as the statement of the differences in the answers of employees according to their personality traits. To achieve the goals of research has been the use of the questionnaire as a tool for the collection and distribution of data on a sample of (90) individuals, as was the use of statistical program (SPSS) in the process of statistical analysis methods (mean, sta

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The role of Internal Audit Standards IIA`s in improving the local guideline and its reflection on the efficiency of internal audit performance
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The function of internal auditing has become an important function that aims at achieving objectives that are compatible with these developments and changes that have occurred in many countries in the world, which required the emergence of professional associations and institutes in the profession of internal auditing. Improve the guideline of the internal audit units issued by the Federal Audit Bureau to enhance the efficiency of internal audit performance in Iraqi government units. The researchers adopted the statistical method of proving the hypothesis by constructing a questionnaire that included three main axes: supporting the senior management in adopting the current guide, and the second being the importance of improving t

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Publication Date
Tue Aug 11 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
The effect of the maximum physical effort on some physiological variables, body components and achievement level in the effectiveness of air rifle shooting
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The job that confronts players with the effectiveness of shooting with an air rifle is high, so it requires necessary functional adaptations that differ in their degrees from other sports. Regular training in air rifle shooting leads to physiological changes in most of the body's internal systems, and changes and responses can be identified. The functional accompanying physical activity through the presence of body components that reflect these physiological changes in the form of changes in some components, and the importance of research lies in studying the physiological changes accompanying the maximum physical effort and the consequent development of the level of achievement in the effectiveness of shooting with air rifle and body

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Structural Imbalances and their impact on Sectoral Growth and Employment in Iraqi Economy for the period 2003-2015: Analytical study.
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Abstract:

     The objective of this study, is to attempt to explain the reality of the Structural Imbalances in the Iraqi Economy during the period of research, by providing a quantitative analysis of the most important types of Imbalances, Which are represented by the disruption in the Productive Structure, the imbalance of the structure of Public Budget, and the imbalance of the Structure of Trade. The problem of the research, is the fact that the economy structure in Iraq has long suffered from an Imbalances in its economic structure, which are represented in the unequal relations between its constituent elements, according to the proportions levels defined by the economic theory.

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Trees and their impact on humans And the environment from a Qur'anic perspective
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Show the greatness of Allah Almighty when contemplating the benefits of trees and plants in
Life in general and trees mentioned in the Koran in particular, do not have to meditate that
He acknowledges the greatness of the Almighty Creator, and his preference over man, that he is prepared for his livelihood
And give him what he can do in this life to the fullest.
  The study also stressed the need to urge people to this great blessing trees
By preserving them and wasteful wastefulness.
  The study also pointed to the need to guide people towards the aesthetics and improvements of
Look through and enjoy the beauty of trees, flowers, greenery and fruits ..

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Publication Date
Sun Nov 20 2022
Journal Name
Journal Of New Zealand Studies
The Impacts of Environmental-Geomorphology of the Kut Barrage on the Tigris Waterway and the Neighboring regions
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The research dealt with the effect of Kut Barrage on the geomorphological processes and the natural environment system in the course of the Tigris between the cities of Al-Ahrar and Kut in central Iraq. It was clear from the research the contribution of Kut Barrage in changing the surface runoff system between the front and back of the barrage, as well as changing the type of processes and the prevailing geomorphic forms, as the sedimentation activates the front of the barrage and erosion at its back, which affected the change in the morphology of the river, sediment retention at the front of the barrage, the burial of the bottom and reducing the validity of the stream. This also affects the efficiency of the barrage’s work and coastal er

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Publication Date
Thu Jun 01 2023
Journal Name
Journal Of Engineering
On the Laser Micro Cutting: Experimentation and Mathematical Modeling based on RSM-CCD
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The laser micro-cutting process is the most widely commonly applied machining process which can be applied to practically all metallic and non-metallic materials. While this had challenges in cutting quality criteria such as geometrical precision, surface quality and numerous others. This article investigates the laser micro-cutting of PEEK composite material using nano-fiber laser, due to their significant importunity and efficiency of laser in various manufacturing processes. Design of experiential tool based on Response Surface Methodology (RSM)-Central Composite Design (CCD) used to generate the statistical model. This method was employed to analysis the influence of parameters including laser speed,

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Publication Date
Fri Jul 18 2025
Journal Name
Sar Journal Of Medical Biochemistry
Western Diets Implications on Health, Including Its Influence on Metabolism and the Immunity
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Processed and red The Western diet, a modern dietary pattern, typically consists of meat, sugar-filled beverages, candies, chocolates, fried foods, prefabricated meals, refined cereals, conventionally produced animal products, high-fat dairy products, and high-fructose items. The goal of this review is to outline how the Western pattern diet affects gut microbiota and mitochondrial fitness, as well as metabolism, inflammation, and antioxidant status. Cancer, mental health, and cardiovascular health; We offer a thorough analysis of how the westernized diet and related nutrients affect immune cell responses as well as the hygienic costs of the Western diet. A consensus critical evaluation utilizing primary sources, including scientifi

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Publication Date
Sat Sep 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Disclosure of insurance services and its impact: On the performance of companies
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The objective of the research is to identify the nature of voluntary disclosure of insurance services and its impact on the financial performance of Iraqi insurance companies by knowing the relationship between increasing disclosure of financial services and financial performance indicators of insurance companies.In order to achieve this objective, the research was applied to a sample of the Iraqi insurance companies listed in the Iraqi Stock Exchange (Al Amin Insurance Company, Al Ahlia Insurance, Dar Al Salam Insurance, Gulf Insurance, Al Hamra Insurance) and based on their published financial statements (2014-2015) ) And by analyzing the sample lists were connected to the research objectives.The main conclusion of the study is that in

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Publication Date
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Temperature on the Stability and Release Profile of Ibuprofen Microcapsules
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The stability and releasing profile of 2:1 core: wall ratio ibuprofen microcapsules prepared by aqueous coacervation (gelatin and acacia polymers coat) and an organic coacervation methods (ethyl cellulose and sodium alginate polymers coat) in weight equivalent to 300mg drug, were studied using different storage temperatures 40°C, 50°C ,60°C and refrigerator temperature 4°C in an opened and closed container for three months (releasing profile) and four months (stability study).It was found that, these ibuprofen microcapsules were stable with expiration dates of 4.1 and 3.1 years for aqueous and an organic method respectively.Aqueous prepared ibuprofen microcapsules were found more stable than those microcapsules prepared by or

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