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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 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 Jun 29 2022
Journal Name
College Of Islamic Sciences
Evidence for monotheism in Islam and the Qur’an and the meaning of the names and attributes and their unification
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This topic is considered to be of a high degree of importance to every Muslim, and its importance is due to the fact that monotheism is:

Prove that God Almighty is the God who created everything and everything opposite to monotheism is polytheism, and it is taking other than God Almighty as a deity.

Therefore, we have to know the concept of God. If he is known, then he knows the concept of monotheism and the concept of polytheism

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Publication Date
Sun Mar 05 2017
Journal Name
Baghdad Science Journal
Positive and Negative Aspects of Copaxone ( Glatiramer acetate) Action on TC, TG HbA1c and Iron Levels in The Sera of Iraqi Women with Multiple Sclerosis in Baghdad
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The aim of the present study is to highlight the role of total cholesterol (TC), triacylglycerol (TG), Glycated hemoglobin A1c and iron in Iraqi women with multiple sclerosis and also to examine the biochemical action of copaxone (which is the most widely used in the 21st century to treat multiple sclerosis) on these biochemical parameters. This is the first study in Iraq which deals copaxone action on TC , TG , HbA1c and iron. Ninety women in their fourth decade suffering from multiple sclerosis were enrolled in this study. They were divided into: the first (group B) composed of (30) women without any treatment related to multiple sclerosis or any treatment linked with chronic or inflammatory diseases. The second (group A1) included (30)

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Effect of measurement and analysis of quality costs on continuous improvement: Applied research in the Directorate General for the distribution of electric power in the Middle Euphrates
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The research aims to identify the theoretical foundations for measuring and analyzing quality costs and continuous improvement, as well as measuring and analyzing quality costs for the Directorate of Electricity Supply / Middle Euphrates and continuous improvement of the distribution of electrical energy,The problem was represented by the high costs of failure and waste in electrical energy result to the excesses on the network and the missing (lost) energy,Thus, measuring and analyzing quality costs for the distribution of electrical energy and identifying continuous improvement leads to a reduction in missing and an increase in sales, as the research reached many conclusions, the most important of which is the high percentage o

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
The impact of The Bransford and Stein Model on the Achievement of Fifth-Grade Literary Students for Geography and their Reflective Thinking
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The current research aims to identify the effect of the Bransford and Stein model on the achievement of fifth-grade literary students for geography and their reflective thinking. To achieve the objective of the research, the following two null hypotheses were formulated:

  • There is no statistically significant difference at the significance level (0.05) between the average scores of the experimental group students who studied geography using the Bransford and Stein model and the average scores of the control group students who studied the same subject in the usual way in the achievement test. 2- There is no statistically significant difference at the significance level (0.05) between the average scores of the experimental gr

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Publication Date
Thu Jan 25 2024
Journal Name
Iraqi Journal Of Agricultural Sciences
EFFECTS OF MINERAL FERTILIZATION AND SPRAYING WITH SALICYLIC ACID AND AMINO ACIDS ON THE GROWTH AND PRODUCTIVITY OF INDUSTRIAL POTATOES
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This experiment was carried out at a private field in the eastern Radwaniyah Baghdad for the fall season 2020/2021 and spring 2021 to study the effects of adding mineral fertilizers, spraying salicylic acid and amino acids on some growth traits and yield of industrial potato plants. 200 kg N h-1 , 100 kg P2O5 h-1, 100 kg K2O h-1 and F2 consist of 275 kg N h-1, 180 kg P2O5 h-1, 200 K2O h-1 and F3 consist of 350 kg N h-1, 360 kg P2O5 h-1, 300 K2O h-1 and salicylic acid in three concentrations of 0,50 and 100 mg L-1 ( S1, S2, S3) and amino acids in three concentrations of 0, 1.25 and 2.5 ml L-1 ( A1, A2 , A3) It was carried out as a factorial split plot experiment, where the fertilizer levels (F1, F2 and F3) are in the main plot and th

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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
Fri Jan 02 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of various endodontic irrigants on the sealing ability of Biodentine and other root perforation repair materials (In vitro study)
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Background: This in vitro study was carried out to evaluate the effect of various endodontic irrigants (sodium hypochlorite, ethylene diaminetetracetic acid and normal saline) on sealing ability of (Biodentine, mineral trioxide aggregate, and amalgam) used to repair furcal perforations. Material and methods: One hundred and twenty extracted human molars with divergent roots were used in this study. A standard root canal access cavity was prepared in each tooth and furcal perforation was made and was standardized by using k file size 100 instrument to get a perforation of (1.32mm) in diameter .The teeth were randomly divided in to three groups of 40 teeth according to the type of material used to repair the perforations (Group A: The furcal

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Publication Date
Thu Sep 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
Human Resource Management and its Impact on the Level of Job Performance: An Analytical Research in the Iraqi Ministry of Interior
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        The current research aims to highlight the role of human resource management with its practices (human resource planning, selection and placement, training and development, performance evaluation, compensation, and incentives) in raising the level of individuals' performance and its dimensions (task performance, contextual performance, unproductive work behavior, and adaptive performance) by explaining the research problem, which can be limited to the low level of performance of individuals, where the researchers use the descriptive analytical approach and the SPSS program in the practical aspect of the research community represented by the general manager and his assistant

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Publication Date
Fri Jan 02 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The Influence of Different Fabrication Techniques and Preparation Designs on the Marginal Adaptation of Ceramic Veneers (An In vitro Comparative Study)
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Background: Ceramic veneers represent the treatment of choice in minimally invasive esthetic dentistry; one of the critical factors in their long term success is marginal adaptation. The aim of the present study is to evaluate the marginal gap of ceramic veneers by using two different fabrication techniques and two different designs of preparation. Material and methods: A typodont maxillary central incisor used in the preparation from which metal dies were fabricated, which were in turn used to make forty stone dies. The dies divided into four experimental groups, each group had ten samples: A1: prepared with butt-joint incisal reduction and restored with IPS e.max CAD, A2: prepared with overlapped incisal reduction and restored with IPS e.

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