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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
Sun Dec 07 2014
Journal Name
Baghdad Science Journal
The effect of different doses levels of silver nanoparticles (AgNPs) on the kidney and liver in Albino male Rat. Histopathological study
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Objective: In this study ,the effects of silver nanoparticles (Ag NPs)were investigated on the liver and kidney tissues. Methodology: The produced nanoparticles have an average particle size of about 30 nm. Eighteen male albino rats were used by dividing them into three groups, each group comprise 6 rats. First group(control group) given food and water like other groups by liberty. Second group was tail injected by (AgNPs) at dose of (0.4 mg/kg. body weight/day). Third group was injected by (AgNPs) at dose of (0.6 mg/kg. body weight/day) for 15 days. All animals were sacrified at the end of experiment. The liver and kidney tissues specimens were fixed in 10% formalin and histological preparations were carried out then stained with H&E. Path

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Publication Date
Mon Aug 30 2021
Journal Name
Al-kindy College Medical Journal
Quality of Life of Parents of Children with Type I Diabetes Mellitus, Baghdad 2017
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Background: Diabetes is defined by the World Health Organization as a metabolic disorder characterized by chronic hyperglycemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. Families are co-regulating systems in which the stresses and strains of one family member affect the well-being of another member of the family. Caregivers of children with chronic illness report experiencing more parental stress than parents of healthy children.

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Publication Date
Wed Apr 10 2013
Journal Name
Journal Of The College Of Basic Education
Effect of heavy metal ions copper, cadmium and cobalt on the growth and reproduction of the aquatic fungus Saprolegnia hypogyna.
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The current study aimed to evaluate the effect of the heavy metals copper, cadmium and cobalt when added individually, in combination and in combination on the growth and reproduction of the aquatic fungus Saprolegnia hypogyna.

Publication Date
Tue Sep 01 2015
Journal Name
Journal Of Engineering
Experimental Study on the Effect of Using Metallic Brushes on the Charging and Discharging Time of Thermal Energy Storage Unit
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Phase change materials are known to be good in use in latent heat thermal energy storage (LHTES) systems, but one of their drawbacks is the slow melting and solidification processes. So that, in this work, enhancing heat transfer of phase change material is studied experimentally for in charging and discharging processes by the addition of high thermal conductive material such as copper in the form of brushes, which were added in both PCM and air sides. The additions of brushes have been carried out with different void fractions (97%, 94% and 90%) and the effect of four different air velocities was tested. The results indicate that the minimum brush void fraction gave the maximum heat transfer in PCM and reduced the time

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of creative accounting practices that are reflected on the sincerity and fairness of financial statements on tax evasion
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The research aims to achieve a set of objectives, the most important of which is to educate the management of companies operating in the private sector about the advantages and risks of using creative accounting practices, as on the one hand they serve the interests of the company and improve its image, and on the other hand it exposes it to the risks of non-compliance with tax laws and legislation or the risks of default and bankruptcy as a result of exploiting gaps and flexibility in the application Accounting standards, and in line with the objectives and through the research problem that was formulated in the form of a question (Are their creative accounting practices that are reflected in the honesty and fairness of financia

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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
Fri Jan 01 2021
Journal Name
Psychology And Education
The effect of Daniel's model on the development of critical thinking in the subject of Arabic language among students of the College of Management and Economics
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This research aims to identify the impact of Daniel's model on the development of critical thinking. In order to achieve this objective, the following hypotheses are formulated: 1. There is no statistically significant difference at the significance level (0.05) between the average differences in the posttest scores of the experimental group taught according to Daniel's model and the control group taught according to the traditional method in the measure of critical thinking. 2. There is no statistically significant difference at the significance level (0.05) between the average differences in the preand post-tests scores of the experimental group taught according to Daniel's model in the measure of critical thinking. The current research i

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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
Fri Jan 02 2026
Journal Name
Revista Iberoamericana De Psicología Del Ejercicio Y El Deporte, Issn 1886-8576, Vol. 18, Nº. 3, 2023, Págs. 319-323
The Effect of Using Exercises Associated With Ischemia and Hyperemia on Some Immunoglobulins (Igm - Igg) and White Blood Cells (Wbc) in the Rehabilitation and Treatment of Ankle Sprain Injury Lateral Side of Swimmers
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Autorías: Wafaa Sabah Mohammed Al-Khafaji, Fatimah Hameed Kzar Al-Masoodi, Suadad Ibrahim Suhail Al-Kinani. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 3, 2023. Artículo de Revista en Dialnet.

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Reinsurance risks and their reflex on the financial performance of the National Insurance Company: Applied Research in Maritime Insurance Branch
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The research dealt with the risks of reinsurance and its impact on the financial performance of the National Insurance Company by focusing on reinsurance in the marine insurance branch. Negative impact on the financial performance of the NICs and the Marine Insurance Branch. The research sample resulted in a main hypothesis that reflects this relationship. Lee in the analysis of financial information reports National Insurance Company of the branch of marine insurance for the period of 2010 until 2017, and the use of (retention) for measuring the re-insurance operations index, and (insurance financial surplus rate) to measure financial performance. For the purpose of obtaining the results, a number of statistical methods were used accord

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