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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
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the rebound effect and interactive between fiscal and monetary policy on the General economic equilibrium (IS-LM)
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      Will address this research interaction and coordination between fiscal and monetary policies and the impact of this interaction and coordination on economic stability and growth، and how the financial implications of monetary policy may stimulate action monetary policy and treatment side effects and the nature of responsiveness and bounce between procedures both two policies and their impact on the balance of overall economic and explained in the folds of searchjustifications coordination and the extent necessary in order to address the imbalances in economic activity through twinning actions of monetary and fiscal، has embodied this coordination and interaction between policies and their impact m

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Survey theopinions professional and academics on building the strategy of internal audit function and the possibility of keeping abreast of developments
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The research problem is clearly deficient suffered by the internal audit function in all institutions of Iraq, as a result of the lack of sponsor organizations for this profession and there is no law or local legislation determine its powers and its responsibilities and scope of work As well as the lack of interest of senior management in economic units that function, as it focuses its work on the scope of financial and accounting matters only So required to rebuild this function in line with the current developments as well as the lack of a framework that defines the strategy of this function, and it came the idea of research to find out how to create a regulatory method for re-strategic construction of the internal audit function depen

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Nitrogen fertilization and plant density and their impact on the growth indicators and plant winning livestock
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This experiment was conducted in the season 2001-2000 in station Ishaqi the company's general industrial crops to plant livestock Vigna radala deleted (Khadrawi) carried out the experiment design panels splinter and order in RCBD with three balls two factors are levels nitrogen fertilizer (120 and, 100.0 kg urea / ha)nitrogen ratio of 46%, which put in the main panels mAIN PLOT and Alkiavat three levels that were placed in secondary panels .....

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of marketing tools on the legal liquidity index : an applied research in the International Development Bank for Investment and Finance
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Abstract

               The main problem of the study lies in the lack of a clear perception among the study sample about the impact of digital marketing tools on legal liquidity. Legal) of the International Development Bank for Investment and Finance and to achieve the objectives of the research, the method of observation and survey was used in measuring the dimensions of digital marketing. As for banking liquidity, the reports and financial statements of the bank were used as the research sample, as well as the use of the statistical analysis program SPSS in the statement of the relationship The study concluded, in summary, the following: Mar

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Publication Date
Fri Oct 03 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of curvature angle and rotational speed on the cyclic fatigue of three types of rotary instrument (In vitro): comparative study
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Background: The fracture of instruments within root canal during endodontic treatment is a common incidence, fracture because of fatigue through flexure occurs due to metal fatigue, this study aimed to assess the effect of curvature angle and rotational speed on the cyclic fatigue of different type of Endodontic NiTi Rotary Instruments and compare among them. Materials and method: Three types of rotary instruments with tip size 0.25: ProTaPer F2 (Densply, Malifier) Revo-S SU( 0.06 taper, MicroMega) and RaCe system (0.06 taper, FKG, Dentaire), Forty file of each instrument were used within two canals with angle of curvature (40 &60 )at two speed (250&400)RPM, twelve group were formed for all instruments(total number=120),ten file fo

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Publication Date
Sat Jun 06 2020
Journal Name
Journal Of The College Of Education For Women
Spatial Analysis of Soil Characteristics and its Effect on Determining the Susceptibility of lands of the RasheedRegion: A Study in Soil Geography
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Twelve pends were selected and distributed on three verticals transects paths on the Tigers river in Al Rasheed county.Passing through land covers, that classified and covers the whole region. Based on the 8 Landsat of the year 2015. It was oriental classified by using Erdas 10.2 . The pedons were distributed on the area of each varicty of these classes. the series of soil according of the transect series (DW74,MMg,DMu6 , Df96) respectively were represented P1 , P2 , P3 , P4  .

The second transits series(DM97,MM5,DM96,DF115) respectively were  represented P5 , P6 , P7 , P8  .The third  transits series(DM46,MMg,MF12,MM11) re

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Publication Date
Mon Oct 01 2012
Journal Name
Iraqi Journal Of Physics
Effects of copper doping and annealing on the structure and optical properties of ZnxCdx-1S thin films
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Effect of copper doping and thermal annealing on the structural and optical properties of Zn0.5Cd0.5S thin films prepared by chemical spray pyrolysis have been studied. Depositions were done at 250°C on glass substrate. The structural properties and surface morphology of deposited films were studied using X-ray diffraction (XRD) and photomicroscope (PHM) techniques. XRD studies reveal that all films are crystalline tetragonal structure. The film crystallinity are increased with 1% Cu-doping concentration and also increased for the films annealed at 300°C than the other studied cases. The lattice constant 'a' and 'c' varies with doping concentrations from 5.487Å to 5.427Å and 10.871Å to 10.757Å respectively. The grain size attained

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Publication Date
Sun Feb 03 2019
Journal Name
Iraqi Journal Of Physics
Influence of Nd and Ce doping on the structural, optical and electrical properties of V2O5 thin films
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Nano-structural of vanadium pentoxide (V2O5) thin films were
deposited by chemical spray pyrolysis technique (CSPT). Nd and Ce
doped vanadium oxide films were prepared, adding Neodymium
chloride (NdCl3) and ceric sulfate (Ce(SO4)2) of 3% in separate
solution. These precursor solutions were used to deposit un-doped
V2O5 and doped with Nd and Ce films on the p-type Si (111) and
glass substrate at 250°C. The structural, optical and electrical
properties were investigated. The X-ray diffraction study revealed a
polycrystalline nature of the orthorhombic structure with the
preferred orientation of (010) with nano-grains. Atomic force
microscopy (AFM) was used to characterize the morphology of the
films. Un-do

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Publication Date
Wed Jan 05 2022
Journal Name
International Journal Of Aquatic Science
Effects of Selenium Sources and Concentrations on the Performance, Meat Quality, and Tissue Properties of Broiler Chickens
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We wanted to find out how selenium (Se) affects broiler chicken performance, meat physicochemical properties, and selenium deposition in the tissues of broilers. Each of the 96 experimental pens had 30 chickens and included a total of 2,880 one-day-old broilers (Cobb 500 strain). A factorial design of four-by-three (SY + SS) and eight replicates (SY + SS) was used for the 12 experimental treatments, with selenium levels ranging from 0.15 to 0.60 ppm and organic (SY) or inorganic (SS) sources of selenium and their relationship (SY + SS). There were no differences in performance (P > 0.05) across Se levels or sources. 106 g/day of ADFI, 63 g/day of ADG, and 1.6844 kg/kg of FCR were found to be the averaging values for these three parameters:

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Global Pharma Technology
Parasitological and immunological study of the effect of chitosan and chitosan nanoparticles loaded with spiramycin on toxoplasmosis
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This study was carried out to evaluate parasitological and immunological of the effect of chitosan and chitosannanoparticles loaded with spiramycin on toxoplasmosis infected mice. After injection intra peritoneal with 103viable tachyzoites for acute infection, treatments given for seven days. Peritoneal fluid examination revealed a significant decrease in the number of Toxoplasmagondiitachyzoites in all treated infected mice compared with infected non-treated. The combined therapy gave better results than single. The best effect was observed in group of mice treated with spiramycin combined with chitosan nanoparticles. Also immunoglobulin Ig Manti body and gamma Interferon (INFγ), Tumor Necrosis Factor alpha (TNF-α) cytokines responses ag

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