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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 Jan 07 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
Relationship of Low Maternal Vitamin D3 Level and Adverse Early Neonatal Outcomes
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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Performance Appraisal and its impact on behavioral and Attitudinal work outcomes Analytical research of the views of a sample of teaching staff at Colleges of the University of Fallujah
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The current research aims to know the extent of the impact of performance evaluation in its dimensions as an explanatory variable in the behavioural and attitudinal work outputs with its dimensions as a response variable in order to reach appropriate solutions through which the University of Fallujah seeks to achieve its goal in the process of diagnosing the axes of strength and to benefit from them in the process of strengthening the status and sobriety of the academic position of the professor and the researcher relied on The descriptive and analytical approach in carrying out this study, and data was collected from university professors, including leaders, heads of departments and divisions, who numbered (97) teachers. And fie

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Publication Date
Wed Jan 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
The role of electrolytes and inflammatory biomarkers in the development of febrile seizure in children
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Publication Date
Sun Dec 01 2013
Journal Name
Baghdad Science Journal
Bacterial Causes Tonsillitis in Children, Study the Resistance to Antimicrobials and the Effect of Clove Extracts on Selected Isolated Bacteria.
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In this study Isolated Pathogenic bacteria which causes Tonsillitis in Children with ages between 3-17 years. They are admitted to Central Children Hospital (Al-Karch) and Ebn-Albalady Hospital (Al-Rusafa). 200 cases were collected which include 120 Male and 80 Female. The result of the recent study shows that the isolation percentage was 40% from Male and 35% from Female. In this study Fifty six isolated were Identified, 20 were ?-hemolytic Streptococcus which was Streptococcus pyogenes, formed (36%) from all isolated.6 Pathogenic bacteria were ?- hemolytic Streptococcus which was Streptococcus pneumoniae formed (11%). The number of Moraxella catarrhalis bacteria was 12 formed (21%), the number of Haemophilus influenzae was 1

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Publication Date
Sun Mar 04 2018
Journal Name
Baghdad Science Journal
Synthesis and Characterization of a Molecularly Imprinted Polymer for Diclofenac Sodium Using (2-vinylpyridine and 2-hydroxyethyl metha acrylate) as the Complexing Monomer
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Four electrodes were synthesized based on molecularly imprinted polymers (MIPs). Two MIPs were prepared by using the diclofenac sodium (DFS) as the template, 2-hydroxy ethyl metha acrylate(2-HEMA) and 2-vinyl pyridine(2-VP) as monomers as well as divinyl benzene and benzoyl peroxide as cross linker and initiator respectively. The same composition used for prepared non-imprinted polymers (NIPs) but without the template (diclofenac sodium). To prepared the membranes electrodes used different plasticizers in PVC matrix such as: tris(2-ethyl hexyl) phosphate (TEHP), tri butyl phosphate (TBP), bis(2-ethyl hexyl) adipate (BEHA) and tritolyl phosphate (TTP). The characteristics studied the slop, detection limit, life time and linearity range of DF

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Publication Date
Wed Aug 30 2023
Journal Name
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Post COVID-19 Effect on Medical Staff and Doctors' Productivity Analysed by Machine Learning
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The COVID-19 pandemic has profoundly affected the healthcare sector and the productivity of medical staff and doctors. This study employs machine learning to analyze the post-COVID-19 impact on the productivity of medical staff and doctors across various specialties. A cross-sectional study was conducted on 960 participants from different specialties between June 1, 2022, and April 5, 2023. The study collected demographic data, including age, gender, and socioeconomic status, as well as information on participants' sleeping habits and any COVID-19 complications they experienced. The findings indicate a significant decline in the productivity of medical staff and doctors, with an average reduction of 23% during the post-COVID-19 period. T

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Publication Date
Sun Jul 01 2001
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIELD EFFICACY OF THREE TYPES OF INSECTICIDES AGAINST LARVAE OF MUSCADOMESTICABREEDING IN EQUINE MANURE AND THEIR EFFECTS ON PREDATORY MITES
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The field efficacy of Actellic (organophosphate), Neporex (insect growth regulator) and
Ficam (carbamate), at the application rates of 2-4, 0.4-0.8 and 0.1-0.2 g AI/m2 respectively,
was studied against the larvae of Musca domestica L. Results of treatments involving horse
manure indicated that Actellic and Neporex produced sharp decrease of larval numbers (close
to zero) for 21d. But there was a slight recovery in larval numbers 14 d following treatment
with Ficam. The populations of predator mites were not affected due to insecticidal
applications.

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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Leptin and Insulin Resistance in Obese Children
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Background: Insulin resistance (IR) is the primary metabolic disorder associated with obesity. Obesity is a growing worldwide health problem affecting both adults and children. Objectives: To determine the association between leptin and IR, and to identify the ratio of fasting glucose/leptin (G/L) and insulin/leptin (I/L) as a new simple method for the detection of IR in obese children.Methods: This study was done in the National DiabeticCenter/ AL-Mustansiriya University during the period fromMay 2013 until the end of October 2013. Fasting bloodglucose (FBG), serum insulin, leptin, and lipid profile weremeasured in 52 obese children (24 children with IR and 28without IR); their age range was (5-15) years, they werecompared with 38 healt

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Publication Date
Sat Jul 26 2025
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Al–bahith Al–a'alami
THE ROLE OF WESTERN LEGISLATIONS AND LAWS IN PROTECTING CHILDREN FROM ADVERTISEMENT
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This study aims to identify the most important legislatures and legal frameworks pertaining to advertisement for children. It focuses on the western approach, which is characterized by the variety of its perspectives in presenting issues and in identifying problems. However, if studies show that there is a certain awareness about the advertisement impact on children, it is obvious that most of legislatures reject the laws restricting the broadcast advertising spots intended for children under 12 years of age, with the exception of the Swedish and the Canadian province of Quebec experiences, which opted for total ban on advertising spots broadcast messages targeting children.

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The regulatory climate in the government and private kindergarten children (Comparative Study)
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The research problem boils question is there in Riyadh organizational climate that enables them to do their work properly and whether there are differences between the government and private Riyadh depending on the organizational climate has sought Find measure: 1 regulatory climate for kindergarten 2. The difference between government and private Riyadh depending on the organizational climate. Limited research on the (200) parameter of the Riyadh government and private parameters for the year (20,142,015) In order to achieve the research objectives the researchers built a regulatory climate in accordance with the scientific steps to build a psychological scales measure After the formulation of climate regulation paragraphs of the (30) p

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