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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
Mon Jul 01 2019
Journal Name
Journal Of Craniofacial Surgery
The Impact of Blast Implosions and Bullet Injury on Maxillary Air Sinus
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Background:

Successive waves and generations of terrorists attacked the Iraqis in the years following the fall of the regime in Iraq in 2003, after the US invasion of the country under the pretext of weapons of mass destruction. Hence, the Iraqi people enrolled in ongoing war with these armed groups which led to massive casualties due to blasts and missile injuries.

Mechanism of blasts injury can be classified into primary, secondary, tertiary, and quaternary. While bullet injuries can be classified into low and high-energy injuries, the type and severity of the injury will influence the type of management, together with facilities available in

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Publication Date
Thu Mar 31 2022
Journal Name
Journal Of The College Of Education For Women
Human Properties of Singapore’s People and their Impact on the State Might
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The research aims to study some of the human characteristics of the state of Singapore to know the impact of these characteristics on the strength of the state, its development and. The research included two aspects, theoretical and analytical, using the descriptive analytical method, force analysis method, as well as the historical method. The data was analyzed according to mathematical equations, including the size of the country's population, the extraction of the population growth rate and the concept of age structure, where some indicators related to this concept have been explained. The researcher reached a set of results, the most important of which were: that the population size of the state of Singapore in the period between (19

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Publication Date
Wed Feb 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Performance Evaluation Strategy and its Impact on the Achievement of Organizational Effectiveness
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Abstract

The research aims to determine the impact of the strategy performance evaluation and of the Standards (leadership, people, knowledge, processes, financial) in the achievement of organizational effectiveness in accordance with the dimensions (planning and setting goals, Exploitation of the Environment, achieve the goals, the ability to adapt, information management and communications) and the relationship between them, the problem of the research in the growing interest in the process of performance evaluation for organizations, the erroneous belief that the performance evaluation activity is useful, and the fact that performance evaluation process is one of the main tasks of the work of the Office of the Inspecto

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Publication Date
Sun Sep 15 2019
Journal Name
Route Education And Social Science Journal
The influence of textual and visual reading on EFL Iraqi students' comprehension
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Reading roles as the third skill in the range of English as a Foreign Language (EFL) learning. Although the capability of reading in both academic and non-academic texts is assessed on standardized tests, few of oral interpretation of written language excludes images from estimating literary knowledge. This paper highlights strategies of reading comprehension and visual literacy. It aims to investigate either textual or visual reading in EFL can make an impact on students' comprehension. The effective use of visuals changes instructing reading comprehension recently.The imagery-text model can affect developing reading comprehension and enhancing intellectual thinking. The study hypothesizes that there is no relationship between reading and

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Publication Date
Thu Jan 03 2008
Journal Name
Kufa Med. Journal
Synrgistic Activity of Peganum Harmala Extract and Pentostam on the Leishmania Donovania
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Publication Date
Wed Nov 03 2021
Journal Name
International Journal Of Energy Research
Simulation and experimentation study on the performance of metal hydride storage vessels
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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
Visual analysis of the Kurdish women's dress and its impact on modernity
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A collection of pictures of traditional Kurdish women's national clothing and contemporary clothing was collected. A visit was also made to the city of Sulaymaniyah and the city of Halabja to find out the foundations of traditional clothing for the Kurdish regions and the impact of contemporary fashion on traditional dress. Which represents the culture and regionalism and reflects the picturesque nature of northern Iraq, and in order to complete the study, the parametric measurements of the clothes were analyzed and the graphs of the dress and its accessories were re-drawn to understand and make a comparison between them to study the clear influences and changes and examine the possibility of benefiting from them in sewing contemporary f

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The Effect of Eruca sativa extract on Gram Posative and Negative Bacteria
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The antibacterial effect of (Eruca sativa) extract was evaluated by an in vitro study testing the growth of various Gram-Positive and Gram-Negative bacteria . The bactericidal activity of this extract was analyzed by serial dilution in tubes. This study,found that Gram-Negative and Gram-Positive bacteria susceptible to very low eruca concentrations. On the other hand, Gram-positive bacteria were more susceptible than Gram-negative bacteria, the minimal bactericidal concentration of Gram-positive bacteria was 5 mg ml-1 but minimal bactericidal concentration of Gram-negative bacteria was 10 mg ml-1 that mean duble inhibation concentration of Gram-positive bacteria . this study suggest that Eruca sativa leaves have inhibation effect on Gra

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Publication Date
Mon Mar 17 2025
Journal Name
International Journal Of Civil Engineering
Understanding the Role of Nanosilica and Nanoalumina on Hot Mix Asphalt Performance
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This study explores the role of nanomaterials in the performance of asphalt binders and mixtures. Two commonly available nanomaterials, i.e., nanosilica (NS) and nanoalumina (NA), were used at contents of 0%, 2%, 4%, 6%, and 8% by weight of asphalt binder. A set of experiments was carried out at the binder level to investigate properties such as penetration, softening point, aging-related mass loss, nanomaterial dispersion (storage stability), and workability (rotational viscosity). In addition, the suitability of NS and NS was also assessed through the testing of nanomodified asphalt mixtures, which focused on Marshall properties, the resilient modulus, moisture susceptibility, permanent deformation, and fatigue resistance. The findings in

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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
The Impact of Fear and Rational Appeal Scam Techniques on Individual Susceptibility
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Scams remain among top cybercrime incidents happening around the world. Individuals with high susceptibility to persuasion are considered as risk-takers and prone to be scam victims. Unfortunately, limited number of research is done to investigate the relationship between appeal techniques and individuals' personality thus hindering a proper and effective campaigns that could help to raise awareness against scam. In this study, the impact of fear and rational appeal were examined as well as to identify suitable approach for individuals with high susceptibility to persuasion. To evaluate the approach, pretest and posttest surveys with 3 separate controlled laboratory experiments were conducted. This study found that rational appeal treatm

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