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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 Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Auditing the technical reserves of the aircraft body insurance branch and its reflection on the fairness of the financial statements : applied research in the National Insurance Company
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The research gained its importance from the importance of technical reserves in the insurance activity and its impact on the result of the activity of insurance companies and their financial position and thus reflected on the insurance prices as the technical reserves are one of the most important and most valuable budget items usually, as well as that the insurance activity has a role in maintaining economic development where some countries develop laws and instructions for the formation of those reserves binding application to insurance companies and the fact that the financial statements in general are of interest to shareholders, banks, the General Tax Authority and other beneficiaries In the insurance activity as policyholders and t

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Publication Date
Mon Nov 26 2018
Journal Name
Al-khwarizmi Engineering Journal
Study the Effect of Different Percentages of Natural (Orange Peels and Date Seeds) and Industrial Materials (Carbon and Silica) on the Mechanical and Thermal Properties of Polymeric Reinforced Composites
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Mechanical and thermal properties of composites, consisted of unsaturated polyester resin, reinforced by different kinds of natural materials (Orange peels and Date seeds) and industrial materials (carbon and silica) with particle size 98 µm were studied. Various weight ratios, 5, 10, and 15 wt. % of natural and industrial materials have been infused into polyester. Tensile, three-point bending and thermal conductivity tests were conducted for the unfilled polyester, natural and industrial composite to identify the weight ratio effect on the properties of materials. The results indicated that when the weight ratio for polyester with date seeds increased from 10% to 15%, the maximum Young’s modulus decreased by 54%. When the weight rat

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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Strategic planning of human resources and its impact on the stages of a career path :A field research in the Ministry of Health
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Abstract

The objective of this research is to analyze the relationship between the strategic planning for human resources and career path, and I have tested Search the Ministry of  Health and some health centers headquarters in the Karkh district, that is applied in sample Consist of (45) Deputy Director, Head of Depts, Departmental Manager, and health center Manager.

Find interested in studying the two subjects are important and vital, at the level of organizations at the present time, namely the strategic planning of human resources and career path. To achieve the objectives of the research was designed Qusestionnair (31) items to collect  Primary data. and collected t

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Publication Date
Tue Dec 22 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Continuous improvement of technology and its role In reducing the costs in accordance with the management style On the basis of the activities (ABM): Applied Research in the General Company for Textile Industries / hula
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The administration on the basis of the activities designed to evaluate the performance of activities in terms of cost, time and quality by identifying activities that add value and those that are no add value and  enables the administration of making up their own continuous improvement in production, through lower costs and reduce the time and improve the quality   and reduce the incidence of spoilage and waste, y based search Ally premise that (the continuous improvement of the adoption of management style on the basis of the activities helps management in decision-making wise to reduce  costs) to prove the hypothesis has sought research to achieve its goal of  Alkadivh and Alkoppelan     &nb

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Publication Date
Wed Sep 20 2023
Journal Name
Journal Of Aeronautical Materials
The Effect of A Dry Training Program Using Aids On The Results Of Error Measures And The Effect Size On The Air Pistol Accuracy Of Correction
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The world is keeping pace with evolution in all its fields as a result of scientists' pursuit of continuous scientific and technological development. This evolution included the sports field, which had a large space in the aspect of development and for all disciplines, Therefore, it's reflected today in what we see of records and advanced achievements in sporting events and activities. The development in the field of sports was the result of scientific research (Hussein and Jawad., 2022), where the interest in the training process has become one of the most important pillars of the development of achievement (Neamah and Altay., 2020). The shooting sport has also witnessed a remarkable development due to the diversity and development of its

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Publication Date
Tue Dec 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Administrative Accounting Functions on the Practices of the Higher and Central Administrations of the Economic Unit "An Applied Study on Joint Stock Companies"
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The Key Role of Management Accountant is to Evlaute The Successful it Has Been in Implementing Organization Strategy.

This Research Target to Explain The Key Role of Management Accountant in Evaluate of  Organization Strategy. by Strategic Analysis of Operating Income From Specific Sources Such as Cost Savings and Growth in Stead of Emphasizing Only The Aggrega

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Crossref
Publication Date
Tue Dec 29 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of the activities of the national poverty reduction strategy On achieving the sustainable development goals An applied research in the Ministry of Labor and Social Affairs
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The objective of the research is to shed light on the nature of the impact of the activities of the national strategy for poverty alleviation in achieving the goals of sustainable development, and the research problem was represented by Is there an effect of the activities of the national strategy for poverty reduction in achieving the goals of sustainable development? and represents the field of research in the Ministry of Labor and Social Affairs For the years (2012-2016) and the results of the sustainable development goals indicators for the years (2012-2016), the ready-made statistical program (SPSS ver.10) was used to calculate the percentages, multiple linear regression equation, the F test and the R2 coefficient, and the research

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Publication Date
Fri Jul 01 2022
Journal Name
Translation & Linguistics
TO THE QUESTION ABOUT THE USE OF METAPHORS IN THE CREATION OF ART (ON THE EXAMPLE OF THE STORY BY D. RUBINA "YOU AND ME UNDER THE PEACH CLOUDS")
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The article reflects the results of the analysis of the use of metaphors when creating the image of the main character of the story by D. Rubina "You and me under the peach clouds" - a pet, a dog named Kondraty. Through metaphorization, the image of the dog is filled by the author with purely human qualities, thus passing into the category of a full member of the family. The article is a continuation of the study of the work of D. I. Rubina.

Publication Date
Thu Mar 14 2013
Journal Name
Journal Of Kerbala University 11 (3)‏
Effect of chemical fertilization and gibberellic acid on the contentofsomechemical compounds of Nepali and Khudairi cultivars of olive‏
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Publication Date
Tue Jul 12 2016
Journal Name
World Journal Of Experimental Biosciences
Effect of honey and sodium bicarbonate on formation inhibition and removal of Staphylococcus aureus and Klebsiella pneumoniae biofilm in vitro
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