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bijps-974
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 Sep 01 2024
Journal Name
Heliyon
Synthesis and characterization of some Metal ions complexes with mixed ligand of azo dye and Metformin and evaluation of its effectiveness on the growth of some pathogenic bacteria clinically isolated and study of its Toxicity on normal and cancerous Hepatocytes
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Four metal compounds mixed ligand of azo dye ligand (L) and metformin.(Met) were produced at aquatic ethanol for (1:1:1) (M:L:Met). The prepared compounds were identified by utilizing atomic absorption flame, FT.IR and UV–Vis spectrum manners as well as conductivity mensuration. These compounds was assayed of the gained datum the octahedral geometry was proposed into whole prepared complexes.Also in this research was studied represented examining the antibacterial and antifungal impact of the azo dye ligand (L), metformin.(Met) and (Co,Ni, Cu and Cd complexes) on four types of pathogenic, clinically isolated bacteria that are resistant to antibiotic, like Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Klebsiella pneu

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Publication Date
Sun Sep 01 2024
Journal Name
Heliyon
Synthesis and characterization of some Metal ions complexes with mixed ligand of azo dye and Metformin and evaluation of its effectiveness on the growth of some pathogenic bacteria clinically isolated and study of its Toxicity on normal and cancerous Hepatocytes
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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 May 28 2025
Journal Name
Retos
The effect of exercises in the third intensity zone of the strength characteristic of speed for the legs on some physiological and biochemical indicators for handball players
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Objective: preparing exercises for the third intensity zone for strength and speed for the legs, and identifying their effect on some physiological and biochemical indicators for (the level of lactic acid concentration, the concentration of sodium bicarbonate, the concentration level of (potassium K+) and (sodium Na+) in the blood, and the number of breathing times (RF) Research methodology: the experimental research method was adopted by designing the experimental and control groups on a sample of Army Sports Club players amounting to (16) players, deliberately selected (100%) from their community using a comprehensive enumeration method, and then divided into two groups of equal number, After determining the tests for physiologica

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Wed Nov 30 2016
Journal Name
International Business Management
ESTIMATE OF THE MULTIPLIER EFFECT OF THE MONETARY AND FISCAL POLICY ON NON-OIL GROSS DOMESTIC PRODUCT IN THE IRAQI ECONOMY FOR THE PERIOD OF 1990-2014
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The monetary policy is a vital method used in implementing monetary stability through: the management of income and adjustment of the price (monetary targets) in order to promote stability and growth of real output (non-cash goals); the tool of interest rate and direct investment guides or movement towards the desired destination; and supervisory instruments of monetary policy in both quantitative and qualitative. The latter is very important as a standard compass to investigate the purposes of the movement monetary policy in the economy. The public and businesses were given monetary policy signals by those tools. In fiscal policy, there are specific techniques to follow to do the spending and collection of revenue. This is done in order to

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Publication Date
Thu Feb 07 2019
Journal Name
Iraqi Journal Of Laser
The Effect of 532 nm Diode Pumped Solid State (DPSS) Laser in Combination with Safranin on the Growth of Pseudomonas aeruginosa and Staphylococcus aureus in Vitro
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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
The effectiveness of prediction and clairvoyance and its functions in the inner space
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The research dealt with the effectiveness of prediction and foresight in design as a phenomenon that plays a role in the recipient's engagement with the design, as it shows the interaction between the recipient and the interior space. The designer is keen to diversify his formal vocabulary in a way that secures visual values that call for aesthetic integration, as well as securing mental and kinetic behavioral understanding in the interior space.
As the designer deals with a three-dimensional space that carries many visual scenes, the designer should not leave anything from it without standing on it with study and investigation, and puts the user as a basic goal as he provides interpretive data through prediction and foresight that le

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Publication Date
Sun Sep 27 2020
Journal Name
Journal Of The College Of Education For Women
The Term Delay and its Jurisprudences in the Section of Punishments and Felonies
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Different Arabic and Islamic societies are free of evil instincts. Therefore, certain provisions of legitimacy came to stress the importance of the intentions of sharia to achieve the interests of all people that involve several aspects, including the five fundamental things: religion, oneself, offspring, mind and money. Almighty Allah has specified certain punishments on those who violate these things by imposing punishments on the part of the criminal to preserve souls. He imposes the penalty of theft to preserve property, the Hadd punishment for adultery to preserve the symptoms, the punishment on the drunk to preserve the mind, and the Hadd punishment for the apostate to preserve the religion. By the adherence to these punishments li

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Suggested Technique for Creating Physical Growth Curves Charts for Anthropometric Measurements in Admixed form in a sample of children under two years of age In Diyala Governorate
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Objective: This study aimed to assessing new suggested technique of Physical Growth Curves (PGC) charts in
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Methodology: A non-probability sample of size (420) children under two years selected from 12 Primary
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chart included in at least weight, Height, and Head circumference. And to overtake the problem of the norm

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Publication Date
Mon Jan 01 2018
Journal Name
Int. J. Agricult. Stat. Sci. V
The role of irrigation management processes and micronutrient fertilization on parameter of growth and yield of two wheat varieties
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The experiment was conducted in Al- Mahaweel Research Station in Babel Governorate, Ministry of Agriculture during autumn season 2016-2017 to determine the role of irrigation management processes and micronutrient fertilization in growth and productivity of two varieties of wheat IPA 99 and Al-Rasheed 22 in clay loam soil classified as Typic Torriflovent. The experiment included four irrigation treatments and six fertilization treatments. The experiment was designed under randomized complete block design (RCBD) with three replications. Wheat grain IPA 99 and Al-Rasheed 22 varieties were planted in 23/11/2016 and harvested in 13/5/2017. The amount and periods of irrigation depended on sensors reading of volumetric water content was measured

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