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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 Oct 28 2023
Journal Name
Baghdad Science Journal
Lead acetate deteriorates the improvement effect of L-arginine and tetrahydrobiopterin on endothelin-1 receptors activity in rat aorta
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Endothelin-1 (ET-1) is a potent vasoconstrictor hormone that has been identified as an important factor
responsible for the development of cardiovascular dysfunctions. ET-1 exerts its vasoconstrictor activity
through two pharmacologically distinct receptors, ETA and ETB that are found in vascular smooth muscle
cells (VSMCs) and the vasodilator activity through an ETB receptor located on endothelial cells. This study
aimed to show the impact of 1µM L-arginine (LA), 100µM tetrahydrobiopterin (BH4), and their combined
effect on ET-1 activity in both lead-treated and lead-untreated rat aortic rings. This means, investigating how
endothelial dysfunction reverses the role of nitric oxide precursor and cofa

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of The College Of Education For Women
The RoleThe Role of the Arbitration Treaty and Decisiveness in the Consolidation of Relations Between Britain and France (1903-1904) of the Arbitration Treaty and Decisiveness in the Consolidation of Relations Between Britain and France (1903-1904)
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The Risks Faced by Britain in their Areas of Influence at the Beginning of the Twentieth Century Drove her to the Alliance with the State of European such as France, and Contributed to the Tireless and made by the British and French Politicians in the Consolidation of Friendly Relations between the two Countries Efforts and Strengthened Cooperation in a Positive Way to Visit the king of Britain's Edward VII to France, Offset by Visit French President Loubet to Britain in the Same Year, those Negotiations Bore Fruit between the two Countries for Reaching a Contract Arbitration and Decisiveness between Britain and France Treaty on the Fourteenth of November 1903, Promised that Treaty First Step that Paved the Way for a General Agreement be

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Job satisfaction and its relation to the effectiveness of performance: Applied research on a sample of employees in the Federal board of supreme Audit
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The research aimed to study the job satisfaction of the staff of the Federal board of supreme Audit and its relation to the effectiveness of their performance, The questionnaire was adopted as a main tool in the collection of data and information from a random sample of (54) employees of the Federal board of supreme Audit. In light of this, the data were collected and analyzed and the hypotheses were tested using the statistical program (SPSS).

The researchers reached a number of conclusions, the most important of which were: (1) the respondents' response to the variables of job satisfaction and the effectiveness of the performance were medium; (2) there was a significant relationship between job satisfaction and performance effe

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Publication Date
Tue Dec 06 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Quality of Life of Children age from (8- lessthan13) years with Acute Lymphocytic Leukemia Undergoing Chemotherapy at Hematology Center in Medical City
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Objective (s): To assess the QoL of children age from (8- lessthan13) years with acute lymphocytic leukemia undergoing chemotherapy and to find out the relationship between the QoL of children with acute lymphocytic leukemia and their illness history.

Methodology:  A descriptive study included (40) children with acute lymphocytic leukemia who were ranged between (8 - less than 13 years) at the Hematology Center in Medical City for the period from 4th March 2021 to 1st September 2021. The sample was non-probability (purposive) sample of children (male and female). A questionnaire designed with 2 main parts was used. The first part focused on sociodemographic characterist

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Publication Date
Fri Jun 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Phenomena of corruption and money laundering: and causes and risks and their role in the financing of terrorism in Iraq and finding ways of treatment
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Iraq  is Suffering nowadays from the criminal triad represented by the fiscal and administrative corruption, money laundering and terrorism, which are intertwined in a very related relations, as each of them support the other . Since the over growth has been one of its characteristics leaving behind a very dangerous negative effects whether it was social , economic or even political impacts . As a result , this trial is now represents a high risk that threatens the present and the future of Iraq . On the political , economic and social level , it is well to mention that the poor direct investment , the increasing rates of poverty , unemployment , inflation as well as the smuggling of goreign currency an

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Publication Date
Sun Oct 21 2018
Journal Name
Al–bahith Al–a'alami
Islamic Knowledge and its role in the Development of the Culture and Values of the Islamic Community
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The human perception of science and knowledge is affected by the personal point of view, thus giving it its religious, mental and emotional dimensions to make that perception an effective tool for realizing the truth comprehensively in the delivery of knowledge to the depths of the human soul. The later is composed of multiple factors, which contributes to the human self-development with dimensions beyond the limits of mental logic and the perception of material and emotional situations. That knowledge in the perception of Islamic virtue, which must characterize each Muslim.
Human beings have been striving for knowledge and the understanding of the universe in which they live. For centuries, mankind has acquired knowledge directly an

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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of Educational And Psychological Researches
A training program for chemistry teachers based on the knowledge economy and its impact on the productive thinking of their students
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       The current research aims to build a training program for chemistry teachers based on the knowledge economy and its impact on the productive thinking of their students. To achieve the objectives of the research, the following hypothesis was formulated:

   There is no statistically significant difference at (0.05) level of significance between the average grades of the students participating in the training program according to the knowledge economy and the average grades of the students who did not participate in the training program in the test of productive thinking. The study sample consisted of (288) second intermediate grade students divided into (152) for the control group

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of multiple sources of funding on the disclosure of cash flow and the activation of control procedures
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The principle of an interview requires revenues to expenditures by linking the efforts and achievements and disclosure sufficient to result activity, in the case generate future benefits of a particular asset, this asset appears in the balance sheet to reflect with the rest of the accounting unit's assets on the strength of financial position In the absence of future benefits from the effort are so loaded effort on the result accounts that reflect the outcome of activity during a specific period if the month or be separated or fiscal year. 

The researcher reached the following conclusions:

 1- difficult to control the cash inflows and outflows as a result of the multiplicity of sources of funding.

2- wea

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Publication Date
Thu Feb 13 2020
Journal Name
Energies
Impact of the Type of Fertilization and the Addition of Glycerol on the Quality of Spring Rape Straw Pellets
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This paper presents an analysis of selected qualitative characteristics of pellets produced from rape straw obtained from cultivations subjected to different fertilization treatments and from mixtures of straw selected for testing with crude glycerol obtained as a by-product from biodiesel production. The assessment focused on the following qualities of the obtained pellets: Moisture content, mechanical durability, heating value and main elements, that is, carbon, hydrogen, nitrogen, sulphur, chlorine and oxygen. The obtained results indicated that the different treatment regimens applied in spring rape cultivations had a significant impact on the physicochemical qualities of the straw. In terms of the heating value, traditional fer

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The impact of the use of pulverized black bean and fat in homemade bread mix in the quality and attributes Alkhoznip
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Factory is trotting home favorite of of Aeidid of Iraqi families since he Amta imparted to the taste of the housewife on the method of processing and preparation and the possibility of using some of the ingredients to raise the nutritional value of meat, sesame and other, but how keep Bz'zajh this product Atne storage

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