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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 Sep 20 2021
Journal Name
Key Engineering Materials
Heat Treatment at Different Temperatures and its Effect on the Optical Properties of Pure PMMA and PMMA-Coumarin
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The effect of thermal treatment on optical constants of pure PMMA and with addition (15 and 35) ml of coumarin at different temperatures (100, 110 and 120) C0 for 1 hour were investigated. Cast method used to prepares films of pure PMMA and PMMA with (15 and 35) of coumarin. UV/VIS spectrometer technique used to measure the absorption spectra for these films. The optical constant (absorption spectra and absorption coefficient) don’t changes after applied temperatures in pure PMMA film but the optical constant (absorption spectra and absorption coefficient) in PMMA with (15 and 35) ml of coumarin increased with applied temperatures. The optical energy gap of pure PMMA and PMMA with (15 and 35) ml of coumarin sl

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Publication Date
Sat Jul 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
The Effect of Dry Farming and Water Stress under Subsurface Drip Irrigation System on Water and Rice Productivity
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Abstract<p>A field experiment was carried out during the 2020 season at the College of Agricultural Engineering/ University of Baghdad, Al-Jadriya to evaluate the effect of dry farming when applying water stress under the subsurface drip irrigation system on water productivity and rice yield. The experiment was conducted with three levels of irrigation water stress when 10, 20 and 40% of the available water was depleted and in three dimensions between drip lines 10, 15 and 20 cm. The experiment was designed according to a randomized complete block design, according to the split plot design, with three replications. Determine the depth of irrigation water depending on the moisture depletion of th</p> ... Show More
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Thu Jan 12 2023
Journal Name
Journal Of The Saudi Society Of Agricultural Sciences
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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Comparative Effects of Fentanyl, Medazolam, Lignocaine and Propranolol on Controlling the Hemodynamic Pressor Response during Laryngoscopy and Intubation
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Laryngoscopy and tracheal intubation are considered the most invasive stimuli in anesthesia. They provoked cardiovascular responses that include hypertension, tachycardia and dysrhythmias. Various pharmacological approaches have been used to blunt or attenuate such pressor responses. The present study was designed to evaluate the effect of medazolom, lignocaine and propranolol as a valuable adjuvant to fentanyl in attenuating hemodynamic responses to endotracheal intubation in normotensive patients. Thirty two patient with physical status I or II according to the score of American Society of Anesthesiologist (ASA), scheduled for elective surgery under standard general anesthesia, were randomly allocated into four groups (8 patients in ea

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Publication Date
Thu May 24 2018
Journal Name
Aip Conference Proceedings
The study effect of weight fraction on thermal and electrical conductivity for unsaturated polyester composite alone and hybrid
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In this research prepared two composite materials , the first prepared from unsaturated polyester resin (UP) , which is a matrix , and aluminum oxide (Al2O3) , and the second prepared from unsaturated polyester resin and aluminum oxide and copper oxide (CuO) , the two composites materials (Alone and Hybrid) of percentage weight (5,10,15)% . All samples were prepared by hand layup process, and study the electrical and thermal conductivity. The results showed decrease electrical conductivity from (10 - 2.39) ×10-15 for (Up+ Al2O3) and from (10 - 2.06)×10-15 for (Up+ Al2O3+ CuO) .But increase thermal conductivity from( 0.17 - 0.505) for (Up+ Al2O3) and from (0.17 - 0.489) for (Up+ Al2O3+ CuO).

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Educational And Psychological Researches
Teachers and Headmasters’ Perspectives toward the Application of the Organizational Culture in the Intermediate and Secondary Schools in Arar city
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The aim of the current research is to identify the level of organizational culture among the headmasters and teachers of intermediate and secondary schools in Arar city. It also aims to identify the effect of job variables, qualifications, educational stage, and years of experience on the level of organizational culture and its domains. The research sample consisted of 62 participants divided into 7 headmasters and 55 teachers. The researcher used the questionnaire of the organizational culture. The researcher used also statistical methods such as mean, standard deviation, t-test, and One way ANOVA. The results revealed that the level of organizational culture and its four domains were high, and there was no effect of the variables (teac

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Engineering
Digital Image Authentication Algorithm Based on Fragile Invisible Watermark and MD-5 Function in the DWT Domain
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Using watermarking techniques and digital signatures can better solve the problems of digital images transmitted on the Internet like forgery, tampering, altering, etc. In this paper we proposed invisible fragile watermark and MD-5 based algorithm for digital image authenticating and tampers detecting in the Discrete Wavelet Transform DWT domain. The digital image is decomposed using 2-level DWT and the middle and high frequency sub-bands are used for watermark and digital signature embedding. The authentication data are embedded in number of the coefficients of these sub-bands according to the adaptive threshold based on the watermark length and the coefficients of each DWT level. These sub-bands are used because they a

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Publication Date
Sat Jan 01 2022
Journal Name
3rd International Scientific Conference Of Alkafeel University (iscku 2021)
Exposure and etching time effects on the fission track density in CR-39 detectors using teeth samples
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Tue Apr 16 2024
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AN ELECTRONIC SYSTEM ACCORDING TO THE COOPERATIVE METHOD AND ITS IMPACT ON DEFENSIVE MOVEMENTS IN YOUTH BASKETBALL
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What distinguishes the athlete in dealing with all stimuli is the ability to understand the cognitive rules through which he acts and directs behavior through thinking and regular planning methods in dealing with the environment in a realistic manner, and this comes through techniques and means based on modernity in obtaining information that makes the athlete arrange in His memory is the programs that are the most important crutch for relying on when he asks for them in applying and executing the skill assignment. One of the enhancers of awareness of variables is the ability of coaches to provide openness in modern ideas to find solutions, through which the player can sense and interpret events and produce outputs for quick and successful

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Dimensions Of Banking Service Quality and Its Rule On Customer's Satisfaction: Applied Study On Al- Rasheed Bank
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The purpose of this research is to recognize the relationship between the dimensions of  banking service quality and customer's satisfaction , through customer's evaluation of the level of service quality offered to them by Al – Rasheed bank. Also to determine the proportional importance of different dimensions of service quality. In addition to examine the relationship between banking service quality in its dimensions  and customer's satisfaction. (150 ) samples were distributed among the bank customers , only (130 ) samples were collected and good for analysis.

The results were analyzed and examined the hypothesis through a group of statistical methods. The most important results is the positive evaluation of the ba

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