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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
Wed Feb 22 2023
Journal Name
Iraqi Journal Of Science
The Acute and Chronic Toxicity of Copper on The Behavioral Responses and Hematological Parameters of Freshwater Fish, Common Carp (Cyprinus carpio L.)
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The present study was conducted to examine toxicological effects of copper sulfate (Cu) in common carp fish (Cyprinus carpio L.). The LC50 (median lethal concentrations) of copper on Cyprinus carpio were 3.64, 3.36, 3.04, 2.65 mg/L respectively. In general, behavioral responses of the fishes exposed to copper included uncontrolled swimming, erratic movements, loss of balance, swam near the water surface with sudden jerky movements. Haematological parameters such, red blood cells (RBC), white blood cells (WBC), haemoglobin (Hb), Packed cell volume (PCV), mean cell volume (MCV) mean cell haemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were studied. The obtained results indicated that the (RBC) and (WBC) have increas

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Publication Date
Sat Oct 10 2026
Journal Name
Journal Of Physical Education
The Effect of Compound Physical and Skill Exercises on the Development of Explosive Strength and Some Offensive Skills for Basketball Players U18
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Publication Date
Tue Jul 11 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of the Six Thinking Hats Strategy on the Development of Essay Writing Skills and Creativity in It among Persian-Speaking Students Who are Studying Arabic Language and Literature At Shiraz University: Literature and Humanities, Shiraz University
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The study aims to investigate the effect of the Six Thinking Hats Strategy on the achievement of essay writing skills among third-year students in Arabic Language and Literature who are Persian speakers enrolled in the course of Essay Writing (III) at Shiraz University for the academic year 2019-2020. The sample of the study consisted of (15) male and female students who were taught according to the pre-posttest, using the quasi-experimental approach. After applying the statistical analysis on the scores of the post-test, the results showed that there are statistically significant differences in the average of students' achievement in the skills of essay writing in terms of using the Six Thinking Hats Strategy. The results also proved th

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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
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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Scopus
Publication Date
Wed Dec 15 2010
Journal Name
Iraqi Journal Of Laser
Evaluation the Effect of 805 nm Wavelength Diode Laser on Repair of Mandibular Bone Repair and Skin Incisions in Rabbits
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The long healing time of bone after tooth extraction in order to construct artificial teeth is uncomfortable to the patient because of aesthetic or masticatory problems in addition to the daily visit to dental clinic. The objective of this study was to evaluate the effect of 805 nm diode laser with long time intervals on repair of bone and skin incisions in rabbits through biochemical, radiological and histological findings. Eighteen New-Zealand rabbits were undergone surgical operations to make a cavity in the bone of the lower jaw, the rabbits were divided into two groups:- Group A (control group) containing nine rabbits. Group B (lased group) containing nine rabbits in which two cavities were done, one on the right side and the other

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Effectiveness of Management Information Systems (MIS) and its impact on Governmental Organization Performance in Jouf Region of Saudi Arabia
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The aim of this research is to find the impact of the efficiency of Management information systems (MIS) on the effectiveness of governmental organizations performance.

To achieve the objective of the research, the analytical descriptive method was adopted. A questionnaire was designed consisting of (35) paragraphs, and the sample consisted of (200) individual. The research attemped to answer the following question: To achieve the objective of the research, the analytical descriptive method was adopted. A questionnaire was designed consisting of (35) paragraphs, and the sample consisted of (200) individual. The research tried to answer the following question: What is the actual utilization of modern admi

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Publication Date
Sat Oct 01 2011
Journal Name
Baghdad Science Journal
Studying the Effect of Aqueous Extract from Curcuma Longa on Some Parameters of Cytogenetic, Immunity and Fertility in Female Mice
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The research work was conducted to investigate the effect of oral administration of aqueous extract of turmeric at doses of (5, 10) mg/kg body weight for two weeks daily by determining the genotoxic effect (mitotic index), evaluation of immunological effect (IgG, IgM, IgA, C3, C4) and measuring fertility hormones (follicles stimulation hormone/FSH, lutenising hormone/LH) levels with histological examinations of female albino swiss mice ovaries in comparison with control (normal saline). A clear effect in increasing mitotic activity was reveled for both doses in comparison with control. Results also showed a significant increase in the value of all immunological parameters at both doses, in comparison with control. Also, obvious raise was se

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Publication Date
Wed Jun 19 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Impact of Self-Assessment on Income and Sale Tax Collection' From the Point View of Income Tax Auditors in Jordan
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This study aimed to show the extent of compliance with the income taxpayer  to provide tax returns and increase the speed of collection of these taxes in addition to increasing confidence in  Income Tax department and reduce the number of cases transferred to the courts and promote taxpayer awareness in charge of the importance of self-assessment system, and study sought to investigate the effect of the existence of records documents, technical audit, and computational audit and documentary audit on income tax collections in Jordan, from the point of viewof Jordanian income tax auditors ,results shows there's a strong  relation between these variables and Income Tax collections.

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