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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
Thu Jan 23 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Impact of self-assessment on income and sales tax collections from the point of 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 system self-assessment, 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 view of Jordanian income tax auditors ,results shows there's a strong  relation between these variables and Income Tax collections.

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Publication Date
Sun Dec 31 2023
Journal Name
College Of Islamic Sciences
The most prominent philosophical and rhetorical concepts in the perspective of philosophers and theologians
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     This research aims to clarify and define the most important philosophical and rhetorical concepts to which many philosophical and rhetorical issues refer، since they have an effective role in the diversity and difference of intellectual schools، which are indispensable in proving major dogmatic issues، such as the concept of (existence، being، essence، and authenticity). Existence or Essence in contrast to the consideration of the other concept)، because it is one of the complex concepts and common words that carry different connotations among thinkers.

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Tue Aug 16 2022
Journal Name
Journal Of Positive School Psychology
Electronic Publishing And Its Impact On Building And Developing Groups In Jordanian University Libraries
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Sun Sep 30 2001
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
Analysis of the symbolic images in the work of Mexican theater of: "all cats are brown," the writer Carlos Fuentes and "Palinuro on the stairs," the writer Fernando del Paso
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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Studying the Effect of Adding Doekhla kaolin Clay and Alumina to Iraqi Bauxite on Some Physical and Mechanical and Thermal Properties
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The aim of this work is to produce samples from Iraqi raw materials like Husyniat Bauxite (raw and burnt) and to study the effect of some additives like white Doekhla kaolin clays and alumina on that material properties were using sodium silica as a binding material. Five mixtures were prepared from Bauxite (raw and burnt) and kaolin clays, with an additive of (40) ml from sodium silica and alumina of (2.5, 5, 7.5,10 wt %) percentage as a binding material. the size grading was through sieving. The formation of all specimens was conducted by a measured gradually semi-dry pressing method under a compression force of (10) Tons and humidity ratio ranging from (5-10) % from mixture weight. Drying all specimens was done and then they were burn

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
The phenomenon of building the act of the actor and the effect in the Quranic readings                          (Structural and semantic study)
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After this systematic presentation of the phenomenon of rotation of formulas, ie the construction of the verb and the verb, and the narrated narratives therein differed among the readers, it became clear to us how the difference was clear between reading and the other, and how readers have varied in their readings of the verb, As we have noted through our modest research that the phenomenon of building the verb for the actor and the effect have included the act of both past and present tense, and not limited to a specific time, and this difference in reading was not limited to a particular environment, but beyond To more than one environment This is evidenced by the readings of various readers from the environment of Kufa, Basra, Mecca,

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Publication Date
Fri Oct 01 2021
Journal Name
Journal Of Al-rafidain University College For Sciences ( Print Issn: 1681-6870 ,online Issn: 2790-2293 )
The Use of Logistic Regression Model in Estimating the Probability of Being Affected By Breast Cancer Based On the Levels of Interleukins and Cancer Marker CA15-3
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Breast cancer has got much attention in the recent years as it is a one of the complex diseases that can threaten people lives. It can be determined from the levels of secreted proteins in the blood. In this project, we developed a method of finding a threshold to classify the probability of being affected by it in a population based on the levels of the related proteins in relatively small case-control samples. We applied our method to simulated and real data. The results showed that the method we used was accurate in estimating the probability of being diseased in both simulation and real data. Moreover, we were able to calculate the sensitivity and specificity under the null hypothesis of our research question of being diseased o

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Publication Date
Fri Oct 28 2022
Journal Name
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The protest movements in Sudan and their role in the political and social transformation
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This study investigates the factors that led to the outbreak of protest movements in Sudan, since Sudan’s independence in 1956 until December 2018. The study aims to identify the role of protests in bringing about political and social transformations in Sudan, besides identifying the factors that help in the success or failure of the governments that resulted from those protests, with special emphasis on the challenges of the government of the 2018 revolution. The main results of the study reveal that the December 2018 protests are the largest in term of numbers, and witness huge participation of youth and women, and the slogans raised were national and comprehensive. However, the challenges that the transitional government is going th

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of The Mechanical Behavior Of Materials
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Abstract<p>Gypseous soils are considered one of the most problematic soils. The skirted foundation is an alternative technology that works to improve the bearing capacity and reduce settlement. This paper investigates the use of square skirted foundations resting on gypseous soil subjected to concentric and eccentric vertical load with eccentricity values of 4, 8, and 17 mm in 16 experimental model tests. To obtain the results by using this type of foundation, a small-scale physical model was designed to obtain the load–settlement behavior of the square skirted foundation; the dimension of the square footing is 100 mm × 100 mm with 1 mm thickness, the skirt depth (<italic>D</italic></p> ... Show More
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