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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
Fri Jun 01 2018
Journal Name
Journal Of Biotechnology Research Center
Effect of maca(Lepidium meyenii) aqueous extract on the epididymal sperms quality and the DNA normality of vasectomized mature mice:model forobstructive azoospermia in men
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        This study was aimed to found out the effect of Maca extract on certain sperm function characters and sperm DNA normality in vasectomized and healthy adult mice as a model for men complaining from obstructive azoospermia. Twenty adult male mice were randomly divided into four groups (5males per each group).The first group(GI) was regarded as a negative control that treated with distilled water. Whereas group II  was gavage maca extract daily  with 1mg/100gm.GropIII,and IV were vasectomized . Mice in GIII were vasectomized without treatment while the mice in group GIV were vasectomized and orally administrated maca dose(1mg/100gm).At the last of experiment(35 days), all the mice were scarified for assessment of  cer

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Publication Date
Tue Jan 24 2023
Journal Name
Journal Of Advanced Biotechnology And Experimental Therapeutics
Influence of the high mobility group A1 genetic polymorphism on indices of metabolic syndrome and insulin resistance in the Iraqi population: Case-control study
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The high mobility group A1 gene (HMGA1) rs139876191 variant has been related to metabolic syndrome and type 2 diabetes, but data are lacking in Middle Eastern populations. The study aimed to assess whether the HMGA1 rs139876191 variant is associated with metabolic syndrome risk and whether this variant predicts the risk of insulin resistance. This case-control study was carried out at single center in Kirkuk city/ Iraq from February to August 2022. Polymorphisms in HMGA1 and genotyping were identified by Sanger sequencing of genomic DNA obtained from 91 Iraqi participants (61 patients with metabolic syndrome and 30 control). Lipid profile, serum (glucose and insulin), glycated hemoglobin, blood pressure, body mass index, and waist circumfer

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Teaching Strategy Based on the Cognitive Model of Daniel in the Development of Achievement and the Motivation of learning the School Mathematics among the Third Intermediate Grade Students
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This research aims to examine the effectiveness of a teaching strategy based on the cognitive model of Daniel in the development of achievement and the motivation of learning the school mathematics among the third intermediate grade students in the light of their study of "Systems of Linear Equations”. The research was conducted in the first semester (1439/1440AH), at Saeed Ibn Almosaieb Intermediate School, in Arar, Saudi Arabia. A quasi-experimental design has been used. In addition, a (pre & post) achievement test (20 Questions) and a (pre & post) scale of learning motivation to the school mathematics (25 Items) have been applied on two groups: a control group (31Students), and an experimental group (29 Students). The resear

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Publication Date
Mon Oct 12 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Prevalence of molar-incisor-hypomineralization among children attending pedodontic clinic of college of dentistry at Baghdad University
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Publication Date
Mon Sep 30 2024
Journal Name
Modern Sport
The Effect of Skill Exercises According to the Concentration Technique of Lateral Thinking on Motor Accuracy and Learning the Diving Stop Attack for Students in the Epee Weapon
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لمعرفة مدى تأثير تمرينات مهارية وفق تقنية تركيز للتفكير الجاني على الدقة الحركة وتعلم هجمة الإيقاف  بالغطس للطلاب في سلاح الشيش استخدمت الباحثتان المنهج التجريبي على عينة من طلاب المرحلة الثالثة بكلية التربية البدنية وعلوم الرياضة –جامعة ديالى والتي بلغت (30) طالباً موزعين على مجموعتين التجريبية والضابطة وبعد إكمال اجراءات البحث وتطبيق الاختبارات القبلية وتنفيذ التمرينات والاختبار البعدي ومعالجة الب

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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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Publication Date
Tue Apr 16 2024
Journal Name
International Development Planning Review
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
Wed Dec 01 2021
Journal Name
Int. J. Agricult. Stat. Sci
THE EFFECT OF PUTRESCINE AND SPERMIDINE ON SOMATIC EMBRYOGENESIS AND REGENERATION OF DATE PALM (PHOENIX DACTYLIFERA L.) CV. BARHEE
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The present study was conducted to determine the effect of different concentrations of putrescine and spermidine at all stages of regeneration (callogenesis, somatic embryos multiplication, germination and rooting)) of date palm cultivar Barhee. Shoot tips were eradicated from 2-3 years old offshoots, surface sterilized and inoculated onto Murashiege and Skoog, 1962 (MS) medium supplemented with 20 mg/L 2,4-D and 3 mg/L N6-2-isopentyl adenine (2ip). Primary callus was obtained after 24 weeks on the nutrient medium. Calli were then transferred onto fresh MS medium containing 0.0, 50, 100 or 150 mg/L of putrescine or spermidine individually. Results were recorded after 12 weeks. A significant increase in embryonic callus fresh weights reached

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Publication Date
Sun Sep 29 2024
Journal Name
Journal Of Global Innovations In Agricultural Sciences
The Impact of pH and Growth Phases on Photosynthetic Pigments and Carotene of Coelastrella saipanensis N. Hanagata (Scenedsmacese, Shaerophleales)
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The present study aimed to investigate the effects of level pH and the growth phases of Coelastrella saipanensis on Chlorophyll a,b, total, and Carotene. The algae were cultured in BG11 media and grown at different pH levels. We measured chlorophyll a, b, total chlorophyll, growth phases, and carotene concentrations. The results showed that at pH 8.5, the measurements of photosynthetic pigments-chlorophyll a, Chlorophyll b, and the total chlorophyll (0.183, 0.268, and 0.433 mg L-1, respectively). The highest values of chlorophyll a (0.185 mg L-1), and b (0.339 mg L-1), and the total chlorophyll (0.492 mg L-1) were recorded in the stationary phase. In addition, the study found that at pH 8.5 and the beginning of the stationary phase,

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