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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 Dec 30 2004
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Influence of Temperature and Flow Velocity on the Corrosion Inhibition of Low Carbon Tubes in Recirculating Water System by a Dicomponent Inhibitor Blend
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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
Wed Aug 05 2026
Journal Name
Chemical And Process Engineering Research
Spectrophotometric Determination of Sulfanilamide in Pure and in Synthetic Sample based on Condensation Reaction Method
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A new, Simple, sensitive and accurate spectrophotometric methods have been developed for the determination of sulfanilamide (SNA) drug in pure and in synthetic sample. This method based on the reaction of sulfanilamide (SNA) with 1,2-napthoquinone-4-sulphonic acid (NQS) to form N-alkylamono naphthoquinone by replacement of the sulphonate  group of the naphthoquinone sulphonic acid by an amino group. The colored chromogen shows absorption maximum at 455 nm. The optimum conditions of condensation reaction forms were investigated by: (1) univariable method, by optimizing the effect of experimental variables; (different bases, reagent concentration, borax concentration and reaction time),     (2) central  composite design (CCD) including

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Publication Date
Fri Sep 30 2022
Journal Name
College Of Islamic Sciences
The policy of Islamic legislation and its impact on the promotion of the values of justice and the fight against corruption: Legislation, Promotion, Values, Corruption, Justice, Collapse of Nation
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Since the advent of the sunrise of the immortal message, Islamic legislation has always established justice and the right guidance, and has prevented any perversion, injustice or corruption, with a divine system that called in its course the characteristics of the legislation on its general basis and its ability to develop, progressivity, and paving the way with a collective approach, accompanied by the worldly and moral punishment. When the corrupters went too far, reformers were delayed and values were missed; Mankind has been afflicted with the scourge of injustice and loss, and has lost sight of the approach that the Creator of the world has given to the people of the world, for what would guide them in their affairs sooner and later

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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
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
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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
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
Mon Dec 11 2017
Journal Name
Al-khwarizmi Engineering Journal
Experimental and Numerical Research on Flow-Induced Vibration in Valves
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All central air conditioning systems contain piping system with various components, sizes, material, and layouts. If such systems in operating mode, the flow in piping system and its component such as valves can produce severe vibration due to some flow phenomenon’s. In this research, experimental measurements and numerical simulation are used to study the flow-induced vibration in valves. Computational fluid dynamics (CFD) concepts are included with one-way and two-way fluid-structure interaction concepts by using finite element software Package (ANSYS 14.57). Detection analysis is performed on flow characteristics under operation conditions and relations with structural vibration. Most of

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Publication Date
Thu May 18 2023
Journal Name
Journal Of Engineering
Experimental and Numerical Study on Cavitation Effects in Centrifugal Pumps
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Experimental and numerical investigations of the centrifugal pump performance at non-cavitating and cavitating flow conditions were carried out in the present study. Experiments were performed by applying a vacuum to a closed-loop system to investigate the effects of the net positive suction head available (NPSHa), flow rate, water temperature and pump speed on the centrifugal pump performance. Accordingly, many of the important parameters concerning cavitation phenomenon were calculated. Also, the noise which is accompanied by cavitation was measured. Numerical analysis was implemented for two phase flow (the water and its vapor) using a 2-D simulation by ANSYS FLUENT software to investigate the internal flow of centrifugal pump under c

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