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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
Sat Jan 04 2014
Journal Name
Journal Of Materials And Chemical Engineering
The Effect of Atomic Percentage Selenium Content on the Permittivity and Polarizability of Ge1-xSex thin films
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Generally the a.c. conductivity shows a power law in frequency s  ()  where the exponent s ≤ 1. As the frequency goes to zero the conductivity become frequency independent. The a.c. conductivity was studied for the Ge1-xSex thin films to see how the selenium contents affect the permittivity and the permeability for the Ge1-x Sex. The thin films prepared by thermal evaporation at room temperature and under vacuum (~2 x10-5toor) using Edward coating unit model 306A. From the relation between ln conductivity and ln w, the effect of selenium contents in Ge1-x Sex thin films on the exponent value, the relaxation time and the maximum barrier height. An algebric fitting method for circles and circular arcs was used to find the permit

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Publication Date
Fri Oct 13 2023
Journal Name
Engineering, Technology & Applied Science Research
The Experimental and Theoretical Effect of Fire on the Structural Behavior of Laced Reinforced Concrete Deep Beams
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A Laced Reinforced Concrete (LRC) structural element comprises continuously inclined shear reinforcement in the form of lacing that connects the longitudinal reinforcements on both faces of the structural element. This study conducted a theoretical investigation of LRC deep beams to predict their behavior after exposure to fire and high temperatures. Four simply supported reinforced concrete beams of 1500 mm, 200 mm, and 240 mm length, width, and depth, respectively, were considered. The specimens were identical in terms of compressive strength (  40 MPa) and steel reinforcement details. The same laced steel reinforcement ratio of 0.0035 was used. Three specimens were burned at variable durations and steady-state temperatures (one

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Engineering
The Effects of Different Water Types on the Dissolution, Physical Appearance, and Compressive Strength of Gypsum Rock
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Dissolution of gypsum rock in water is significant, which may result in hydrocarbon reservoir formation and evaporate deposits. However, the complexity of the gypsum dissolution process is still of interest because of its uncleanness that requires more critical analysis. The objectives of this experimental study are emphasis on the dissolution characteristics of gypsum rock under room temperature and by various types of water; namely: deionized, tap, fresh, acidic, well, and normal rainwatre. In addition, the influences of dissolution on gypsum rock's mechanical and physical characteristics. Gypsum rock was obtained from Agjalar area, in the southwest of Sulaymaniyah city, Northern Iraq. Experimental results show that we

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Publication Date
Mon Jun 30 2008
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Effect of Temperature and pH on the Removal / Recovery of ZN++ from Solution by Chemical Coagulation
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This work was conducted to study the treatment of industrial waste water, and more particularly those in the General Company of Electrical Industries.This waste water, has zinc ion with maximum concentration in solution of 90 ppm.
The reuse of such effluent can be made possible via appropriate treatments, such as chemical coagulation, Na2S is used as coagulant.
The parameters that influenced the waste water treatment are: temperature, pH, dose of coagulant and settling time.
It was found that the best condition for zinc removal, within the range of operation used ,were a temperature of 20C a pH value of 13 , a coagulant dose of 15 g Na2S /400ml solution and a settling time of 7 days. Under these conditions the zinc concentrat

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Publication Date
Tue Oct 18 2022
Journal Name
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The Influence of Flight Direction and Camera Orientation on the Quality Products of UAV-Based SfM-Photogrammetry
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Unmanned aerial vehicles (UAVs) can provide valuable spatial information products for many projects across a wide range of applications. One of the major challenges in this discipline is the quality of positioning accuracy of the resulting mapping products in professional photogrammetric projects. This is especially true when using low-cost UAV systems equipped with GNSS receivers for navigation. In this study, the influence of UAV flight direction and camera orientation on positioning accuracy in an urban area on the west bank of the Euphrates river in Iraq was investigated. Positioning accuracy was tested in this study with different flight directions and camera orientation settings using a UAV autopilot app (Pix4Dcapture software

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Wed Mar 01 2017
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International Journal Of Science And Research (ijsr)
The Effect of the Five Fingers Strategy and Traffic Signals Strategy on Physics First Grade Intermediate School Students' Achievement and Personal Intelligence
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The aim of this research is to know the effect of two strategies of active learning, the five fingers and traffic signals, on the first grade intermediate level student's achievement and personal intelligence. The research sample was chosen from the Al- Mansour intermediate school for boys, including (101) students divided into three groups chosen randomly which represented the first experimental group (32) students, the second experimental group (34) students, and the control group (33) students. To achieve the research aims, the research prepared a physics achievement test containing (26) items, and a personal intelligence test containing (20) items. The psychometric characteristics, of the tests were checked up the following results were

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Publication Date
Sat Jan 01 2022
Journal Name
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Adsorption of Phosphorous and Zinc, and their interaction and processing power on Bentonite
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Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Asset Utilization Efficiency and its effect on the sustainable Stockholder’s Wealth: Apply Study of Iraqi Companies listed on the Iraqi Stock Exchange
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The research discusses one of the most critical issues of corporate finance which is related to asset utilization efficiency. Researchers used internal growth rate as independent variable (Proxy of asset utilization efficiency) and sustainable growth rate-dependent variable (proxy of stockholders wealth). According to these two variables, researchers formulate major hypotheses (There is no significant effect of internal growth rate on sustainable growth rate), as well as two sub-hypotheses, examine the components of major variables. Sample of Iraqi industrial companies which listed in the Iraqi stock exchange selected to test and examine main hypotheses. Result of simple and multiple regressions explain there is a significant effect of i

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Publication Date
Mon Aug 01 2022
Journal Name
Journal Of Medicine And Life
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ST segment, T wave changes, QT interval changes, and QTc dispersion are among the parameters used to diagnose ischemic heart disease. The increase in the QT dispersion can be caused by myocardial ischemia, among other heart diseases, whereas cardiac diseases such as coronary artery disease (CAD) can be diagnosed by observing an abnormally high QTc dispersion. This study aimed to evaluate the variations in the QTc dispersion (depolarization and repolarization) of surface electrocardiography as a result of percutaneous coronary intervention (PCI) in patients with chronic total occlusion. This study took place in the Iraqi Center for Heart Disease from October 2020 to February 2021. 110 patients who suffered from chronic occlusion of t

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Publication Date
Sun Sep 22 2019
Journal Name
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Synthesis and Characterization of New Selenonitrone Derivative and Its Effect on Breast Cancer Cell Line Viability in Vitro
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