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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
Sun Jan 01 2023
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Physical Mesomechanics Of Condensed Matter: Physical Principles Of Multiscale Structure Formation And The Mechanisms Of Nonlinear Behavior: Meso2022
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Publication Date
Wed Jun 01 2016
Journal Name
Journal Of Engineering
Experimental and Simulation for the Effect of Partial Shading on Solar Panel Performance
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Partial shading is one of the problems that affects the power production and the efficiency of photovoltaic module. A series of experimental work have been done of partial shading of   monocrystalline PV module; 50W, Isc: 3.1A, Voc: 22V with 36 cells in series is achieved. Non-linear power output responses of the module are observed by applying various cases of partial shading (vertical and horizontal shading of solar cells in the module). Shading a single cell (corner cell) has the greatest impact on output energy. Horizontal shading or vertical shading reduced the power from 41W to 18W at constant solar radiation 1000W/m2 and steady state condition. Vertical blocking a column

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Fri Mar 01 2019
Journal Name
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The Effect of Micro and Nano Material on Critical Heat Flux (CHF) Enhancement
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The Nano materials play a very important role in the heat transfer enhancement. An experimental investigation has been done to understand the behaviors of nano and micro materials on critical heat flux. Pool boiling experiments have used for several concentrations of nano and micro particles on a 0.4 mm diameter nickel chrome (Ni-Cr) wire heater which is heated electrically at atmospheric pressure. Zinc oxide(ZnO) and silica(SiO2) were used as a nano and micro fluids with concentrations (0.01,0.05,0.1,0.3,0.5,1 g/L), a marked enhancement in CHF have been shown in the results for nano and micro fluids for different concentrations compared to distilled water. The deposition of the nano particles on the heater surface was the rea

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Publication Date
Sun Jan 01 2017
Journal Name
Journal Of The College Of Languages (jcl)
The Impact of Using PowerPoint presentation on EFL Students’ Attendance, Achievement, and Engagement
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The current study examined the impact of using PowerPoint presentation on EFL student’s attendance, achievement and engagement. To achieve the aim of this study, three null hypotheses have been posed as follows: There is no statistically significant difference between the mean score of the experimental group attendance and that of the control one; there is no statistically significant difference between the mean score of the experimental group achievement and that of the control one, and there is no statistically significant difference between the mean score of the experimental group engagement and that of the control one. To verify a hypothesis, a sample of sixty students is chosen randomly from the third year, department of English,

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Publication Date
Fri Mar 01 2024
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Isotherms and Thermodynamic Parameters of Metoprolol Drug Adsorption on the Prepared Mesoporous Silica
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Publication Date
Wed Aug 07 2019
Journal Name
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Impact of Factors upon Children’ Weight Status of age one to Five years old at Primary Health Care Centers in AL Samawah City
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Fri Jan 01 2016
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Sun Oct 20 2024
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A Theoretical and Experimental Investigation of the Effects of Inverted Wings Modifications on the Stability and Aerodynamic Performance of a Sedan Car at Cornering
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ABSTRACT<p>This research examines the impact of cornering on the aerodynamic forces and stability of a Nissan Versa (Almera) passenger sedan car by introducing novel modifications. These modifications included single inverted wings with end plates as a front spoiler, double‐element inverted wings with end plates as a rear spoiler, and incorporating the ground as a diffuser under the car trunk. The goal is to enhance the performance and stability of conventional passenger cars. To ensure the accuracy of the numerical data, the study utilized multiple methodologies to model the turbulence model, ultimately selecting the most suitable option. This involved comparing numerical data with wind tunnel experimental d</p> ... Show More
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Publication Date
Sat Sep 30 2023
Journal Name
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Measuring the cost of consulting services under the traditional cost approach and the performance-based costing technique and its impact on achieving profits : Applied research in the advisory office of Al-Khwarizmi College of Engineering - University of Baghdad
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Abstract:

                    This research aims to apply the Performance Focused Activity Based Costing System in the consultant office of Al-Khwarizmi College of Engineering at the University of Technology for the purpose of measuring the cost of consulting services provided by these offices in order to reduce costs and their reflection in achieving profits. For the purpose of calculating costs accurately, and to test the hypothesis of the research, the research was applied in the office of the consultant of the College of Engineering Al-Khwarizm - University of Baghdad through the financial statement

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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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