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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
Wed May 31 2023
Journal Name
International Journal Of Sustainable Development And Planning
Prediction of Formal Transformations in City Structure (Kufa as a Model) Based on the Cellular Automation Model and Markov Chains
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The research utilizes data produced by the Local Urban Management Directorate in Najaf and the imagery data from the Landsat 9 satellite, after being processed by the GIS tool. The research follows a descriptive and analytical approach; we integrated the Markov chain analysis and the cellular automation approach to predict transformations in city structure as a result of changes in land utilization. The research also aims to identify approaches to detect post-classification transformations in order to determine changes in land utilization. To predict the future land utilization in the city of Kufa, and to evaluate data accuracy, we used the Kappa Indicator to determine the potential applicability of the probability matrix that resulted from

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Publication Date
Mon Jun 27 2022
Journal Name
Sustainability
Thermal Properties of Hydrated Lime-Modified Asphalt Concrete and Modelling Evaluation for Their Effect on the Constructed Pavements in Service
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Flexible pavements are subjected to three main distress types: fatigue crack, thermal crack, and permanent deformation. Under severe climate conditions, thermal cracking particularly contributes largely to a considerable scale of premature deterioration of pavement infrastructure worldwide. This challenge is especially relevant for Europe, as weather conditions vary significantly throughout the year. Hydrated lime (HL) has been recognized as an effective additive to improve the mechanical properties of asphalt concrete for pavement applications. Previous research has found that a replacement of conventional limestone dust filler using hydrated lime at 2.5% of the total weight of aggregates generated an optimum improvement in the mec

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Publication Date
Fri Dec 15 2023
Journal Name
Iraqi Journal Of Laser
In vitro Investigation the Antifungal and 940 nm Diode Laser Effects on Inhibition of Candida Albicans Isolated from Oral Cavity
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Background: Candida albicans is a prevalent commensal that can cause severe health problems in humans. One such condition that frequently returns after treatment is oral candidiasis. Aim: the goal of this research is to evaluate the efficiency of 940 nm as a fungicidal on the growth of Candida albicans in vitro. Material and Methods: In vitro samples (fungal swabs) were taken from the oral cavity of 75 patients suffering from oral thrush. Following the process of isolating and identifying Albicans. The samples are divided into four groups:(Group 1): Suspension of C. albicans was put in a solution of saline as a control group. (Group 2): Suspension of C. albicans that had been treated with nystatin. (Group 3): Suspension of C. albica

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Publication Date
Fri Sep 30 2022
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Publication Date
Fri Dec 15 2023
Journal Name
Iraqi Journal Of Laser
In vitro Investigation the Antifungal and 940 nm Diode Laser Effects on Inhibition of Candida Albicans Isolated from Oral Cavity
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Fri Mar 30 2007
Journal Name
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Effect of Sintering Temperature and Soaking Time on the physical and Dielectric Properties of BaTiO3 for Different Ba/Ti Ratio
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Recent research has examined the improvement of physical and dielectric properties of BaTiO3 ceramic material by small addition of excess TiO2 or BaCO3. The prepared samples sintered at different temperatures and varying soaking time. The results show that increasing the sintering temperature within 1350°C and soaking time of 10 hrs give better electrical and physical properties, which indicate the reaction is complete at higher temperature and period.

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Publication Date
Wed Dec 30 2020
Journal Name
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Experimental Investigation of Pomegranate Peel and Grape Seed Powder Additives on the Rheological and Filtration Properties of Un-Weighted WBM
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Publication Date
Fri Jan 03 2020
Journal Name
Chalcogenide Letters
THE EFFECT OF Ag CONTENT AND HEAT TREATMENT ON STRUCTURAL AND MORPHOLOGICAL PROPERTIES OF THIN (Cu1-xAgx)2 ZnSnSe4 FILMS
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(Cu1-x,Agx)2ZnSnSe4 alloys have been fabricated with different Ag content(x=0, 0.1, and 0.2) successfully from their elements. Thin films of these alloys have been deposited on coring glass substrate at room temperature by thermal evaporation technique under vacuum of 10-5Torr with thickness of 800nm and deposition rate of 0.53 nm/sec. Later, films have been annealed in vacuum at (373, and 473)K, for one hour. The crystal structure of fabricated alloys and as deposited thin films had been examined by XRD analysis, which confirms the formation of tetragonal phase in [112] direction, and no secondary phases are founded. The shifting of main polycrystalline peak (112) to lower Bragg’s angle as compared to Cu2ZnSnSe4 angle refers to incorpora

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Publication Date
Tue Dec 15 2020
Journal Name
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Aesthetic and Functional Dimensions of the Industrial Product and their Influence on Construction of Consumer's Visual Impression: جاسم احمد زيدان
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Publication Date
Fri Mar 01 2019
Journal Name
Al-nahrain Journal Of Science
Effect of Active Galactic Nuclei (AGN) on the Photometric and Morphologic Properties of NGC 4414 and NGC 4369 Spiral Galaxies
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The purpose of this work is to clarify the effect of the Active Galactic Nucleus (AGN) on the properties of the galaxy. A photometric study of two galaxies by surface optical measurements techniques and by using'griz filters' was performed. The scientific material that used in this work was obtained from ''SLOAN DIGITAL SKY SURVEY'' (DR7), a fuzzy color, contour maps, photometric parameters, and color indices were studied by using surface photometric technique. The work was done by Ellipse task in IRAF (Image Reduction and Analysis Facility) software from the National Optical Astronomy Observatory (NOAO).

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