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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
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Organizational Red Tapes and their Reflections on Entrepreneurial Orientation: an Exploratory Study of a Sample of Employees in Some Organizations in the Province of Ninewah
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Organizations adopt a number of procedures and instructions in their field of activities in order to aid their resources development   and energies to serve their entrepreneurial orientations. This calls for preparing a range of mechanisms to mitigate the strictness and complexity of procedures. The ambiguity and severe  complexity  of procedures means acknowledging the loss in energy and this in turn  impedes the hopes while in the same time weakens the  enthusiasm in these organizations and an impedes the possibility to achieve continues innovation, thereby losing opportunities to the level of surrender to the risks and  assuming them to be unconquered obstacles.

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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
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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Publication Date
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Experimental Investigation of Pomegranate Peel and Grape Seed Powder Additives on the Rheological and Filtration Properties of Un-Weighted WBM
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   The chemical additives used to enhance the properties of drilling mud cause damage to humans and the environment. Therefore, it is necessary to search for alternative additives to add them to the drilling mud. Thus, this study investigates the effects of pomegranate peel and grape seed powders as natural waste when added to un-weighted water-based mud. The test includes measurements of the rheological properties and filtration, as well as the alkanity and density of the drilling mud. The results showed a decrease in PH values ​​with an increase in the concentrations of pomegranate peel or grapeseed, and a decrease in mud density with an increase in powders of pomegranate peel and grape seed concentrations that resulted f

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Publication Date
Tue Dec 15 2020
Journal Name
Al-academy
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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  The visual impression represents a compound process of a group of concepts that might be secondary and interrelated to constitute, in reality, a cognitive image stored in the memory that can be retrieved according the implications of the situation in which the individual lives in his environment, as it awakens in him an image from the sub consciousness, thus it gets stimulated, and it is among the tangible things.
Since we live in our contemporary world under the development of knowledge, micro and wide technology of the devices, tools, materials, mechanisms, current developments and openness… etc. this transformation created visual impressions that the individual in general and the consumer in specific enjoys concerning his

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Publication Date
Fri Mar 30 2007
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
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 Jul 27 2022
Journal Name
Journal Of Positive School Psychology
Exercises Of Varying Resistances And Muscular Work Exchange Effects On Physical Adequacy And The Completion Of 200m - Meter Freestyle Swimming
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This research aims to prepare exercises of varying resistances and muscular work exchange for 200m freestyle swimmers, in addition to these exercises’ effects on physical adequacy and the time needed to complete this distance. The experimental method is the basis for the design of the experimental group and the control group of a 100% intentionally chosen sample from a community of  elite-youth swimmers of 200m freestyle swimming for the sport season of 2020-2021 at the Police Sports Club. The sample consists of 15 swimmers that were divided, randomly, into two groups; 7 of them in the experimental group while 8 were in the control group. Physical adequacy was calculated with the use of swimmers’ mechanical energy measurements

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Publication Date
Wed Jan 01 2020
Journal Name
Plant Archives
The effect of adding some organic and mineral substances to calcareous soil on adsorption and desorption of copper and its removal efficiency from soil
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Publication Date
Sat Apr 13 2024
Journal Name
مجلة واسط للعلوم الریاضیة
The development of the leading Arab scouting movements and their role in the development of youth and society
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the history of the Scouting movement reflects the global social cultural and technological change over more than a century. scouting aims to develop young people worldwide through educational programs based on specific principles and values. in arab countries, the scouting movement is considered one of the most important platforms contributing to developing young people and enhancing their rule. positive in society, began with the establishment of the first Scout camp in the region and witnessed great growth and prosperity over the decades the research reveals the historical roots and development of the scout movement in the leading arab countries and analyzes the positive impact of scout movement in the leading arab countries on the develo

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Publication Date
Fri Jan 01 2016
Journal Name
Iraqi Journal Of Agricultural Sciences
Influence of cytokinins and sucrose concentrations on bulblet characters of In Vitro Hippeastrum Hybridum
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