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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
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effects of Allopurinol on Ketone Body Metabolism and Tissue Lipid Peroxidation in Alloxan Diabetes in Rats
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The aim of the present study is to investigate whether or not xanthine oxidase (XO)–derived reactive oxygen species (ROS) may play a role in the pathogenesis of alloxan (ALX)–induced diabetes in rats using the specific XO inhibitor and hydroxyl radical scavenger, allopurinol

The involvement of oxidative stress in ALX – diabetes was assessed by the measurement of plasma and various tissues lipid peroxides levels ( using thiobarbituric acid ( TBA ) reactive substances ). Furthermore, the ability of allopurinol to influence these and other biochemical parameters, including plasma and urine ketones levels were also investigated in diabetic rats.

Rats were divided into four groups: control, untreated diabe

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Publication Date
Sat Jun 30 2012
Journal Name
The Iraqi Journal Of Veterinary Medicine
The effect of Foot and Mouth disease on reproductive performance of Holstein bulls in Artificial Insemination Center of Iraq: AL-Badry K I * , Ibrahim F F ** and Rajab BA **
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This study was carried out in Artificial Insemination Center of Iraq to revealed FMD disease effect on some seminal attributer parameters of 14 imported Holstein bulls divided to three groups according to different reproductive efficiency (four High, five medium and five weak). Results showed that FMD disease had significant (P < 0.05) adverse effect on most seminal attributer parameters, mass, individual motility and sperm concentration / ml during post disease in first of two, four, all months of high, medium and weak semen quality bulls respectively .but semen volume didn’t influenced significantly with this disease. So semen collection should be suspended until resume normal fertility of sperm, after two, four month of high and

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Publication Date
Wed Aug 17 2022
Journal Name
Al–bahith Al–a'alami
The role of public relations in educating the Palestinian public about the issue of prisoners under the occupation An applied study on the employees of the Ministry of Detainees and Ex-Prisoners Affairs
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The issue of Palestinian prisoners inside the prisons of the Israeli occupation is considered
a humanitarian issue par excellence، as it affects every Palestinian family as a
result of the absence of a husband، wife or son.
Almost no Palestinian house is vacant without one or more prisoners، and even women،
children and the elderly are not spared from these arrests.
The problem of the study was to identify the role of public relations in the Ministry
of Detainees and Ex-Prisoners Affairs in educating the Palestinian public about the
issue of prisoners، the nature of this role and the means used to bring support and
solidarity with this important and sensitive issue through the applied study on the
employee

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Publication Date
Mon Dec 31 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDYING THE EFFECT OF Proteinase K AND α-Amylase ON INHIBITION OF Staphylococcus aureus AND Klebsiella pneumoniae BIOFILM ISOLATE FROM URINARY TRACT INFECTION.: STUDYING THE EFFECT OF Proteinase K AND α-Amylase ON INHIBITION OF Staphylococcus aureus AND Klebsiella pneumoniae BIOFILM ISOLATE FROM URINARY TRACT INFECTION.
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The current study aimed to investigate the viability of biofilm formation klebsilla pneumoniae and Staphylococcus aureus. 440 urine samples were collected from patients suffering from urinary tract infection (UTI) from those who were admitted and visitors to Al-Ramadi Teaching Hospital, Al-Yarmouk Teaching Hospital, Al-Ramadi Teaching Hospital for women and children and , Teaching Laboratories in the Medical City for both genders for a period extended from 5 July, 2017 to 10 October, 2017. Samples were diagnosed by culturing them on a selective media and by biochemical testes , also, diagnosis was ensured by using VITEK-2 compact system. Results showed that K.pneumoniae isolation ratio was 17.1%(68) and S.aureus ratio was 13.1%(52). Thei

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Publication Date
Thu Mar 02 2023
Journal Name
East European Journal Of Physics
Evaluation of the Influence of Body Mass Index and Signal-to-Noise Ratio on the PET/CT Image Quality in Iraqi Patients with Liver Cancer
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Image quality has been estimated and predicted using the signal to noise ratio (SNR). The purpose of this study is to investigate the relationships between body mass index (BMI) and SNR measurements in PET imaging using patient studies with liver cancer. Three groups of 59 patients (24 males and 35 females) were divided according to BMI. After intravenous injection of 0.1 mCi of 18F-FDG per kilogram of body weight, PET emission scans were acquired for (1, 1.5, and 3) min/bed position according to the weight of patient. Because liver is an organ of homogenous metabolism, five region of interest (ROI) were made at the same location, five successive slices of the PET/CT scans to determine the mean uptake (signal) values and its standard deviat

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Publication Date
Thu Aug 14 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of thermocycling and debonding time on the shear bond strength of different orthodontic brackets bonded with light-emitting diode adhesive (In vitro study)
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Background: Thermocycling simulates the temperature dynamics in the oral environment. This in vitro study done to measure and compare the effect of thermocycling on the shear bond strength of stainless steel and sapphire brackets bonded to human enamel teeth using light cured orthodontic adhesive and debonded at various time, and to measure adhesive remnant index after debonding. Materials and Methods: one-hundred-twenty extracted upper first premolars for orthodontic reason were used in this study; depending on weather thermocycled or not, the sample was divided into two main groups, then within each group 30 teeth were used for stainless-steel brackets (Bionic®) and for sapphire brackets (Pure®). Both groups were subdivided into three

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Publication Date
Fri Sep 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Investigating the impact of non-nutritive sweeteners on the antifungal potential of alcoholic and aqueous Eucalyptus extracts against salivary candida albicans (An in-vitro study)
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Background: Eucalyptus extracts and derivatives are natural substances with potent antimicrobial properties. This study investigated the in- vitro effects of non-nutritive sweeteners on the antifungal activity of alcoholic and aqueous Eucalyptus extracts against Candida albicans, a common oral pathogen. Materials and Method: Ten isolates of Candida albicans were isolated from dental students’ salivary samples. The alcoholic and aqueous extracts were prepared from fresh Eucalyptus leaves using maceration. The sensitivity of Candida albicans isolates to various concentrations of Eucalyptus extracts ranging from 50 to 250 (mg/mL) was evaluated via agar well diffusion method, while the agar streaking method  was used to assess the minimum

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Publication Date
Tue Dec 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
The global financial crisis and the role of war and its characterization as solutions "The objective roots and the legal possibility of the crisis in economic thought"
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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Industrial Policy and Development in Developing Countries (The Proponents and the Opponents
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This paper aims to discuss and analyse the role and importance of implementing industrial Policy to promote industry and enhance economic development in developing countries. The paper discusses the economic justifications for using industrial policy as well as the criticisms leveled against it, for this purpose it analyses the ideas of two different approaches to industrial policy. The first held by the neo-liberals in the USA , who oppose the use of industrial policy and emphasise the role of the market in attaining economic development. The second, represented by many economists who support the use of industrial policy to promote industry and accelerate economic development, they justify their stand by pointing to the negative

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Wed Feb 20 2019
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Federal and problematic relationship between the center and the region in Iraq
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The US invasion of Iraq in 2003 unleashed the repressed national aspirations of the Kurdish people. After the colonial powers, especially Britain, failed to establish a homeland of scattered Kurds in Iraq, Turkey, Syria and Iran, Iraq's Kurds managed to establish a semi-independent state in the north of the country Which lasted decades against the central authority in Baghdad in protest against what they call the forced integration of Kurds in the Iraqi state, and to obtain more rights and privileges as partners in this country. The federal region in the Kurdistan region of Iraq has become a reality, and it is eager not to strengthen its authority in return for the authority of the central government, but to annex other areas inhabited b

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