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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 Sep 15 2023
Journal Name
Al-academy
The plastic dimension of the balcony scene in the movie (Romeo and Juliet) and its relationship to the movie and theatrical original text
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This research deals with one scene from the movie Romeo and Juliet, which is the balcony scene, due to the importance of this scene in the formation of the construction of the subsequent events of the movie.

The first chapter contained the methodological framework of the research, where the research problem was identified in how Zeffirelli dealt with the balcony scene in the play Romeo and Juliet and enriched it in the cinematic language with a comparison with the original text of the scene. In the balcony scene with comparative parts between the film and the text and the limits of the research that was limited to the film Zeffirelli and the translated text by Munis Taha Hussein.

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Relationship between the central government and local governments in the light of the centralized and decentralized administrative
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Gaining the relationship between the central government and local governments is great importance especially after the expanded functions of the central government and became unable to carry out their works without all that delegate or transfer parts of its powers to lower levels.

The aims of the research is  to determine the relationship of the central government with the local government in accordance with the principle of administrative decentralization with the presentation of the competent authorities, the control of local governments, according to the Provincial Council Act No. 21 of 2008 amended.

The research has a problem that has been the relationship of the central

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Publication Date
Thu Apr 01 2010
Journal Name
Journal Of Educational And Psychological Researches
The Academic and Practical Frames to The roles Of Systematic Education in the Social and Economic development
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Education in it s different levels becomes development in any country. There fore, nations pay great attention to educational systems, because they perceive that preparing human resources is essential to the development of these nations.
The present study deals with the a academic frames which formulate education in each educational system such as educational philosophy , educational aims , educational strategies by which the academic frames are carried out, which is limited to curriculum, teacher preparations, school activities, in addition to guidance and counseling.
This study reaches some conclusion which are derived from the description of the academic and practical frames some suggestion are made for the mechanism which facil

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Publication Date
Mon Oct 27 2025
Journal Name
Plant Science Today
Optimization of ultrasonic-assisted extraction and in vitro determination of the cytotoxic effect of ethyl acetate fraction of wild Amaranthus viridis on SKGT-4, AGS and A431 cell lines
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Amaranthus viridis L. belongs to the Amaranthaceae family. It is a rich source of numerous phytochemicals and amino acids. The objective of this work was to optimize Ultrasound-Assisted Extraction (UAE) based on the extraction yield and Thin-Layer Chromatography (TLC) profile under different conditions, to compare the optimized UAE to the Soxhlet extraction method and evaluate the cytotoxic effects of the ethyl acetate fraction of the 80 % ethanolic extract on the SKGT-4 (human esophageal adenocarcinoma), AGS (human gastric adenocarcinoma) and A431 (human epidermoid carcinoma). A one-factor at a time experiment was carefully designed to assess the influence of the following factors on the extraction: time, frequency, solid-to-solven

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Publication Date
Wed Mar 15 2023
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The Developed Materials and Techniques and Its Role in Exposing the Aesthetic Of Art Work
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This study is targeting the new developed materials and techniques and how they were affected by the scientific and technological developments that contributed to revelated new and varied developed materials and techniques. And from the artist’s formulation by using the materials and techniques and through its embodiment and sensor the values, artistic and aesthetic standards by breaking from the familiar in aesthetic contemporary way.
The studies on questioning what’s the role of The New Developed Materials and Techniques in exposing the aesthetic of the art work?

This study is to show the aesthetic of the art work through the new developed materials and techniques. Which was based on descriptive analyzing method and hig

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Publication Date
Fri Jul 01 2022
Journal Name
Aip Conf. Proc. 2450, 020031 (2022)
The study of the identification and association of adiponectin and Interleukin-6 and some variables. Biochemical parameters in the Iraqi cord blood of newborns
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t. The current study was conducted on the umbilical cord blood of newborns in the Banks Hospital in Baghdad, Diyala, and Khalis in Diyala, where the study included 90 samples of blood, and samples were collected for the period from the 1st of October;2020 to The first of February;2021 AD, where the study included measuring levels of interleukin-6;Adiponectin,glucose and bilirubin in the blood, comparison study between the study variables with the child's weight (greater than 3 kg),(less or equal 3 kg),the mother's age (greater than 25 years, less or equal to 25 years),the sex of the child (male, female).The results of our study showed that there were no significant differences between the variables of the current study between the two sex

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Kinds of Food and Drinks in Morocco in the Period of Al-Murabteen and Al-Moahideen
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Cooking was of great importance in the Islamic Arabic culture and the
people of Morocco have shown great interest in this aspect and also in the
variety in the making of food. They used all kinds of meat of and have shown
interest in preserving and distributing it .The people of Morocco used the
additives in their cooking such as salt, saffron and many other kinds to add
special flavor and taste and their cooking a distinctive flavor.
Sweet and pastry, in addition to the drinks, represented another aspect of the
Moroccan kitchen. At that time women were brought as slaves from Sudan
and as a result they brought their experience in the making of sweets and
pastry with them to Morocco, they used sugar, fat, wheat

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Publication Date
Sun Jan 21 2024
Journal Name
Biomedicine
Detection of the effect of synthetic siRNA on efflux pump MexA gene expression and antibiotic resistance in clinical isolates of Pseudomonas aeruginosa
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Introduction and Aim: Pseudomonas aeruginosa is a nosocomial infection with an ability to develop high levels of antibiotic resistance. The efflux pump system is one of the mechanisms that is linked to multidrug resistance in P. aeruginosa. In this study, we employed siRNA loaded on gold nanoparticles against the MexA efflux pump gene to decrease the MexA gene expression in P. aeruginosa and estimated antibiotic resistance after gene silencing.   Materials and Methods: This study examined four strains of P. aeruginosa isolated from patients in various hospitals in Baghdad. Bacteria isolated were identified by biochemical tests and Vitek compact 2 system.  Single-stranded siRNA (33bp) designed in this study was loaded onto gold

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Publication Date
Wed Jun 01 2016
Journal Name
Journal Of Engineering
The Effects of Inclination and Compounds Angles of Round Holes in Staggered Rows on Adiabatic Film Cooling Effectiveness of Vane Suction side
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The aim of this work is oriented to increase film cooling effectiveness value through numerical investigations for flow of Mach number not more than 0.3 around vane surface, to find the effects of inclination and compounds angles of round holes in staggered rows on adiabatic film cooling effectiveness of vane suction side. Multi cylindrical film cooling hole cases were studied with pitch ratio P/d =2 and 3, local blowing ratios M=0.382, 0.77 and 1.14,  inclination angles a=30° and 45°, compound angles β= 0°, 15°, 30° and 45° and local momentum ratios I= 0.084, 0.34 and 0.756  for better cooling process.

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Publication Date
Tue Feb 12 2019
Journal Name
Iraqi Journal Of Physics
Effect of laser energy and ablation time on the formation of aluminum nanoparticles by nanosecond laser ablation of aluminum target in ethanol
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In this work we study the influence of the laser pulse energy and ablation time on the aluminum nanoparticles productivity during nanosecond laser ablation of bulk aluminum immersed in liquid.
Aluminum nanoparticles were synthesized by pulsed laser ablation of Al targets in ethanol for 3-8 minutes using the 1064 nm wavelength of a Nd:YAG laser with energies of 300-500 mJ per pulse.The laser energy was varied between 300 and 500 mJ/pulse, whereas the ablation time was set to 5 minutes. UV-Visible absorption spectra was used for the characterization and comparison of products.

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