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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 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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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
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
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 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
Tue Dec 15 2020
Journal Name
Al-academy
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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
Tue Mar 01 2022
Journal Name
Iraqi Journal Of Physics
Effect of Copper on Tensile and Hardness of Al-Si Alloy in Automotive Application
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In current research Copper was employed for preparing a ternary system of Al–Si alloy in different (0.2–2.5 wt. %) the best was taken is (1.5%wt) of copper that circumstances of solidification for improving the mechanical performance of the available in aluminium alloy. Cast iron molds were prepared to obtain tensile strength testing specimens. Alloys were prepared by employing gas furnaces. The molten metal was poured into a preheated cast-iron mold. The obtained alloy structures were studied using an X-ray diffractometer and optical microscopy. The mechanical performance of the prepared alloys was examined under the influence of different hardening conditions in both heat and non-heat-treated conditions. The outcomes showed at the

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