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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 Apr 01 2022
Journal Name
Baghdad Science Journal
Effect of different levels and sizes of walnut seed residues on phosphorus availability and alkaline phosphatase activity in calcareous soil
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A laboratory experiment has been carried out in the College of Science-University of Salahaddin to study the effect of different levels (0,5,10 and 15%) and sizes(250 and 1000µm) of walnut seeds residues and (160mg.kg-1) phosphorus fertilization on the concentration of phosphorus availability and alkaline phosphatase activity in calcareous soil during 15 and 30 days period of incubation, the experimental design in factorial complet randomize design (C.R.D) with three replications. The results indicated that the application of different levels of walnut seed residues decreases the concentration of phosphorus availability and alkaline phosphatase activity, however the results revealed that combination between levels and sizes o

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Publication Date
Fri Jun 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of Alendronate Treatment on Salivary Levels of Osteoprotegrin and TNF-α in Postmenopausal Woman with Osteoporosis and Periodontal Diseases
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Background: All diseases concerning bone destruction such as osteoporosis and periodontal diseases share common pattern in which the osteoclast cells are absolutely responsible for bone resorption that occurred when osteoclast activity exceeds osteoblast activity. Osteoprotegrin (OPG) considered as novel soluble decoy receptor known as “bone protector” since it prevents extreme bone resorption through inhibition of differentiation and activity of osteoclast by competing for binding site. It binds to receptor activator of nuclear factor kappa-B ligand (RANKL) and prevent its interaction with receptor activator of nuclear factor kappa-B (RANK), thus inhibits osteoclast formation. TNF-α is a pro-inflammatory cytokines having

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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
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
Sun Jan 25 2026
Journal Name
Al–bahith Al–a'alami
The role of witchery and astrology programs in spreading illusion and myth
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« The emergence of satellite channels has led to fundamental changes in the supposed role of television, making it a center of culture and an important tributary to social upbringing and influencing the attitudes and values of individuals and in making public opinion regarding various issues, some television programs target ordinary people at home by virtue of the nature of their subjects, where there is a large audience of viewers, who consume and absorb what is offered to them from the cultural production of those satellite channels that play with the aspirations of groups of society to find metaphysical or magic solutions to their social problems or psychological delusions. The media, through its various messages, contributes to brin

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Publication Date
Sun Aug 04 2024
Journal Name
International Journal Of Home Science
The phenomenon of drugs in Iraq and its international and national impacts
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Abstract Drug addiction is considered a criminal behavior, which led the Iraqi legislator to prohibit and criminalize it, imposing penalties on those who use or even approach it. This aims to limit its presence in Iraq and reduce unethical behaviors, leveraging the divine prohibition to curb it. The legislator also encourages media organizations to raise awareness about the dangers of this substance, which has contributed to reducing the phenomenon of drugs in Iraq.

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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
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
Sun Jan 25 2026
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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