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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 Dec 01 2017
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
SEASONAL CHANGES ON EPIDIDYMAL HISTOLOGY AND TESTOSTERONE RECEPTORS IN IRAQI DOGS
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    The present study was carried out on forty eight epididymis of sexually mature dogs to elucidate light microscope features and the presence of testosterone receptors inside epididymis in different seasons. Twenty four dogs aged 3 years were used during the periods from 1/2/2015-1/2/2016. The epididymis were carefully dissected from the testis after orchidectomy operations and fixed, dehydrated, clarified and embedded in paraffin. Sections were stained with hematoxylin and eosin and periodic acid schiff. As well as, paraffin embedded cytoimmunochemistry technique was used for detection of testosterone receptors. Muscular coats showed no significant differences during different seasons or among segments. Epithelial heigh

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Publication Date
Sun Jan 01 2017
Journal Name
Journal Of Central European Agriculture
Seed priming effect on field emergence and grain yield in sorghum
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Most cultivars of sorghum have low field emergence as common problem. Three experiments were carried out at Agriculture College, Baghdad University. First experiment was conducted in laboratory according to Complete Randomized Design (CRD) with four replicates. Second and third experiments were conducted at field according to Randomized Complete Block Design (RCBD) during the spring and the fall seasons of 2015, respectively, with four replicates for each one. Same two factors were studied at each experiment. First factor was seed priming by seed soaking for 10 hours in distilled water, solvents of GA3, KCl and thiamine (300, 40 and 30 mg*L-1, respectively) and non-primed seed. Second factor was three cultivars of sorghum (Inqath, Kafier an

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Publication Date
Sun Oct 06 2024
Journal Name
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Self-criticism in Quranic models and its impact on building them
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Self-criticism is that a person confronts himself with his mistakes in order to reform and develop them for the better, motivate them and inspire hope in them to push them forward and continue to give in this life. The Holy Qur’an teaches us, through the models it cited in its verses, that this is through repentance, a feeling of remorse, and a determination to leave mistakes, and quit disobedience and sins, etc., and all this is done through constructive criticism, and at the same time, one must realize his strengths. , in order to succeed in preserving it and employing it in the right path that pleases God, His Messenger, himself and his society. This has been explained through an introduction, two topics and a conclusion, and God is t

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Financial austerity in Iraq causes and effects on economic performance indicators
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Abstract:

The Iraqi economy faces complex economic challenges that threaten the prospects for growth and stability in the short and medium term, The decrease in oil revenues on which Iraq is based in financing its total expenditure, both operational and investment, led to the emergence of a deficit in the government budget, As the global oil price crisis affected the revenues of the Iraqi government negatively, especially as this negative impact coincided with the increase in military spending resulting from Iraq's war against terrorism, Which led to the Iraqi government to implement austerity measures were to reduce public spending on several projects, which are less important compared to projects that a

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Publication Date
Mon Jul 01 1996
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
PATHOGENIC FUNGI IN PEAT MOSS AND SOIL AND THEIR IMPACTION ON COVERED FARM VEGETAB¬LE CROPS
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Identification of pathogens and locating their inocul¬um source (S) are the first strategies toward successful disease management program the pretransplating seedl¬ing damping - off problem on vegetable crops was found to be caused by Pythium aphanidermatum and Rhizocto¬nia solani. Both fungi were isolated from peat (moss) for the first time in Iraq. In addition, considerable num¬ber of pathogenic fungi was found as contaminants in soil samples from Alrashidiah vegetable covered farming station. Among the isolated fungi were: Pythium apha¬nidermatum, Rhizoctonia solani, Sclerotinia sclerotiorum, Fusarium oxysporum, Fusarium solani phialophora spp., Cephalisporium spp Rizopus stolonfier and Botrytis cine¬rea, in addition to several

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Publication Date
Sun Jan 06 2019
Journal Name
Arabian Journal Of Geosciences
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Thu Nov 17 2016
Journal Name
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Efficient and Stable Routing Algorithm Based on User Mobility and Node Density in Urban Vehicular Network
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Vehicular ad hoc networks (VANETs) are considered an emerging technology in the industrial and educational fields. This technology is essential in the deployment of the intelligent transportation system, which is targeted to improve safety and efficiency of traffic. The implementation of VANETs can be effectively executed by transmitting data among vehicles with the use of multiple hops. However, the intrinsic characteristics of VANETs, such as its dynamic network topology and intermittent connectivity, limit data delivery. One particular challenge of this network is the possibility that the contributing node may only remain in the network for a limited time. Hence, to prevent data loss from that node, the information must reach the destina

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Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of economic factors on the appearance of unequal costs and rationalization of operational decision: An applied research in Wasit State Company for Textile Industries
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There is a set of economic factors that affect the rationalization of decisions on unexploited resources within the economic unit and here determines the problem of the search for the question of what economic factors cause the emergence of asymmetric costs, and aims to identify these factors in the costs of adjustment to resources, change in The size of the activity of the economic unit, the general trend of sales change in the previous period, and the economic level of the country. Rh measure the impact of these factors on economic unity, and taking into consideration the impact when formulating decisions.

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Publication Date
Fri Jul 01 2022
Journal Name
Nternational Journal Of Special Education
Comparative Study between a Combination of Plants Extracts and Drugs on Thyroid Hormones and Lipid Profile in Experimental Animals
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The thyroid gland is a vital part of the overall endocrine system, which is regulated some of body function as oxygen use, basal metabolic rate, growth, cellular metabolism and development This study shed light on a number of extracts that have been shown to have beneficial effects on the thyroid and its function, as well as the various factors linked to thyroid dysfunction. The experiment was conducted to determine the effect of a mixture of two extracts of "Fucus vesiculosus (150 mg/ kg) with Coleus forskohlii (1000 mg/ kg) and Rosmarinus officinalis (220 mg/ kg) with Camellia sinensis (1.25 mg/ kg)" on thyroid hormones as well as lipids profile and tested the effectiveness of two drugs one of them stimulates the hormones of the thyroid (

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Sun Mar 04 2012
Journal Name
Baghdad Science Journal
Biochemical and Kinetic Studies on Alkaline Phosphatase and other Biochemical Features in Sera of Patients with type 2 Diabetes
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Background :Alkaline phosphatase (ALP) was a widely used marker for skeletal and hepatobiliary disorders, but its activity was also increased in atherosclerosis and peripheral vascular disease. Several study has showed that ALP activity was increased in the sera of diabetic patients. The current study was conducted to evaluate ALP activity in type 2 diabetic patients and optimum conditions for enzyme activity in their sera.Methods: This study was carried out at in AL-Yarmok hospital(diabetic center) between February /2009 and April /2009. Fifty two patients with type 2 diabetes have been enrolled. Besides BMI, WHR, serum fasting blood glucose, ALP, HbA1C,uric acid and lipid profile levels have been performed .The relationship bet

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