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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
Wed May 09 2012
Journal Name
Fuzzy Inference System - Theory And Applications
Some Studies on Noise and Its Effects on Industrial/Cognitive Task Performance and Modeling
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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Marketing commission and its role in enhancing the competitive advantage of insurance companies : Applied research on a sample of Iraqi insurance companies
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Abstract:

                 The research aims to improve the insurance service through the marketing commission as a tool that enables the insurance companies to achieve a competitive advantage. The researcher, by observing the challenges faced by insurance companies, insurance agents and brokers, raised the main question of the research: Is there an effect of the marketing commission on the competitive advantage of insurance companies? The data was obtained through the financial statements and annual reports of the research sample companies (the National General Insurance Company, the Iraqi General Insurance Company, Al-Hamra Private

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Publication Date
Thu Jul 27 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Clinicopathological Features of Colorectal Cancer in the Iraqi Population Focusing on Age and Early-Onset of Malignancy: A Descriptive Cross-Sectional Study
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Background: Colorectal cancer (CRC) is one of the top ten most common cancers worldwide. There are multiple risk factors for CRC, one of which is aging. However, in recent years, CRC has been reported in children. Objective: To describe the main characteristics and symptoms of CRC as well as highlight pathologic data for early-onset CRC. Methods: 79 CRC patients were recruited from the Oncology Teaching Hospital in the period February–December 2022. A questionnaire was used to collect demographic and clinical data. Results: 25 (31.6%) of patients were below 50 years of age. 52 (65.8%) patients had tumors in the colon. The most common symptom is bleeding per rectum in both age groups. There was no significant difference in patholog

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Publication Date
Fri Dec 01 2017
Journal Name
International Journal Of Chemtech Research
The Effect of Ginger Plant (Zingiber officinale) Aqueous Extract on Function and Histological Structure of Kidney in Mice Treated with Carbon Tetrachloride
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The percent work was designed to determine the effect of ginger plant aqueous extract on function and histological structure of kidney in mice treated with carbon tetrachloride (CCl4). Ginger plant caused a protective effect against CCl4 induced kidney damage and improved the kidney weight and biochemical parameters including urea, uric acid and creatinine. The ginger plant has a protective effect against injury in the kidney of mice treated with CCL4, because the ginger plant protects the tissues of kidney from toxic effect of CCL4. The kidney of CCL4 treated mice showed many histological alterations in the kidney included: atrophy, vascular degeneration and hemorrhage, death cell, degeneration of epithelial cells, destruction of basement

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Publication Date
Sat Feb 01 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
Impact of Bubbles Map strategy on developing science operations’ skills for 5th grade literary students in the subject of rhetoric and application
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This research aims to know the effect of the strategy of map bubbles on developing the skills of science operations among 5th grade literary students in the subject of rhetoric and application, and the design of the experimental and control groups with the pre and post-tests was used. The research sample consisted of (50) students divided into two groups, an experimental group of which reached the number of its members is (25) students and studied using the strategy of map bubbles, and a control group of its members reached (25) students and studied in the traditional (standard) method. The researchers prepared a multiple-choice achievement test with several (30) paragraphs, and its validity and consistency were extracted. Then the test was

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Clinical And Experimental Dentistry
Preventive effect of combined Er, Cr: YSGG and fluoride gel on acid resistance of the permanent tooth enamel: An in vitro study
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Publication Date
Sun Sep 06 2015
Journal Name
Baghdad Science Journal
A study of the effect of new cobalt (II) complex and cyclophosphamide drug on (GPT, ALP) activity by using in vivo system
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The present work involved a study the effect of cobalt(II) complex with formula [CoL(H2O)NO3] .4ETOH where L=Nitro [5-(P-nitro phenyl) -4-phenyl-1,2,4 traizole-3-dithiocarbamato hydrazide] aqua. (4) Ethanol and anti-cancer drug - cyclophosphamide on specific activity of two liver enzymes (GPT,ALP) by utilizing an in vivo system in female mice. On the enzymatic level an inhibition in the activity of GPT was noticed in different body organs such as liver, kidney and lung. The inhibition was noticed in both test and cyclophosphamide drug (cp). Mice were treated with three doses of cyclophosphamide (90,180, 250) ?g/ mouse for three days. The same doses were used for the cobalt (II) complex. The liver shows the highest rate of(GPT) inhibition co

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Publication Date
Sat Aug 16 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of Acidity Level on Ions Released and Corrosion of Metal Orthodontic Appliances at Different Time Intervals (An In vitro Study)
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ABSTRACT Background: This study measured the effects of three parameters pH value, length of immersion and type of archwire on metal ions released from orthodontic appliances. Materials and Methods: Ninety maxillary halves simulated fixed orthodontic appliances that were immersed in artificial saliva of different pH values (6.75, 5 and 3.5) during 28 day period. Three types of archwires were used: stainless steel, nickel titanium and thermal activated nickel titanium. The quantity of nickel and chromium ions was determined with the use of atomic force spectrophotometer while iron ions by spectrophotometer. Each orthodontic set was weighted two times, before the ligation and immersion in the artificial saliva and after 28 days at the end of

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Publication Date
Mon May 01 2023
Journal Name
Journal Of Engineering
Assessment of Climate Change Impact on Water Productivity and Yield of Wheat Cultivated Using Developed Seasonal Schedule Irrigation in the Nineveh Province
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The agricultural lands that depend on supplementary irrigation methods for winter wheat cultivating in wide areas of the Nineveh province are most vulnerable to climate change concerns. Due to frequent rainfall shortages and the temperature increase recently noticed and predicted by the climate scenarios. Hence important to assess the climate effect on the crop response in terms of water consumption during the periods (2021-2040) and (2041-2060) by using high-resolution data extracted from 6 global climate data GCMs under SSP5-8.5 fossil fuel emission scenarios in changing and fixed CO2 concentration. And validate the Aqua-Crop model to estimate the yield and water productivity. And gives the RRSME of 7.1- 4.1

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Publication Date
Wed Jan 01 2020
Journal Name
Plant Archives
Morpho-physiological study on the effect of lead stress and selenium foliar application on growth of dill plant anethum graveolens l
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The experiment was carried out in the green house of botanical garden belong to Department of Biology/College of Education for Pure Science Ibn AL-Haitham, University of Baghdad for growing season 2017-2018 to evaluate effect of lead stress with concentrations (0, 50, 100, 150) mg.L -1 and Selenium concentrations (0, 15, 30) mg.L-1 on growth of dill plant using pots. The experiment was designed according to completely randomized design (CRD) with three replications. Result indicated that dill plants subjected to lead stress with height concentrations caused decrease in plant parameters (plant height, no. of branches. plant-1, root length, shoot dry weight, the content of nitrogen, phosphorus and potassium, protein concentration, no. of umbe

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