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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 Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
The Basic Words and Terms of Sport Games and Motions in the Holy Quran : semantic study
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(( The Basic word and Terms of sports, games and motions in the Holy Quran : semantic
study )).
The research consists of apreface followed by an Introduction , and three sections and
aconclusion, finally the research concluded with a list of the sources . and also alist of terms
and word in English language for a wider use .
As for reach sections, they are section one it covers a group of words sports games that
are forty two words .
Section two : it covers five fields :-
a- A group of words ( sports ruless) that an seventeen words.
b- A group of ( sports montions ) that are ten .
c- A group of ( sports tools ) that are seven words.
d- A group of ( sports sciences ) that are seven words only .
e- A gro

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of exercising occupational hypocrisy on organizational strategic success: An Empirical study on university of kufa faculty of administration and economic
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This research aims to identify the relationship between occupational hypocrisy and organizational strategic success, It was done by analyzing the correlations and influence between variables,  applied to a random sample of university professors at the University of Kufa faculty of administration and economic.

 The main tool for data collection is the survey were questionnaires were distributed randomly to the professors , and (43) questionnaires were returned, and test its validity by using (SEM) (Structural Equation Modeling), Hypothesis has been tested by using Statistical Package for Social Sciences (SPSS v. 18), The research found a set of conclusions:(The occupational hypocrisy has

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Publication Date
Wed Jan 01 2020
Journal Name
Biochemical Of Cellular Archieves
HISTOLOGICAL AND IMMUNOHISTOCHEMICAL STUDY OF OSTEOCALCIN TO EVALUATION THE EFFECT OF LOCAL APPLICATION OF LEPIDIUM SATIVUM OIL ON BONE HEALING ON RAT
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ABSTRACT : The restoration of bone continuity and bone union are complex processes and their success is determined by the effectiveness of osteosynthesis. The use of plants for healing purposes predates human history and forms the source of current modern medicine. This research was planned to study the histological and immunohisto-chemistry of osteocalcin to evaluate of effect of local application of lepidium sativum oilon healing of induced bone defect in rat tibia. In this study, fourty albino male rats, weighting (300-400) gram, aged (6-8) months, will be used under control conditions of temperature, drinking and food consumption. The animals will subject for a surgical operation of medial side of tibiae bone, in control group the bone

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Publication Date
Tue Jun 02 2020
Journal Name
Diyala Journal Of Medicine
Histological and Immunohistochemical Study of Osteocalcin to Evaluate The Effect of Local Application of Symphytum Officinale Oil on Bone Healing on Rat
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Background: The repair of bone defects remains a major clinical challenge in dentistry. Bone is a highly vascularized tissue reliant on the close spatial and temporal connection between blood vessels and bone cells to maintain skeletal integrity. The health promotive , preventive, and curative properties of herbs were recognized by the ancient and the present pharmacist and physicians to form the theoretical foundations in Medicine. Objective: Immunohistochemistry of osteocalcin and histological study to prove that symphytum officinale oil when applied locally on generated bone defect healing in rat tibia, it was very effectiveness. Patients and Methods: 0ur study fourty male rats , weighting (250-350) grams ,aged (5 7)months ,was

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Publication Date
Sun Aug 17 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of waterlase laser and herbal alternative, green tea and Salvadora Persica (Siwak) extract on push-out bond strength
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Background: The bond strength of root canal sealers to dentin was important for maintaining the integrity of the seal in root canal filling in both static and dynamic situations. In a static situation, it should eliminate any space that allowed the percolation of fluids between the filling and the wall while in a dynamic situation; it was needed to resist dislodgement of the filling during subsequent manipulation. Materials and Methods: Forty mandibular premolars were selected for this study. All canals were instrumented using ProTaper rotary instruments. Instrumentation was done with copious irrigation of 5.25% sodium hypochlorite. Roots were randomly divided into four groups according to the type of cleaning and method of root canal irrig

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Publication Date
Mon Feb 24 2025
Journal Name
Advances In Structural Engineering
Experimental and numerical investigation on the behavior of composite reinforced concrete columns encased by steel section and hybrid GFRP section
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GFRP was employed in constructions as an alternative to steel, which has many advantages like lightweight, large tensile strength and resist corrosion. Existing researches are insufficient in studying the influence of hybrid reinforced concrete composite columns encased by GFRP I-section (RCCCEG) and I-section steel (RCCCES). In this study twenty one (RC) specimens of a cross-section of 130 mm × 160 mm, with different length (long 1600 mm and short 750 mm) were encased by using I-section (steel and GFRP) and tested under various loading (concentric, eccentric and flexural loads). The test was focused on the influence of many parameters; load-carrying capacity, mode of failure, deformation and drawing an interaction diagram (N-

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Publication Date
Wed Jan 01 2020
Journal Name
Indian Journal Of Ecology
Study on major constraints and problems in transfer of technology by agricultural extension organization
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Publication Date
Sun Jan 01 2017
Journal Name
Spe/iatmi Asia Pacific Oil & Gas Conference And Exhibition
Influence of miscible CO2 flooding on wettability and asphaltene precipitation in Indiana Lime Stone
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Carbon dioxide (CO2) flooding is an EOR technique in which carbon dioxide is injected into the reservoir to improve the oil recovery. The reservoir oil and rock properties are altered when carbon dioxide interacts with the oil and rock present in the reservoir. Carbon dioxide injection alters the oil and rock properties by causing reduction in oil viscosity, oil swelling and wettability alteration of the rock. This paper will present a proposal to study the wettability alteration in carbonate formations during miscible carbon dioxide flooding. In miscible carbon dioxide flooding, the injection pressure of carbon dioxide would be kept above the minimum miscibility pressure. Thus carbon dioxide is miscible with the oil present in the reservoi

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Publication Date
Sat Nov 09 2019
Journal Name
Biochem. Cell. Arch.
EFFECT OF HEAT EXPOSURE AND GINSENG EXTRACT ON BLOOD CELLS COUNT IN BROILER CHIKS
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The current study was conducted on 504(Ros-308) broiler chicks reared in Animal farms belong to College of Agriculture, University of Baghdad during the period 28/9/2017- 9/11/2018 to determine the effect of ginseng additive on the performance of chicks. Results of study showed a significant effect (p≤0.05) of exposure period an Red blood cells, 3.56×106ml3 of blood was in bird, which exposure to 2hr at heat shock. In 42 day at age 106 ×38 ml3 of blood can noticed in the blood at birds, which exposure to 2hr in 21-42 days at 3 days of age. No significant effect at ginseng on blood cells. The results showed a significant effect (p≤0.05) of interaction on red blood cells at 21 and 42 days of age and the average cells between these ages

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Publication Date
Wed Dec 12 2018
Journal Name
Iop Conference Series: Materials Science And Engineering
Effect of silicon calcium, boron on Proline and relative water contents in Apple leaves
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