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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
Mon Sep 30 2024
Journal Name
مجلة التراث العلمي العربي
The problem of masculinity and femininity in Arabic
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Perhaps masculinity and femininity in our Arabic language are among the linguistic issues that have occupied the attention of researchers, ancient and modern. Many books, works, and research have been written on this subject, but there is still something in it that must be revealed, clarified, and established, as the ancients did not classify the feminine and masculine into real, metaphorical, auditory, analogical,

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Publication Date
Sun Nov 20 2016
Journal Name
مجلة كلية التربية الاساسية
The secret of Repentance and Confession in Christianity
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The reason for studying (The secret of Repentance and Confession in Christianity) goes back to the deep roots of repentance in all religions, specially the three revealed religions, and those who adhere to them. The human psych by nature is incessantly demanding sins and the wrong deeds. It is in need of repentance which God has opened for them. Almighty God is happy when his creatures repent and refrain from sinning. This is the reason for success in life and the hereafter and the principle of the happiness. It is also a condition for the good course. Therefore, man should refrain from sinning and feel regret for committing sins forever.

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
consideration In the purposes of faith and destiny
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consideration
In the purposes of faith and destiny

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Publication Date
Wed May 12 2021
Journal Name
Annals Of The Romanian Society For Cell Biology
The Speed and Direction of the Ball's Rotation and its Relationship to the Accuracy of the Front and Rear Side Longitudinal Blow in Wheelchair Tennis Players.
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The study aimed to identify the relationship between the speed and direction of the ball's rotation in the accuracy of the front and rear side longitudinal blow in wheelchair tennis players. The descriptive approach wasused in the manner of correlations to suit the nature of the problem to be studied. The research community identified the 32 players aged18 and over, and the search sample was selected from players with a local classification registered with the 2020 Wheelchair Ground Tennis Federation (2020) in the intentional manner of 8 players, using Smart Tennis Sensor technology to measure the speed and direction of the ball and test the accuracy of the front and rear side longitudinalstraightstrike. She conducted the reconnaissance exp

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the relationship between the prices of wheat and rice importer in Iraq and crude oil prices and the exchange rate using the ARDL model
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Since the beginning of 21st century, the prices of Agricultural crops have increased. This Increases is accompanied with that increases of crude oil prices and fluctuation of a dollar exchange rate as a dominant currency used in the global trade. The paper aimed to analysis the short run and long run cointegration relationships between prices of some of Agricultural crops imported by Iraq such as wheat and rice crops and both the crude oil prices and the Iraq dinar exchange rate a gained America dollar using ARDL model. The results show the long run equilibrium between they three variable throng the error correction mechanizem. The results also show the significant and economically sound effects of cru

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Publication Date
Tue May 16 2023
Journal Name
Political Sciences Journal
Public Rights and Freedoms in the Constitution of the Sultanate of Oman and Ways to Protect Them
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What distinguishes human rights issues is their importance to the international community and their importance to democratic political regimes, because they are the axis of any political regime that seeks to achieve a successful democratic path and a stable state. So, countries that are interested in human rights try to enshrine those rights and freedoms in their constitutions and reinforce their concepts in their laws and legislations. Not to mention its involvement in international conventions and treaties concerned with human rights and freedoms, and this is what the Sultanate of Oman has worked on and confirm in the provisions of its 1996 constitution and its amendments

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Publication Date
Thu Sep 01 2022
Journal Name
Archives Of Razi Institute
Effects of Avena sativa and Glycyrrhiza glabra Leaves Extracts on Immune Responses in Serum Cytokine and Liver Enzyme Levels in NIH Mice
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In addition to their high quantities of active chemicals, medicinal plants are well-known for their pharmacological qualities, which include immunological modulation. T Consequently, this study aimed to examine the effects of Avena sativa and Glycyrrhiza glabra leaf extracts on immunological responses as measured by blood cytokine and liver enzyme levels. The phytochemical analysis of Avena sativa crude leaf extracts revealed the presence of alkaloids,flavonoids, tannins, phenolic compounds, and saponins but the absence of resins and violet oils. On the other hand, violet oils, flavonoids, tannins, saponins, and glycosides were detected in significant concentration in Glycyrrhiza glabra ethanolic extract, although resins and phenolic compou

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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
Wed Oct 17 2018
Journal Name
Iraqi Journal Of Laser
The Effect of using 940 nm Diode Laser in Comparison with Endoactivator on Radicular Dentin Permeability and Smear Layer Removal (An in Vitro Study)
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Abstract: The aim of this study is to assess the effectiveness of 940 nm diode laser in comparison to Endoactivator in elimination of smear layer in terms of radicular dentin permeability and ultra-structural changes of root canal walls by SEM evaluation. Twenty-eight single-rooted extracted lower premolars were instrumented up to size X4 (protaper Next, Dentsaply) and divided into two experimental groups according to the irrigation system, G1; activated by EndoActivator and G2; activated by Diode laser 940 nm, CW mode, 1.7 W. Afterward, the roots were made externally impermeable, filled with 2%methylene blue dye, divided horizontally into three segments representing the apical, middle, and coronal thirds then examined under stereo- micr

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Publication Date
Fri Jun 30 2006
Journal Name
Journal Ibn-alhaitham Jornal For Applied And Pure Sciences
A Study of Soluble Proteins(Spl and Sp2) Effect of extracted from Proteus mirabilis on the Activity of Superoxide Dismutase,SOD in the Sera of albino rabbit
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The aim of this study is to shed light on the immunological effect of soluble protein extracted from Proteus mirabilis through employing the level of the enzymatic activity of superoxide dismutase ,SOD The Soluble proteins, SP1 and SP2,were extracted by using the lysozyme enzyme . The rabbit were divided into three groups. the first one was injected with SP1 , the second group with SP2 for four weeks while the third group were untreated. The results revealed that enzymatic activity of SOD was increased significantly in the fifth week of injection withSP1 in comparison with control.