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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 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.

Publication Date
Thu Oct 30 2008
Journal Name
College Of Islamic Sciences
The love of the world and its lusts The preference and bliss of the Hereafter In Surat Al-Imran: "objective study"
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The love of the world and its lusts are the head of sins and the corruptors of religion, and the one who loves and loves them who prefers them over the hereafter is one of the most pitiful of creation, and the least intelligent of them, as he prefers imagination over reality, sleep over wakefulness, fleeting shadow over eternal bliss and the mortal abode over the eternal abode, and he sold the life of eternity for the most luxurious life. In life, it is dreams and sleep or as a fleeting shadow, and as it was said: The intelligent person is not deceived.
The reason for choosing this topic is due to two things:
The first: When I contemplated the reasons for the differences and conflicts that afflicted our wounded and occupied country

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Physics: Conference Series
Measurement the Concentrations of Radon and Thoron and Their Progeny in the Air Samples of Al-Haswaa City in Babylon province
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Publication Date
Sun Jan 27 2019
Journal Name
Journal Of The College Of Education For Women
Analytical study of the images and roles of women and men in the books of the Arabic language at the elementary level
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Importance of the research:
The importance of any educational or scientific research through its intellectual arena of facts supply the individual and society, Supports Knowledge and Science Group, which raised will be locked in these topics in the future.
This research seeks to shed light on the image and the role of women and men in the books of the Arabic language in primary education (primary), To illustrate the negative effects of the phenomenon of sexism in textbooks, And its negative impact on emerging, And stay away as much as possible about the distinction between the sexes in the roles and qualities in textbooks traditional stereotypes and remove that put both sexes templates hinder the development of the individual and t

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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 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
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
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
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
Sat Oct 17 2026
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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