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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
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Additives on the Solubility and Dissolution of Piroxicam From Prepared Hard Gelatin Capsule
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Piroxicam is a non-steroidal anti-inflammatory drug (NSAID) used in the treatment of musculo-skeletal and joint disorders. The problem with this drug is its poor solubility in water and hence poor bioavailability after oral administration. In order to improve its solubility and dissolution behavior, hydrophilic additives such as starch, lactose, superdisintegrants including crospovidone (C.P), cross carmellose sodium (CCS), and sodium starch glycolate (SSG) were physically dry mixed with the drug by simple trituration. The improvement in the solubility in 0.1 N HCl was obtained as the amount of starch or lactose increased in the physical mixture, while for superdisintegrants, they further improve the solubility when they are present in s

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Publication Date
Sat Apr 01 2023
Journal Name
Egyptian Journal Of Veterinary Sciences
Effect of Crocin on the Spermatogenesis Indices of Mice Testis: A Histopathological and Histomorphological Study
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Publication Date
Wed Aug 01 2018
Journal Name
Global Journal Of Health Science
The Effect of Nebulized Salbutamol on Serum Potassium and Blood Sugar Level of Asthmatic Patients
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BACKGROUND: Nebulized Salbutamol have great advantages for patients with respiratory problems by depositing drugs directly to the lungs, inspite of reported adverse metabolic effects on different electrolytes and glucose heamostasis of patients.AIM OF STUDY: To evaluate the effect of nebulized salbutamol used in the management of patients with asthma who have normal serum potassium and blood glucose levels. in the emergency department after 30 and 60 minutes of administration and to find out if these results are of clinical importance that should be taken in consideration when treating patients especially those with abnormal glucose hemostasis or electrolyte disturbance. PATIENTS & METHODS: The study is a prospective follow

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Publication Date
Sun Dec 30 2007
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Effect of Solvent Extraction of Light Lubricating Oil on Viscosity Index and Chemical Composition
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An investigation was conducted for the improvement of viscosity index of light lubricating oil fraction (40 stock)
obtained from vacuum distillation unit of lube oil plant of Daura Refinery, using solvent extraction process.
In this study furfural solvent was used to extract the undesirable materials which reduce the viscosity index of raw
lubricating oil fraction.
The studied effecting variables of extraction were extraction temperature range from 70 to 110°C, and solvent to oil
ratio range from 1:1 to 4:1 (wt/wt).
The n-d-M method was used for calculation of carbon distribution and structural group analysis of the raffinate
produced from furfural extraction.
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Publication Date
Sat Jan 05 2019
Journal Name
Iraqi Journal Of Physics
Influence of chemical and thermal treatment on the purity of silica extracted from rice husk
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In this work, chemical and thermal treatment were used to enhance silica extract on the purity of rice husk and to reduce the impurities associated with the extraction of silica. The thermal degradation of rice husk was studied. The characteristics and thermal degradation behavior of rice husk which investigated using thermogravimetric analyzer (TGA). Hydrochloric acid was used to soak the rice husk and the study of leaching influence is followed by XRF tests for samples before and after the combustion process. Acid treatment and combustion method seem to have a clear effect on silica purity. The pyrolysis processes were carried out at Laboratory temperature up to 650 oC in the presence of nitrogen gas flowing at 150 ml/min. The effect o

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Publication Date
Fri May 01 2020
Journal Name
Journal Of Engineering
Influence of fly ash on the volumetric and physical properties of Stone Matrix Asphalt Concrete
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Publication Date
Sat Jul 01 2000
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
EFFICIENCY OF AL-RUSTAMITYAH SEWAGE PLANT AND THEIR CONSEQUENCES ON THE POLLUTION OF DIYALA RIVER
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The present work initiated to eaIuate the efficiency of Al-Rustamivah sewage treatment plant
as reflected by the quality of final effluent that is thrown to Di ala river. Weekly samples of
wastewater and final effluent were collected between November 1994 and end of January
1995 and analyzed for different chemical and biological features. Results ha e inidicated that
Al-Rustamiyah sewage treatment plant could not be able efficiently to purify the raw sewage.
The mean values of suspended solids. BOD. COD Dichromate and Oil & grease effluents
were felt to pass standard limits (98.4. 92.8. 125.2 and 39.1 ppm. respectiel). The atherse
possible effects of pollution on Diuala equatic life hae been also discussed in res

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Publication Date
Sat Nov 30 2019
Journal Name
Journal Of Engineering And Applied Sciences
Study the Effect of Heat Treatment and Pressure on Some Electrical Properties of Nano Polycarbonate
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In the present research, the electrical properties which included the ac-conductivity (σac), loss tangent of dielectric (tan δ) and real dielectric constant (ε’) are studied for nano polycarbonate in different pressures and frequencies as a function of temperature these properties were studied at selective temperature gradients which are (RT-50-100-150-250)°C. The results of the study showed that the values of dielectric constant and dissipation factor increase with increasing pressure and temperature and decreases by increasing frequency. And the results of electrical conductivity showed that it increases with increasing temperature, pressure and frequency.

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Publication Date
Sun Dec 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Effect of Laser Shock Peening on the Fatigue Behavior and Mechanical Properties of Composite Materials
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In this study, Laser Shock Peening (LSP) effect on the polymeric composite materials has been investigated experimentally. Polymeric composite materials are widely used because they are easy to fabricate and have many attractive features. Unsaturated polyester resin as a matrix was selected and Aluminum powder with micro particles as a reinforcement material was used with different volume fraction (2.5%, 5% and 7.5%). Hand lay-up process was used for preparation the composites. Fatigue test with constant amplitude with stress ratio (R =-1) was carried out before and after LSP process with two levels of energy (1Joule and 2Joule). The result showed an increase in the endurance strength of 25.448% at 7.5% volume fraction when peened is 1J

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Publication Date
Fri Sep 01 2017
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