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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
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
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
Mon Jan 01 2024
Journal Name
Aims Energy
The impact of different compression ratios on emissions, and combustion characteristics of a biodiesel engine
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<p>The current work investigated the combustion efficiency of biodiesel engines under diverse ratios of compression (15.5, 16.5, 17.5, and 18.5) and different biodiesel fuels produced from apricot oil, papaya oil, sunflower oil, and tomato seed oil. The combustion process of the biodiesel fuel inside the engine was simulated utilizing ANSYS Fluent v16 (CFD). On AV1 diesel engines (Kirloskar), numerical simulations were conducted at 1500 rpm. The outcomes of the simulation demonstrated that increasing the compression ratio (CR) led to increased peak temperature and pressures in the combustion chamber, as well as elevated levels of CO<sub>2</sub> and NO mass fractions and decreased CO emission values un

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Publication Date
Tue Jan 18 2022
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Effect of receiver geometry on the optical and thermal performance of a parabolic trough collector
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Publication Date
Tue Mar 21 2023
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International Journal Of Professional Business Review
Analysis of the Impact of Six Sigma and Risk Management on Iraq's Energy Sector Metrology
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Mon Feb 01 2021
Journal Name
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The Effect of Adding Poloxamer Surfactant on Cleaning Efficiency of NaOCl and NaOH (SEM Study)
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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
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The studied effecting variables of extraction were extraction temperature range from 70 to 110°C, and solvent to oil
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The n-d-M method was used for calculation of carbon distribution and structural group analysis of the raffinate
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Publication Date
Sun Dec 08 2019
Journal Name
Journal Of Global Pharma Technology
Effect of Functionalized Graphene Oxide (FGO) on the Electrical and Dielectrical Properties of PVA Films
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In the present work, nanocomposite of poly (vinyl alcohol) (PVA) incorporated with functionalized graphene oxide (FGO) were fabricated using casting method. PVA was dispersed by varying content of FGO (0.3, 0.5, 0.8, 1 wt %). The PVA- FGO nanocomposite was characterized by FT‐IR, FE-SEM and XRD. Frequency dependence of real permittivity (ε’), imaginary (ε’’) and a.c conductivity of PVA/FGO and PVA/GO nanocomposite were studied in the frequency range 100 Hz- 1 MHz. The experimental results showed that the values of real (ε’) and imaginary permittivity (ε’’) increased dramatically by increasing the FGO content in PVA matrix. PVA/ FGO (1 wt %) nanocomposite revealed higher electrical conductivity of 6.4×10-4 Sm-1 compared to

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Publication Date
Tue Mar 21 2023
Journal Name
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Analysis of the Impact of Six Sigma and Risk Management on Iraq's Energy Sector Metrology
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Purpose: aims the study to show How to be can to enhance measurement management by incorporating a risk-based approach and the six sigma method into a more thorough assessment of metrological performance.   Theoretical framework: Recent literature has recorded good results in analyzing the impact of Six Sigma and risk management on the energy sector (Barrera García et al., 2022) (D'Emilia et al. 2015). However, this research came to validate and emphasize the most comprehensive assessment of metrological performance by integrating Risk management based approach and Six Sigma analysis.   Design/methodology/approach: This study was conducted in Iraqi petroleum refining companies. System quality is measured in terms of sigmas, and t

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