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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 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
A Contrastive Study on the Syntactic Structure of Standard English and Standard Arabic Determiner Phrase
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The determiner phrase is a syntactic category that appears inside the noun phrase and makes it definite or indefinite or quantifies it. The present study has found wide parametric differences between the English and Arabic determiner phrases in terms of the inflectional features, the syntactic distribution of determiners and the word order of the determiner phrase itself. In English, the determiner phrase generally precedes the head noun or its premodifying adjectival phrase, with very few exceptions where some determiners may appear after the head noun. In Arabic, parts of the determiner phrase precede the head noun and parts of it must appear after the head noun or after its postmodifying adjectival phrase creating a discontinu

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Publication Date
Fri Sep 24 2021
Journal Name
Applied Sciences
The Impact of Calcitriol on Orthodontic Tooth Movement: A Cumulative Systematic Review and Meta-Analysis
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A cumulative review with a systematic approach aimed to provide a comparison of studies’ investigating the possible impact of the active form of vitamin D3, calcitriol (CTL), on the tooth movement caused by orthodontic forces (OTM) by evaluating the quality of evidence, based on collating current data from animal model studies, in vivo cell culture studies, and human clinical trials. Methods: A strict systematic review protocol was applied following the application of the International Prospective Register of Systematic Reviews (PROSPERO). A structured search strategy, including main keywords, was defined during detailed search with the application of electronic database systems: Medline/Pubmed, EMBASE, Scopus, Web of Science, and

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Publication Date
Thu Jun 09 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The financial aid of the Central Bank of Iraq to the government and its reflection on indicators of banking stability/ Applied Research
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The research aims to define the images of financial aid that it provides within their tasks (central banks to governments) and how it can affect the indicators of banking stability, as well as monitoring the levels of banking stability in the Iraqi economy through the indicators used by the Central Bank of Iraq, and the importance of research in banking stability lies in Iraq, because any decrease in the movement of the aggregate banking stability index will reflect negatively on the financial sector in Iraq. Therefore, the Central Bank sought to provide financial aid to the government through a group of components, some of which are represented by initiatives that contribute to revitalizing the national economy and the other hel

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
Listening to music and its reflection on the artistic output of the students of the Department of Art Education: سميعه فاضل كعود
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The relationship between music and plastic arts can be viewed as an interdependent relationship, as they both develop imagination, focus and sensory perception, as well as the presence of some artistic concepts that music shares with the art of drawing, on this basis the rationale for this research aimed at identifying (the influence of music) was dealt with On the artistic output (drawing) of students of the Department of Art Education - College of Fine Arts) In the first chapter the problem of research, importance, terminology, boundaries and goal was addressed, and in the second chapter the researcher dealt with in the first topic the relationship between music and painting, and in the second topic the use of music in education. As fo

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The dominance of the consumption pattern of government Expenditure and its impact on economic growth of Iraq for the period 2003-2014
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The importance of government Expenditure policy in economy come from its role leading to the mitigation and adjustment of fluctuations in macroeconomic variables caused by imbalance between aggregate demand and aggregate supply,  It is associated with the efficient management of government Expenditure to reinforcement the relationship between government Expenditure and the overall economic system .

Regarding the Iraqi economy,the increasing in financial rentier after the political change in 2003 has led to finance the budgets Characterized by consumption,The government Expenditure employed to encourage government employment in services jobs, and find different channels for the distribution of

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
The effect of usage two methods of garlic extraction( foliar and ground application) on the growth of the tomatoes (Solanum lycopersicum) plant
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Abstract<p>Garlic is rich in nutritional and medicinal value as it has been found that the water extract of garlic plant contains 31% carbohydrates and rich in elements calcium, phosphorus, magnesium, potassium, sodium, iron, zinc, manganese, vitamin C, thiamine, riboflavin, niacin and pyridoxine. The aim of this study was to investigate the effect of garlic extract (<italic>Allium sativum</italic> L.) on tomatoes (<italic>Solanum lycopersicum</italic> L.) plant. The trend is to use plant extracts in foliar and ground fertilization. Three levels of foliar application (4, 6, 8%), three levels of ground application (10, 20, 40%), one treatment 6% of foliar and 20% ground applic</p> ... Show More
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Publication Date
Sat Jan 04 2020
Journal Name
زانكو - الإنسانيات
The Effect of Linguistic Propositions on the Collection of Arabic Language Norms and the Development of Critical Thinking among Middle-Grade Students.
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The reality of teaching the Arabic language rules is not satisfactory, as the pedagogical methods used do not help students develop their mental skills, especially critical thinking skills. They are often traditional in terms of teaching students, who are passive, passive, often passive, active, and often active, their listening task, and the teacher's task of narrating facts and judgments. It is a blind simulation student, a dependency on others, and a weak spirit of creativity, innovation, and opinion. The opinions of educators and teachers almost agree on the reasons for students' weakness in learning the rules of Arabic, and that the reason lies in the way of teaching. The difficulty or the ease of the rules of Arabic does not lie in th

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Publication Date
Fri Jan 24 2020
Journal Name
Iraqi Journal Of Agricultural Sciences
THE EFFECT OF TERMITES EXTRACT ON INHIBITION OF GROWTH OF SOME PATHOGENIC BACTERIA AND SYNTHESIS OF BIOFILM
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This study was aimed to extract the effective material from the dry nests of termites and detect its antibacterial activity against some pathogenic bacterial isolates and inhibit synthesis of its biofilm. Termites dry nests were collected and the effective material was extracted then the antibacterial activity was detected using the disc diffusion assay. Results were showed that the extract have antibacterial material from the Termites dry nests, this extract showed antibacterial activity against Gram positive bacteria (Staphylococcus aureus) at (21.5mm) and Gram negative bacteria ( Enterobacter sp. and Pseudomonas aeruginosa) at (26 mm and 20 mm) respectively by inhibiting their growth, as well as its effect on biofilm production o

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Publication Date
Thu Jan 29 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of LED Light on Depth of Cure and Microhardness of Three Types of Bulkfill Composite
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Background: To evaluate the ISO depth of cure of bulkfill composites and depth of cure which determined by Vickers microhardness test. Materials and Methods: Bulkfill resin composite specimens (n=150) were prepared of three bulkfill composite materials (TetricEvo Ceram, Quixfil and SDR) and light cured by Flash max p3 for 3, 10, 20 seconds and by wood pecker for 10, 20 seconds respectively, a mold was filled with one of the three bulkfill composites and light cured. The specimens removed from the mold and scraped by plastic spatula and the remaining length (absolute length) was measured which represent the ISO depth of cure. After that the specimens were returned into the mold and a microhardness indentation device applied on the specimen

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Publication Date
Thu Jan 29 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of AcceleDent® Device on Both Gingival Health Condition and Levels of Salivary Interleukin-1-βeta and Tumor Necrosis Factors-Alpha in Patients under Fixed Orthodontic Treatment
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Background: Orthodontic tooth movement is characterized by tissue reactions, which consist of an inflammatory response in periodontal ligament and followed by bone remodeling in the periodontium depending on the forces applied. These processes trigger the secretion of various proteins and enzymes into the saliva.The purpose of this study was to evaluate the activity of alkaline phosphatase (ALP) in saliva during orthodontic tooth movement using different magnitude of continuous orthodontic forces. Materials and Methods: Thirty orthodontic patients (12 males and 18 females) aged 17-23 years with class II division I malocclusion all requiring bilateral maxillary first premolar extractions were randomly divided into three groups according to t

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