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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 Nov 15 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Enamel defect of primary and permanent teeth in relation to nutrients daily intake among Down's syndrome children in comparison to normal children
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Background: Any child with Down's syndrome does not develop in the same manner as normal child. Therefore, the child should not be viewed as being like everyone else. Developmental enamel defects in primary teeth have been found at least twice as frequently in disabled children as in control children. Down's syndrome consumed protein more than the recommended daily allowance compared to other disabled groups. Therefore, the aim of this study was to investigate developmental defects of enamel and their relations to nutrient intake among Down's syndrome children in comparison to normal children. Materials and Methods: A sample consisted of fifty institutionalized Down's syndrome children (study group) and 50 normal children (control group)

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Publication Date
Tue Apr 22 2025
Journal Name
Bulgarian Journal Of Agricultural Science
The economic impacts of the post-harvest losses of tangerines and Seville oranges crops in Iraq (Baghdad Governorate: As a case study)
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This study aims to calculate the percentage of loss and its causes of the horticultural crops tangerines and Seville oranges in Baghdad governorate for the 2020 agricultural season and estimate the economic impacts of losses both crops tangerines and Seville oranges at the study samples level. The research followed both methods descriptive and the quantitative mathematical in estimating the loss of horticultural crops from tangerines and Seville oranges trees and calculating the economic impact of this loss. The results showed that the percentage of losses of tangerines and Seville oranges crops on the level of wholesalers was about 12% and 13% respectively; causing economic losses estimated at about 3184.41 Euro. The results also displayed

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Publication Date
Tue Dec 01 2020
Journal Name
Al-khwarizmi Engineering Journal
Studying the Radial and Tangential Velocity Components of the Epithelization Healing Post Photorefractive Keratectomy Surgery of the Human Eye
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Photorefractive keratectomy (PRK) is the refractive technique that began with a physical scraping of the epithelial layer of cornea subsequent by laser treatment. Post this procedure to about 48 hours the removed epithelial layer regenerated to protect the eye again. The regeneration process (called re-epithelization) started from the limbus of the cornea toward the central part of it. The re-epithelization mechanism consists of a change in cell density (mitosis) and cell concentration (migration) with a velocity in two directions: radial and tangential. In the present study, an estimation for both radial (responsible for the overlapped layers toward the outward direction of the cornea) and tangential comp

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Publication Date
Sun Jan 01 2006
Journal Name
Iraqi Journal Of Community Medicine
The Effectiveness & Safety of Topical Podophyllin Therapy in Condylomata Acuminata in Iraqi Infants and Young Children
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KE Sharquie, MM Al-Waiz, AA Al-Nuaimy, IRAQI JOURNAL OF COMMUNITY MEDICINE, 2006

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Publication Date
Tue Jan 01 2002
Journal Name
Journal
The Effectiveness & Safety of Topical Podophyllin Therapy in Condylomata Acuminata in Iraqi Infants and Young Children.
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KESMM Al, WAA Al-Nuaimy

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Publication Date
Sat Dec 24 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Prevalence of AGER gene polymorphism in post menopause Iraqi sample with Osteoporosis and osteopenia in type 2DM
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Osteoporosis (OP)is one of the most important metabolic disorder also affected by interaction of genetic and environmental factors by almost 70% and 30% respectively. Genetic components are identified to strongly effect bone mineral density, bone building and turnover, so they play an important role in determining risk of OP and fragility fractures. This study consists of patient and control group; Group A: (70) postmenopausal women with OP and osteopenia, Group B: (20) control group.  five milliliters of blood sample were divided into three tubes; one tube (1ml) contain gel for obtain serum to measure glucose level, the others tubes containing ethylene-diamine-tetra-acetic acid (EDTA), in 2 tube 2ml stored in deep freeze at (–40

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Publication Date
Fri Aug 29 2014
Journal Name
American Journal Of Pharmacological Sciences
Efficacy and Safety of Ranibizumab Intravitreal Injections versus Laser Photocoagulation in Patients with Diabetic Macular Edema
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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Self-Efficacy and its Relation to the Cognitive Assessment for the Daily Disturbances for the University of Baghdad Students
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The current research tackles the self-efficacy and its relation to the cognitive assessment for the daily disturbances for the University of Baghdad students. Two criteria have been adopted to achieve the objectives of the research. The sample of this study consists of 200 male and female students who were chosen randomly. The data were analyzed statistically, revealing that the university students owned their own self-efficacy as well as a cognitive assessment for the daily disturbances and they recognized them as self-threatening. The results also indicated the existence of a prediction activity in the field of the cognitive assessment to the daily disturbances selection. In light of the acquired results, the study recommends the neces

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Publication Date
Thu Dec 01 2016
Journal Name
Al.qadisiya Journal For The Sciences Of Physical Education
Comparing self-learning associated with the model and learning reverse fashioned way of partial way to learn Olympic lifts for beginners
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Abstract The purpose of this study, teach the art of performing Olympic lifts (snatch and, clean and jerk) using the two methods are instructional (self-learning associated with the model) and (reverse style of partial way). Identify the effectiveness of these methods in learning the art of performance and style of the best Olympic lifting in the learning and retention of novice for Olympic lifts. The research sample consisted of 16 lifters were selected purposively representing specialist center for the care of athletic talent to weightlifting for ages 14 years. The sample was divided into two experimental, Each group (8) eight weightlifters. The experimental group used the style of the first self-learning associated with the m

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Publication Date
Sun Sep 01 2013
Journal Name
Baghdad Science Journal
Comparing Study of The Stability and spectral properties vibrations for some Tellurium (IV) compounds containing cycloctadienyl group by Quantum Mechanical Calculations
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Density Functional Theory (DFT) with B3LYP hybrid exchange-correlation functional and 3-21G basis set and semi-empirical methods (PM3) were used to calculate the energies (total energy, binding energy (Eb), molecular orbital energy (EHOMO-ELUMO), heat of formation (?Hf)) and vibrational spectra for some Tellurium (IV) compounds containing cycloctadienyl group which can use as ligands with some transition metals or essential metals of periodic table at optimized geometrical structures.

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