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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 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Management Representations Effect on Auditor Responsibility: Applied Research in a sample of Companies under Control and Audit of BSA and private sector auditing offices
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Management Representations Letter plays a significant role as an evidence to get conclusions the Auditor is looking for. These conclusions could show the professional opinion of auditor over the fairness and integrity of financial statements for many issues and numbers that management claims, Hereby, the research aims at highlighting the importance of Management Representations Letter and the way of using as an evidence with expressing its meaning and means of application in addition to identify the Responsibility of Auditor on that Letter, This research discusses also the effect of Management Representations Letter on the credibility of financial statement and enhancing the credibility of the submitted reports, From other side, in the t

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Publication Date
Thu Sep 05 2024
Journal Name
Journal Of Ecohumanism
Early Warning System Means and Tools in the African Union and the Organization of American States: An Analytical Study
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Disasters, crises and wars are a serious and unforeseen threat. The capacity of the early warning system to monitor such crises is therefore crucial. The ability to make quick decisions in a short time is necessary to prevent crises from occurring. Here, the role and effectiveness of the early warning system emerges through its ability to monitor, record and analyze signals. It can also be evidenced by its ability to immediately convey these indicators to the concerned authorities to take measures that ensure these conflicts and disasters do not worsen. The system’s ability to detect disasters and crises, identify the crisis and its type, and use the scientific method and common sense to deal with it is something that contributes to findi

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Publication Date
Sat Dec 01 2018
Journal Name
Political Sciences Journal
The Patterns of the Strategic Environment and its Role in Determining Strategies for Dealing with Conflict and Peace Situations
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Abstract

The decision maker needs to understand the strategic environment to be addressed through different means and methods. It is obvious that there is a difference between the three strategic environments (conflict environment, peace environment, post- peace environment) in terms of inputs and strategies to deal with each one of them. There is an urgent need to understand each pattern separately, analyze its inputs, and identify the factors and variables that affect the continuity of this situation (conflict, peace, post-peace). It is not appropriate to identify treatment without diagnosis of the condition, so it is very important to understand the type of strategic environment to be dealt with it.

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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)
The Relationship between ABO Blood Group Distribution and the incidence of Upper Gastric and Duodenal Ulcer in Iraqi Patients
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The relationship between blood group antigens and peptic ulcer disease has been widely evaluated in the past, but only one study relating H pylori seroprevalence to ABO blood groups among Iraqi patients with peptic ulcer disease is available. We aimed to evaluate the frequency of peptic ulcer disease among different ABO blood groups in Iraqi patients, and we thought it was worthwhile to try to determine whether these components take some part in disease etiology. One hundred and six patients with peptic ulcer disease (PUD) (43 male and 63 female; mean  age: 48 ± 18 years) who attended Baghdad teaching hospital and Al- Yarmouk teaching hospital endoscopy centers were enrolled , and 238 control Subjects.  Fing

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Publication Date
Wed Sep 29 2021
Journal Name
College Of Islamic Sciences
The attitude of Imam Ibn Jarir al-Tabari to the occurrence of unanimous and its convening by statement of the majority in light of his interpretation - Jami` al-Bayan on the interpretation of the verse of the Qur’an -‘‘Applied Models’’
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The research deals with the statement of the importance of unanimous in Islamic Sharia in terms of being the third source of Islamic legislation after the Holy Qur’an and the Sunnah of the Prophet, and the extent of interest of the scholars of interpretation in it, and those who took great interest in mentioning what was agreed upon in every site that necessitated mentioning its issues within, or mentioning an event that has encountered an unanimous, and in various sciences, to extract and extrapolate Sharia rules when these rules are lost in the texts, because it is based on them and derived from them. Among these distinguished scholars is Muhammad bin Jarir al-Tabari. Besides, the research discusses in

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Publication Date
Sat Jun 12 2021
Journal Name
Biochemical And Cellular Archives
EFFECT OF SINGLE ORAL DOSE OF FUMONISIN B1 ON IMMUNOHISTOCHEMICAL EXPRESSION OF TLR-2 AND 4 IN MICE
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Fumonisin B1 is toxic secondary metabolites compound produced by Fusarium spp. on maize and maize products causes health problems to human and animal. Therefore, this research is planned to study the effect of FB1 on the expression of TLR-2 & 4 in liver and kidney cells of mice. Four group of male mice were orally administrated with single dose of FB1 toxin as the following: 0 ppb, 800 ppb, 1200 ppb and 1600 ppb. After two weeks all animals were sacrificed, liver and kidney autopsies were taken and the level of TLR-2 & 4 detected in each four group by immunohistochemistry technique (IHC). According to the IHC examination of groups (1, 2, 3 and 4) strong expression of TLR2 in liver and kidney were (0%, 33.3%, 100%, 100%), respectively. This

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Publication Date
Wed Jul 01 2020
Journal Name
Indian Journal Of Forensic Medicine And Toxicology,
Effects of alcoholic extracts of cinnamomum zeylanicum and origanum majorana on expression of hly gene in escherichia coli
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Publication Date
Mon Sep 28 2015
Journal Name
Journal Of Parasitic Diseases
The effect of toxoplasmosis on the level of some sex hormones in males blood donors in Baghdad
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Toxoplasma gondii is a unique intracellular parasite, which infect a large proportion of the world population, but uncommonly causes clinically significant disease. The present study was performed to estimate the prevalence of toxoplasmosis in 400 apparently healthy blood donor males, their ages were between 18 and 57 years using enzyme linked immunosorbent assay, and to examine the effects of infection on total testosterone, free testosterone and follicle stimulating hormone (FSH) levels in their sera. Seroprevalence showed 10 (2.5 %) and 121 (30 %) of them had IgM and IgG antibodies respectively. Both acute and chronic toxoplasmosis in males recorded higher significant (P < 0.05) mean concentration for total and free testosterone hormone,

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Publication Date
Sat Jan 01 2022
Journal Name
Annals Of Parasitology
The effect of toxoplasmosis on renal function in hemodialysis patients
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Toxoplasma gondii is an obligate intracellular protozoan parasite; it spreads via the circulatory system during infection and causes chronic infection in various organs. Toxoplasmosis affects nearly one third of people worldwide, especially immunocompromised people. This study aimed to determine the effect of toxoplasmosis on renal function in hemodialysis patients. Overall 300 patients referred to the Medical City, Al-Karama General Hospital, Baghdad, Iraq were enrolled from 2021 to 2022. All serum samples were tested for T. gondii immunoglobulins (IgG and IgM) antibodies, urea and creatinine levels. In patients undergoing hemodialysis, the results revealed a high positivity percentage for anti-Toxoplasma IgG. In hemodialysis patients infe

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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The impact of public debt on financial stability in Iraq
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Countries have faced the challenges of high levels of public debt and seek to define the optimum limits to reduce risks to which the financial system can be exposed and its impact on the economy as a whole. Hence the importance of research in studying the impact of internal and external public debt components on indicators of stability of the financial system for the period 2005-2017 for the purpose of knowing the extent of the financial stability indicators response to the high level of the public debt from its optimum ratio, as the aim of the research is to estimate and analyze the dynamic relationship of short and long term between the components of public debt and indicators of financial stability using the (ARDL) model that

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