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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 Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact of Instructional Intervention about Personal Hygiene upon Women who complain Pelvic Inflammatory Disease
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Objective: To determine the impact of personal hygiene on woman who complain pelvic inflammatory disease Methodology: A quasi experimental study in the High Institute Infertility Diagnostic and A.R.T.(assistance reproductive technology) in AL-Kadimya city and al-Emamian al Kadmain medical city hospital. The sample collected during (26th ) January – (30th ) April 2014. A purposive sample of (60) women, (30) of them regard as study group and (30) regard as a control group whom they take routine care in the institute and hospital. The questionnaire consisted of socio-demographic data, reproductive heal

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Publication Date
Sun Sep 03 2017
Journal Name
Baghdad Science Journal
Biological control of saw toothed beetle Oryzaephilus surinamensis(L.)Using fungi Lecanicillium lecanii(Zimm.)
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This study is conducted to determine the effect of pathogenicity of the fungus Lecanicillium lecanii in some aspects of life of the insect saw toothed beetle Oryzaephilus surinamensis L. (Coleoptera: Silvanidae) under laboratory conditions with three concentrations of spores and mildew commentator (1 × 103, 1 × 105, 1 × 107) spore / ml , on eggs and larvae second phase of the insect .The study also includs the effect of the fungus concentrations of germination on rice (jasmine) by using direct spray treatment. The results show great fungus efficiency in the control of some aspects of life of the insect, where varied efficiency depends on the concentration of spores, The highest percentage loss of eggs is 63.33% at a concentration

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Publication Date
Tue Jan 01 2013
Journal Name
International Journal Of Advances In Pharmacy, Biology And Chemistry
Synthesis of NSAID with Sulfonamide Conjugates as Possible Mutual Prodrugs using Amino Acid Spacer
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The purpose of this research work is to synthesize conjugates of NSAIDs (ibuprofen, and naproxen) with sulfadiazine as possible mutual prodrugs to overcome the local gastric irritation of NSAIDs with free carboxyl group by formation of ester linkage that supposed to remain intact in stomach and may hydrolyze in intestine chemically or enzymatically; in addition to that attempting to target the synthesized derivative to the colon by formation of azo bond that undergo reduction only by colonic bacterial azoreductaze enzyme to liberate the parent compound to act locally (treatment of inflammation and infections in colon)

Publication Date
Thu Dec 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Eliminate harmful side – effects of Controls System by designing Activity – Based Responsibility Accounting model
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This research has come out with that, function-based responsibility accounting system has harmful side – effects preventing it of achieving its controlling objective, that is, goal congruence, which are due to its un integrated measures, its focus on measuring measurable behaviors while neglecting behaviors that are hardly measured, and its dependence on standard operating procedures.

In addition, the system hypotheses and measures are designed to fit previous business environment, not the current environment.

The research has also concluded that the suggestive model, that is, activity-based responsibility accounting is designed to get ride of harmful side – effects of functi

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Wed Nov 12 2014
Journal Name
Wireless Personal Communications
A Multi-objective Disjoint Set Covers for Reliable Lifetime Maximization of Wireless Sensor Networks
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Publication Date
Sun Dec 02 2018
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
Improvement of Domestic Wastewater Treated Effluent from Sequencing Batch Reactor Using Slow Sand Filtration
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The effluent quality improvement being discharged from wastewater treatment plants is essential to maintain an environment and healthy water resources. This study was carried out to evaluate the possibility of intermittent slow sand filtration as a promising tertiary treatment method for the sequencing batch reactor (SBR) effluent. Laboratory scale slow sand filter (SSF) of 1.5 UC and 0.1 m/h filtration rate, was used to study the process performance. It was found that SSF IS very efficient in oxidizing organic matter with COD removal efficiency up to 95%, also it is capable of removing considerable amounts of phosphate with 76% and turbidity with 87% removal efficiencies. Slow sand filter efficiently reduced the mass of suspended

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Publication Date
Thu Dec 01 2022
Journal Name
Structural Concrete
Enhancement of RC T‐beams toughness using laced stirrups reinforcement for blast response predictions
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Publication Date
Fri May 20 2022
Journal Name
Al-kindy College Medical Journal
Potential Influence of Parasitic Diseases as Protective Agents from Infection with Pandemic COVID-19
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Parasitic diseases can affect infection with COVID-19 obviously, as protective agents, or by reducing severity of this viral infection. This current review mentions the common symptoms between human parasites and symptoms of COVID-19, and explains the mechanism actions of parasites, which may prevent or reduce severity of this viral infection. Pre-existing parasitic infections provide prohibition against pathogenicity of COVID-19, by altering the balance of gut microbiota that can vary the immune response to this virus infection.  

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Publication Date
Tue May 01 2018
Journal Name
Iop Conference Series: Materials Science And Engineering
Evaluation of Electromagnetic Near-Field Measurement Technique as Non-Destructive Testing for Composite Structures
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Publication Date
Mon Jun 01 2015
Journal Name
المؤتمر العلمي التخصصي الحادي والعشرون لكلية التربية/ الجامعة المستنصرية 22-23 نيسان 2015 الفيزياء
Computer Simulations of Imaging a Dirac Delta Function by a Ground-Based Optical Telescope
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Two- dimensional numerical simulations are carried out to study the elements of observing a Dirac point source and a Dirac binary system. The essential features of this simulation are demonstrated in terms of the point spread function and the modulation transfer function. Two mathematical equations have been extracted to present, firstly the relationship between the radius of optical telescope and the distance between the central frequency and cut-off frequency of the optical telescope, secondly the relationship between the radius of the optical telescope and the average frequency components of the modulation transfer function.

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