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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
Sun Mar 01 2020
Journal Name
Iraqi Journal Of Physics
Blood Vessels Detection of Diabetic Retinopathy from Retinal Fundus Image using Image Processing Techniques
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Early detection of eye diseases can forestall visual deficiency and vision loss. There are several types of human eye diseases, for example, diabetic retinopathy, glaucoma, arteriosclerosis, and hypertension. Diabetic retinopathy (DR) which is brought about by diabetes causes the retinal vessels harmed and blood leakage in the retina. Retinal blood vessels have a huge job in the detection and treatment of different retinal diseases. Thus, retinal vasculature extraction is significant to help experts for the finding and treatment of systematic diseases. Accordingly, early detection and consequent treatment are fundamental for influenced patients to protect their vision. The aim of this paper is to detect blood vessels from

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Publication Date
Mon Apr 17 2023
Journal Name
International Journal Of Veterinary Science And Medicine
Donor variability of ovine bone marrow derived mesenchymal stem cell - implications for cell therapy
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Publication Date
Tue Jan 31 2017
Journal Name
Journal Of Engineering
Static Analysis of Laminated Composite Plate using New Higher Order Shear Deformation Plate Theory
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 In the present work a theoretical analysis depending on the new higher order . element in shear deformation theory for simply supported cross-ply laminated plate is developed. The new displacement field of the middle surface expanded as a combination of exponential and trigonometric function of thickness coordinate with the transverse displacement taken to be constant through the thickness. The governing equations are derived using Hamilton’s principle and solved using Navier solution method to obtain the deflection and stresses under uniform sinusoidal load. The effect of many design parameters such as number of laminates, aspect ratio and thickness ratio on static behavior of the laminated composite plate has been studied. The

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Engineering
Experimental Investigation of Natural Convection into a Horizontal Annular Tube with Porous Medium Effects
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In this work, an experimental investigation has been done for heat transfer by natural-convection through a horizontal concentric annulus with porous media effects. The porous structure in gap spacing consists of a glass balls and replaced by plastic (PVC) balls with different sizes. The outer surface of outer tube is isothermally cooled while the outer surface of inner tube is heated with constant heat flux condition. The inner tube is heated with different supplied electrical power levels. Four different radius ratios of annulus are used. The effects of porous media material, particles size and annulus radius ratio on heat dissipation in terms of average Nusselt number have been analyzed.

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Publication Date
Sun Jan 01 2017
Journal Name
Catalysis Science & Technology
Mechanisms governing selective hydrogenation of acetylene over γ-Mo<sub>2</sub>N surfaces
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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Engineering
Finite Element Analysis of Cracked One-Way Bubbled Slabs Strengthened By External Prestressed Strands
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Bubbled slabs can be exposed to damage or deterioration during its life. Therefore, the solution for strengthening must be provided. For the simulation of this case, the analysis of finite elements was carried out using ABAQUS 2017 software on six simply supported specimens, during which five are voided with 88 bubbles, and the other is solid. The slab specimens with symmetric boundary conditions were of dimensions 3200/570/150 mm. The solid slab and one bubbled slab are deemed references. Each of the other slabs was exposed to; (1) service charge, then unloaded (2) external prestressing and (3) loading to collapse under two line load. The external strengthening was applied using prestressed wire with four approaches, wh

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Publication Date
Mon Jan 19 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of bone density after six months from dental implants placement using Computed Tomography
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Background: Determination of local bone mineral density (BMD) immediately after implant insertion play an important role in implant success rate, may offer comprehensive description of the bone, and give enough information to the surgeon prior to implant insertion and at follow up status. The aim of the present study is to evaluate the changes of local bone density in the dental implant recipient sites by using computerized tomography. Material and method: The sample consisted of (20) dental implants recipient sites, bone density assessment was done twice, immediately after implants insertion and after six months. Results: The mean HU of the bone around the implant insertion site, immediately after implant placement was 552.28 HU, and inc

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Publication Date
Fri Oct 01 2021
Journal Name
The Iraqi Postgraduate Medical Journal
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Publication Date
Sun Nov 01 2020
Journal Name
2020 8th Ieee Ras/embs International Conference For Biomedical Robotics And Biomechatronics (biorob)
Estimating Wrist Joint Torque Using Regression Ensemble of Bagged Trees under Multiple Wrist Postures
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Publication Date
Thu Sep 13 2018
Journal Name
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Estimation of some Organophosphorus Pesticides Using Carbon Paste Electrode Coupled with Molecularly Imprinted Polymers
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The aim of this study was to develop a sensor based on a carbon paste electrodes (CPEs) modified with used MIP for determination of organophosphorus pesticides (OPPs). The modified electrode exhibited a significantly increased sensitivity and selectivity of (OPPs). The MIP was prepared by thermo-polymerization method using N,N-diethylaminoethymethacrylate (NNDAA) as functional monomer, N,N-1,4-phenylenediacrylamide (NNPDA) as cross-linker, the acetonitrile used as solvent and (Opps) as the template molecule. The three OPPs (diazinon, quinalphos and chlorpyrifos) were chosen as the templates, which have been selected as base analytes which used widely in agriculture sector. The extraction efficiency of the imprinted polymers has been evaluat

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