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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
Mon Feb 14 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of S.N.I.P.S Strategy on the Achievement of Fifth Grade Students in Geography
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The present research aims at identifying the impact of S.N.I.P.S strategy on the achievement of fifth grade students in natural geography

For the purpose of verifying the objective of the research, the researcher put the following zero hypothesis: There is no statistically significant difference at the level of (0.05) between the mean score of experimental group who study according to the (S.N.I.P.S) strategy, and the mean score of control group who study according to the traditional method in the achievement test.

In order to verify the validity of this null hypothesis, the researcher adopted the experimental method. Two groups of (60) fifth grade literary students were collecte

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Publication Date
Sat Aug 01 2020
Journal Name
Journal Of Engineering
The Effect of Staggered porous fins on the performance of Photovoltaic panel in Baghdad
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The performance of photovoltaic (PV) panel having staggered metal foam fins was examined experimentally in Baghdad, Iraq. Three staggered metal foam fin configurations attached to the backside of the PV panel were studied. The measured parameters were front and back surfaces temperature, open voltage and current circuits, maximum power, and PV efficiency. It was noted that the maximum electrical efficiency enhancement was 4.7% for staggered metal foam fins (case III) than the reference PV panel. The operating temperature of the cell was increased when the value of solar intensity was high. Thereby, the electrical efficiency was decreased. It was found that the metal foam fins decreased the PV temperature by 2-3 o

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Publication Date
Thu Jun 30 2016
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Effect of Asphaltene on the Stability of Iraqi Water in Crude Oil Emulsions
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In the present work, asphaltenes and resins separated from emulsion samples collected from two Iraqi oil wells, Nafut Kana (Nk) and Basrah were used to study the emulsion stability. The effect of oil resins to asphaltene (R/A) ratio, pH of the aqueous phase, addition of paraffinic solvent (n-heptane), aromatic solvent (toluene), and blend of both (heptol) in various proportions on the stability of emulsions had been investigated. The conditions of experiments were specified as an agitation speed of 1000 rpm for 30 minutes, heating at 50 °C, and water content of 30%.  The results showed that as the R/A ratio increases, the emulsion will be unstable and the amount of water separated from emulsion increases. It was noticed that the em

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Publication Date
Sun Jun 30 2013
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Effect of Promoters on the Activity of Prepared Zeolite Catalyst in FCC Process
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Faujasite type NaY zeolite catalyst was prepared from locally available kaolin, then the prepared NaY zeolite have been modified by exchanging of sodium ion with ammonium to produce NH4Y zeolite. NH4Y zeolite was converted to HY zeolite by ion exchanging with oxalic acid. Zinc and nickel promoters have been added to the prepared HY zeolite catalyst, and the effect of these promoters on the catalytic activity of the prepared HY catalyst was studied in fluid catalytic cracking process using light gas oil as a feedstock. The experimental results show that the promoted catalyst gives higher gas oil conversion and gasoline yield than HY zeolite catalyst at the same reaction temperature and WHSV. It was also found that the promoted catalyst gi

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Publication Date
Fri Mar 10 2023
Journal Name
Journal Of Namibian Studies : History Politics Culture
The Costs of Environmental Failure and The Impact of The Green Value Chain in Reducing Them
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The research aims to apply the activities of the green value chain as one of the modern administrative techniques that economic units resort to develop solutions to the pollution problems that occur due to the activity of economic units and their products that may cause damage to the environment as well as the waste of natural resources and to identify the production of environmentally friendly products and reduce the costs of environmental failure of both types Internal and external that may be borne by economic units such as taxes, fines and compensation due to non- observance of environmental requirements and the preservation of human health and protection of the environment.To achieve the goal of the research, the researchers re

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
The status of the state and its relationship to the concept of force in international relations
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The concept of power despite its implications unclear and unknown was one of the most standards in international relations ambiguity and lack of clarity, however was more standards important and influential in the conduct of international relations, and since that time until today since that ambiguity in the meaning of power and use it as a factor of international relations factors and drive the engines were very different and irony from case to case and from researcher to another, but it may be classified force as the international status enjoyed by the state in the international ocean and here is a structure formed of forces posed by the state, such as economic and political nature of the political system and military power and concept

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Publication Date
Thu Jun 28 2018
Journal Name
Journal Of The College Of Education For Women
The literature of the teacher and learner is a study in the light of “Holly Quran
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Praise be to Allah, Lord of the Worlds, teach the pen, taught the human what he didn't know, Ihmad - Almighty - and thank him, and repent to him and ask forgiveness, which is the most forgiving, and bear witness that there is no god but Allah alone has no partner, gives and prevents, And I bear witness that Muhammad is  a slave to Allah  and his Messenger, who called for guidance and good speech and spoke, peace be upon him and his family and companions, and those who followed them until the Day of Judgment.

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Study of the Singlet and the Triplet States of Two ElectronSystems in the First Excited State
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A study of the singlet and triplet states of two electron systems in the first excited state was performed using a simple quantum mechanical model, which assigns the 1s,and 2s orbital with two different variational parameters. Our results agree with a high level calculation used by Snow and Bills.

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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
The changes in the thickness of 1000 – 500 MB and it effects the climate of Iraq
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This research paper is about synoptic climate specifically with in the upper air layers
using upper air layers maps analysis which are maps of thickness for the level 1000 – 500
MB, that their high average ranges between 100 – 5600 M above surface. This research paper
focuses on studying special and temporal variations of the atmosphere thickness above Iraqaccording
to this study, it is concluded that atmosphere thickness above Iraq increases
towards south with an average of 100 M as compared with north of Iraq. Regarding the
temporal variations, it is concluded that atmosphere thickness during hot months. In July, for
example, the atmosphere thickness becomes thicker than in January with an average of
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Publication Date
Sun Feb 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The role of the integration of the knowledge economy and international accounting in achieving sustainable development
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     The current environment is witnessing several developments as a result of the changes  taking place in all areas of economic, social , political and legal that led to the transformation of the industrial economy , which depends based on quantitative production to a knowledge economy which relies based on information and knowledge , as the central pillar of this economy during the trading  of  these information and knowledge between all individuals in general and decision makers , in particular, through information and communication technology of computers and the Internet to achieve sustainable human development in the social dimension.         &

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