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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
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Orbital Hydatid Disease: A case study of young patients with primary orbital lesion
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Background:This is a prospective study of three children presented to us in the Orbital clinic in AL ShahidGazi Al Hariri Hospital with painless proptosiswith suspension of Hydatid disease.Objectives: : Orbital hydatid disease is a rare lesion accounting for less than 1% of the total lesions of the body (1, 2). Orbital cysts presented as a primary lesion in our study which is rare to have such lesion without involvement of other organs (3). Humans represent the intermediate host where the commonly affected organ are liver and the lung (10-15%) (4). Methods:This is a prospective study of three Children presented to us in the Orbital clinic in Al Shahid Ghazi Alhariri Hospital with painless proptosis with suspension of Hydatid disease, dep

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Remediation of Groundwater Contaminated with Copper Ions by Waste Foundry Sand Permeable Barrier
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The permeable reactive barrier (PRB) is one of the promising innovative in situ groundwater remediation technologies, in removing of copper from a contaminated shallow aquifer. The 1:1- mixture of waste foundry sand (WFS) and Kerbala’s sand (KS) was used for PRB. The WFS was represented the reactivity material while KS used to increase the permeability of PRB only. However, Fourier-transform infrared (FTIR) analysis proved that the carboxylic and alkyl halides groups are responsible for the sorption of copper onto WFS. Batch tests have been performed to characterize the equilibrium sorption properties of the (WFS+KS) mix in copper- containing aqueous
solutions. The sorption data for Cu+2 ions, obtained by batch experiments, have be

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Publication Date
Thu Sep 06 2018
Journal Name
Al-khwarizmi Engineering Journal
Performance Augmenting of a Vertical Axis Wind Turbine using Adaptable Convergent Ducting System
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Developments are carried out to enhance the performance of vertical axis wind turbines (VAWT). This paper studies the performance of the ducted wind turbine with convergent duct (DAWT). Basically, the duct technique is utilized to provide the desired wind velocity facing the turbine. Methodology was developed to estimate the decisive performance parameter and to present the effect of the convergent duct with different inlet angles. The ducted wind turbine was analyzed and simulated using MATLAB software and numerically using ANSYS-Fluent 17.2. Result of both approaches were presented and showed good closeness for the two cases of covering angles 12  and 20 respectively. Results also showed that the convergent duct with an inlet angl

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Publication Date
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Discrimination of Malignant from Acute Benign Compression Spinal Fractures with Magnetic Resonance imaging
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Background: Differentiation between malignant and benign vertebral compression fracture is often problematic. This is precisely difficult in elderly who are predisposed to benign compression caused by osteoporosis .Establishing correct diagnosis is of great importance in determining the treatment andprognosis.A study was performed to determine which magnetic resonance imaging findings are useful in discrimination between metastatic and acute osteoporotic compression fractures of the spine. Recently MRI is being increasingly used for evaluation of these fractures.Objectives: The aim of this study is to establish the correct diagnosis of malignant and benign compression vertebral fracture by MRI to determine treatment and prognosis.Methods

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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Engineering
Behavior of Reinforced Concrete Deep Beams Strengthened with Carbon Fiber Reinforced Polymer Strips
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This research is concerned to investigate the behavior of reinforced concrete (RC) deep beams strengthened with carbon fiber reinforced polymer (CFRP) strips. The experimental part of this research is carried out by testing seven RC deep beams having the same dimensions and steel reinforcement which have been divided into two groups according to the strengthening schemes. Group one was consisted of three deep beams strengthened with vertical U-wrapped CFRP strips. While, Group two was consisted of three deep beams strengthened with inclined CFRP strips oriented by 45o with the longitudinal axis of the beam. The remaining beam is kept unstrengthening as a reference beam. For each group, the variable considered

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Publication Date
Wed Jun 01 2022
Journal Name
Iraqi Journal Of Physics
Evaluation of Mechanical Properties for Epoxy reinforced with palm oil /Zinc oxide composites
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In this research, the effect of reinforcing epoxy resin composites with a filler derived from chopped agriculture waste from oil palm (OP). Epoxy/OP composites were formed by dispersing (1, 3, 5, and 10 wt%) OP filler using a high-speed mechanical stirrer utilizing a hand lay-up method. The effect of adding zinc oxide (ZnO) nanoparticles, with an average size of 10-30 nm, with different wt% (1,2,3, and 5wt%) to the epoxy/oil palm composite,  on the behavior of an epoxy/oil palm composite was studied with different ratios (1,2,3, and 5wt%) and an average size of  10-30 nm.  Fourier Transform Infrared (FTIR) spectrometry and mechanical properties (tensile, impact, hardness, and wear rate) were used to examine the composites. The FTIR

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Publication Date
Sat Dec 30 2017
Journal Name
International Journal Of Heat And Technology
Optimization of a rectangular pin fin using rectangular perforations with different inclination angles
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Publication Date
Sun Jan 01 2023
Journal Name
2nd International Conference On Mathematical Techniques And Applications: Icmta2021
Antimicrobial activities of some new heterocyclic compounds bearing imidazo[2,1-b]benzothiazole moiety
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Publication Date
Fri Mar 01 2019
Journal Name
Optical Fiber Technology
Highly sensitive measurement of surrounding refractive index using tapered trench–assisted multicore fiber
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Fri Sep 03 2021
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Buildings
Structural Efficiency of Hollow Reinforced Concrete Beams Subjected to Partial Uniformly Distributed Loading
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Reinforced concrete (RC) beams containing a longitudinal cavity have become an innovative development and advantage for economic purposes of light-weight members without largely affecting their resistance against the applied loads. This type of openings can also be used for maintenance purposes and usage space of communication lines, pipelines, etc. RC beams are primarily loaded in the plane of the members, which are two-dimensional in a plane stress state and the dominant structural behaviours include bending, shear, or combination of both. In the present study, six numerical models of RC beams with and without openings were simulated by using commercial finite element software ANSYS to evaluate the structural behaviours of those b

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