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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 Jan 01 2016
Journal Name
International Journal Of Applied Pharmaceutics
Preparation of ferrous sulfate microcapsules as a sustained release dosage forms
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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Synthesis of Polyimides derived from 2,6-diamino-4-methyl-1,3,5-triazine
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This work included synthesis of several new polymers of polyacryloyl chloride in two steps . The first step the included the reaction of N-( sub. or un sub. benzoyl and sub. or un sub. acetyl ) amidyl sub. 2,6- diamino -4-methyl-1,3,5-triazine (1-5) by condensation of many substituted acid chlorides with 2,6- diamino -4-methyl-1,3,5-triazine . While the second step included the reaction of polyacryloyl chloride with the produced compounds (1-5) in step (1) in the presence amount triethyl amine (Et3N) to obtain new polyimides (6-10). The prepared compounds were characterized by UV. , FT-IR, and some of them by 1H-NMR and 13C- NMR spectroscopy.

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Publication Date
Thu Jul 01 2010
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
SEDIMENTO LOGICAL STUDY OF SHIRANISH FORMATION WELL DD-1 (N-IRAQ)
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Shiranish formation has been divided into two microfacies units: 1-Marly biowacke stone facies 2-Biogenic pack stone facies These microfacies reflected marine deep shelf margin in the upper part of the formation, the lower part was deeper. 238 slides were investigated depending on Mineralogical, compositional and Biological processes, which reflect deep shelf margin at upper part of the formation, but at the lower part open sea environment. The age of the formation is estimated depending on the recognized biostratigraphic zone using the index fossils to be Upper- Middle Maestrichtian.

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Publication Date
Sun Jul 02 2023
Journal Name
Iraqi Journal Of Science
Biofuel Production from Cellulosic Wastes by Local Isolates of Streptomyces sp.
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The current study aims to produce cellulase enzyme from Streptomyces spp. isolates and study the effect of some cultural conditions on cellulase production; biofuel production from cellulotic waste through enzymatic and acids hydrolysis. Out of 74 isolates of Streptomyces sp. were screened for cellulse production in solid and liquid media. Results showed higher capability of isolate Streptomyces sp. B 167 for cellulase production and bioconversion of cellulose, therefore selected for further studies. The results of optimization revealed that the cellulase enzyme productivity by the selected isolate reached 2.1 and 2.28 U/ml after 48 h of incubation time and pH 7 respectively. Cellulase productions in tested isolate improved (2.57 U/ml) b

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Publication Date
Sun Apr 30 2017
Journal Name
Journal Of Engineering
Implementation of a Proposed Load-Shedding System Using Altera DE2 FPGA
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A load-shedding controller suitable for small to medium size loads is designed and implemented based on preprogrammed priorities and power consumption for individual loads. The main controller decides if a particular load can be switched ON or not according to the amount of available power generation, load consumption and loads priorities. When themaximum allowed power consumption is reached and the user want to deliver power to additional load, the controller will decide if this particular load should be denied receiving power if its priority is low. Otherwise, it can be granted to receive power if its priority is high and in this case lower priority loads are automatically switched OFF in order not to overload the power generation. The

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Publication Date
Wed May 03 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Using Magic Square of Order 3 To Solve Sudoku Grid Problem
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   The research tackled to solve Sudoku grid problem 9 ×9 , one of artificial intelligence problems. This problem has many of solutions in search space to generate Sudoku grid by using magic square of odd order as 3. This research concludes solution by proposed heuristic algorithm from magic square of odd order as 3 and no given numbers (from 1 to 9) in each cell of nine Sudoku grid cells in starting of problem solution, this is not similar the solution in old classic methods to generate all sub grids in Sudoku grid. The experimental results in this paper show the easily implementation to solve the problem to manage without manual method, additional to position of numbers (1, 2,..9) in center of each sub grid in Sudoku grid

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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
Removal of Cadmium Ions from Simulated Wastewater Using Rice Husk Biosorbent
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Biosorption of cadmium ions from simulated wastewater using rice husk was studied with initial concentration of 25 mg/l. Equilibrium isotherm was studied using Langmuir, Freundlich, BET and Timken models. The results show that the Freundlich isotherm is the best fit model to describe this process with high determination coefficient equals to 0.983. There was a good compliance between the experimental and theoretical results. Highest removal efficiency 97% was obtained at 2.5g of adsorbent, pH 6 and contact time 100 min.

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Publication Date
Mon Nov 19 2018
Journal Name
Al–bahith Al–a'alami
Analytical Study of Cartoon picture AL-Mada Newspaper is a model
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The researcher studies and explains the content of some pictures that are published in al-Mada newspaper. The research is important as it deals with a topic that has a relation with visual culture and its role to transfer the press letter to the audience. The researcher finds that cartoonist exposed the security services through important people who have a major role in state policy and reveals the level of corruption and the weak treatments for this phenomenon and its reflection on the whole society and individuals. In addition to that, cartoonists try to encourage the public for going on the peaceful demonstrations since it is a good tool to make pressure on the government to punish the corrupts.

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Publication Date
Thu Nov 30 2023
Journal Name
Iraqi Journal Of Science
Effect of Genetic Algorithm as a Feature Selection for Image Classification
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     Analysis of image content is important in the classification of images, identification, retrieval, and recognition processes. The medical image datasets for content-based medical image retrieval (  are large datasets that are limited by high computational costs and poor performance. The aim of the proposed method is to enhance this image retrieval and classification by using a genetic algorithm (GA) to choose the reduced features and dimensionality. This process was created in three stages. In the first stage, two algorithms are applied to extract the important features; the first algorithm is the Contrast Enhancement method and the second is a Discrete Cosine Transform algorithm. In the next stage, we used datasets of the medi

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Publication Date
Thu Jun 01 2023
Journal Name
Journal Of Engineering
Performance of STBC Based MIMO-OFDM Using Pilot-aided Channel Estimation
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Many studies have been published to address the growing issues in wireless communication systems. Space-Time Block Coding (STBC) is an effective and practical MIMO-OFDM application that can address such issues. It is a powerful tool for increasing wireless performance by coding data symbols and transmitting diversity using several antennas. The most significant challenge is to recover the transmitted signal through a time-varying multipath fading channel and obtain a precise channel estimation to recover the transmitted information symbols. This work considers different pilot patterns for channel estimation and equalization in MIMO-OFDM systems. The pilot patterns fall under two general types: comb and block types, with

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