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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 Apr 28 2022
Journal Name
Iraqi Journal Of Science
Photometric Investigations of Peculiar spiral galaxy NGC 2608 Using Multiband CCD Camera
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The structural of peculiar spiral galaxy NGC 2608 have been studied using multiband CCD surface photometry of the observations that have been obtained by the 1.88 m optical telescope of Kottamia Astronomical Observatory (Egypt). We studied the structure and radial brightness distribution of the galaxy. The surface brightness distribution indicate that the center of the galaxy consist of two nucleus. The photometric parameters of its components and the color distribution over the galactic are estimated and stellar populations in different regions of the galaxy are analyzed using color diagram. The distributions of the color indices show that the observed photometric symmetry in the inner part of the galaxy, including the bar, is due to a

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Poly Acrylamide Gel Electrophoresis of Serum Protein, Application to Kala-azar Patients
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         Sera samples were collected from 60 children aged 4-60 months, all were clinically and serologically proven cases of visceral leishmaniasis, as well as  from 10 healthy children, all were seronegative with no history of parasitic infection who serve as a control during the study. Serum total protein and albumin were measured and compared between the control and visceral leishmaniasis patients. Serum protein profiles have been investigated using the conventional sodium dodecyl sulphate – polyacrylamide gel electrophoresis (SDS-PAGE).  Serum of control group showed the specific protein pattern with five protein bands, while serum protein profile in visceral leishmaniasis pat

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Publication Date
Sun Apr 30 2017
Journal Name
Ibn Al-haitham Jour. For Pure & Appl. Sci.
Solution of High Order Ordinary Boundary Value Problems Using Semi-Analytic Technique
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The aim of this paper is to present a method for solving high order ordinary differential equations with two point's boundary condition, we propose semi-analytic technique using two-point oscillatory interpolation to construct polynomial solution. The original problem is concerned using two-point oscillatory interpolation with the fit equal numbers of derivatives at the end points of an interval [0 , 1] . Also, many examples are presented to demonstrate the applicability, accuracy and efficiency of the method by comparing with conventional methods.

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
Diversity of design methods for global competitive advertising: عمار صباح شاكر ناجي
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As a result of the development and global openness and the possibility of companies providing their services outside their spatial boundaries that were determined by them, and the transformation of the world due to the development of the means of communication into a large global market that accommodates all products from different regions and of the same type and production field, competition resulted between companies, and the race to obtain the largest market share It ensures the largest amount of profits, and it is natural for the advertising promotion by companies for their product to shift from an advertisement for one product to a competitive advertisement that calls on the recipient to leave the competing product and switch to it

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Publication Date
Wed Jun 27 2018
Journal Name
Iraqi Journal Of Science
Coefficient Bounds for Certain Subclass of Analytic Functions Defined By Quasi-Subordination
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In this paper, we define certain subclasses of analytic univalent function associated with quasi-subordination. Some results such as coefficient bounds and Fekete-Szego bounds for the functions belonging to these subclasses are derived.

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Assessment of Patients’ Knowledge Toward Total Hip Replacement Home – Care
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To assess the total hip replacement patients’ knowledge of home – care regarding pain management, medication therapy, wound care, mobility limitation and complications may occur in the post hip replacement surgery, and to assess relationship between some variables such as, age level of education, sex & marital status with home- care knowledge. A descriptive study was used to assess the hip-replacement patient home-knowledge, a purposive sampling of (60) hip-replaced –patients were selected from Gazy Alhariri Hospital  (central of surgical profession ) and Alwasity Hospital ( plastic surgery) , the questionnaire  obtains two parts , part one, which included socio-demographical characteristics of the samp

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Crossref
Publication Date
Wed May 30 2018
Journal Name
Journal Of Engineering
Numerical Modeling of Water Movement from Buried Vertical Ceramic Pipes through Soils
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The problem of water scarcity is becoming common in many parts of the world, to overcome part of this problem proper management of water and an efficient irrigation system are needed.  Irrigation with a buried vertical ceramic pipe is known as a very effective in the management of irrigation water.  The two- dimensional transient flow of water from a buried vertical ceramic pipe through homogenous porous media is simulated numerically using the HYDRUS/2D software.  Different values of pipe lengths and hydraulic conductivity were selected.  In addition, different values of initial volumetric soil water content were assumed in this simulation as initial conditions.  Different value

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Crossref
Publication Date
Wed Dec 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of Mandibular Third Molar Position by Using Space-Width Ratio Method
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Background: The prediction of changes in the mandibular third molar position and eruption is an important clinical concern because third molar retention may be beneficial for orthodontic anchorage. The aims of this study were to assess the mandibular third molar position by using medical CT scan and lateral reconstructed radiograph and evaluate gender differences. Materials and Methods: The sample of present study consisted of 39 patients (18 males and 21 females) with age range 11-15 years who were attending at Al-Suwayra General Hospital/ the Computerized Tomography department. The distance from anterior edge of ramus to distal surface of permanent mandibular second molar and mesio-distal width of developing mandibular third molar were

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Publication Date
Sun May 12 2019
Journal Name
Al-khwarizmi Engineering Journal
Motion Control of Three Links Robot Manipulator (Open Chain) with Spherical Wrist
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Robot manipulator is a multi-input multi-output system with high complex nonlinear dynamics, requiring an advanced controller in order to track a specific trajectory. In this work, forward and inverse kinematics are presented based on Denavit Hartenberg notation to convert the end effector planned path from cartesian space to joint space and vice versa where a cubic spline interpolation is used for trajectory segments to ensure the continuity in velocity and acceleration.  Also, the derived mathematical dynamic model is based on Eular Lagrange energy method to contain the effect of friction and disturbance torques beside the inertia and Coriolis effect. Two types of controller are applied ; the nonlinear computed torque control (CTC

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Publication Date
Sun Jun 01 2008
Journal Name
Baghdad Science Journal
Plasma Heating of Tokamak by Microwaves at Electron Cyclotron Resonance Heating (ECRH)
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The brief description to the theory of propagation of electromagnetic waves in plasma was done. The cutoff and resonance regions have been showed. The principles of plasma heating at electron cyclotron resonance (ECRH) method have been mentioned. The numerical simulation to three different station: Tosca station in United Kingdom, ISX-B station in USA and T-10 station in Russia had been done. The optical depth and the friction of energy absorbed A have been calculated. The simulation results indicate that both and A are increase with size of the tokamak and it is possible to obtain full absorption in large tokamak.

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