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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 Jan 13 2019
Journal Name
Iraqi Journal Of Physics
Radiological risk assessment of fuel fabrication facility at Al- Tuwaitha nuclear site
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The specific activity of 29 soil samples collected from Fuel
Fabrication Facility FFF at AL-Tuwaitha site, 20 km south of
Baghdad were determined using HPGe detector in a low background
configuration, it's relative efficiency of 40%, and resolution of 2keV
for the 1332 keV gamma ray emission of 60Co. The range of activity
concentrations of 226Ra, 232Th and 40K were between (12.56-31.96),
(10.2-18.4) and (47.47-402.1) Bq/kg respectively. In order to assess
any radiological hazard to human health, the absorbed gamma dose
rate D in air at 1m above the ground surface was calculated in the
range (18.87 to 36.46) nGy/h; the outdoor annual effective dose
equivalent AEDE was evaluated to vary from 0.0039 to 0.0076

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Publication Date
Tue Dec 01 2020
Journal Name
Baghdad Science Journal
Genotypic Variations of Mutans Streptococci Isolated from Dental Caries by REP-PCR
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Mutans streptococci (MS) are a group of oral bacteria considered as the main cariogenic organisms. MS consists of several species of genus Streptococcus which are sharing similar phenotypes and genotypes. The aim of this study is to determine the genetic diversity of the core species of clinical strains of Streptococcus mutans, Streptococcus sobrinus and Streptococcus downei by using repitative extragenic palindromic (REP) primer. The DNA of the clinical strains of S. mutans (n=10), S. sobrinus (n=05) and S. downei (n=04) have been employed in the present study, which have been previously isolated from caries active subjects. The DNA of the clinical and reference strains was

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Publication Date
Fri Jan 07 2022
Journal Name
Materials
Impact Behavior of Composite Reinforced Concrete Beams with Pultruded I-GFRP Beam
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Publication Date
Sat Sep 23 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Ferqnency of some Legionella species isolated from cooling towers, during two years
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One   hundred   Ninty   two  s mples  were  collected from   (Cooling towers) between           the                 period       1 /l/2004-13/12/2005.   The                          Results Rev a)ecL that  physical    and   chemic:a)  analysefor watr  samples including   Tempera  re,,  pH and  cWodde  concentration  ranges were f01:md

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of The College Of Languages (jcl)
Dylan Thomas:The Vision of Death as a Prologue to a New Life
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Dylan Thomas (1914-1953) is a modern poet belongs to the apocalyptic movement of the 1940's.This movement is influenced by the doctrines and techniques of surrealism.

              Poetry for him should not be primarily concerned with man in society, but with the celebration of spiritual truth. It should bring to light the hidden causes, hence  his personal interest is to strip darkness and explore the inward motives. To do this he uses a cluster of images: a constant building up and breaking down of images. His poetry depends on the romantic spontaneity, suggestiveness of the Symbolists and the the surrealists' mysterious liberation of the unconsciousness and

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Publication Date
Sun Feb 02 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Stem cells a novel approach to periodontal regeneration (A review of literature)
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In this review of literature, the light will be concentrated on the role of stem cells as an approach in periodontal regeneration.

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Publication Date
Sun May 01 2016
Journal Name
Journal Of Engineering
Experimental Behavior of Laced Reinforced Concrete One Way Slab under Static Load
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Test results of eight reinforced concrete one way slab with lacing reinforcement are reported. The tests were designed to study the effect of the lacing reinforcement on the flexural behavior of one way slabs. The test parameters were the lacing steel ratio, flexural steel ratio and span to the effective depth ratio. One specimen had no lacing reinforcement and the remaining seven had various percentages of lacing and flexural steel ratios. All specimens were cast with normal density concrete of approximately 30 MPa compressive strength. The specimens were tested under two equal line loads applied statically at a thirds part (four point bending test) up to failure. Three percentage of lacing and flexural steel ratios wer

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Publication Date
Fri Apr 01 2022
Journal Name
Baghdad Science Journal
Numerical Solutions of Two-Dimensional Vorticity Transport Equation Using Crank-Nicolson Method
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This paper is concerned with the numerical solutions of the vorticity transport equation (VTE) in two-dimensional space with homogenous Dirichlet boundary conditions. Namely, for this problem, the Crank-Nicolson finite difference equation is derived.  In addition, the consistency and stability of the Crank-Nicolson method are studied. Moreover, a numerical experiment is considered to study the convergence of the Crank-Nicolson scheme and to visualize the discrete graphs for the vorticity and stream functions. The analytical result shows that the proposed scheme is consistent, whereas the numerical results show that the solutions are stable with small space-steps and at any time levels.

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Publication Date
Wed Nov 24 2021
Journal Name
Iraqi Journal Of Science
Evaluation of Trichoderma Harzianum Biological Control Against Fusarium Oxysporum F. Sp. Melongenae
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The present study was conducted to biocontrol in vitro and in vivo of Fusarium
oxysporum that cause Fusarium wilt diseases for eggplant plants by using biological
control agent fungus Trichoderma harzianum. Fourteen isolates from F. oxysporum
were isolated and identified from two fields in Iraq. Pathogenicity test indicated that
all F. oxysporum isolates were pathogenic for eggplant but differed in its level of
pathogenicity. Four of the fourteen isolates from F. oxysporum were selected
depending on their highest pathogenicity for eggplant plants, F. oxysporum four
isolates F5, F6, F13 and F14 achieved at pre emergence 83.3%, 83.3%, 86.7% and
83.3% and at post emergence 90.0%, 90.0%, 83.3% and 76.7% respectively.

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Publication Date
Wed May 24 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Identification of Adenosine-3', 5'-Cyclic Monophosphate Purufied From Leukaemic Human Urine
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    Human urinary Adenosine-3',5'-cyclic monophosphate (cAMP) was studied in 90 normal healthy volunteers (49 males and 41 females) aged between (11 months -55 years), and 86 leukemia patients (48 males and 38 females) of four types (25 ALL, 28 AML, 14 CLL, 19 CML) aged between (11 months - 65 years). The study includes the following:- Extraction and purification of urinary cAMP from the interfering nucleotides, proteins, phosphates and pyrophosphates, by using Zinc sulphate –Barium hydroxide precipitation. The extracted cAMP was purified by using Dowax 50W-H+ hydrogen form column chromatography (1x5 cm). Identification of the purified cAMP, this was achieved by applying the following techniques: a- U.V analysis: -

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