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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
Tue Nov 15 2022
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
A-mechanical properties of engineered cementitious composite concrete produced from Portland limestone cement
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Conventional concretes are almost unbending, and even a small amount of strain potential leaves them brittle. This lack of bendability is a major source of strain loss, and it has been the main goal behind the development of bendable concrete, often known with engineered ce ment composites, or ECC. This form of concrete has a lot more flexibility than regular concrete. Micromechanical polymer fibers are used to strengthen ECC. In most cases, ECC uses a 2% amount of thin, separated fibers. As a result, bendable concrete deforms but unlike traditional concrete, it does not crack. This study aims to include this kind of concrete, bendable concrete, which can be used to solve concrete problems. Karasta (CK) and Tasluja (CT) Portland Lime

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Publication Date
Sun Mar 31 2019
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
Behavior of Clay Masonry Prism under Vertical Load Using Detailed Micro Modeling Approach
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The aim of this research is to assess the validity of Detailed Micro-Modeling (DMM) as a numerical model for masonry analysis. To achieve this aim, a set of load-displacement curves obtained based on both numerical simulation and experimental results of clay masonry prisms loaded by a vertical load. The finite element method was implemented in DMM for analysis of the experimental clay masonry prism. The finite element software ABAQUS with implicit solver was used to model and analyze the clay masonry prism subjected to a vertical load. The load-displacement relationship of numerical model was found in good agreement with those drawn from experimental results. Evidence shows that load-displacement curvefound from the finite element m

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Publication Date
Thu Apr 01 2021
Journal Name
Journal Of Engineering Science And Technology
Assessment Of Municipal Wastewater Treatment Using Sequencing Batch Reactor Under Real Operation Conditions
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The Sequencing Batch Reactor system (SBR) is a major component of the municipal wastewater biological treatment system and water reclamation that provides high-quality water that could be reused in restricted plants that which require large quantities of water despite the lack of water. The research aims to investigate the performance of a pilot plant SBR unit under real operation conditions that was installed and operated in Al-Rustamiya Wastewater Treatment Plant (WWTP), Baghdad, Iraq. Results showed that the BOD5/COD ratio of the raw wastewater was within the average value at 0.66 emphasizing the organic nature of the influent flow and hence the amenability to biological treatment. The results also ensured that the treatment pro

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Publication Date
Thu Nov 30 2017
Journal Name
Journal Of Engineering
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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Engineering
Design of a PID-Lead Compensator for a Twin Rotor Aerodynamic System (TRAS)
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This paper deals with a Twin Rotor Aerodynamic System (TRAS). It is a Multi-Input Multi-Output (MIMO) system with high crosscoupling between its two channels. It proposes a hybrid design procedure that combines frequency response and root locus approaches. The proposed controller is designated as PID-Lead Compensator (PIDLC); the PID controller was designed in previous work using frequency response design specifications, while the lead compensator is proposed in this paper and is designed using the root locus method. A general explicit formula for angle computations in any of the four quadrants is also given. The lead compensator is designed by shifting the dominant closed-loop poles slightly to the left in the s-plane. This has the effect

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Wed Dec 04 2013
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Thu Dec 01 2022
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Publication Date
Thu Dec 12 2013
Journal Name
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Publication Date
Wed Jun 28 2017
Journal Name
Proceedings Of The 2017 Acm Conference On Innovation And Technology In Computer Science Education
Media Literacy as a By-Product of Collaborative Video Production by CS Students
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Publication Date
Sun Jan 01 2017
Journal Name
Proceeding Of The 1st International Conference On Recent Trends Of Engineering Sciences And Sustainability
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This paper proposes a new structure for a Fractional Order Sliding Mode Controller (FOSMC) to control a Twin Rotor Aerodynamic System (TRAS). The new structure is composed by defining two 3-dimensional sliding mode surfaces for the TRAS model and introducing fractional order derivative integral in the state variables as well as in the control action. The parameters of the controller are determined so as to minimize the Integral of Time multiplied by Absolute Error (ITAE) performance index. Through comparison, this controller outperforms its integer counterpart in many specifications, such as reducing the delay time, rise time, percentage overshoot, settling time, time to reach the sliding surface, and amplitude of chattering in control inpu

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