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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 Mar 09 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Correction of Non-Uniform illumination for Biological Images Using Morphological Operation Assessing with Statistical Features Quality.
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Non Uniform Illumination biological image often leads to diminish structures and inhomogeneous intensities of the image. Algorithm has been proposed using Morphological Operations different types of structuring elements including (dick, line, square and ball) with the same parameters of (15).To correct the non-uniform illumination and enhancement biological images, the non-uniform background illumination have been removed from image, using (contrast adjustment, histogram equalization and adaptive histogram equalization). The used basic approach to extract the statistical features values from gray level of co-occurrence matrices (GLCM) can show the typical values for features content of biological images that can be in form of shape or sp

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Publication Date
Fri Dec 30 2022
Journal Name
Iraqi Journal Of Science
Electrical Resistivity Imaging (ERI) for Identifying Near-surface Bodies at Diyala University site, NE of Iraq
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      The current research demonstrates the ERI method's effectiveness as a supplementary engineering site investigation approach. Engineering site research is important to indicate the subsoil of proposed production sites. The benefit of the dipole-dipole array for ERI electrical resistivity imaging is that it provides informative records of subsurface geology and condition along with profiles. The dipole-dipole array was performed along with three parallel profiles at the Diyala University site to identify the buried facilities (pipes and cables) in the area. The buried electric cable embedded in a plastic tube was used for simulation to report and verify the field resistivity results. Interpretation of field facts confirmed that

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Publication Date
Wed Dec 29 2021
Journal Name
Journal Of The College Of Education For Women
A Speech Acts Analysis of English COVID-19 News Headlines: مثنى نجيب المرسومي, جمعة قادر حسين
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News headlines are key elements in spreading news. They are unique texts written in a special language which enables readers understand the overall nature and importance of the topic. However, this special language causes difficulty for readers in understanding the headline. To illuminate this difficulty, it is argued that a pragmatic analysis from a speech act theory perspective is a plausible tool for a headline analysis. The main objective of the study is to pragmatically analyze the most frequently employed types of speech acts in the news headlines covering COVID-19 in Aljazeera English website. To this end, Bach and Harnish's (1979) Taxonomy of Speech Acts has been adopted to analyze the data. Thirty headlines have been collected f

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Publication Date
Mon Dec 31 2012
Journal Name
Al-khwarizmi Engineering Journal
Genetic Algorithm Based PID Controller Design for a Precise Tracking of Two-Axis Piezoelectric Micropositioning Stage
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 In this paper, an intelligent tracking control system of both single- and double-axis Piezoelectric Micropositioner stage is designed using Genetic Algorithms (GAs) method for the optimal Proportional-Integral-Derivative (PID) controller tuning parameters. The (GA)-based PID control design approach is a methodology to tune a (PID) controller in an optimal control sense with respect to specified objective function. By using the (GA)-based PID control approach, the high-performance trajectory tracking responses of the Piezoelectric Micropositioner stage can be obtained. The (GA) code was built and the simulation results were obtained using MATLAB environment. The Piezoelectric Micropositioner simulation model with th

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Publication Date
Tue Oct 20 2020
Journal Name
International Journal Of Civil Engineering
Structural Performance Under Monotonic Static Loading of Reinforced Concrete Gable Roof Beams with Multiple Web Openings
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Publication Date
Fri Apr 30 2021
Journal Name
Iraqi Journal Of Science
A study of m-N-extremally Disconnected Spaces With Respect to, Maximum mX-N-open Sets
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The aim of this research is to prove the idea of maximum mX-N-open set, m-N-extremally disconnected with respect to t and provide some definitions by utilizing the idea of mX-N-open sets. Some properties of these sets are studied.

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Publication Date
Tue Nov 01 2022
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Robust adaptive active disturbance rejection control of an electric furnace using additional continuous sliding mode component
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The temperature control process of electric heating furnace (EHF) systems is a quite difficult and changeable task owing to non-linearity, time delay, time-varying parameters, and the harsh environment of the furnace. In this paper, a robust temperature control scheme for an EHF system is developed using an adaptive active disturbance rejection control (AADRC) technique with a continuous sliding-mode based component. First, a comprehensive dynamic model is established by using convection laws, in which the EHF systems can be characterized as an uncertain second order system. Second, an adaptive extended state observer (AESO) is utilized to estimate the states of the EHF system and total disturbances, in which the observer gains are updated

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Tue Jan 01 2019
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I-V characteristics of n-Si /ZnO/Se/MWCNTs nanocomposite solar cell fabricated by solvothermal technique
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Publication Date
Sat Feb 01 2020
Journal Name
Journal Of Water Process Engineering
Waterworks sludge-filter sand permeable reactive barrier for removal of toxic lead ions from contaminated groundwater
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Publication Date
Sun Sep 22 2019
Journal Name
Baghdad Science Journal
Detection of CTX-M-type ESBLs from Escherichia coli Clinical Isolates from a Tertiary Hospital, Malaysia
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The present study aims to detect CTX-M-type ESBL from Escherichia coli clinical isolates and to analyze their antibotic susceptibility patterns. One hundred of E. coli isolates were collected from different clinical samples from a tertiary hospital. ESBL positivity was determined by the disk diffusion method. PCR used for amplification of CTX-M-type ESBL produced by E. coli. Out of 100 E. coli isolates, twenty-four isolates (24%) were ESBL-producers. E. coli isolated from pus was the most frequent clinical specimen that produced ESBL (41.66%) followed by urine (34.21%), respiratory (22.23%), and blood (19.05%).  After PCR amplification of these 24 isolates, 10 (41.66%) isolates were found to possess CTX-M genes. The CTX-M type ESBL

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