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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 Nov 02 2023
Journal Name
Journal Of Engineering
Optimum Reinforcement Depth Ratio for Sandy Soil Enhancement to Support Ring Footing Subjected to a Combination of Inclined-Eccentric Load
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This work investigates the impacts of eccentric-inclined load on ring footing performance resting on treated and untreated weak sandy soil, and due to the reduction in the footing carrying capacity due to the combinations of eccentrically-inclined load, the geogrid was used as reinforcement material. Ring radius ratio and reinforcement depth ratio parameters were investigated. Test outcomes showed that the carrying capacity of the footing decreases with the increment in the eccentric-inclined load and footing radius ratio. Furthermore, footing tilt and horizontal displacement increase with increasing the eccentricity and inclination angle, respectively. At the same time, the increment in the horizontal displacement due t

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Publication Date
Sat Dec 30 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Sy nthesis of Some New Schifrs-Bases Derived From 2-(4-m ethoxy phenyl)-5- (4-amino phenyl)-1,3,4-0xadiazole
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A new compound  2-(4-methoxyphcnyl)-5-(4-aminophenyl)-1,3,4-

oxadiazole (VI) was prepared by intramol ecular condensation reaction followed  by elimination  of some simple  moieties such  as IhO  and HCI by using  POCI3 with acid hydrazide. A series of new Shiffs­

bases 2-(4-methoxyphenyl)-5-[4(4:alkoxybenzoyloxy) benzylidene amino phenyl] I,3,4-oxadia:t.ole (VII].was synthesized from treatment

of oxadiazole derivative [VI] with an appropriate  aromatic aldehyde

(IU). Struct\lfe of the resulting products have been ascertaim:d by their melting pointS, elemental analysis ( some of them) and spectral data.

 

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Publication Date
Fri Nov 24 2023
Journal Name
Iraqi Journal Of Science
Using Ultrasonic Technique to Measure Some Petrophysical Properties of Yamama Formation at Ratawi-7 Oil Well Core Samples, Southern Iraq
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Twenty nine core samples were taken from Ratawi 7 Oil well according to the presence of oil in formation and availability of core samples. This well is located in the province of Basra/southern Iraq. The samples were collected from Yamama Formation. The core samples are taken from the well at different depths, ranging between (3663m-3676m). The range of Vp for these core samples is (668-4017 m/sec) and its average is (1779 m/sec), While the range of Vs is (291-1854 m/sec) and its average is (796 m/sec). In the current study the ultrasonic method is conducted to measure Vp, Vs as well as some petrophysical properties for core samples and some elastic moduli such as (Young's modulus, Bulk modulus, Shear modulus, Poisson's ratio and Lame's

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Publication Date
Thu Sep 01 2016
Journal Name
Chem Istry & Chem Ical Technology
SYN TH ESIS, CH ARACTERIZATION AN D AN TIM ICROBIAL ACTIVITY OF N EW N UCLEOSIDE AN ALOGUES FROM BEN ZOTRIAZOLE
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Novel derivatives of 1-(´1, ´3, ´4, ´6-tetra benzoyl-β-D-fructofuranosyl)-1H- benzotriazole and 1-(´1, ´3, ´4, ´6-tetra benzoyl-β-D-fructofuranosyl)-1H- benzotriazole carrying Schiff bases moiety were synthesised and fully characterised. The protection of D- fructose using benzoyl chloride was synthesized, followed by nucleophilic addition/elimination between benzotria- zole and chloroacetyl chloride to give 1-(1- chloroacetyl)- 1H-benzotriazole. The next step was condensation reaction of protected fructose and 1-(1-chloroacetyl)-1H- benzotriazole producing a new nucleoside analogue. The novel nucleoside analogues underwent a second conden- sation reaction with different aromatic and aliphatic amines to provide new Schiff b

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Publication Date
Fri Feb 28 2020
Journal Name
Neuroquantology
Using X-Ray Films for Evaluation efficiency of Unsaturated Polyester Reinforced by Lead Oxide as Shielding for Medical X-ray Devices
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The largest use of x-ray in medical by dentists, employers or persons that needed by patients with specific conditions, lead to higher exposure of x-ray that may cause many diseases. In the present work radiography films have been used in evaluating the efficiency of using unsaturated polyester polymer reinforced with lead oxide (PbO) as shield material for medical x-ray devices, many parameters studied like concentration and thickness that they are increasing the attenuation of x-ray in them. The results show that the attenuation of X-ray increasing with concentration of reinforced material and with thickness, and the optical density decreases with increasing concentration from 0% to 50%, we chose 30% as suitable concentration to increase

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Publication Date
Thu Sep 13 2018
Journal Name
Baghdad Science Journal
An Efficient Numerical Method for Solving Volterra-Fredholm Integro-Differential Equations of Fractional Order by Using Shifted Jacobi-Spectral Collocation Method
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The aim of this article is to solve the Volterra-Fredholm integro-differential equations of fractional order numerically by using the shifted Jacobi polynomial collocation method. The Jacobi polynomial and collocation method properties are presented. This technique is used to convert the problem into the solution of linear algebraic equations. The fractional derivatives are considered in the Caputo sense. Numerical examples are given to show the accuracy and reliability of the proposed technique.

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Publication Date
Sun Oct 30 2022
Journal Name
Iraqi Journal Of Science
A Single Layer of Chromium Oxide Nanoparticles Films Coated with Carbon by Applying Exploding Wire Technique for Efficient Solar Selective Absorber
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    The efficiency of solar energy absorption in solar heaters is increased by the use of selective absorption coating that possesses high absorption of solar radiation in the UV-visible spectrum as well as low emission at the operating temperature in the infrared region. In this work, novel selective coatings were synthesized by improving the selectivity of chromium oxide (Cr2O3) nanoparticles by doping with carbon nanoparticles using the exploding wire technique for carbon rods by high current in suspended Cr2O3 particles. The structural properties and surface topography were studied by XRD and FE-SEM, which illustrate the carbon-coated Cr2O3 nanoparticles. The prepar

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Publication Date
Thu Oct 01 2020
Journal Name
Journal Of Engineering
Chemical-Free Greywater Treatment Using Aeration, Sedimentation, Followed by Granular Activated Carbon Filter (GAC) -A Case Study of Baghdad city household
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Greywater is a possible water source that can be improved for meeting the quality required for irrigation. Treatment of greywater can range from uncomplicated coarse filtration to advanced biological treatment. This article presents a simple design of a small scale greywater treatment plant, which is a series of physical and natural processes including screening, aeration, sedimentation, and filtration using granular activated carbon filter and differentiates its performance with sand filter. The performance of these units with the dual filter media of (activated carbon with sand) in treatment of greywater from Iraqi house in Baghdad city during 2019 and that collected from several points including washbasins, kitchen si

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Publication Date
Sun Jan 01 2017
Journal Name
Food And Nutrition Sciences
Optimization of Culture Conditions to Produce Phytase from <i>Aspergillus tubingensis SKA</i>
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The effects of nutrients and physical conditions on phytase production were investigated with a recently isolated strain of Aspergillus tubingensis SKA under solid state fermentation on wheat bran. The nutrient factors investigated included carbon source, nitrogen source, phosphate source and concentration, metal ions (salts) and the physical parameters investigated included inoculum size, pH, temperature and fermentation duration. Our investigations revealed that optimal productivity of phytase was achieved using wheat bran supplemented with: 1.5% glucose. 0.5% (NH4)2SO4, 0.1% sodium phytate. Additionally, optimal physical conditions were 1 × 105 spore/g substrate, initial pH of 5.0, temperature of fermentation 30˚C and fermentation dura

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Publication Date
Sun Mar 02 2014
Journal Name
Baghdad Science Journal
Determination of Advanced Oxidation Protein Products, E3 SUMO-Protein Ligase NSE2[NSMCE2], as a Marker to Predict Child Acute Lymphoblastic Leukemia
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Acute lymphoblastic leukemia (ALL) is a cancer of the blood and bone marrow (spongy tissue in the center of bone). In ALL, too many bone marrow stem cells develop into a type of white blood cell called lymphocytes. These abnormal lymphocytes are not able to fight infection very well. The aim of this study was to investigate possible links between E3 SUMO-Protein Ligase NSE2 [NSMCE2] and increase DNA damage in the childhood patients with Acute lymphoblastic leukemia (ALL). Laboratory investigations including hemoglobin(Hb) ,white blood cell (WBC) , serum total protein , albumin ,globulin , in addition to serum total antioxidant activity (TAA) , Advanced oxidation protein products(AOPP) and E3 SUMO-Protein Ligase NSE2[NSMCE2]. Blood samples

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