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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 23 2020
Journal Name
Annals Of Tropical Medicine & Public Health
STUDY THE EFFICACY OF TITANIUM OXIDE (TIO2) NANOPARTICLES AGAINST PROTOSCOLICES OF HYDATID CYSTS
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Hydatid cyst disease is one of the most common diseases in many places in the world. The infection occurs when human and livestock drinking or eating contaminated water and food with eggs of Echinococcus granulosus worm. Surgery is the best solution to eradicate cysts and rapid healing, but it may be accompanied by some risks such as rupture of the cyst and leakage its contents of protoscolices, which leads to the return of infection and spread in the body. Several methods have been used to reduce the risks of surgery, including withdrawal of hydatid fluid and its contents and injection scolicidal substances like ethanol and others. Researchers have recently tested the efficiency of nanoparticles such as selenium, silver, and gold nanoparti

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Publication Date
Sun Aug 18 2019
Journal Name
Political Sciences Journal
The challenges of precision axes for futuristic regional relations in the middle east (Iraq after post triumph's period)
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The research has tackled about an important transformation within the whole region of middle east, especially there were more challenges which revealed under the huge pivotal interests of global powers that ruled the new world order by United states of America ; being very affected over the international and regional relations than any situations appeared previously within political realities. So that, many of variables inside the international scene which happened during of this period of contradicting strategic policies by the process of reforming and restructuring of difficult equations that imposed by international and regional allies and blocs . This article had concentrated over various strategic and political studies which reflect

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Publication Date
Mon Feb 16 2026
Journal Name
Journal Of Physical Education
Comparing Angiotensin Gene polymorphisms According to Mechanical Ability for Weightlifter Selection
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Publication Date
Sat Oct 01 2011
Journal Name
Iraqi Journal Of Physics
Stand-Alone PV Generator Comparing with Conventional Systems for Electrification of Small Social Centres in Remote Area
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Many isolated rural communities are located in regions where there is an abundant and reliable supply of solar energy, but where the distance to the nearest power station is many tens or even hundreds of kilometre. It is therefore mainly in these areas that rural electrification is now being provided by PV generators. since Stand-Alone PV generator can offer the most cost-effective and reliable option for providing power needed in remote places. Accordingly these isolated rural canters are fitted with PV for lighting, a refrigerator, a television and socket to supply kitchen appliances

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Publication Date
Fri Jun 30 2023
Journal Name
College Of Islamic Sciences
The strategy of applying quality indicators to educational outcomes according to market requirements - a fundamental study
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A research study in which a methodology for quality indicators that can be adopted to evaluate the educational process in educational institutions within a specific strategy helps individuals in charge of educational education to make appropriate decisions based on accurate and properly approved plans to achieve successful outcomes.

These indicators can be used to judge the quality of educational institutions in order to improve, improve and develop them. This study has concluded the necessity of putting quality into actual application in order to benefit from it in evaluating the future action of Iraqi educational institutions.

The external changes brought about by technology and family life have made the

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Publication Date
Sun Dec 06 2015
Journal Name
Baghdad Science Journal
Efficacy of some local isolates of Beauveria bassiana(Bals.) and Metarhizium anisopliae (Met.) in control of mosquito larvae of Culex quinquefasciatus (Say)
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The main aim of this study is to investigate the ability of four local entomopathogenic isolates Beauveria bassiana (Bals.) and Metarhizium anisopliae (Met.) to control the mosquito larvae in the lab. The results revealed that the isolate (MARD48) B .bassiana reduced the survival rate of the mosquito larvae to (80%) followed by the isolate M. anisopliae (MARD10) to (90%) in the first two days of treatment, and 60 and 66% respectively in the third day. The results also showed that the isolate B. bassiana (MARD48) killed 50% of the population (LC50) with the concentration 1×104 conidia/ml compared to 1×107 conidia/ml for the isolates B. bassiana (MARD14) and M. anisopliae (MARD10), and 1×108 conidia/ml for the isolate B .bassiana (MARD76).

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Publication Date
Mon Aug 15 2022
Journal Name
International Journal Of Science& Research Archive
Nonalcoholic fatty liver disease in a group of Iraqi obese children attending children welfare teaching hospital
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Nonalcoholic fatty liver disease in a group of Iraqi obese children attending children welfare teaching hospital

Publication Date
Sat Dec 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
The Impact of Breastfeeding Duration on the Development of Normal Occlusal Features of the Primary Dentition among Baghdad Preschool Children
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Background: Normal occlusal features of primary dentition are crucial for normal development of the permanent dentition. Breastfeeding is an important factor for both general and dental health of children. Aim: The aim of the present study is to assess the impact of the breastfeeding duration on the prevalence of normal occlusal features of the primary dentition among preschool children in Baghdad. Materials and Methods: The sample was 630 Iraqi children (270- boys, 360 girls), aged 3-5 years selected from four kindergartens in Baghdad city. The study was carried out through questionnaire and clinical examination. Normal occlusal features were examined as the presence or absence of interincisive spaces (IS) and primate spaces (PS), termi

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Risk Factors influencing Post-Partum Depression Severity in Iraqi Women
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Background: Post-partum depression (PPD) is a form of postnatal depression that affects mothers. Clinical manifestations usually appear within six months after delivery. Risk factors that influence the severity of post-partum depression are not fully known in the Iraqi population.
Objectives: We aim to evaluate the risk factors and identify potential predictors that may influence the symptom levels (severity) of post-partum depression among Iraqi women from Baghdad.
Subjects and Methods: The current study is cross-sectional, and we used the Edinburgh Postnatal Depression Scale (EPDS) and a cut-off value of 13 to differentiate patients into two those with lower symptom levels (LSL) and higher symptom levels (HSL). We also explored p

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Publication Date
Sun Jan 03 2010
Journal Name
Journal Of Educational And Psychological Researches
The non right behavior appearance for the kindergarten children and its relation with the kindergarten teaching style
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The kindergarten teacher play a role in fixing the children behavior so she must plant the value and the habits that make a positive behavior and accepted by the society so the teacher must know all the right educational psychological styles to fix the children behavior and make them accepted psychologically and socially so the problem of the research start from knowing the relation between the methods of dealing with the kindergarten’s teachers and the non right behavior appearance for the kindergarten children. The current research aims to measure the negative behavior appearance of the children of kindergarten and distinguish it according to (sex and levels) and to distinguish the most using styles by the teachers of kinderg

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