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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 May 01 2025
Journal Name
The Scientific World Journal
Investigating the Influence of Ellipticity on the Purcell and Quality Factors in Planar–Elliptical Bragg Mirrors
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High‐quality factor Q  and elliptical cross‐section microcavity of small size are described. We present a numerical investigation of the performance of the elliptical microcavity. We design elliptical microcavities to control the emission rate of dipolar emitters and investigate how the ellipticity factor influences the Purcell and Q ‐factors. We demonstrate an enhancement of up to 16 × 10 3 in the Purcell factor for TiO 2 ‐based mirrors and 8 × 10

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
The effect of Allium sativum and Capsicum spp. Watery extracts on the Entamoeba histolytica in vitro.
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In vitro tests have been carried out to find out the efficacy of watery extracts of garlic Allium sativum and hot pepper Capsicum spp. against the trophozoites of Entamoeba histolytica cultivated in liver infusion agar media at 37 c . The doses of ( 0.01, 0.05 ,0.1, 0.5, 1 ml )of garlic and hot pepper watery extracts were added to certain number of E. histolotica trophozoits for exposure time of 24 hrs., the mortality percentage of trophozoites treated with garlic extract were ( 14.82 %, 31.05% ,46.16% , 64.29% , 92.7%) respectively , these percentages were very close to that obtained from the treatment with the hot peper extract which were (17.86%, 32% , 44% ,66.67% ,100%) respectively . Generally these results showed that the ga

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Publication Date
Wed Aug 08 2012
Journal Name
Arabian Journal Of Geosciences
Chemical and physical control processes on the development of caves in the Injana Formation, Central Iraq
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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Adopting IPSASs and its impact on the quality of financial reporting and performance evaluation in Iraqi government units
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Abstract

     Performance evaluation is of great importance in all countries of the world, because it has a prominent and effective role in determining the efficiency and effectiveness of the optimal use of available resources, which are rare and important in achieving the desired objectives. With the continued growth of public spending and the limited resources, the State seeks to achieve its objectives through its units with minimal expenditure or deficit, rationality and wastefulness in the spending. In many countries, particularly developing countries, reforms are made in the public sector to achieve that goal through the adoption of IPSAS, which is reflected in the developmen

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Publication Date
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Macton's Method for Developing Non-Linguistic Cognitive Sensory Skills for Autistic Spectrum Children
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The present study aimed at identifying the effectiveness of Macaton method in improving some sensory and cognitive skills in autistic children. In order to achieve the aims of the study, the researcher used the experimental method. The present study sample was (10) children whose ages ranged between (7-10) years and were diagnosed medically with autism disorder. The researcher randomly selected the sample and divided it into two groups: the first group consisted of (5) children representing the experimental group, and (5) children representing the control group after extracting the equivalence between the two groups in terms of age, intelligence, economic and social level and the degree of communication. The program was implemented for t

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Publication Date
Mon Jan 16 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation Nurses Practice about Care of Children with Febrile Convulsion
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Abstract

Objective(s): To evaluate the nurses` practices for children who diagnosed with febrile convulsion.

Methodology: A quantitative research, descriptive correlational design was used in this study, the study conducted on nurses who work in Al-Diwaniya Pediatrics Teaching Hospital-Iraq for Maternal and Children period from 12th September 2021 to 10th October 2022. A non- probability (convenience) sample has been applied to obtain the study goals. The study sample was (21) nurses who participate in the study. The study tool is composed of two parts: The first part is concerned with collection of nurses socio-demographic data obta

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Publication Date
Sat Nov 03 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Incidence of Seasonal Diarrhea among Children at Child's Central Hospital
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Objective: Diarrhea is a symptom of a variety of conditions may attack the child. It considered one of
mam causes of mortality rates especially in low socio- economic level countries. The child can be
easily got dehydration and pass from loss of too much body fluid and due to the Common thoueht of
increasing the incidence of diarrhea during summer season, this study is done to find out the relation
between the high incidences rate of diarrhea and weather variation
Methodology: This survey conducted in AL- Markazi Child's Teaching Hospital for the year 2005 the
data were gathered from hospital records for the period (January - December) and age groups
taxonomy used by hospital applied. Descriptive statistical analysis

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Publication Date
Sun Jun 27 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Quality of Nursing Care Services Provided to Children under Five Years Based on Integrated Management of Child Health at Primary Health Care Centers in Baquba City
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Objective(s): The study aims to evaluating the quality of nursing care provided to children under five years to compare between quality related to type of health sectors; to determine the quality of nursing care and to compare between such care in Baquba Health Care Sector I and II.

Methodology: A descriptive study is carried out for the period from December 15th 2019 to May 1st 2020. A purposive "non- probability" sample, of (60) staff nurse and (60) children is selected. An adopted questionnaire has been selected for the study which consists of three parts. The first part is nurses’ socio-demographic characteristic; the second part is ch

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Publication Date
Thu Dec 31 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Premiums and compensations and their impact on the financial solvency of insurance companies: applied research in the Iraqi General Insurance Company
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The collected premiums and the compensations paid are among the main variables that have a prominent role in determining the level of financial solvency of insurance companies, as the higher the financial solvency of the insurance company, the more attractive it is to the target audience to acquire the company's insurance services.

Hence the importance of the issue of the solvency of insurance companies, as it is one of the critical matters on which the effectiveness of the insurance company and its continuation in the labor market depend.

In this research, we try to clarify the role of collected premiums and compensations paid in determining the level of operational solvency of t

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Renzulli Model on Achievement and Holistic Thinking among Fifth Grade Students in the Holy Quran and Islamic Education
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The present study aims at identifying the effect of Renzulli model on achievement and holistic thinking among the fifth grade students in the Holy Quran and Islamic Education. The experimental method with partial control was used, and the sample was chosen randomly. The sample consisted of (62) students distributed into experimental and control groups. 164 behavioral goals were formulated based on Bloom's first three levels taxonomy (knowledge and comprehension, application, analysis and installation, and evaluation). The researchers designed a post-test to measure the achievement of students in the subject of Holy Quran and Islamic Education which consisted of (40) objective items and a measure of holistic thinking which consisted of (3

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