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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
Fri Jun 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The tax planning and its effect on the investment: On sample of Iraqi Contribution Company
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The importance of the current study  lies in the  importance of the  Tax policy that  being considered one of the most important tools working on fulfilling  the  social,  financial  and economic  goals  and improving  the investment environment  in the country  to become  having the ability to  activate the  national economy. The current study  has  referred  that  (  Has  the  tax planning  practiced by  the Iraqi  contribution  companies  led to increase  the  far-term tax  outcome through  getting  benefit of   the monetary  funds  and expansion in&nbs

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Publication Date
Wed Jul 01 2015
Journal Name
Political Sciences Journal
Article The reality of the settlements in the occupied West Bank, and its impact on the future of the Palestinian state
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الخلاصة

تتناول هذه الورقة مخططات وسياسات الاستيطان في الضفة الغربية والقدس الشرقية منذ العام 1967، عبر سياسات قادها حزب العمل وأكملها حزب الليكود وكاديما وبقية الأحزاب الإسرائيلية، تلك السياسات التي استهدفت فرض السيطرة السياسية الكاملة على الأرض، وما نتج عن ذلك من سيطرة حصرية على الأرضوتقييد استخداماتها، ومحاصرة الوجود الفلسطيني والتضييق عليه، وتحويل مراكز ال

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Publication Date
Thu Mar 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
The Study of Oral Findings, Oxidative Stress and Antioxidant Vitamin E in Serum and Saliva of Crohn's Patients on Azathioprine Monotherapy and those on Combination of Anti-TNF-α Plus Azathioprine
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Background: Crohn's disease (CD) is an immunological disorder associated with chronic inflammatory process of several unspecific regions of gastrointestinal tract but frequently detected in the terminal Ilium and proximal colon or both. This disease frequently presented with various oral manifestations as a consequence of inflammatory process of the disease, nutritional deficiency or medications side effects. Several therapeutic approaches have been developed for CD management that are targeting the inflammatory process and directed at controlling the host immune response. Immunosuppressants such as Azathioprine and anti-TNF α agents as well as the combination of them have been widely used as an effective therapeutic modality with a bett

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Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The Relationship Between The Internal Marketing and Quality Services : a Filed Study on Samples of Customers and Employees In Iraqi Commercial Banks
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Abstract

The Paper highlights on one of the main activities in marketing management. That is the internal marketing in the commercial banks and its relationship with the quality services offered to satisfy customers needs and wishes in order to reach he ultimate objectives of those banks. Two state and five private banks in Basrah city (Iraq) were taken in a field study. The survey covered the opinions of (184) state bank employees and (158) clients . The analysis of the survey shows that there is a strong relationship between the internal marketing ( in the banks covered by the survey) and the quality of banking objective services and the private banks show greater interest and concern to the internal ma

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Publication Date
Mon Dec 31 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
THE EFFECT OF ALCOHOLIC EXTRACT OF Borage officinalis ON MONOAMINE OXIDASE (MAO) AND ACETYLCHOLINESTERASE (AChE) IN HUMAN SERUM IN VITRO.: THE EFFECT OF ALCOHOLIC EXTRACT OF Borage officinalis ON MONOAMINE OXIDASE (MAO) AND ACETYLCHOLINESTERASE (AChE) IN HUMAN SERUM IN VITRO.
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This study was designed to show the inhibitory effect of different concentrations of alcoholic extract of Borage officinalis on the Monoamine oxidase (MAO) and Acetylcholinesterase (AChE) enzymes in human serum. The results obtained from the study exhibited that alcoholic extract of Borage officinalis caused inhibition to enzymes activity with all concentrations of the extract. The results also showed that when the concentration of the extract was (0.001 mg/ml), the percentage of inhibition was (4.3% with MAO and 15.2% with AChE) and this percentage increases until reaching up to (74.7% with MAO and 84.18% with AChE) when the concentration of the extract was (0.1 mg/ml). From the kinetic parameters, studies found that alcoholic extract o

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Publication Date
Thu Mar 30 2017
Journal Name
Journal Of Biotechnology Research Center
Study the Effects of Methotrexate with and without Vitamin A on Some Biochemical and Histological Parameters in Male Rabbits
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The present study aims to evaluate the effects of methotrexate (MTX) with and without vitamin A (Vit. A) on some biochemical parameters and histological structure in male rabbits liver. Twenty male rabbits weighing 1250-1480 gm were divided into four equal number groups. The first group was given 2 ml distilled water as control group. The second group was given MTX (20 mg/kg), the third group was given Vit. A (5000 IU), while the fourth group was given MTX (20 mg/kg) +Vit. A (5000 IU) in alternative days. Following four weeks of treatment, lipid profile total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), [low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL)]; in addition to thyroid hormones tr

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Publication Date
Thu Sep 15 2022
Journal Name
Alustath Journal For Human And Social Sciences
The Impact of Mind and Informational Strategy on the ‎Achievement of the Second Intermediate Students in the Grammar ‎of Arabic Language
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The aim of the current research is to recognizing the impact of mind and informational strategy on the achievement with the second intermediate students in the grammar of arabic language, the researcher used a partial-set experimental design and intentionally selected a sample out of the second intermediate class from (AL- Markazya Intermediate school) in the district of Hilla, affiliated which belongs to General Directorate of Babylon Education in the year (2020-2021) for applying the experiment. The sample was composed of (50) students, (25) ones for each group, the experimental group and normal one. The researcher balanced between the two groups in various changes including: (the chronological age counted by months, the academic achie

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Publication Date
Sat Oct 30 2021
Journal Name
Iraqi Journal Of Science
The Effects of Conductance on Metastable Switches in Memristive Devices Based on Anti-Hebbian and Hebbian (AHaH) Learning Rules
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     In the last few years, the literature conferred a great interest in studying the feasibility of using memristive devices for computing. Memristive devices are important in structure, dynamics, as well as functionalities of artificial neural networks (ANNs) because of their resemblance to biological learning in synapses and neurons regarding switching characteristics of their resistance. Memristive architecture consists of a number of metastable switches (MSSs). Although the literature covered a variety of memristive applications for general purpose computations, the effect of low or high conductance of each MSS was unclear. This paper focuses on finding a potential criterion to calculate the conductance of each MMS rather t

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Nonlinear Analysis And Applications
Rock facies classification and its effect on the estimation of original oil in place based on petrophysical properties data
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The most significant function in oil exploration is determining the reservoir facies, which are based mostly on the primary features of rocks. Porosity, water saturation, and shale volume as well as sonic log and Bulk density are the types of input data utilized in Interactive Petrophysics software to compute rock facies. These data are used to create 15 clusters and four groups of rock facies. Furthermore, the accurate matching between core and well-log data is established by the neural network technique. In the current study, to evaluate the applicability of the cluster analysis approach, the result of rock facies from 29 wells derived from cluster analysis were utilized to redistribute the petrophysical properties for six units of Mishri

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Zankoy Sulaimani - Part A
A Comparison Study on the Formation of Administrative and Leadership Policies for the Team and Individual Olympic Games in the Iraqi National Olympic Committee
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The planning for the formation of administrative policies and guidance through leadership are important things for managing administrative processes and sporting activities. As both contribute in the stability of the administrative conditions, and their development in the sport federations, whether they both were attentive about team and individual Olympic Games. The two researchers observe that, there is a variation in the correct way of application. Particularly in the formulation of administrative policies and leadership describing it as, modern management standards for both team and individual Olympic Games in the Iraqi National Olympic Committee. That led to cause a misconception and lack of clarity for some administrators of those uni

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