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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 18 2023
Journal Name
College Of Islamic Sciences
The battle of Dumat al-Jandal And its impact on the era of prophecy And the righteous caliphate
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The research in Islamic history is considered a title for the glory of the nation and a mirror for the intellectual and mental maturity of the men of the Islamic state who played an important role in saving humanity from darkness to light and from ignorance to knowledge and to show their position in building the Islamic state, and to highlight the importance of their conquests of neighboring cities and the expansion of Islam, and for this reason they appear The importance of writing on the topic (The Battle of Dumat al-Jandal and its impact on the era of the Prophethood and the Rightly Guided Caliphate). The reason for choosing this topic was to show the status of Dumat al-Jandal and its importance in the Islamic state and its great role

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Publication Date
Sun May 08 2011
Journal Name
Journal Of Planner And Development
The Effect of the Natural and Cultural Environments Factors on the Architectural and Planning Characteristics of Sulaymaniyah Mosques
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Most of the mosques in the Islamic world fall under specific and known forms and patterns to a large extent, and such patterns have grown and evolved from the few basic and uniform models, but they changed slowly due to the impact with a mixture of changing functional requirements and cultural landscapes because of the variables of time and place to form patterns known and famous in this day across parts of the Islamic world and its borders. There was no exception to these patterns, but small numbers of mosques that were probably the result of personal experiences or improvisational resolutions, or in response to specific or temporary stimuli. However, the emergence of a specific pattern which does not belong to any of these patt

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Publication Date
Fri Mar 07 2025
Journal Name
Jurnal Keperawatan Soedirman
THE EFFECTS OF MUSIC INTERVENTIONS ON CHILDREN'S PAIN SEVERITY AND ANXIETY DURING DRESSING CHANGES IN IRAQ: A RANDOMIZED CONTROLLED TRIAL
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Abstract Daily dressing changes cause distress and pain for victims of burn injuries. The study aimed to determine the effect of music in reducing the pain and anxiety of thermally burned children during routine dressing changes. This quantitative study employed a randomized controlled trial design. The participants comprised 80 children at the Specialized Burns Hospital, in Baghdad, Iraq who were divided into two groups. The intervention group were exposed to three generic musical pieces (children’s music, nature sounds, and classical music) for 10-15 minutes. The researchers used the Objective Pain Scale, State-Trait Anxiety Inventory, and physiological parameters to measure the children’s responses immediately before the dressing cha

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Publication Date
Thu Dec 31 2020
Journal Name
Political Sciences Journal
The Chinese Economy and its impact on international trade (Study on the role of the port of Gwadar)
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China's economic policy and its huge capabilities operate according to an expansion strategy, especially in investing foreign projects, as the past ten years have witnessed a major development in the elements of comprehensive strength, especially in the economic field, in 2014 China launched the largest initiative in the world, represented by the Belt and Road Project (BRI), which links nearly 70 countries, through this project, a very important region has emerged, which is (the port of cadres) in Pakistan, as China has headed towards that region and given the highest importance that is in its interest in the first place regardless of the great Pakistani interest, This is consistent with its future aspirations, especially after breaking

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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Assessing the Iraqi general budget in light of corruption and fluctuations in oil prices, and their repercussions on unemployment rates after 2003
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The researcher highlighted the general budget in Iraq for the period (2003-2018) facing the challenges of administrative and financial corruption, in addition to the fluctuations in oil prices, the repercussions and many problems suffered and will suffer the Iraqi government in the process of preparing the general budget of the state and weak contribution of the agricultural and industrial sectors and other economic sectors and neglect altogether, oil has become the main supplier in funding Iraq's budget after 2003, and the impact on the unemployment rates in Iraq, which recorded fluctuating rates and then increased during the period (2012-2018) to achieve this, an inductive method was adopted, using theoretical and descriptive a

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Engineering
Numerical and Experimental Investigations of the Effect of PVD and Vacuum Pressure on the Degree of Saturation
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    Soft clays are generally characterized by low shear strength, low permeability and high compressibility. An effective method to accelerate consolidation of such soils is to use vertical drains along with vacuum preloading to encourage radial flow of water.  In this research numerical modeling of prefabricated vertical drains with vacuum pressure was done to investigate the effect of using vertical drains together with vacuum pressure on the degree of saturation of fully and saturated-unsaturated soft soils.  Laboratory experiments were conducted by using a specially-designed large consolidometer cell where a central drain was installed and vacuum pressure was applied. All tests were conducted

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Publication Date
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Parents’ Knowledge about Nutritional Management of children with Phenylketonuria
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Abstract

Objective(s): to Evaluation of Parents’ Knowledge about Nutritional Management of kids with Phenylketonuria; to Identify the association between parents’ Knowledge about nutritional management then their demographic variables of fathers, mothers (parents age, residence then socioeconomic position).

Methodology: A non-experimental project; was accompanied on parents of phenylketonuria kid in Baghdad town since the period 3 June to 5 October 2022. A Non-probability sample (convenience) of 35 PKU children and their parents (father and mother) was selected Purposively from the hospitals that are select for the study. A survey is built for the purpose of the educa

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
The Effect of Ceramic Coating on Performance and Emission of Diesel Engine Operated on Diesel Fuel and Biodiesel Blends
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In this work, the effect of ceramic coating on performance, exhaust gas temperature and gases emissions of diesel engine operated on diesel fuel and biodiesel blends was investigated. A conventional four stroke, direct injected, single cylinder, diesel engine was tested at constant speed and at different load conditions using diesel fuel and biodiesel blends. The inlet and exhaust valves, the head of piston and cylinder head of the engine were coated by ceramic materials. Ceramic layers were made of (210-240) μm of Al2O3 and (30-60) μm of 4NiCr5Al as a bond coat for inlet and exhaust valves and (350-400) μm of YSZ and (50-100) μm of 4NiCr5Al as a bond coat for head of piston and (280-320) μm of Sic and (40-80) μm of 4NiCr5Al as a b

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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Traumatic Stress Disorders & Treatment
Randomised Controlled Study Comparing Two Psychological Therapies for Posttraumatic Stress Disorder (PTSD): Emotional Freedom Techniques (EFT) vs. Narrative Exposure Therapy (NET)
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Publication Date
Sat Aug 31 2024
Journal Name
Folia Medica
Dental plaque caries related microorganism in relation to demographic factors among a group of Iraqi children
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Introduction: Streptococcus mutans and lactobacilli are most important bacteria in the pathogenesis of dental caries. Cariogenic microflora has been associated to the primary caregiver transmission and sugary diets.

Aim: This study aimed to relate S. mutans and lactobacilli in the plaque to demographic factors in Iraqi children.

Materials and methods: The study included 135 children aged 3-10 years. Samples of their dental plaque were taken from the upper second primary molars on the buccal surfaces using a clean toothpick. Each sample was stored in 1 ml of n

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