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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
Wed Jan 04 2023
Journal Name
College Of Islamic Sciences
Predicting the financial distress of companies using logistic regression and its impact on earnings per share in companies listed on the Iraqi Stock Exchange: Predicting the financial distress of companies using logistic regression and its impact on earnings per share in companies listed on the Iraqi Stock Exchange
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Abstract

The prevention of bankruptcy not only prolongs the economic life of the company and increases its financial performance, but also helps to improve the general economic well-being of the country. Therefore, forecasting the financial shortfall can affect various factors and affect different aspects of the company, including dividends. In this regard, this study examines the prediction of the financial deficit of companies that use the logistic regression method and its impact on the earnings per share of companies listed on the Iraqi Stock Exchange. The time period of the research is from 2015 to 2020, where 33 companies that were accepted in the Iraqi Stock Exchange were selected as a sample, and the res

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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of the Self-Questioning Strategy on the Achievement of the Fourth Grade and Their Reflective Thinking in Physics
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Abstract

The aim of the research is to identify the effect of using the self-questioning strategy on the achievement of fourth-grade students in science and the development of their reflective thinking in physics in the city of Baghdad. The research sample was divided into two groups: an experimental group of (20) students and a control group of (20) students. The researchers developed two tools: a test of (40) multiple-choice questions. The second tool is a test to measure the reflective thinking skills of fourth-grade students. It consists of (25) multiple-choice questions distributed on skills as follow: reflection and observation, detection of inaccuracies, reaching conclusions, giving clear explanations, an

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Publication Date
Wed Aug 03 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the currency sale window in the stability of the dinar exchange rate and its reflection on inflation
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The: currency Auction is one of the monetary policy tools created after 2003, in order to keep pace with the changes that the monetary and financial policies will witness from financial openness and expectations of high levels of liquidity after international economic restrictions. It is necessary to re-evaluate the work of the currency Auction from time to time and observation its efficiency in adjustment the exchange rate And its reflection on the general level of prices as one of the objectives of its inception, and during the analytical aspect, it was confirmed that the currency Auction for selling the currency had a major role in adjustment the exchange rate and controlling inflation levels, due to the market’s dependence

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Publication Date
Thu Feb 01 2018
Journal Name
European Journal Of Internal Medicine
On the use of substandard medicines in hematology: An emerging concern in the Middle East and North Africa region
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Publication Date
Tue Oct 01 2024
Journal Name
Results In Engineering
Nanomaterials in asphalt cement: exploring their single and combined effects on the physical and rheological properties
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Publication Date
Thu Jan 13 2022
Journal Name
Journal Of Water And Land Development
A study of the climate and human impact on the future survival of the Al-Sannya marsh in Iraq
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Polish Academy of Sciences

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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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Publication Date
Fri Aug 26 2022
Journal Name
Journal Of Research In Medical And Dental Science
Evaluation of Some Salivary Characteristics in Relation to Dental Caries among Children with Beta-Thalassemia Major
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Publication Date
Fri Jan 01 2016
Journal Name
The Journal Of The College Of Basic Education
Polymorphism of IL-4 -590 (C>T) gene in Iraqi children with Type 1 Diabetes Mellitus
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This study included 50 blood serum samples that collected from children with age ranged between 7-12 years. Thirty five samples collected from children with Type 1 Diabetes Mellitus (T1D), and 15 blood serum samples collected from healthy children as a control sample. The polymorphism of IL-4 -590 (C>T) gene, which amplified by using amplification refractory mutation system (ARMS-PCR) was showed high percentage of C allele frequency in T1D patients sample in comparison with T allele frequency, and the C allele revealed as etiological faction with risk by having T1D disease, whereas the T allele showed high frequency from the C allele frequency in control sample, and the T allele revealed as preventive faction from infection by this disease.

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Publication Date
Wed Oct 22 2025
Journal Name
Journal Of Composites And Biodegradable Polymers
Experimental Behavior of One-Way RC Ultra-Thin Slabs Retrofitted with Post-Installed NSM CFRP Rods
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This study evaluates the flexural behavior of ultra-thin (50 mm) one‑way reinforced‑concrete (RC) slabs retrofitted with near‑surface mounted (NSM) carbon‑fiber‑reinforced polymer (CFRP) rods under quasi‑static loading. T300‑grade CFRP rods (≈4 mm diameter) were bonded in pre‑cut 7 mm × 7 mm grooves using a two‑part epoxy. As a proof-of-concept experimental baseline, three simply‑supported specimens (1000 mm × 500 mm × 50 mm) were tested in a six‑point bending configuration (four applied loads + two reactions): two conventional controls and one strengthened slab. A load‑control rate of ~15 kN/min was applied; the controls were cycled twice and the strengthened slab four times. Relative to the average of

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