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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 Jun 29 2017
Journal Name
College Of Islamic Sciences
Opinions of Abu Bakr Muhammad bin Al-Fadl Al-Bukhari Al-Hanafi (d. 381 AH): In acts of worship: the books of fasting and Hajj
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In The Name of Allah Most Gracious Most Merciful

Scholars, past and present, have paid attention to the books of Fasting and Hajj, and they have compiled literature on that, and they have written treatises and researches. The best days, and as for the pilgrimage, it is one of the great pillars of Islam, which God Almighty has distinguished by making its rituals in the best of places, which is the Sacred House of God.

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Publication Date
Fri Dec 08 2023
Journal Name
Iraqi Journal Of Science
Evaluation of the activity of crude alkaloids extracts of Zingiber officinale Roscoe, Thymus vulgaris L. and Acacia arabica L. as coagulant agent in lab mice.
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As Alkaloids known for their pharmaceutical importance; this research included the extraction of crude alkaloids of three plants (Zingiber officinale Roscoe., Thymus vulgaris L. and Acacia arabica L.) and evaluate their activity as coagulant agent by using three degraded concentrations of each plant extract and tested them on lab mice through the observation of the variations in bleeding time (BT), clotting time (CT) and platelet count. The results revealed differences in the percentage of alkaloids in the plants under the study; Z. officinale extract was the higher one followed by T. vulgaris and A. arabica respectively. Z. officinale extract was also the most effective plant as coagulant factor than other two plants as it decreased bot

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Publication Date
Thu Sep 15 2022
Journal Name
Alustath Journal For Human And Social Sciences
The Effectiveness of Counseling on Using the Technique of ‎Positive Self-talk to Develop the Habits of Mind Among Secondary ‎School Students
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This research aims to identify the effectiveness of counseling by using the technique of self-talkin developing the habits of mind among middle school students by testing important hypotheses, and choosing the experimental design for the two groups (experimental - control). The classification of "Costa & Kallick" was adopted to measure the habits of the mind, and the scale consisted of (64) items, and after confirming the psychometric properties of the scale, the researcher applied it to the research sample (487) students from middle school students. One of the students who got the lowest marks after answering the scale. purpose of applying the experiment. He divided them into two groups, one of them is experimental (10) students, as

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Publication Date
Wed Jul 02 2008
Journal Name
Iraqi Journal Of Science
Petrology, geochemistry and tectonic environment of the Shalair Metamorphhic Rock Group and Kater Rash Volcanic Group, Shalair Valley area, Northeastern Iraq
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Publication Date
Sun Sep 03 2017
Journal Name
Baghdad Science Journal
Kinetic and Mechanistic Studies for the Gas-phase Reaction of Ozone with 2, 3-Dimethyl-2-Butene and 1, 3-Butadiene
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The reactions of ozone with 2,3-Dimethyl-2-Butene (CH3)2C=C(CH3)2 and 1,3-Butadiene CH2=CHCH=CH2 have been investigated under atmospheric conditions at 298±3K in air using both relative and absolute rate techniques, and the measured rate coefficients are found to be in good agreement in both techniques used. The obtained results show the addition of ozone to the double bond in these compounds and how it acts as function of the methyl group substituent situated on the double bond. The yields of all the main products have been determined using FTIR and GC-FID and the product studies of these reactions establish a very good idea for the decomposition pathways for the primary formed compounds (ozonides) and give a good information for the effe

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Publication Date
Sat Feb 01 2025
Journal Name
Journal Of The College Of Basic Education
The effectiveness of upward training with weights to develop explosive power and speed and some functional variables for young volleyball players
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The effectiveness of upward training with weights to develop explosive power, characterized by speed and some functional variables for young volleyball players Many efforts of sports laboratories in various countries have been devoted to laying scientific foundations and rules in caring for the physical, skilled, planning, and psychological preparation of players and creating the conditions and requirements for reaching players to higher standards. The research aims to:1- Preparing an ascending training program with weights to develop explosive strength, which is characterized by speed and some functional variables for volleyball players.2- Identify the effect of the training program with upward training in weights to develop explosive stre

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Publication Date
Sat Sep 30 2023
Journal Name
Iraqi Journal Of Science
Studying the Optical and Structural Properties of Cadmium Oxide Thin Films Prepared by Successive Ionic Layer Adsorption and Reaction (SILAR) Technique
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     Cadmium oxide CdO thin films were prepared by successive ionic layer adsorption and reaction (SILAR) technique at varying number of dippings. The CdO thin films were prepared from a source material of Cadmium acetate and ammonium hydroxide solution deposited on glass substrate at 95℃.    The prepared thin films were investigated by X-ray diffraction (XRD), Atomic force microscopy (AFM), Scanning Electron Microscopy (SEM), Fourier Transform Infrared (FTIR), and UV-Visible spectrometry. The XRD analysis reveals that the films were polycrystalline with cubic structure having preferential orientation along (1 1 1), (2 0 0), (2 2 0), and (3 1 1) planes. While the tests of the scanning electron microscopy and the atomic force mic

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Publication Date
Mon May 22 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Univariate and Simplex Optimization for the Spectrophotometric Determination of Cimetidine and Erythromycin ethylsuccinate Drugs Using Bromothymol Blue Via Ion-Pair Formation
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    The ion-pair formation method has been applied for the spectrophotometric determination of Cimetidine and Erythromycin ethylsuccinate, in bulk samples and in dosage form. The methods are accurate, simple, rapid, inexpensive and sensitive depending on the extraction of the formed ion-pair with brompthymol blue (BTB) as a chromogenic reagent in chloroform, use phthalate buffer of pH 5.5 and 4.0 for Cimetidine and Erythromycin ethylsuccinate respectively.  The formed complexes show absorbance maxima at 427.5 nm and 414.5 nm for Cimetidine and Erythromycin ethylsuccinate respectively against reagent blank. The calibration graphs are linear in the ranges of 0.5-15 µg.mL-1 with detection limit of 0.222 µg.mL-1 for

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Publication Date
Fri Nov 01 2019
Journal Name
Recent Technologies In Sustainable Materials Engineering
A Comparative Study Between the Individual, Dual and Triple Addition of (S.F.), (T.G.P.) and (P.V.A.) for Improving Local Gypsum (Juss) Properties
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Publication Date
Fri Feb 26 2021
Journal Name
Iraqi Journal Of Science
Studying the Physicochemical Properties and Isolation of Unsaturated Fatty Acids from Edible Oils by GC-MS and Argentated Silica Gel Chromatography
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The core objective of this study was to investigate the physicochemical characteristics and fatty acid composition of the oils of sunflower, olive, virgin coconut and ginger oils, as well as the separation of their unsaturated fatty acids. The data indicated a significant variation in physicochemical properties (acid, saponification, ester, and iodine values) among oils. Transesterification process was carried out at a molar ratio of 1:7:0.1 of oil: methanol: KOH. Fatty acid methyl esters of oils were analyzed by infrared (IR) and gas chromatography–mass (GC-MS) spectrometry. Twelve fatty acids were identified, where the major fatty acid of  olive oil was found to be  oleic acid (89%), whereas those of sunflower and ging

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