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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
Mon Jan 29 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Role of Ultrasound in Antenatal Detection of Echogenic Amniotic Fluid and Pregnancy Outcome
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Background: Ultrasound is a valuable tool for evaluating fetal problems throughout pregnancy. Amniotic fluid anomalies have been associated with unfavorable maternal, fetal, and obstetrical outcomes. Objective: To determine the effect of echogenic amniotic fluid during term pregnancy on the presence of meconium stain liquor and pregnancy outcome. Methods: A cross-sectional study was conducted on 1080 term pregnant women who visited Al-Elwiya Maternity Teaching Hospital from May 1st, 2021, to May 1st, 2023. Ultrasound was used to analyze echogenic amniotic fluid and turbid liquor. The liquor state was tested either after an artificial membrane rupture in the vaginal delivery trial or during a cesarean section. Results: Echogenic amni

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Publication Date
Tue Oct 22 2024
Journal Name
Hemoglobin
Prevalence and Molecular Characterization of β-Thalassemia in Kirkuk Province of Northern Iraq
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Publication Date
Sat Apr 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Effect of Nano and Mineral NPK in Vegetative Growth Parameter of Pear Saplings
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Abstract<p>An experiment during the two seasons 2019, 2020. The experiment conducted according to Split Plot Design by two factors; the first was addition Nano NPK with five levels (control, addition 7.5 g.plant<sup>-1</sup>, addition 15 g.plant<sup>-1</sup>, spray 1 g.L<sup>-1</sup>, spray 2 g.L<sup>-1</sup>). The second factor was four levels of Mineral NPK which were (control, 50 g.plant<sup>-1</sup>, 100 g.plant<sup>-1</sup>, 50 g.plant<sup>-1</sup>+1.5 g.L<sup>-1</sup>) respectively. N<sub>3</sub> (spray 1 g.L<sup>-1</sup> ) increased plant height, stem diameter first season, branch number se</p> ... Show More
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Publication Date
Thu Sep 15 2022
Journal Name
Bionatura
Submission and Phylogenetical of Local Isolated Trichophyton interdigitale of Iraqi Patients in NCBI
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Dermatophytes are species with slight genetic variation, and are yet several uncertainties about the differences among species. This study aims to isolate and diagnose the Trichophyton interdigitale by molecular technique and to reveal the phylogenetic distance and similarity of the Iraqi isolates to other isolates from the globe, in addition, to submit the obtained sequences to the NCBI database. This study included 86 with multiple lesions on different parts of the body. The results showed different variations within the ITS gene between the isolates. It was concluded that Trichophyton interdigitale in Iraqi isolates had two types of substitution variations (Transition and Transversion) different than global isolates. Moreover, it

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Publication Date
Thu May 04 2023
Journal Name
Journal Of Communicable Diseases
Enhancement of Swarming and Inhibition of Prodigiosin in Serratia marcescens by Glyceryl Trinitrate
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Introduction:Serratia marcescens is a gram-negative pathogen of many species. Its pathogenicity and survival are linked to its capacity to build biofilms as well as its strong inherent resistance to antimicrobials and cleaning agents. Objectives: To analyse the impact of glyceryl trinitrate (GTN) on the gene expression of QS-related genes (rssB, rsmA,and pigP) of S. marcescens. Methodology: The broth microdilution technique estimated the bactericidal effectiveness of glyceryl trinitrate. The presence of rssB, rsmA,and pigP in S. marcescens isolates was detected using PCR. qRT-PCR was used to assess the effect of GTN on rssB, rsmA,and pigPgene expression. Results: The results demonstrated that GTN has no effect on S. marcesce

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Publication Date
Sat Dec 01 2012
Journal Name
Al Mustansiriyah Journal Of Pharmaceutical Sciences
Formulation and In Vitro Evaluation of Mucoadhesive Antimicrobial Vaginal Tablets of Ciprofloxacin Hydrochloride
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Ciprofloxacin is a broad spectrum fluoroquinolone, effective in the treatment of a wide range of infections, including genitourinary tract infections.In this study, bioadhesive vaginal tablets of ciprofloxacin hydrochloride were prepared by direct compression method using a combination of bioadhesivepolymers carbopol 934P(Cp), carboxymethylcellulose (CMC) and sodium alginate (SA) in different ratios.The prepared tablet formulations were characterized by measuring their swelling capacity, surface pH, bioadhesive properties, and in-vitro drug dissolution. It was found that the bioadhesive force was directly proportional to carbopol 934P content in different formulae and was further enhanced by the inclusion of carboxymethylcellulose.

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Publication Date
Mon Mar 15 2021
Journal Name
Al-academy
Manifestations of Selfhood and Otherness in Indian Schools of Photography: رشا اكرم موسى
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The current research addressed (the manifestations of selfhood and otherness in Indian schools of photography) through studying the concept of selfhood and otherness and their manifestations in Indian miniatures scenes for the period (1625-1790). The researcher, in the first chapter, sought to clarify the research problem, importance, and the need for it, in addition to the objective of the study represented by the following: "how did selfhood and otherness manifest in the Indian schools of photography?". The researcher, then, concluded the aforementioned chapter by defining the terms that have direct relation to the title and the objectives of the research. As for the second chapter, it consists of an overview for the theoretical framew

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Publication Date
Sun Mar 13 2011
Journal Name
Baghdad Science Journal
Use of Coliphages as an indicators of enteroviruses and faecal pollution in Water
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In spite of increasing clinical cases which caused by enteroviruses transferred by water and no documents about entericviruses in the Iraqi water standards. The use of coliphages as an indicator of enteroviruses and fecal pollution were suggested two procedures were applied . The first is Two-Step Enrichment Method and the second is Single Agar Layer Method. Both methods gives good results in Identification of coliphages through testing fifty different water samples (Tap water, Surface water and Bottled water) the study shows the presence of coliphages in fourteen samples.

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Publication Date
Wed Feb 01 2023
Journal Name
Baghdad Science Journal
Accumulation of Heavy Metals in Agricultural Crops and Ecological Series of Crops Placement
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The accumulation of toxic elements in vegetables and melons grown in agriculture, Brassica rapa - turnip, Solanum lycopersicum - tomato, Citrullus lanatus - watermelon, Capsicum annuum - bell pepper, Daucus carota - carrots, Cucurbita pepo - pumpkin, Cucumis melo - melon, and also Prunus armeniaca - apricot from fruit trees were analyzed. The excess of maximum allowable concentrations in agricultural crops of the element As by 1.65-1.75, Cd - 1.6-2.3, Cr -1.2-2.35, Cu -1.6-3.3, Ni - 1.16-3.53, Pb - 1.54-3.08, Al - 1.36-3.5, Sb - 2.0-33, Se - 1.1-3.3 times was established. The maximum allowable concentration of mercury in vegetables and melons was equal to 0.02 mg/kg,

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Publication Date
Mon Jan 01 2018
Journal Name
Asian Journal Of Chemistry
Levels and Distribution of Trace Metals in Surface Soils of Al-Diwaniya, Iraq
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In this work, monitoring of monthly variation (from May 2016 to October 2016) in the concentration of the metals (Co, Zn, Cd, Pb, Ni and Fe) from Al-Diwaniya city of Iraq. Investigation about the pollution with these metals was achieved from five selected sites locate in study area by flame atomic absorption spectroscopy. The results showed a wide variation in the levels of heavy metals from site to site and from month to month. A total of 180 surface soil samples were analyzed to detecting the pollution with selected samples. The resultsshowed that the highest concentration with Ni was 6.290 mg kg-1 while the lowest concentration detected with Ni was 0.080 mg kg-1. The results of pollution index (enrichment factor, contamination factor, po

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