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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 01 2024
Journal Name
Journal Of Research In Pharmacy
Preparation and in-vitro evaluation of Carbopol hydrogel of clobetasol-loaded ethylcellulose microsponges
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: Clobetasol propionate (CP) is a potent corticosteroid used for skin conditions but often causes side effects due its systemic absorption. To improve its solubility and reduce it side effects (like skin irritation, skin atrophy, hypopigmentation and steroidal acne), Microsponge (Msg) has been employed as a unique three-dimensional particle that can encapsulate hydrophilic and lipophilic drugs. This study aims to develop and evaluate CP Msg-loaded hydrogels. Two Clobetasol-loaded ethylcellulose-based Msg formulas were prepared using the quasi-emulsion solvent diffusion method, then they were incorporated into Carbopol hydrogel. Two ratios of Carbopol 940 (1% and 1.5% w/w) were used. The prepared hydrogel were assessed for appearance, pH, dr

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Publication Date
Wed Mar 15 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Effect of Adding NPKZn Fertilizer in Growth and Yield of (Vigna raditia L.)
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Experiment was conducted using clay pots at botanical garden of Department of Biology/ College of Education for Pure Science / Ibn –AL- Haitham, University of Baghdad during the growth season of (2013-2014).The experiment aimed to study the effect of NPK Zn fertilizer in (15-15-15-1)% with the levels 0.2, 0.4, 0.6 grams per five kilograms soil based on (80, 120, 240 kg per Hectare)in some of morphological characters and yield of Vigna radiatia. The results showed a significant increase in plant height, dry weight, biological yield, economic yield, weight of 100 seeds, harvest index, absolute growth rate (AGR) were all increased and amount of output compared with control plants.

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Publication Date
Sun Jan 30 2022
Journal Name
Iraqi Journal Of Science
Classification and Measurement of Land Cover of Wildfires in Australia Using Remote Sensing
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Publication Date
Sun Jun 30 2013
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Kinetic Study and Simulation of Oleic Acid Esterification in Different Type of Reactors
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Publication Date
Wed Apr 05 2023
Journal Name
Journal Of Agriculture And Crops
Distribution and Classification of Medicinal Plants in Zakhikhah Area of Al-Anbar Desert
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This study included the Zakhikhah area in the Al- Anbar desert, which it bounded on the north, east, and west by the Euphrates River and on the south by the Ramadi-Qaim road. Several exploratory field trips were taken to the study area. During this time, a semi-detailed area survey was carried out based on satellite imagery captured by American Land sat-7, topographic maps, and natural vegetation variance. All necessary field tools, including a digital camera and GPS device, were brought to determine the soil type and collect plant samples. All of these visits are planned to cover the entire state of Zakhikhah. All vegetation cover observations, identifying sampling sites and attempting to inventory and collect medicinal plants in t

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Publication Date
Wed Aug 30 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
The Space-Charge Effect on Theoretical Design of the Electron Gun Operated under Finite Magnification Condition
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A computer theoretical s1udy has been carried out in field of opto - clcctroniccs, to design  an electron  gun using the space charge effect.

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Publication Date
Fri Apr 01 2022
Journal Name
Baghdad Science Journal
Study the Efficiency of Two Concentrations from Algae Cladophora glomerata Extract on the Giardia lamblia parasite
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Giardia lamblia parasite was isolated from the diarrhea samples of patients with Giardiasis dysentery and was developed in HSP media, four mice groups have been used to find in vivo efficacy of two concentrations (128,256) mg/ml of chlorophorm extracts from Cladophora glomerata algae against Giardia lamblia parasite  as compared with (Flagyl) by measuring several biochemical markers as ( GPT and GOT) enzymes ,sodium ,potassium and iron concentration as well as counting the number of parasitic cysts in each mice groups. The results demonstrate that levels of GPTA GOT enzymes have been decreased in mice treated with algal extract. As for the concentration of the Sodium, Potassium and Iron increased in mice treat

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Publication Date
Tue Mar 01 2011
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of differentiation strategy on achieve competitive advantage: survey comparison between the companies maintenance service
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Publication Date
Fri Sep 30 2022
Journal Name
Iraqi Journal Of Science
A Deep Study on the Performance of the Spatial Density Distribution Method to Recognize Handwritten Signatures
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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The impact of strategic leadership skills on effective environmental management according to the (VUCA Prime) model
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Purpose: clarify the integrative relationship of strategic leadership skills and effective management and the role of those skills combined or individually in achieving effective management.

Research design: The researchers used the quantitative method by surveying a class sample from the heads of the executive departments in a group of Iraqi private banks, consisting of (106) individuals according to the (VUCA Prime) methodology for effective management and the ten skills model for Johansen. The questionnaire was analyzed using a model of the structural equation.

Findings: The most prominent results of the research were the presence of a weak ro

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