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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
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
Sun Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Analytical study on the implications of the GATS Agreement and its implications on the Egyptian banking sector
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International trade in services is becoming increasingly important as it is an economic activity that deals with invisible trade, which has become increasingly important in the balance of international trade. The establishment of the WTO is a starting point in international trade relations. It is responsible for all aspects of international trade, , And in view of the continued increase in international trade in services, the need for more internationally recognized rules has become more urgent, especially as it has been increasingly proven that the traditional framework of public services is inadequate to operate some of the most dynamic and innovative sectors of the economy. (GATS) to be the regulatory framework for this sector

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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of the Interaction between the Use of the Improve Strategy in Teaching Mathematics and Achievement Levels on the Acquisition of Algebraic Concepts and Habits of Mind among Tenth Grade Students in Oman
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The current study aims to investigate the effect of the interaction between the use of the improve strategy in teaching mathematics and the level of academic achievement on the acquisition of algebraic concepts and habits of mind among tenth-grade students in Oman. The study adopted the experimental method, based on a quasi-experimental design with two groups: experimental and control groups and pre-post-measurement. The study sample consisted of (28) 10th-grade students as an experimental group and 26 of 10th-grade students as a control group in Al-Tufail bin Amr School in South Al Batinah. The differences in the pretest and posttest gains were analyzed using mean, standard deviation, ANCOVA, t-test, effect size (eta-square), and two-wa

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Publication Date
Sat Dec 28 2024
Journal Name
Journal Of Physical Education
The effect of rehabilitation exercises with body weight and rubber resistance on the range of motion and the strength of the sprained ankle muscles in female rugby players
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The study aimed to prepare a set of qualifying exercises to improve the muscular strength of the muscles surrounding the ankle joint by applying different resistances according to the nature of the movement of this joint, which is one of the second moving joints (flexion, extension and rotation of the right and left) in order to increase the efficiency of all muscles working on this joint according to those movements and identification On the impact of these exercises and assume that there will be statistical differences between the two tests of the research sample. The researcher used the semi-articulated experimental method with a pre- and post-test for one group. The injury was evaluated on the women's national team players durin

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Publication Date
Sun Apr 30 2023
Journal Name
Al-kindy College Medical Journal
Persistent Intraocular Pressure Elevation after Silicon Oil Removal in Patients with Post-Pars Plana Vitrectomy: IOP Level After SO Removal
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Background: It is well-known that silicon oil (SO) injection into the vitreous cavity after pars plana vitrectomy is usually associated with high intraocular pressure.

Objectives: To determine the influence of silicon oil (SO) removal on IOP level after pars plana vitrectomy for spontaneous rhegmatogenous retinal detachment (RRD)

Subjects and Methods: A prospective study was conducted at Ibn Al-Haitham eye teaching hospital, Baghdad- Iraq. Intraocular pressure (IOP) was measured pre and post SO removal in patients who have underwent retinal detachment surgery with SO injection of 1000 centistokes (cSt) viscosity. Baseline IOP was measured for all the patient before the SO

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Publication Date
Mon Jun 28 2021
Journal Name
Journal Of Physical Education
The Effect of Electronic Apparatus on Developing Balance in National Center for Gifted in Boxing and Basketball
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The problem of the research lies in special motor abilities training programs like the balance that positively affect coordination between the nervous system and muscles. These training programs did not get enough attention from athletes especially young athletes; their training was restricted to physical abilities like strength, speed, and endurance instead. The research aimed at designing an apparatus for developing athletes’ balance in national centers for gifted/ ministry of youth and sport so as to provide a measurement for coached in this field. The results showed that the designed apparatus have a positive effect on developing the subjects’ balance in boxing and basketball athletes.

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Crossref
Publication Date
Mon Jun 05 2023
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Knowledge Upgrading on Business Continuity:A Field Research in Private Colleges and Universities in Baghdad
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The research aims to study the effect of knowledge upgrade on business continuity in private colleges and universities in Baghdad. The research problem is summarized in the main question (were the academic leaders able to employ knowledge upgrading to enhance business continuity). The most important of this sector were the universities and the private college in the city of Baghdad as a field for this research, the researchers conducted a field visit to (10) universities or private colleges, the research sample consisted of (177) individuals from the deans of colleges and their assistants, as well as heads of scientific and administrative departments. The data was analyzed and the hypotheses were tested using the appropriate statistical

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Crossref
Publication Date
Thu Mar 30 2006
Journal Name
College Of Islamic Sciences
The novel of the innovator and its impact on the differences of jurists
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Praise be to God, Lord of the worlds, and prayers and peace be upon our master and beloved Muhammad, the wise guide and great teacher, the guide to a straight path, the one sent as a mercy to the worlds, and upon his good and chosen family, his chosen companions, the working scholars, and those who follow them in righteousness until the Day of Judgment.

And after:

One of the important controversial topics shared between the sciences of the Noble Hadith and the Fundamentals of God is the issue of the innovator in terms of accepting and rejecting his narration and testimony, and the difference in it leads to disagreement in many branches of jurisprudence that were based on texts narrated by innovated narrators or those accu

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Publication Date
Tue Feb 17 2026
Journal Name
Journal Of Studies And Researches Of Sport Education
The effectiveness of the use of yoga exercises and its impact on the reactions of the two Alvesologih nervous and respiratory systems in the correction of antenna pistol shooting accuracy
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Publication Date
Fri Mar 31 2023
Journal Name
Oncology And Radiotherapy
The Effect of Green Low Laser (LLL) on the white blood cells on platelet on people on brain and prostate cancer
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The effect of Low-Level Laser (LLL) provided by green semiconductor laser with an emission wavelength of 532 nm on of human blood of people with brain and prostate cancer has been investigated. The effect of LLL on white blood cell (WBC), NEUT, LYMPH and MONO have been considered. Platelet count (PLT) has also been considered in this work. 2 ml of blood sample were irradiating by a green laser of the dose of 4.8 J/cm2. The results suggest a potential effect of LLL on WBC, PLT, NEUT, LYMPH, and MONO of people with brain and prostate cancer Key words: white blood cell , platelet , low-level laser therapy