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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
Tue Jan 03 2023
Journal Name
College Of Islamic Sciences
The position of the Jews on divinity, lordship, names and attributes
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Judaism followed the approach of monotheism after God Almighty sent Moses (peace be upon him) to convey to them the messages of their Lord, so that they might be on a right guidance and path, but the people did not follow that path.” Love of matter and faith in what is witnessed, so they portrayed the Lord in several images in line with what their souls drew upon them.

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
On The Convergence Speediness of K * and D-Iterations
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Abstract<p>In this article, we introduced a new concept of mappings called δZA - Quasi contractive mapping and we study the K*- iteration process for approximation of fixed points, and we proved that this iteration process is faster than the existing leading iteration processes like Noor iteration process, CR -iteration process, SP and Karahan Two- step iteration process for 𝛿𝒵𝒜 − quasi contraction mappings. We supported our analytic proof by a numerical example.</p>
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Publication Date
Sun Jun 03 2012
Journal Name
Baghdad Science Journal
Study the effect of the mixture aquatic extract of Peganum harmala seeds and Pericarp of Punica granutum on viability of protoscolices of Echinococcus granulosus in vitro and in vivo
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This study included the preparation of the mixture aquatic extracts of Peganum harmala seeds and Pericarp of Punica granutum at concentration (10+50) ?(15+55)? (20+60) mgml .To study the influence of the mixture on the percentage of vitality of the protoscolices of E. granulosus In vitro, as the vitality of protoscolices had caused complete death when the using concentration at time 120,90,60 minute respectively. Also study the effect of mixture in white mice with infectious protoscolices In vivo and study the change occurred in the averages of the weights of the liver and spleen and the averages of its distension In vivo in processed group with mixture at concentration (15+55) , (10+50)mgml ,as which was approach to the negative gro

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Publication Date
Mon May 08 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
The Effect of Variety , Gibberellic Acid And NPK Fertilizer and their Interactions On Absorption and Transport Rates of Some Macronutrient Elements in Chamomile plant
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This experiment was carried out in the field of botanical garden which belongs to Biologi
Department , College of Education (Ibn Al-Haitham), University of Baghdad during the
growing season 2009-2010.The experiment was designed to study the effect 5 concentrations
of Gibberellic acid(GA3)( 25,50,75,100and125mg.L
-1
) and 2 levels of NPK (17:17:17)
fertilizer (200 and 400 Kg.ha
-1
) and their interaction on the rates of absorption and transport
of some macronutrient elements in two varieties of chamomile plant ( Local variety ,
Matricaria chamomilla L. and German variety , Matricaria recutitia L.) . Randomized
Complete Block Design (RCBD) was used with 3 replicates for each treatment .Control plants

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Publication Date
Sun Mar 19 2023
Journal Name
Nasaq Journal
The impact of the Roundhouse strategy on the achievement of the fifth grade secondary school in physics and their pivotal thinking
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The aim of the research is to study the effect of the roundhouse strategy on the achievement of fifth grade secondary school in physics and their pivotal thinking. The experiment has been applied for obtaining the data, which were processed statistically using the Statistical Package for Social Sciences, the results revealed that the students of the experimental group who studied using the roundhouse strategy was superior to the students of the control group who studied in the traditional method in the achievement exam. The results also show that there are statistically significant differences between the mean scores of the students of the experimental group and the control group in the pivotal thinking exam, in favor of the experimental gr

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of The College Of Education For Women
The Impact of Anticyclones Merge on the Temperature in the stations of Mosul, Baghdad and Basra for the Period (2005-2015)
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           The Anticyclone Merge affects Iraq’s climate clearly through its impact on the different climatic elements. where it appears while they pass through special and distinctive weather . and most of this affection appears in temperatures, Therefore, this research study the relationship between the repetition and the survival period of the Anticyclone Merge and temperature average by using coefficient correlation (Pearson) that shows there’s strong inverse relationship between the integration of Anticyclones and temperatures average.                        &nbs

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Publication Date
Tue Jan 07 2020
Journal Name
Xi,an University Of Architecture &technology
The Effect of Jigsaw strategy on Academic Achievement and Engagement in Learning among the 3rd male graders students in Chemistry
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The research aims to identify the effect of jigsaw strategy in learning achievement and engaging for the third grade intermediate students in chemistry. The research sample consisted of (61) students distributed in two experimental and control groups. The research tools consisted in the achievement test and the measure of engaging learning. The results showed that there are statistically significant differences at the level of (α = 0.05) between the experimental group and the control group in both the achievement test and the measure of learning involvement for the benefit of the experimental group. In this light, the researcher recommended the use of jigsaw strategy for teaching the subject matter. Lamia because of its impact in raising

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Publication Date
Wed May 05 2021
Journal Name
Mustansiriyah Journal Of Sports Science
The Effect of Parachute Exercises and Cloud Pockets in the Water Ocean on Some Special Physical Abilities and the Achievement of 50-Meter Swimming for Youth
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ولاء طارق حميد, Mustansiriyah Journal of Sports Science, 2021

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
Strategic Information Systems and their effects on the Developing of Intellectual Capital in the Electricity Distribution Company in the Hashemite Kingdom of Jordan
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This research aims to study the impact of strategic information systems on the development of intellectual capital in the Public Shareholding Electricity Distribution Company in the Hashemite Kingdom of Jordan. To achieve the objectives of the study, a questionnaire was developed for the purpose of data collection, as the number of valid questionnaires for analysis was about (135), and SPSS and AMOS 0.26 software was used to analyze the collected data. The study found out that the respondents' perceptions of the level of importance of strategic information systems and the level of importance of intellectual capital were high, and that the relational capital has ranked as first, followed by structural capital, and h

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Publication Date
Sun Mar 30 2003
Journal Name
College Of Islamic Sciences
Scientific interpretation of the Holy Qur’an and its impact on belief and thought
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Praise be to God, Lord of the Worlds, and prayers and peace be upon the Master of Messengers, Muhammad and his family

The good and pure and after his companions

God Almighty said: ( ) Do they not contemplate the Qur’an? If it had been from other than God, they would have found in it much discrepancy. God Almighty has made the well-being of people and their lives linked to faith in it. So what is the need of people today to return to the Book of their Lord so that they may return to the right path that God intended for His servants so that they may attain sustenance? Security and the good life. How could it not be, when many of the nations of the world no longer see security or stability because their leaders and politic

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