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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
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
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
Wed Oct 28 2020
Journal Name
International Journal Of Agricultural And Statistical Sciences 16
Effect of nano-fertilizers and amino acids on the growth and yield of broccoli
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Publication Date
Sun Sep 01 2019
Journal Name
Journal Of Engineering And Applied Sciences
The role of e-Government on corruption and its impact on the financial performance of the government: An empirical analysis on the Iraqi government
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This study aimed to provide a conceptual model for the use and benefits of the e-Government as related to administrative fraud and financial corruption. The study also looked into their concepts, forms, dimensions and types and the role of e-Government on fraud reduction, corruption in administration and finance and its impact on the government performance. From the result, it is revealed that there is need for electronic government for implementation in order to curb the rate of fraud and administrative and financial corruption and improve the quality of service provision for better performance

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Publication Date
Fri Jan 01 2016
Journal Name
International Journal Of Advanced Research
ON STABILITY AND THE BOUNDEDNESS OF THE ZERO SOLUTION OF FIFTH ORDER
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This paper is illustrates the sufficient conditions of the uniformly asymptotically stable and the bounded of the zero solution of fifth order nonlinear differential equation with a variable delay τ(t)

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
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
Fri Aug 25 2023
Journal Name
Enterprenuership Journal For Finance And Bussiness
Argumentative Accounting conservatism and the performance of institutions listed on the Iraq Stock Exchange in light of the Coronavirus pandemic
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This study aims to test whether the institutions listed on the Iraq Stock Exchange have a significant correlation between the level of conservative accounting practice with the level of market share returns during the Coronavirus pandemic period as one of the policies to confront the economic repercussions of the Coronavirus pandemic. Furthermore, the sample included institutions listed on the Iraq Stock Exchange during the 2019 and 2020 years, i.e., the period before the Coronavirus pandemic and during the Coronavirus pandemic for the purpose of comparison. The market value to book value model was used, and the study found that conservative institutions had achieved the highest level of market share prices compared to non-conservat

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
Die Wirkungen der Nachkriegsliteraur Die Kurzgeschichte " Das Brot" von Wolfgang Borchert als Beispiel Eine analytische Studie The effect of post-war literature / short story ( The Bread )
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Die Zusammenfassung :

In der  Forschung „ Die Wirkungen der  Nachkriegliteratur „ findet man einen Überblick über die Wirkungen der Literatur im Allgemeinen und besonders über die Wirkungen der Nachkriegliteratur in Deutschland. Das Kurzgeschichte „ das Brot“ von Wolfgang Borchert „  wird in dieser Forschung als Beispiel analysiuert, weil sie die Nachteile des Kriegs und ihre Wirkungen auf die Familienbeziehungen behandelt. Die Hauptfiguren der Kurzgeschichte sind ein alter Mann und seine Frau. Der Schriftsteller bestimmt die Rolle der Frauen in Deutschland. Die Frau in dieser Geschichte ist stärker als ihren Mann , denn er war lügner und schwach.

Post-war Literature has an e

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Publication Date
Sat Jun 19 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Serum Chitotriosidase level as a Novel Biomarker for Therapeutic Monitoring of Nephropathic Cystinosis among the Iraqi children
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Background: Cystinosis is a rare autosomal recessive lysosomal storage disease with high morbidity and mortality. It is caused by mutations in the CTNS gene that encodes the cystine transporter, cystinosin, which leads to lysosomal cystine accumulation. It is the major cause of inherited Fanconi syndrome, and should be suspected in young children with failure to thrive and signs of renal proximal tubular damage. The diagnosis can be missed in infants, because not all signs of renal Fanconi syndrome are present during the first months of life. Elevated white blood cell cystine content is the cornerstone of the diagnosis. Since chitotriosidase (CHIT1 or chitinase-1) is mainly produced by activated macrophages both in normal and inflammator

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