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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 Dec 07 2018
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Phytochemical Investigation of Corchorus olitorius L. Leaves Cultivated in Iraq and it’s In Vitro Antiviral Activity
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The aim of our study was to investigate the antiviral activity of the Corchorus olitorius family Tiliaceae cultivated in Iraq against measles virus, and to demonstrate an overview about chemical constituents and pharmacological activity of Corchorus olitorius L.

About150 gm Leaves of Corchorus. olitorius were defatted by maceration in hexane for 24 hrs. The defatted plant materials were subjected for extraction after filtration using Soxhlet apparatus, with aqueous methanol 85% as a solvent extraction for 24 hours, the extract was filtered, and the solvent was evaporated under reduced pressure using a rotary evaporator to get a dry extract of about 12 gm. About 4 gm from the residue was suspended in 100

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Publication Date
Wed Jan 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
Volumetric assessment of maxillary sinus in cleft lip and palate patients in comparison to normal subjects
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Publication Date
Thu Jul 20 2023
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Measurement of Radon Concentration in Drink and Well Water Samples for Selected Regions in Baghdad City
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 The concentration of radon gas in the samples for drinking water and wells in the same place from selected homes in which wells were built in the Hay-al-Bayaa region of Baghdad was measured, by using a CR-39 nuclear track detector. It turns out that the maximum value of the concentration of radon in drinking water was 3.83 Bq/L, and the lowest was 2.30 Bq/L. As for the estimation of radon gas concentration in well water samples, the highest value was 5.6 Bq/L, while the lowest one was 3.1 Bq/L. In order to assess the committed effective dose received by the public due to the inhalation of radon gas. The highest value of the annual effective dose in drinking water was recorded in Al-Bayaa region, which is equal to 14.30 μSv/y, while th

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Publication Date
Sun Jan 01 2023
Journal Name
Iraqi Journal Of Hematology
Evaluation of angiopoietin-2 level in patients with multiple myeloma at presentation and in remission state
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The study aimed to assess the level of ANG‑2 in MM patients at diagnosis and in remission state and elaborate on its correlation with interleukin‑6 (IL‑6) and beta‑2 microglobulin (B2M) levels. Sixty MM patients; 20 newly diagnosed (ND), and 40 patients in remission were included. Twenty healthy individuals were included as a control group. Plasma levels of ANG‑2, B2M, and IL‑6 were tested by enzyme‑lin ked immunosorbent assay. There are significant statistical differences between ND patients and those in remission in hemoglobin, neutrophil count, blood urea, serum creatinine, glomerular filtration rate, B2M, IL6, and ANG‑2 (P = 0.001, 0.033, 0.005, 0.001, 0.001, 0.001, 0.004, and 0.001, respectively). ANG‑2 showed signifi

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Publication Date
Sun Jun 30 2019
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Effect of Microwave Treatment in Graphite Anode for Microbial Fuel Cell and Its Application in Biosensor
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The electrode in the microbial fuel cell has a significant effect on cell performance. The treatment of the electrode is a crucial step to make the electrode surface more habitable for bacteria growth, thus, increases the power production as well as waste treatment. In the current study, two graphite electrodes were treated by a microwave. The first electrode was treated with 100W microwave energy, while the second one was treated with 600W microwave energy. There is a significant enhancement in the surface of the graphite anode after the pretreatment process. The results show an increase in the power density from 10 mW/m2 to 15 mW/m2 with 100w treatment and to 13.47 mW/m2 with 600w treatment. An organic

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Publication Date
Wed Jan 01 2020
Journal Name
Plant Archives
An analysis for adoption of subsurface irrigation technology and its role in agricultural development in Iraq
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Publication Date
Mon Jun 26 2023
Journal Name
International Conference On Scientific Research & Innovation (icsri 2022)
Age and gender profile of coronavirus disease 2019 (COVID 19) in Quarantine Center in Baghdad, Iraq
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Sun Jan 01 2023
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8th Engineering And 2nd International Conference For College Of Engineering – University Of Baghdad: Coec8-2021 Proceedings
Prediction of pore and fracture pressure using well logs in Mishrif reservoir in an Iraqi oilfield
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Publication Date
Sun Jul 29 2018
Journal Name
Iraqi Journal Of Science
Evaluation of Natural Radioactivity in Granite and Marble used as Flooring Materials in Baghdad Province/ Iraq
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Twenty four  samples of  various granites and marble used common as flooring materials were collected from many factories and market in Baghdad Province, Iraq. Natural radioactivity of 226Ra, 232Th and 40K in the samples was measured by using high purity germanium detectors with an efficiency of 40%. The Specific activity concentration in granite samples ranged from 9.20 to 79.64 Bq/kg, 10.50 to 229.40 Bq/kg and 185.30 to 1391.20 Bq/kg for 226Ra, 232Th and 40K, respectively. The estimated  of radiological parameters: radium equivalent activity (Req), activity concentration Index (I) and hazard indices (internal (Hin) and External (H

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Publication Date
Wed Apr 19 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Separation and Determination of Poly Aromatic Hydrocarbons in Vegetables Samples in Baghdad City Using HPLC Technique
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The Reversed  Phase High Performance Liquid  Chromatography (RP-HPLC) has been used for the separation of  Poly aromatic hydrocarbons(PAHs) by using column Reprosil 100 C 18 which  was found to be a suitable one for this purpose. The result showed that using mobile phase of (Acetonitrile-water) Reversed Phase HPLC , flow rate  of (1.2 ml/min) , column temperature (30CËš) and wave length of (254nm), give a complete separation with a good resolution . The total separation time was less than 20 min. The result of the study showed that the vegetables of Baghdad city were   polluted by poly aromatic hydrocarbons(PAHs) in different places where samples taken because of drainage  of the heavy water ,ind

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