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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 Dec 01 2002
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
PREDATION BY THE MITE MACROCHELES GLABER (MÜLLER) (ACARINA: MACROCHELIDAE) ON THE HOUSE FLY MUSCA DOMESTICA L. WITH SOME NOTES ON ITS BIOLOGY
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Macrocheles glaber (Müller) is one of several mites that feeds on eggs, newly hatched &
small larvae of house fly Musca domestica L. This mite was reared in the laboratory on house
fly frozen eggs at constant conditions of 28°C±1 and 90% relative humidity using sterilized
horse dung substrate. The predation rate of adult female and male on frozen eggs was (18, 3)
eggs/mite/day respectively, the number of frozen eggs destroyed by adult female through its
life was 185.6 eggs.
The mean duration of adult female from egg to adult stage was 2.67 days, the longevity of
female was 27.8 days, the mean daily egg production was 2.7 egg with total egg productivity
of 72.1 egg.

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Publication Date
Mon Jan 13 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Diagnosis and localization of the maxillary impacted canines by using dental multi-slice computed tomography 3D view and reconstructed panoramic 2D view
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Background: Diagnosis and treatment planning can be difficult with conventional radiographic methods as the orthodontic-surgical management of impacted canines requires accurate diagnosis and precise localization of the impacted canine and the surrounding structures. This study was aimed to localize and evaluate weather there is any differences in the diagnostic information provided by multi-slice computed tomography three dimensional volumetric CT images and two dimensional reconstructed panorama images (derived from CT) in subjects with impacted maxillary canines. Materials and Methods: Thirty patients including 24 female and 6 male with mean age of 18 years with suspected unilaterally or bilaterally impacted maxillary canines were evalu

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Publication Date
Tue Mar 01 2016
Journal Name
Journal Of Pharmaceutical Sciences
Development and Evaluation of Biodegradable Particles Coloaded With Antigen and the Toll-Like Receptor Agonist, Pentaerythritol Lipid A, as a Cancer Vaccine
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Publication Date
Thu Nov 02 2023
Journal Name
Journal Of Engineering
Improving Voltage Stability in Kurdistan Power System in Areas with Deficit Power Production by Rescheduling the Active Power Based on PSS/E Simulation
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This paper aims to improve the voltage profile using the Static Synchronous Compensator (STATCOM) in the power system in the Kurdistan Region for all weak buses. Power System Simulation studied it for Engineers (PSS\E) software version 33.0 to apply the Newton-Raphson (NR) method. All bus voltages were recorded and compared with the Kurdistan region grid index (0.95≤V ≤1.05), simulating the power system and finding the optimal size and suitable location of Static Synchronous Compensator (STATCOM)for bus voltage improvement at the weakest buses. It shows that Soran and New Koya substations are the best placement for adding STATCOM with the sizes 20 MVAR and 40 MVAR. After adding STATCOM with the sizes [20MVAR and 40MV

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Publication Date
Sat Dec 31 2022
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
PREPARATION AND STUDY OF THE PHYSICAL PROPERTIES OF SOME COMPLEXES WITH SCHIFF BASE LIGAND FOR CEFDINIR DERIVATIVE : PREPARATION AND STUDY OF THE PHYSICAL PROPERTIES OF SOME COMPLEXES WITH SCHIFF BASE LIGAND FOR CEFDINIR DERIVATIVE
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Metal (II) complexes of Co, Ni, Cu and Zn with cefdinir C14H13N5O5S2 derivative (L) were synthesized and identification by elemental analysis CHNS Uv-Vis, FTIR, TGA, metal analysis AA, magnetic susceptibility and conduct metric measurement. by analysis the ligand behaves as a bidentate. For the cobalt complex, Tetrahedral geometry shape was suggested, while other complexes that have nickel, copper and zinc ions were proposed as octahedral geometry shape. The experimental method was studied for prevention of corrosion carbon steel in 3.5% NaCl by using a novel Cefdinir derivations drugs. The results showed that metal complex was a strong corro

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Publication Date
Thu Oct 29 2020
Journal Name
Toxicological Research
Liver functions in combined models of the gentamicin induced nephrotoxicity and metabolic syndrome induced by high fat or fructose diets: a comparative study
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Publication Date
Wed Mar 27 2019
Journal Name
Iraqi Journal Of Science
Application of Source Parameter Imaging (SPI) Technique to Gravity and Magnetic Data to Estimate the Basement Depth in Diyala Area, Eastern Central Iraq
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The Bouguer gravity and magnetic RTP data were used to detect the depth of basement rocks in middle and south Diyala Province, east Iraq. The depth of the basement rocks was calculated by using the Source Parameter Imaging (SPI) method. New attempt is achieved to applied the SPI technique to the gravity values to estimate the depth of basement rocks. The depths of basement map derived from gravity data range 8-14 km, the depth of basement map derived from magnetic data range 9-13.5 km and the basement depth prepared by C.G.G, 1974 range 9-11 km. The derived maps from SPI method and that prepared by C.G.G, 1974 show good matching in the distribution of the depths of the study area. This study showed that basement’s depth range from

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Publication Date
Sun Mar 03 2013
Journal Name
Baghdad Science Journal
Sedimentological and diagenetic study of the Early Middle Miocene Jeribe Limestone Formation in selected wells from Iraq northern oilfields (Ajil; Hamrin; Jadid; Khashab)
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Five subsurface sections covering the entire length of the Jeribe Limestone Formation (Early Middle Miocene) were studied from four oilfields in northern Iraq. It is hoped to unravel this formation microfacies ; depositional environment; diagenetic attributes and their parental processes; and the relationship between these processes and the observed porosity patterns. The microfacies were found to include mudstone, wackestone, packstone, and grainstone, which have been deposited respectively in open platform, restricted platform, and edge platform which represent the lagoonal environment, while the deposits of the lower parts of the Jeribe formation especially in well Hamrin- 2 reflect a deeper fore slope environment. By using the lithofac

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Publication Date
Sat Oct 01 2022
Journal Name
Baghdad Science Journal
Using Pomegranate Peel Extract to Change the Adverse Effect of Ethephon by Enhancing its Antioxidant, Anti-inflammatory, and Anti-apoptotic Effects in Rats
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Organophosphorus insecticide and growth regulator namely Ethephon (2-chloroethylphosphonic acid) are widely used as a ripening process accelerator and a cultivation duration inhibitor. Pomegranate extract (PPE) has recently been taken into consideration due to its pharmacological effects especially those associated with renal diseases. Thus, this study aims to investigate the possible protective effect of PPE against ethephon-induced nephrotoxicity in rats. In this study four groups of adult male rats were divided into control group, PPE 400 mg/kg group, Ethephon 250 mg/kg group, and finally, PPE + Ethephon group (treated with the same dose of PPE group and Ethephon group). In the current study, kidney function parameters (KIM-1, creatin

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Publication Date
Sat Oct 01 2022
Journal Name
Baghdad Science Journal
The Role of Serum Chitinase-3-Like 1 Protein (YKL-40) Level and its Correlation with Proinflammatory Cytokine in Patients with Rheumatoid Arthritis
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Chitinase-3-like 1 protein (YKL-40) is a glycoprotein primarily produced in the arthritic joint and plays a crucial role in inflammatory processes. The aim of the study is to establish the role of YKL-40 as a biomarker for rheumatoid arthritis (RA) compared to proinflammatory biomarkers and disease activity. The study included 58 patients and 18 control. Diseases activity score (DAS-28) and clinical disease activity index (CDAI) were measured. Serum level of YKL-40, tumor necrosis factor-α (TNF-α), interleukin-1B (IL-1β), erythrocyte sedimentation (ESR), rheumatoid factor (RF), C-reactive protein (CRP), and anti-citrullinated protein antibody (ACPA) were assessed. The results showed that the median serum YKL-40 level which was 5.42 

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