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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
Thu Oct 20 2022
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Evaluation of Insulin Resistance and Glutathione-S-transferase in Iraqi Patients with Type 2 Diabetes Mellitus and Diabetic Peripheral Neuropathy
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Diabetes mellitus type 2 (T2DM) is a metabolic disorder that influences above 450 million individuals around the world. Type 2 diabetes is a lack of insulin due to pancreatic β-cell malfunction and insulin resistance. This study aimed to detect insulin resistance using homeostasis model assessment (HOMA IR) and determined the correlation with glutathione-s-transferase (GST) activity in T2DM and neuropathy patients as a predictor of oxidative stress, which occurs when the oxidation-antioxidant equilibrium is disrupted. Reactive oxygen species causes vascular injury and a series of inflammation. In the present study, the results show there is no significant difference in diabetic patients (DM) and neuropathy patients (NU) versus healthy p

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Publication Date
Sun Jan 20 2019
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Study of IL-33 and IL-1R4 in Iraqi Rheumatoid Arthritis Female Patient's with and without Dyslipidemia Prone to Atherosclerosis
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   This study is planned to find relationship between interleukin-33 (IL-33) with its receptor interleukin-1 receptor 4 (IL-1R4), and assurance IL-33/IL-1R4 proportion as biomarker to atherosclerosisin rheumatoid arthritis (RA) Iraqi females patients with and without dyslipidemia. This study was attempted at Baghdad Teaching Hospital included 60 females patients with RA that were isolated into: 30 patients with dyslipidemia(G2), 30 patients without dyslipidemia(G3) and 30 individual as control group (G1) .Patients were experiencing treatment by methortexiene medication, analyzed by rheumatoid factor(RF) and erythrocyte sedimentation rate( ESR) tests. All patients and control groups age ranged from (30-55) years. The results sho

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Publication Date
Mon Jan 01 2024
Journal Name
Revista Brasileira De Saúde Materno Infantil
Misoprostol and mid trimester termination of pregnancy in patients with two previous scars and more at Elwiya Maternity Teaching Hospital
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Abstract Objectives: to determine efficiency and safety of three misoprostol regimens for 2nd trimester pregnancy termination in individuals with two or more cesarean section scars. Methods: a cross-sectional study included 100 pregnant ladies at 13th-26th weeks gestation with previous two cesarean sections (CSs) who were scheduled for pregnancy termination using misoprostol. Patients were conveniently assigned to 100µg/3h, 200µg/3h or 400 µg/3h regimens. Primary outcome was time to abortion, secondary outcomes were side effect and complications. Results: a significant association was found between number previous CSs and longer time to abortion (p=0.01). A highly significant association was identified between earlier gestatio

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Publication Date
Mon Mar 15 2021
Journal Name
Al-academy
Anthropology and Representations of Magic in Arab Theatrical Text Harut and Marut's Play as a Model: وصال خلفة كاظم البكري
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The research (Anthropology and Representations of magic in Arab Theatrical Text, Harut and Marut's play as a Model) is concerned with studying magic and the forms of its presence in the theatrical text in different human cultures where it belongs. The research consists of four chapters.
The first chapter includes the research problem that revolves around the following questions: (what is the mechanism of employing magic anthropology and its representations in the Arab theatrical text Harut and Marut's play as a model?), and the research importance which is attributed to the necessity of studying (magic) in the Arab theatrical text as it is considered the inauguration of one of the social phenomena that many researchers in the field o

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Publication Date
Sun Jan 12 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Shear bond strength of endodontic sealers to dentin with and without smear layer and gutta percha (An in vitro study)
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Background: The bond strength of root canal sealers to dentin and gutta-percha seems to be an important property for maintaining the stability of root canal filling, which potentially influences both leakage and root strength. The objective of this, in vitro, study was to evaluate the shear bond strength of three different endodontic sealers (Gutta-Flow, AH Plus, Apexit Plus) to dentin, in the presence and absence of the smear layer and gutta percha. Material and Methods: After slicing off the occlusal 2mm of 60 extracted human maxillary premolar teeth, the exposed dentin served as the tested surfaces; the teeth were fixed with cold cure acrylic, and were divided into two groups according to the smear layer presence, group A without smear

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Publication Date
Sun Apr 30 2023
Journal Name
Al-kindy College Medical Journal
Prevalence of Burnout Syndrome and its Association with Job Title and Violence among Physicians in Baghdad: A Triangulated Methodology Study
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Background: Economic Globalization affects work condition by increasing work stress. Chronic work stress ended with burnout syndrome. Objectives: To estimate the prevalence of burnout syndrome and the association of job title, and violence with it among physicians in Baghdad, and to assess the burnout syndrome at patient and work levels by structured interviews. Subjects and Methods: A cross section study was conducted on Physicians in Baghdad. Sampling was a multistage, stratified sampling to control the confounders in the design phase. A mixed qualitative and quantitative approach (triangulation) was used. Quantitative method used self-administered questionnaires of Maslach Burn out Inventory. Qualitative approach used an open-end

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Publication Date
Sun Jun 30 2019
Journal Name
Journal Of Engineering
Numerical Study of Fluid Flow and Heat Transfer Characteristics in Solid and Perforated Finned Heat Sinks Utilizing a Piezoelectric Fan
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Numerical study is adapted to combine between piezoelectric fan as a turbulent air flow generator and perforated finned heat sinks. A single piezoelectric fan with different tip amplitudes placed eccentrically at the duct entrance. The problem of solid and perforated finned heat sinks is solved and analyzed numerically by using Ansys 17.2 fluent, and solving three dimensional energy and Navier–Stokes equations that set with RNG based k−ε scalable wall function turbulent model. Finite volume algorithm is used to solve both phases of solid and fluid. Calculations are done for three values of piezoelectric fan amplitudes 25 mm, 30 mm, and 40 mm, respectively. Results of this numerical study are compared with previous b

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Publication Date
Sun Mar 31 2024
Journal Name
Iraqi Geological Journal
Permeability Prediction and Facies Distribution for Yamama Reservoir in Faihaa Oil Field: Role of Machine Learning and Cluster Analysis Approach
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Empirical and statistical methodologies have been established to acquire accurate permeability identification and reservoir characterization, based on the rock type and reservoir performance. The identification of rock facies is usually done by either using core analysis to visually interpret lithofacies or indirectly based on well-log data. The use of well-log data for traditional facies prediction is characterized by uncertainties and can be time-consuming, particularly when working with large datasets. Thus, Machine Learning can be used to predict patterns more efficiently when applied to large data. Taking into account the electrofacies distribution, this work was conducted to predict permeability for the four wells, FH1, FH2, F

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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of The College Of Languages (jcl)
Innovative approaches to the development of the lexical composition of the oil and gas industry : Инновационные подходы развития лексического состава нефтегазовой промышленности
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 The present study discusses one of the most relevant and required topics in the recent period during globalization, the modern Russian system of terms for the oil and gas industry as a whole acquired a complete form in the second half of the twentieth century. The period of the late XX - early XXI centuries. marked by cardinal transformations in all areas of the political, economic, social and cultural life of Russia. These changes could not but affect industrial production. Transition to a new vector of development of the Russian economy based on the development of commercial trade, on the change and improvement of the development of industrial enterprises in the context of the implementation of national projects and the introduction

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Publication Date
Sat Feb 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
The rationing system effect on seepage from the cement-treated gypsum canals
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Abstract<p>The shortage of irrigation water requires specific measures. One of these measures is the application of the rationing system (a period of irrigation followed by a period of drought). This system could have an effect on the behavior and properties of irrigation canals. So, studying rationing system on the irrigation canals is important both in civil engineering and water resources engineering, especially if these channels constructed with gypsum soil. This study includes the calculation of seepage velocity and water content in each cycle (10 days wetting and 10 days of drying). The model is built for this research contains four samples, two samples for untreated soil one of them expos</p> ... Show More
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