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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
Sat Dec 30 2023
Journal Name
Journal Of The College Of Education For Women
Deception in Amber Heard and Johnny Depp’s Trials
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Deception is defined as a linguistic and non-linguistic behavior that is used in interaction in order to make the addressees believe what is believed to be false or lack evidence. McCornack (1992) classifies deception into four manipulative strategies (i.e., fabrication, distortion, equivocation and concealment), other scholars argue that deception encompasses the strategies of “fabrication (outright lying), equivocation (being vague and ambiguous), or concealment (with holding relevant information) Thus, the present study investigates the deception strategies and motives that are used by Johnny Depp and Amber Heard during their defamation trials. Qualitative and quantitative methods are employed when analyzing the data in question. Th

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Publication Date
Sun Apr 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Educational values and their role in some religions
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 The Islamic religion approach Rabbani urges and seeks to bring happiness to people, as Allah says: ((We sent thee not all people glad tidings and a warner, but most people do not know)) Spa: State 28
   Islam looks at the concept of educational values ​​through positive behavior derived emerging through formal and informal education. The Islamic approach works on the basis of a systematic and clear rule in the form of an integrated system includes multiple areas. As the lead actor role as the desired position.
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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Blindness And Sight In Ralph Ellison's Invisible Man
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The Civil Rights era has been an era of struggle for the African American in the
Unites states. Thus, many writers devoted their writing to reflect the racism and
discrimination that many have suffered from, among them is Ralph Ellison.
Ralph Ellison is a 20th century African-American writer and scholar best known for
his renowned, award-winning novel Invisible Man. He illustrates the powerful
social and political forces that conspire to keep black Americans in their place,
denying them the right to life, liberty, and the pursuit of happiness guaranteed to all
Americans. Invisible Man is a 1952 novel that addresses many of the social and intellectual
issues facing African-Americans in the twentieth century. It exa

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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Research In Social Sciences & Humanities
knowledge sharing and its role in Organizational excellence
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The current research aims to diagnose the extent of interest in knowledge sharing and its role in achieving organizational excellence at the level of the Iraqi environment Primary data through descriptive statistics (arithmetic mean, standard deviation, coefficient of variation, percentages, frequencies) and hypothesis testing using appropriate statistical methods for inferential statistical analysis (Pearson correlation coefficient, simple linear regression, multiple regression, path analysis) and checking the quality of the data from During (normal distribution, confirmatory factor analysis, structural modeling method, and exploratory factor analysis), after collecting data from (358) observations from the company’s leaders, as

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Publication Date
Tue Jun 01 2021
Journal Name
Baghdad Science Journal
Physiological and Immunological Disturbance in Rheumatoid Arthritis Patients
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            Rheumatoid arthritis (RA) is a systematic autoimmune disorder with chronic inflammation changes of unknown etiology. Various synovial inflammatory and proliferative alterations may contribute to the cartilaginous tissues and invasive bony tissues, leading to destructive joints and malformed bones. This disease is mostly due to infective microorganisms or genetic susceptibility causing immune system disturbances through triggering both T-cells and B-cells. Furthermore, different immune cells may secret cytokines, which are responsible for some RA pathogenesis activity. From ninety individuals, serum sample was collected; thirty of them were normal and sixty cases were patients with RA attended a privet medical clin

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Publication Date
Fri Jun 17 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Lornoxicam-Loaded Cubosomes: - Preparation and In vitro Characterization.
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Cubosomes are nanosized structures self-assembled nanostructured materials used for controlling the release of the entrapped drug molecule. Lornoxicam (LXM) is a potent analgesic nonsteroidal anti-inflammatory (NSAID) drug with a short half-life (3-4) hours. The present study aims to prepare LXM-loaded cubosomes with well-defined morphology, particle size, PDI, high entrapment efficiency, sustained drug release, and high zeta potential value, as a transdermal drug delivery system.

      Twelve formulas of LXM-loaded cubosomal dispersions were prepared by a solvent dilution method using Glyceryl monooleate ( GMO) as polar lipid with different stabilizers as Pluronic® F127 or tween 80 and different types o

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Publication Date
Tue Jun 15 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Microneedle Array Patches: Characterization and in -vitro Evaluation
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 Patch in transdermal drug delivery(TDDS) used to overcome the hypodermic drawback, but these patch also have absorption limitation for hydrophilic and macromolecule like peptide and DNA. So that micronized projection have the ability for skin penetration developed named as microneedle.  Microneedle drug delivery system is a novel drug delivery to overcome the limitation of TDDS like skin barrier restriction for large molecule. Microneedle patch can penetrate through skin subcutaneous into epidermis, avoiding nerve fiber and blood vessel contact. There are many type of microneedle patch like solid, polymer, hallow, hydrogel forming microneedle and dissolving microneedle with different method of microfabrication

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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Engineering
Intelligence in Construction between Contemporary and Traditional Architecture
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The authentic traditional architecture proved that it is very convenient to the environmental and social regulations where it appeared and lasted for hundred of years.

This traditional architecture got the intelligence in providing thermal comfort for their occupants by the intelligent usage of the building materials and the intelligent planning and designs which took in consideration the climatic condition and the aerodynamics of the whole city as one ecological system starting from the cold breeze passing through its narrow streets till it enters the dwelling units and glides out through the wind catchers.

This architecture had been neglected and replaced by modern imported architecture which had collap

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Educational And Psychological Researches
Islamic subject teacher and his role in Education
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Using the traditional methods in teaching Islamic subject have neglected student's role and focus mainly toward teacher. Thus, the role of student in teaching process would take a negative side: following these methods cannot achieve the educational objectives of Islamic subject. Teachers who give Islamic subject do not have a full knowledge of the appropriate techniques in teaching. They lack the scientific background that qualify them for teaching. The weakness of knowledge that face Islamic teachers have arisen over different stages of education which showed their lacking in the provision of intonation and interpretation of the Quran as well as the utterance of Prophet Mohammed Hadiths. It takes time to train teachers to do a

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Publication Date
Tue Oct 31 2023
Journal Name
College Of Islamic Sciences
Heretic rulings And related words in Islamic jurisprudence
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How I was eager to research the ruling on three of the most dangerous types to Islam and Muslims (the heretic, the sorcerer, the innovator, and related terms).
Because it is the most dangerous deadly disease that destroys the hearts of Muslims, and may even expel a Muslim from the circle of Islam, and how many Muslims have done or committed such a thing without knowing it. Indeed, how many Muslims have left Islam and whose wife has abandoned him without realizing it, and among them are those who have committed it without knowing it. As well as related words associated with heresy.( )
Because people debated such matters between extremists and lenient ones, most of whom were extremists, and they did not reach a conclusion. So I decid

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