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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
Wed Feb 01 2023
Journal Name
Baghdad Science Journal
Accumulation of Heavy Metals in Agricultural Crops and Ecological Series of Crops Placement
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The accumulation of toxic elements in vegetables and melons grown in agriculture, Brassica rapa - turnip, Solanum lycopersicum - tomato, Citrullus lanatus - watermelon, Capsicum annuum - bell pepper, Daucus carota - carrots, Cucurbita pepo - pumpkin, Cucumis melo - melon, and also Prunus armeniaca - apricot from fruit trees were analyzed. The excess of maximum allowable concentrations in agricultural crops of the element As by 1.65-1.75, Cd - 1.6-2.3, Cr -1.2-2.35, Cu -1.6-3.3, Ni - 1.16-3.53, Pb - 1.54-3.08, Al - 1.36-3.5, Sb - 2.0-33, Se - 1.1-3.3 times was established. The maximum allowable concentration of mercury in vegetables and melons was equal to 0.02 mg/kg,

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Publication Date
Wed Apr 01 2009
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Use of chromogenic Agar in detection of urinary tract pathogens and antimicrobial Susceptibility
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Background: HROM agar Orientation is a chromogenic medium used for the detection and differentiation of Gram’s negative and Gram’s positive pathogenic microorganisms in urine samples. Evaluation of CHROM agar Orientation for identification of urinary pathogens and susceptibility determinations in comparison to the ordinary media used.
Patients and Methods: A total of 375 midstream urine sample collected from patients with urinary tract infection (UTIs). CHROM agar Orientation, blood agar and macConkey agar media were used for direct inoculation.
Results: CHROM agar Orientation succeeded in detecting all the urine pathogens that were detected by the reference media, and antimicrobial Susceptibility

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Antiplatelts Activity of Vitamin E in Relation to Dose and Duration of Therapy
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           Vitamin E, having the well known antioxidant activity  through scavenging free radicals Ùˆ it occurs in several  isomeric forms , these isomers have relatively different functions . One of these actions is related to its ability to inhibit platelets aggregation and hence thrombosis. The present study included a total number of apparently healthy  62 males . 11of them served as standard group , treated  with 100 mg aspirin /day for more than one month . Another 31 subjects were randomly grouped into 5 groups that received different daily doses of α – tocopherol : 400 IU , 800 IU and 1200 IU for  2-6 months.The remainder ( 20 ) subjects served

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Correlation of Concentrations of Certain Trace Elements in Normal and Diseased Human Tissues
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Background Over the past decade there has been a growing awareness of, and interest in, the trace element concentration differences between normal and diseased tissues. Significant changes in tissue concentrations of Zinc (Zn) and Copper (Cu) have been previously reported in inflammation and cancer of certain human tissues.
Aim:(1)To correlate between Zn and Cu concentrations and the histological picture of normal and certain inflamed human tissues, namely the gall bladder (GB) the vermiform appendix (VA), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). (2) to detect whether there is a difference in the above-mentioned parameters between VAT and SAT. (3) to obtain recordings for trace element levels in human tissu

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Publication Date
Mon Mar 15 2021
Journal Name
Al-academy
Manifestations of Selfhood and Otherness in Indian Schools of Photography: رشا اكرم موسى
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The current research addressed (the manifestations of selfhood and otherness in Indian schools of photography) through studying the concept of selfhood and otherness and their manifestations in Indian miniatures scenes for the period (1625-1790). The researcher, in the first chapter, sought to clarify the research problem, importance, and the need for it, in addition to the objective of the study represented by the following: "how did selfhood and otherness manifest in the Indian schools of photography?". The researcher, then, concluded the aforementioned chapter by defining the terms that have direct relation to the title and the objectives of the research. As for the second chapter, it consists of an overview for the theoretical framew

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Publication Date
Sun Mar 13 2011
Journal Name
Baghdad Science Journal
Use of Coliphages as an indicators of enteroviruses and faecal pollution in Water
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In spite of increasing clinical cases which caused by enteroviruses transferred by water and no documents about entericviruses in the Iraqi water standards. The use of coliphages as an indicator of enteroviruses and fecal pollution were suggested two procedures were applied . The first is Two-Step Enrichment Method and the second is Single Agar Layer Method. Both methods gives good results in Identification of coliphages through testing fifty different water samples (Tap water, Surface water and Bottled water) the study shows the presence of coliphages in fourteen samples.

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Publication Date
Mon Jan 01 2018
Journal Name
Asian Journal Of Chemistry
Levels and Distribution of Trace Metals in Surface Soils of Al-Diwaniya, Iraq
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In this work, monitoring of monthly variation (from May 2016 to October 2016) in the concentration of the metals (Co, Zn, Cd, Pb, Ni and Fe) from Al-Diwaniya city of Iraq. Investigation about the pollution with these metals was achieved from five selected sites locate in study area by flame atomic absorption spectroscopy. The results showed a wide variation in the levels of heavy metals from site to site and from month to month. A total of 180 surface soil samples were analyzed to detecting the pollution with selected samples. The resultsshowed that the highest concentration with Ni was 6.290 mg kg-1 while the lowest concentration detected with Ni was 0.080 mg kg-1. The results of pollution index (enrichment factor, contamination factor, po

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Publication Date
Sun Jun 30 2013
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Kinetic Study and Simulation of Oleic Acid Esterification in Different Type of Reactors
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Esterification reaction is most important reaction in biodiesel production. In this study, oleic acid was used as a suggested feedstock to study and simulate production of biodiesel. Batch esterification of oleic acid was carried out at operating conditions; temperature from 40 to 70 °C, ethanol to oleic acid molar ratio from 1/1 to 6/1, H2SO4 as the catalyst 1 and 5% wt of oleic acid, reaction time up to 180 min. The optimum conditions for the esterification reaction were molar ratio of ethanol/oleic acid 6/1, 5%wt H2SO4 relative to oleic acid, 70 °C, 90 min and conversion of oleic 0.92. The activation energy for the suggested model was 26625 J/mole for forward reaction and 42189 J/mole for equilibrium constant. The obtained results s

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Publication Date
Sun Jan 30 2022
Journal Name
Iraqi Journal Of Science
Classification and Measurement of Land Cover of Wildfires in Australia Using Remote Sensing
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     Remote sensing techniques used in many studies for classfying and measuring of wildfires. Satellite Landsat8(OLI) imagery is used in the presented work. The satellite is considered as a near-polar orbit, with a high multispectral resolution for covering Wollemi National Park in Australia. The work aims to study and measure wildfire natural resources prior to and throughout fire breakout which occurred in Wollemi National Park in Australia for a year (October, 2019), as well as analyzing the harm resulting from such wildfires and their effects on earth and environment through recognizing satellite images for studied region prior to and throughout wildfires. A discussion of methods for computing the affecred area i

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Publication Date
Wed Mar 15 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Effect of Adding NPKZn Fertilizer in Growth and Yield of (Vigna raditia L.)
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Experiment was conducted using clay pots at botanical garden of Department of Biology/ College of Education for Pure Science / Ibn –AL- Haitham, University of Baghdad during the growth season of (2013-2014).The experiment aimed to study the effect of NPK Zn fertilizer in (15-15-15-1)% with the levels 0.2, 0.4, 0.6 grams per five kilograms soil based on (80, 120, 240 kg per Hectare)in some of morphological characters and yield of Vigna radiatia. The results showed a significant increase in plant height, dry weight, biological yield, economic yield, weight of 100 seeds, harvest index, absolute growth rate (AGR) were all increased and amount of output compared with control plants.

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