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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 Economics And Administrative Sciences
Classification of Iraqi Children According to Their Nutritional Status Using Fuzzy Logic
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In this paper, we build a fuzzy classification system for classifying the nutritional status of children under 5 years old in Iraq using the Mamdani method based on input variables such as weight and height to determine the nutritional status of the child. Also, Classifying the nutritional status faces a difficult challenge in the medical field due to uncertainty and ambiguity in the variables and attributes that determine the categories of nutritional status for children, which are relied upon in medical diagnosis to determine the types of malnutrition problems and identify the categories or groups suffering from malnutrition to determine the risks faced by each group or category of children. Malnutrition in children is one of the most

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Publication Date
Mon Jan 01 2018
Journal Name
Al–bahith Al–a'alami
Political Marketing and the Formation of Trends in Public Opinion on Social Networking Sites: An Analytical Study of the Two F.B. Pages: the Prime Minister and the Parliament President
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The social networking sites have become one of the most important promotional instruments for their characteristic of facilitation of communication and the creation of public platform for discussion and formation of new points of view. These sites were used in the political marketing process where politicians use Facebook pages to promote their ideologies and spread their programs for the purpose of an influencing public opinion.
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Crossref
Publication Date
Sun May 08 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of the relationship between the internal auditor and the external auditor on the Earnings quality in Iraqi companies listed in the Iraqi Stock Exchange
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The changes that have occurred in the business environment and scientific and technological progress, as well as the complexity of administrative problems resulting from its practice of various activities, have led to an increase in the responsibilities entrusted to it, and for the purpose of achieving its strategic objectives, which has made the pillars of corporate governance an inevitable matter required by the nature of modern scientific management of the governorate, the success that companies seek is based on the fertile environment and the dialectical relationship between the individual and the company, and to achieve this success there must be a compatible and harmonious audit environment between the internal and external

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Publication Date
Sat Mar 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Activating Financial Performance Measures On The Basis Of Value And Its Reflection On Companies Performance Under The Governance: An Applied Study On A sample Of Companies Listed In the Iraqi Stock Exchange
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Increased attention to corporate governance with the increasing need for investors and other parties in the Iraqi market for securities of the information credible and confidence and greater transparency in the disclosure as well as the systems of governance lead to raise the value of the company and that by reducing the cost of capital and reduce the cost of financing, as well as that there are indications modern measurement can be adopted by the Iraqi market for securities for the purpose of evaluating the performance of listed companies and then raise their value.

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Publication Date
Mon Jan 02 2023
Journal Name
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The influence of socioeconomic status and general health on the fracture incidence
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Background/Aim There is an association between patient general health, socioeconomic status and fracture incidence. Aim of this study was to demonstrate the relation between the socioeconomic and health status and the occurrence of fractures in Al-Kindy Hospital residents. Methods A prospective cross-sectional study was performed by using data collected from fractured patients in Al-Kindy Teaching Hospital / Baghdad Orthopaedics Outpatient Clinic, between 12 December 2021 and 8 March 2022. A hundred patients aged 20 to 75 years were included in this study. The data were collected using a researcher-administered questionnaire, which included items to assess patient's socioeconomic status (accommodations, occupation, income status, level of e

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Scopus
Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
On the design of the annexation experience between splintered and dissociated sectors
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The idea of the design of combination Between split – plot and split block means that an experiment conducted with a design

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Crossref
Publication Date
Sun Sep 06 2009
Journal Name
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Biological and chemical Study to evaluate the types of water used for drinking in the Al-youssiffiyah area and its effect on public health
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Election study included four sites for the waters in area of Youssifiyah south of Baghdad (river water, tank water, liquefactions water, and water filtrate and seethed and purifier by alum and chloride), the samples were collected during the month of June in 2007. Temperature, electrical conductivity and acidity are measured. Also , the concentration of chloride , sulphate , carbonate , nitrate , sodium , calcium , magnesium , hard total and total dissolved substances are determined , as well as heavy metals assess environmental risk (such as Cu, Pb, Zn, Fe). It was also a study of bacterial totals included both total Bacteria (TB) and Total Coliform Bacteria (TC) and Fecal Coliform (FC) and Fecal Streptococci (FS). The stu

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Crossref
Publication Date
Mon Jul 04 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of agricultural insurance in the prevention of financing risks in the form of slam : "An Empirical Study on Shikan Insurance and Reinsurance Company
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The aim of this research is to introduce agricultural insurance, to define financing in the form of salam and the role of agricultural insurance in the prevention of risks to agricultural finance operations in the form of salam by verifying the hypotheses through which to reach the results, including the imposition of risks for agricultural finance in the form of salam, The study of agricultural finance in the form of salm, the deductive approach to the development of the problem of research and hypotheses, and the inductive method to extrapolate the results through analysis and brother The researcher concluded that agricultural insurance works to bridge the risks facing agricultural finance in the form of the ladder in cases of

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Publication Date
Thu May 15 2025
Journal Name
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International and Regional Competition in the Middle East and its Impact on Iraqi National Security, with Special Reference to the Kurdistan Region: A Study of Challenges and Opportunities
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This competition between competing forces, organized into axes with conflicting objectives, is reflected in all regional affairs and the goals and interests of countries within them, including Iraq. Among the most important aspects impacted by the repercussions of international and regional competition in the region is Iraqi national security, based on its vital importance in preserving the sovereignty and entity of the Iraqi state, protecting the interests and cohesion of the state and people, ensuring and defending their present and future, and interacting with various regional and international activities. The Kurdistan Region, as an important part of Iraq with its own unique characteristics, may be one of the most important regi

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Crossref
Publication Date
Thu Jan 22 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of the effect of root canal preparation size and flaring on the depth of irrigant penetration (In vitro study)
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Background: Cleaning and shaping of root canals successfully requires high volumes of irrigation solutions that can only be applied to the apical third of root canal after enlargement with instrument, so the aim of this study was to evaluate and to compare the efficiency of Maxi-I-probe (side-vented needle), in the amount of root canal irrigant penetration for five different master apical file sizes (MAF) and four different degrees of coronal and middle thirds flaring. Materials and Methods: Two hundred resin blocks with simulated root canals were used in this study and divided into 5 major groups (40 for each) based on the size of master apical files (#20, #25, #30, #35, and #40). Each major group was subdivided into 4 subgroups depending

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