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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 Mar 24 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
Evaluating the anti- Pseudomonas Aeroginosa Efficacy and Potential Cytotoxicity of Nerium Oleander Alcoholic Extract
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Nerium oleander known as oleander has belonged to the poisonous plants its habitat in a tropical andsubtropical region. The chemical analysis with GC-Mass of the alcoholic extract of oleander leaves revealedthat this plant has many chemical compounds more than 80 compounds and high-peaks about 29 compoundswhich are represented by alkaloids, phenol, terpenes, and fatty acid. HPLC analysis showed many essentialoils that have many biological effects.To evaluate the antibacterial activity of the alcoholic extract of N. oleander against locally isolatedPseudomonas aeroginosa the broth micro-dilution method was adapted to different concentrations werestarted from 3.9 to1000 mg/ml. The results revealed that the alcoholic extract has antiba

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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Training Program for Children with Autism and their Mothers Based on the Picture Exchange Commination System to Confront Some of Basic Disorders for these Children
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The current research aims to examine the effectiveness of a training program for children with autism and their mothers based on the Picture Exchange Communication System to confront some basic disorders in a sample of children with autism. The study sample was (16) children with autism and their mothers in the different centers in Taif city and Tabuk city. The researcher used the quasi-experimental approach, in which two groups were employed: an experimental group and a control group. Children aged ranged from (6-9) years old. In addition, it was used the following tools: a list of estimation of basic disorders for a child with autism between (6-9) years, and a training program for children with autism

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Publication Date
Thu Feb 01 2018
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
Effect of High Temperature (Fire Flame) on the Behavior of Post-tensioned Concrete Beams
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Sun Sep 28 2025
Journal Name
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Contribute to the pivotal thinking skills in performing the transmission skill from Volleyball Fourth preparatory grade adolescents
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The aim of this study was to identify the level of critical thinking skills among fourth-grade middle school students and to determine the performance level of the underhand volleyball pass, with the assumption that there is a positive relationship between critical thinking and skill performance. The study population included 281 students from Basra Preparatory School for Girls under the Second Baghdad Education Directorate for the 2024/2025 academic year, of whom 275 students were intentionally selected as the research sample (97.865% of the population). The experimental procedure involved applying a critical thinking scale and a technical performance test for the underhand pass on 25 students per day over 11 days, from February 9

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Sat Feb 14 2026
Journal Name
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An Evaluation of the Efficacy of Different Gingival Retraction Materials on the Gingival Tissue Displacement (A Comparative In Vivo Study)
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Publication Date
Sun Jul 21 2024
Journal Name
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Microbiological and Salivary Biomarkers Successfully Predict Site-Specific and Whole-Mouth Outcomes of Nonsurgical Periodontal Treatment
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Background/Objectives: Nonsurgical periodontal treatment (NSPT) is the gold-standard technique for treating periodontitis. However, an individual’s susceptibility or the inadequate removal of subgingival biofilms could lead to unfavorable responses to NSPT. This study aimed to assess the potential of salivary and microbiological biomarkers in predicting the site-specific and whole-mouth outcomes of NSPT. Methods: A total of 68 periodontitis patients exhibiting 1111 periodontal pockets 4 to 6 mm in depth completed the active phase of periodontal treatment. Clinical periodontal parameters, saliva, and subgingival biofilm samples were collected from each patient at baseline and three months after NSPT. A quantitative PCR assay was us

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Renal stone density on native CT-scan as a predictor of treatment outcomes in shock wave lithotripsy
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Extracorporeal shock wave lithotripsy (ESWL) is considered a standard treatment for nephrolith or kidney stones measuring less than 20 mm. Anatomical, machine-related, and stone factors play pivotal roles in treatment outcomes, the latter being the leading role. This paper examined the relationship between stone density on native CT scans and ESWL treatment to remove renal stones concerning several treatments. One hundred and twenty patients (64 males and 56 females) were enrolled and completed the study from April 2019 to September 2020. Inclusion criteria were a single renal pelvis stone of 5–20 mm to be treated for the first time in adult patients with no urinary or musculoskeletal anatomical abnormalities. We assessed patients

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Publication Date
Sat Dec 11 2021
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Study the Distribution of Rotavirus Genotypes in Vaccinated and non Vaccinated Children in Babylon Province
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Rotaviruses, a major cause of gastroenteritis in children worldwide accounts for around half a million deaths annually. Vaccine against the virus has been recommended by the WHO to be involved in the national immunization program.To evaluate the genetic characterization of rotavirus among children with acute gastroenteritis in Babylon province is warranted. Children complained of diarrhea with rotavirus infection detected in their stool were involved in the study. The age range was 10 months to 60 months and with retrogradechecking of rotavirus vaccine history. Rotavirus genotypes were detected by reverse transcription-polymerase chain reaction (RT-PCR).A total number of 40 children with rotavirus gastroenteritis were used to examine the

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Sun Jun 01 2014
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Efficacy of Saccharomyces cerevesiae on promoting growth in tomato: Nahida M.Saleh |Adnan A. Issa
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This study was conducted to evaluate the efficacy of Saccharomyces cerevesiae as a growth promoting agent in tomato. Soaking the seeds in yeast suspension at 5 g/L for 12h increased germination percentage, root length, root fresh and dry weight, plant height, foliage fresh and dry weight, attained 88.5% ; 8.1 cm ; 84.3 mg ; 7.03 mg ; 10.75 cm ; 839 mg and 37.75 mg compared with 80% ; 5.33 cm ; 39 mg ; 4.8 mg ; 7.35 cm ; 608 mg and 25.5 mg in seedlings grown from non treated seeds respectively. Similar results were obtained with seedling from seeds soaked in S. cerevesiae filtrate for 12 hrs. with values of 77.5% ; 6.875 cm ; 91.5 mg ; 7.5 mg ; 9.5 cm ; 777 mg and 40.35 mg compared to 66% ; 5.8 cm ; 57.7 mg ; 5.03 mg ; 5.9 cm ; 493 mg

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