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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 30 2016
Journal Name
College Of Islamic Sciences
The impact of the Qur'anic expression on the poetic picture In Oriental poetry in the eighth century AH
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This research deals with the poetic image of poets of the eighth century poetic, where they embodied the features of the religious life in which they live, and their impact on the Koranic text in the reflection of the image on their poems, where it becomes clear the ability of the poet at that stage to clarify the aesthetic components of the poetic text; Investigations, singled out the first topic: the analogy, and the second metaphorical picture, and the third: the picture.

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Publication Date
Mon Nov 01 2021
Journal Name
Journal Of Engineering
Numerical Study for the Tube Rotation Effect on Melting Process in Shell and Tube Latent Heat Energy Storage LHES System
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Although renewable energy systems have become an interesting global issue, it is not continuous either daily or seasonally. Latent heat energy storage (LHES) is one of the suitable solutions for this problem. LHES becomes a basic element in renewable energy systems. LHES compensate for the energy lack when these systems are at low production conditions. The present work considered a shell and tube LHES for numerical investigation of the tube rotation influence on the melting process. The simulation and calculations were carried out using ANSYS Fluent software. Paraffin wax represents the phase change material (PCM) in this work, while water was selected to be the heat transfer fluid (HTF). The calculations were carried o

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Publication Date
Sun Sep 05 2010
Journal Name
Baghdad Science Journal
Extraction and Characterization of rapeseed oil (Brassca campestris ) and it's Effected on Microorganisms
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Oil from Brassca campestris (local variety) was extracted with hexane using Soxhlet. The extracted oil was characterized and its antimicrobial activity was determined as well. The content of extracted oil was 40% with 0.5% of volatile oil .Oil was immiscible with polar solvent such as ethanol, acetone and water, while it was easily miscible with chloroform due to its hydrophobicity. The result of organoleptic tests revealed that the oil is clear yellow in color and odorless with acceptable taste. The oil was stable at 4 -25 C? for a month. Refractive index (RI) of oil was 1.4723 with density of 0.914, [both at 4-25 C?]. Boiling point 386 C?. Infra red spectroscopy (IR) indicated the presence of different chemical groups (C=C

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Publication Date
Sun Mar 06 2016
Journal Name
Baghdad Science Journal
On (σ,τ)-Derivations and Commutativity of Prime and Semi prime Γ-rings
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Let R be a Г-ring, and σ, τ be two automorphisms of R. An additive mapping d from a Γ-ring R into itself is called a (σ,τ)-derivation on R if d(aαb) = d(a)α σ(b) + τ(a)αd(b), holds for all a,b ∈R and α∈Γ. d is called strong commutativity preserving (SCP) on R if [d(a), d(b)]α = [a,b]α(σ,τ) holds for all a,b∈R and α∈Γ. In this paper, we investigate the commutativity of R by the strong commutativity preserving (σ,τ)-derivation d satisfied some properties, when R is prime and semi prime Г-ring.

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Publication Date
Thu Sep 19 2024
Journal Name
Baghdad Science Journal
Effects of Ascorbic, Citric, and Humic Acids on Maize Stem and Leaf Anatomy
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Anatomical changes in internal tissue of stem and leaf when seed and plant treated with acids to enhance growth and development in maize was studied during the spring seasons of 2019 and 2020. Randomized complete block design was used with three replications. Main plots received foliar nutrition treatments, including ascorbic acid (AA), citric acid (CA), and humic acid (HA) at concentrations of 100 mg L−1, alongside HA at 1 ml L−1, with distilled water as the control. Sub-plots underwent corresponding treatments for seed soaking. Results indicated variations in vascular bundle size among treatments, with foliar CA treatment showing superior results in both years, as well as seed soaking in CA and HA. Interaction effects were observed, n

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Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Public Health Research & Development
Effect of Gold Nanoparticles and Laser on Platelet, Lymphocytes, and White Blood Cells
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Publication Date
Thu Jun 01 2023
Journal Name
Baghdad Science Journal
Physiological and Hormonal Effects of Titanium Dioxide Nanoparticles on Thyroid and Kidney Functions
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           Titanium dioxide nanoparticles (TiO2 NPs) are generally used in different types of applications such as the industry of plastics, paper industry, paints, toothpaste, cosmetics, sunscreens, and in various lifestyles, because of the vast range of applications and our daily exposure to these nanoparticles and a lack of information on animal and human health this study was designed to reveal dose and time-dependent effects of TiO2-NPs on the thyroid gland and kidney functions in male rats.

For this study 54, Sprague-Dawley albino adult male rats were classified into three main groups each of 18 rats treated for a particular duration (1,2, and 4) weeks respectively. Each group was subdivided i

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Publication Date
Sat Jan 21 2023
Journal Name
Indian Journal Of Health Sciences And Biomedical Research (kleu)
Vitamin D status of children at a tertiary care hospital of Agartala, North-East India: A cross-sectional study
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Publication Date
Fri Sep 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of Enamel Protective Agent on Shear and Tensile Bond Strength of Stainless Steel Brackets by Using Different Adhesive Agents (In Vitro Study)
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Background: Decalcification of surface enamel adjacent to fixed orthodontic appliances, in the form of white spot lesions, is a wide spread and familiar well-known side effect of orthodontic treatment. The present study was carried out to evaluate the effect of enamel protective agent (Clinpro white varnish) on shear and tensile bond strength of Dentaurum orthodontic stainless steel brackets by using 3M Unitek and Ormco as orthodontic adhesive agents. Materials and methods: Sixty-four extracted human upper first premolar teeth were selected and randomly divided into two groups with 32 teeth each, representing the shear and tensile bond strength testing groups. Then according to the type of bonding adhesive and the addition of Clinpro before

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Publication Date
Sun Jan 01 2023
Journal Name
Dental Hypotheses
Assessment of Salivary Levels of the RANKL and RANK in Patients with Healthy Gingiva on Reduced Periodontium Versus Periodontitis: An Analytical Cross-Sectional Study
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