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bijps-974
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
Fri Dec 15 2017
Journal Name
Journal Of The College Of Education For Women
The Poetics of Mourning and the American Elegy in Walt Whitman's "When Lilacs Last in the Dooryard Bloom'd"
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يجترح الشاعر والت ويتمان انعطافة شعرية لعلاقة الانسان، جسدا وروحا، مع العالم. فهو يستقي الهامه في كتابته لمرثاته (عندما اينع الليلك اخيرا في فناء الدار) من مصادر جمالية واخرى سياسية. ولعل ابرزها تأثره بفكرة الروح الكوني كما جرى طرحها في سياق فلسفة التسامي الامريكية. يظهر ذلك جليا في قصائده التي تتخذ من تماهي روح الانسان مع الطبيعة موضوعة لها. ان فكرة الروح الكوني تلقي ههنا بظلالها على الرتب الانسانية التي

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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of The College Of Education For Women
The Poetics of Mourning and the American Elegy in Walt Whitman's "When Lilacs Last in the Dooryard Bloom'd"
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Walt Whitman adds a poetic twist to the relationship of man’s body, soul with the universe. His inspiration in writing his elegy, "When Lilacs Last in the Dooryard Bloom'd," draws on aesthetico-political resources. Major amongst these is his leaning towards the American Transcendentalist idea of the "Over-Soul".  The basic topoi in his poems is thus his identification of nature with the soul of man. The idea of the Over-Soul sheds light on the three stages of human loss: suffering, despair, and compensation. Whitman witnessed two political events, the outbreak of the civil war and Abraham Lincoln's death, which were of a particular importance to his life and work: they helped him shape a form and thematic concerns of his own. Buil

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Publication Date
Sat Jun 12 2021
Journal Name
Biochemical And Cellular Archives
EFFECT OF SINGLE ORAL DOSE OF FUMONISIN B1 ON IMMUNOHISTOCHEMICAL EXPRESSION OF TLR-2 AND 4 IN MICE
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Fumonisin B1 is toxic secondary metabolites compound produced by Fusarium spp. on maize and maize products causes health problems to human and animal. Therefore, this research is planned to study the effect of FB1 on the expression of TLR-2 & 4 in liver and kidney cells of mice. Four group of male mice were orally administrated with single dose of FB1 toxin as the following: 0 ppb, 800 ppb, 1200 ppb and 1600 ppb. After two weeks all animals were sacrificed, liver and kidney autopsies were taken and the level of TLR-2 & 4 detected in each four group by immunohistochemistry technique (IHC). According to the IHC examination of groups (1, 2, 3 and 4) strong expression of TLR2 in liver and kidney were (0%, 33.3%, 100%, 100%), respectively. This

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Publication Date
Wed Jul 01 2020
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Publication Date
Mon Jan 01 2024
Journal Name
Iraqi Journal Of Hematology
Provisional diagnosis of clinically significant hemoglobinopathies and decision on suitability for marriage as part of the premarital screening program in Iraq: Iraqi Society of Hematology Guidelines
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Publication Date
Fri Jun 01 2012
Journal Name
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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Measure the impact of the age structure of the population on the gross domestic product in Iraq
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Publication Date
Tue Oct 01 2013
Journal Name
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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
The impact of learning strategies in the collection of biology and their systemic thinking
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Publication Date
Thu Aug 31 2017
Journal Name
Journal Of Engineering
The Phenomenon of Division and Modification of The Individual Houses in Baghdad after 2003
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The Research deals with the negative phenomena which appeared in the urban scenes of the  Iraqi cities after 2003, particularly trespassing the architectural design of the urban Individual houses.  Many academic researchers , critics, and cultural circles, drawn attention to the impact of  political and cultural variable change on such phenomena  without detailed  analysis . The research problem  is set according to central questions : If the phenomena is the trespass , what
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