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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
Tue Apr 01 2025
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of Knowledge Management System Requirements According to ISO 30401
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This Paper assesses the knowledge management system (KMS) requirements at Al-Ameed University concerning ISO 30401:2022. Specifically, the research aims to ascertain the degree to which international standards have been complied with and gaps that have been identified. A case study was conducted using field observations, interviews, and checklists to assess the institution's compliance with the KMS framework. The level of implementation and documentation of knowledge management processes was assessed using a seven-point scale. The findings reveal that Al-Ameed University has severe gaps in knowledge creation, sharing, and support for knowledge management in terms of strategic leadership. While certain elements like availability of r

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Fabrication of Advanced Cement Mortar for Building Anti-Bacterial Applications
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In this research, we have added nano anatase TiO2 as a partial replacement of Portland cement by a weight percentage of (0.25 to 1%) for the development of properties for protection against bacteria. The control mix was made by using "the cement to sand" proportion about (1: 2.75) with the "water to cement" proportion of (0.5) to study the structure, porosity, water absorption, density, mechanical properties, as well as anti-bacterial behavior. Inspections have been done such as scanning electron microscopy (SEM), and atomic force microscope (AFM) for mortar. Experimental results showed that after the addition of Nano powders in cement mortar, the structural properties improved significantly with the development of hydration o

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Publication Date
Tue Nov 17 2015
Journal Name
International Journal Of Computer Applications
Categorization of ‘Holy Quran-Tafseer’ using K-Nearest Neighbor Algorithm
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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Optimum Design of Stiffened Plate-Structure Subjected to Static Loading
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The field of structural optimization (optimal design) has grown rapidly over the past decades with many different optimization methods that could be used to produce a structure of minimum weight. This research deals with two aspects, in the first, a general numerical technique based on the finite element analysis and it suggests to investigate the preliminary behavior of metal stiffened plate under action of static load environment. The technique was included a finite element model of the structures using high- order isoparimetric plate elements to be used to create a certain models to obtain their optimum design. The models are characterized such that, each model is builded using different types of stiffener configuration. The second as

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Publication Date
Wed Oct 01 2008
Journal Name
Journal
Topical therapy of xeroderma pigmentosa with 20% zinc sulfate solution
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Publication Date
Fri Jun 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Revitalization of a necrotic immature permanent anterior tooth (Case Report)
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Background: Management of immature permanent teeth with necrotic pulp is considered challenging to the clinician. Regeneration of pulp tissue is a relatively new approach for management of these teeth that allow continuation of root maturation rather than formation of just a calcific barrier as in apexification. Method: 9 years-old girl with traumatized upper left central incisor. The clinical and radiographical examinations revealed uncomplicated crown fracture, tenderness to percussion, absence of response to cold vitality test. Diagnostic X-ray revealed open apex with periapical radiolucency. Revascularization was suggested to treat the tooth, starting with irrigation of canal with 5% NaOCl + 3% H2O2, followed by 2 weeks of triple antibi

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Publication Date
Tue Dec 01 2009
Journal Name
Iraqi Journal Of Physics
Analytical Performance Modeling of InP-InGaAs Hetero-junction Avalanche Photodiode
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In this study, an analytical model depending on experimental results for InPInGaAs
avalanche photodiode at low bias was presented and the characteristics of
gain for this photodiode were determined directly by the impulse response. The
model have considered the most important mechanisms contributing the
photocurrent, they are trapping, photogeneration in the undepleted region and
charge-carriers velocity due to the built-in electrical field. Also, the bandwidth
was determined as a function to the total gain of photodiode and it was mainly
determined by diffusion and trapping processes at low gain regarding to the multilayer
structure considered in this study

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Maxillary Ameloblastic Fibroma: Two Case Reports of a Rare Tumor
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Ameloblastic fibroma is a rare benign tumor usually affects the first two decades of life. The neoplasm is more predominant in mandibular molar-premolar region and rarely affects the maxilla. In this report, we present a couple of Ameloblastic fibroma cases, affecting boys at their 1st decade. The lesions were presented as swellings of their maxilla, which is atypical location. Radiographic images showed well-defined radiolucency containing areas of radio-opacities and impacted teeth. Differential diagnosis was established as cystic/neoplastic conditions. The lesions were incised and histopathologically diagnosed as Ameloblastic fibroma, since they were composed of immature odontogenic mesenchymal and epithelial cells showing different c

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Publication Date
Sun Mar 30 2008
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Preparation of Zeolite Type 13X from Locally Available Raw Materials
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The aim of this work was to prepare zeolite type 13X from locally available kaolin and to study the effects of using some binding materials through the process of agglomeration of this zeolite. This study was focused on using kaolin binder in different weight percents (10,15,25,35 and 45%).Physical and mechanical properties of the agglomerates such as porosity , apparent density , pore volume, crushing strength , loss on attrition , surface area and finally the adsorption capacity had been measured and evaluated .The preparation step was achieved by mixing the reactants consisting of metakaolin , source of silica as ( sodium trisilicate ) and sodium hydroxide . The conditions was temperature of 70° C and time of mixing as 8, 10,24,34,50

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Publication Date
Wed Sep 01 2010
Journal Name
Al-khwarizmi Engineering Journal
Biogas Production by Anaerobic Digestion of Date Palm Pulp Waste
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The purpose of this preliminary study is to verify the possibility of using Iraqi Zahdi date palm biomass as a resource for biogas production, methane in particular using thermophilic anaerobic digestion with waste water treatment activated sludge. Moreover, is to investigate the influence of extra nutrients addition to the digestion mixture. Biogas was captured in sealed jars with remote sensing modules connected to computer with integrated program to record the gas pressure continuously. A total gas pressure with 67% Methane was produced from date pulp waste fermentation with a yield of 0.57 Lit for each gram volatile solid of substrate. Addition of 1% yeast extract solution as nutrient increased Methane yield in liters by 5.9%. This i

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