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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 Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact of Instructional Intervention about Personal Hygiene upon Women who complain Pelvic Inflammatory Disease
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Objective: To determine the impact of personal hygiene on woman who complain pelvic inflammatory disease Methodology: A quasi experimental study in the High Institute Infertility Diagnostic and A.R.T.(assistance reproductive technology) in AL-Kadimya city and al-Emamian al Kadmain medical city hospital. The sample collected during (26th ) January – (30th ) April 2014. A purposive sample of (60) women, (30) of them regard as study group and (30) regard as a control group whom they take routine care in the institute and hospital. The questionnaire consisted of socio-demographic data, reproductive heal

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Publication Date
Sun Sep 03 2017
Journal Name
Baghdad Science Journal
Biological control of saw toothed beetle Oryzaephilus surinamensis(L.)Using fungi Lecanicillium lecanii(Zimm.)
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This study is conducted to determine the effect of pathogenicity of the fungus Lecanicillium lecanii in some aspects of life of the insect saw toothed beetle Oryzaephilus surinamensis L. (Coleoptera: Silvanidae) under laboratory conditions with three concentrations of spores and mildew commentator (1 × 103, 1 × 105, 1 × 107) spore / ml , on eggs and larvae second phase of the insect .The study also includs the effect of the fungus concentrations of germination on rice (jasmine) by using direct spray treatment. The results show great fungus efficiency in the control of some aspects of life of the insect, where varied efficiency depends on the concentration of spores, The highest percentage loss of eggs is 63.33% at a concentration

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Publication Date
Tue Jan 01 2013
Journal Name
International Journal Of Advances In Pharmacy, Biology And Chemistry
Synthesis of NSAID with Sulfonamide Conjugates as Possible Mutual Prodrugs using Amino Acid Spacer
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The purpose of this research work is to synthesize conjugates of NSAIDs (ibuprofen, and naproxen) with sulfadiazine as possible mutual prodrugs to overcome the local gastric irritation of NSAIDs with free carboxyl group by formation of ester linkage that supposed to remain intact in stomach and may hydrolyze in intestine chemically or enzymatically; in addition to that attempting to target the synthesized derivative to the colon by formation of azo bond that undergo reduction only by colonic bacterial azoreductaze enzyme to liberate the parent compound to act locally (treatment of inflammation and infections in colon)

Publication Date
Sun Oct 31 2021
Journal Name
Iraqi Geological Journal
Designing Raw Mix for Manufacturing Portland Cement using Euphrates Formation Marl Instead of Clays
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Portland Cement is manufactured by adding 3% gypsum to clinker which is produced by grinding, pulverizing, mixing, and then burning a raw mix of silica, and calcium carbonate. Limestone is the main source of carbonates, while clay collected from arable land is the main source of silica. The marl in the Euphrates Formation was studied as an alternative to arable lands. Nine boreholes drilled and penetrated the marl layer in selected locations at the Kufa cement quarry. Forty-one samples of marl from boreholes and four samples of limestone from the closed area were collected. The chemical content of the major oxides and the hardness of the marl layer was very encouraging as a raw material for Portland Cement as they are SiO2 (17.60),

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Publication Date
Sun Dec 03 2017
Journal Name
Al-khwarizmi Engineering Journal
A theoretical study for increasing production of electric power from Iraqi steam power plants.
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This article conclude a theoretical study for the possibility to produce additional electric power from Iraqi steam power plants by  cutting – off high-pressure feed water heaters .  Three separated steam power plants which Dura , south –Baghdad and Nasria were studied . The investigation showed the possibity of increasing the electric power from 10 to 15% for Dura and Nasria , whereas 6% for south – Baghdad . According to the nowadays of operation to Iraqi steam power plants , the results showed that by cutting–off high  pressure feed water heaters we can generate additional electric power about 250 MW during 3-4 hrs. daily. In addition, the fuel consumption can be reduced in comparison with diesel generat

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Biogas Recovery from Anaerobic Co-Digestion of Poultry House Wastes for Clean Energy Production
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Anaerobic digestion is a technology widely used for treatment of organic waste for biogas production as a source for clean energy. In this study, poultry house wastes (PHW) material was examined as a source for biogas production. The effects of inoculum addition, pretreatment of the substrate, and temperature on the biogas production were taken into full consideration. Results revealed that the effect of inoculum addition was more significant than the alkaline pretreatment of raw waste materials. The biogas recovery from inoculated waste materials exceeds its production from wastes without inoculation by approximately 70% at mesophilic conditions. Whereby, the increase of biogas recovery from pretreated wastes was by 20% higher than its

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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Engineering
Non-Destructive Testing of Carbon Fiber Reinforced Magnetic Reactive Powder Concrete Containing Nano Silica
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This study involves the design of 24 mixtures of fiber reinforced magnetic reactive powder concrete containing nano Silica. Tap water has been used in mixing 12 of these mixtures, while the other 12 have been mixed using magnetic water. Nano Silica (NS) with ratios (1, 1.5, 2, 2.5 and 3) % were used. The results showed that the mixture containing 2.5%NS gives the highest compressive strength at age 7 days. Many different other tests were carried out, the results showed that the fiber reinforced magnetic reactive powder concrete containing 2.5% NS (FRMRPCCNS)  has the higher bulk density, dynamic modulus of elasticity, ultrasonic pulse velocity  electrical resistivity and lesser absorption than fiber reinforced

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Publication Date
Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
Enhancement of Episiotomy Healing Using (790-805) nm Diode Laser as a Supplementary Treatment
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To show the impact of 790-805 nm diode laser irradiations on wound healing as a supplementary treatment in women underwent episiotomies, and to assess the laser parameters that were used .Material and methods: Eighteen female patients were included in this study; all of them underwent mediolateral episiotomy. Ten patients received laser therapy- diode laser (K Laser) (790-805) nm in CW mode of operation (and eight patients were the control group. Spot size of 8mm, time for exposure for each spot was 30 seconds. The power used was 0.6 W .The power density for each spot of treatment was 1.19 W/cm2 per session (non contact mode of application of laser therapy).The group studied received 2 sessions of laser radiation, day 4, and day 8 after

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Publication Date
Fri Mar 31 2017
Journal Name
Al-khwarizmi Engineering Journal
Preparation of Light Fuel Fractions from Heavy Vacuum Gas Oil by Thermal Cracking Reaction
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This work deals with thermal cracking of heavy vacuum gas oil which produced from the top of vacuum distillation unit at Al- DURA refinery, by continuous process. An experimental laboratory plant scale was constructed in laboratories of chemical engineering department, Al-Nahrain University and Baghdad University. The thermal cracking process was carried out at temperature ranges between 460-560oC and atmospheric pressure with liquid hourly space velocity (LHSV) equal to 15hr-1.The liquid product from thermal cracking unit was distilled by atmospheric distillation device according to ASTM D-86 in order to achieve two fractions, below 220oC as a gasoline fraction and above 220oC as light cycle o

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Publication Date
Thu Dec 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Eliminate harmful side – effects of Controls System by designing Activity – Based Responsibility Accounting model
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This research has come out with that, function-based responsibility accounting system has harmful side – effects preventing it of achieving its controlling objective, that is, goal congruence, which are due to its un integrated measures, its focus on measuring measurable behaviors while neglecting behaviors that are hardly measured, and its dependence on standard operating procedures.

In addition, the system hypotheses and measures are designed to fit previous business environment, not the current environment.

The research has also concluded that the suggestive model, that is, activity-based responsibility accounting is designed to get ride of harmful side – effects of functi

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