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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 Jun 01 2021
Journal Name
Journal Of The College Of Languages (jcl)
A Feminist Discourse Analysis of Writer's Gender Biases about Violence Against Women
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    The present study is concerned with the writer's ideologies towards violence against women. The study focuses on analyzing violence against women in English novel to see the extent the writers are being affected and influenced by their genders. It also focuses on showing to what extent the writer's ideologies are reflected in their works. Gender influences social groups ideologies; therefore, when a writer discusses an issue that concerns the other gender, they will be either subjective or objective depending on the degree of influence, i.e., gender has influenced their thoughts as well as behaviors. A single fact may be presented differently by different writers depending on the range of a

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Mon Jan 01 2018
Journal Name
Aip Conference Proceedings
Theoretical study of electronic transfer current rate at dye-sensitized solar cells
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Mon Nov 01 2021
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Chaos, Solitons & Fractals
Dynamic analysis of a harvested fractional-order biological system with its discretization
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Sat Jun 01 2013
Journal Name
Engineering And Technology Journal
Performance Improvement of Multi-UserMC-CDMA system Using Discrete Hartly Transform Mapper
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Future wireless communication systems must be able to accommodate a large number of users and simultaneously to provide the high data rates at the required quality of service. In this paper a method is proposed to perform the N-Discrete Hartley Transform (N-DHT) mapper, which are equivalent to 4-Quadrature Amplitude Modulation (QAM), 16-QAM, 64-QAM, 256-QAM, … etc. in spectral efficiency. The N-DHT mapper is chosen in the Multi Carrier Code Division Multiple Access (MC-CDMA) structure to serve as a data mapper instead of the conventional data mapping techniques like QPSK and QAM schemes. The proposed system is simulated using MATLAB and compared with conventional MC-CDMA for Additive White Gaussian Noise, flat, and multi-path selective fa

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Publication Date
Tue Oct 01 2024
Journal Name
Mathematics For Applications
DIRICHLET PROCESS ANALYSIS USING BIORTHOGONAL WAVELET: A STATISTICAL STUDY OF FINANCIAL MARKET
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The Dirichlet process is an important fundamental object in nonparametric Bayesian modelling, applied to a wide range of problems in machine learning, statistics, and bioinformatics, among other fields. This flexible stochastic process models rich data structures with unknown or evolving number of clusters. It is a valuable tool for encoding the true complexity of real-world data in computer models. Our results show that the Dirichlet process improves, both in distribution density and in signal-to-noise ratio, with larger sample size; achieves slow decay rate to its base distribution; has improved convergence and stability; and thrives with a Gaussian base distribution, which is much better than the Gamma distribution. The performance depen

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Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of instructional intervention upon multipara women’s practices to control stress incontinence
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Objective(s): to determine the effectiveness of instruction intervention upon multipara women's practices to
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Methodology: A quasi-experimental study was carried out from (2nd) April, 2010 to 15th June, 2010. Nonprobability
(purposive sample) of (60) multiparous women was selected from Baghdad Teaching Hospital and AlElwia
Maternity Teaching Hospital in Baghdad city, the sample was divided into two groups (30) women were
considered as a study group, and another (30) were considered as the control group. An instructional intervention
was applied on the study group, while the intervention was not applied on control group. A questionnaire was
resolve as a tool of data collection to suit the p

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Publication Date
Wed Nov 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Two New Records of Coelioxys Latreille, 1809 (Hymenoptera: Apoidea: Megachilidae) from Iraq
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Abstract<p>Five <italic>Coelioxys</italic> Latreille, 1809 species previously recorded in Iraq; <italic>Coelioxys emargintus</italic> Förster, 1853 and <italic>Coelioxys brevis</italic> Eversmann, 1852 newly recorded species. A brief re-description of each is given, supported by photographs; as well as a provided for their global distribution.</p>
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Tue Dec 05 2023
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Application of Sulfur-2,4-dinitrophenylhydrazine as Modifier for Producing an Advantageous Concrete
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In this investigative endeavor, a novel concrete variety incorporating sulfur-2,4-dinitrophenylhydrazine modification was developed, and its diverse attributes were explored. This innovative concrete was produced using sulfur-2,4-dinitrophenylhydrazine modification and an array of components. The newly created sulfur-2,4-dinitrophenylhydrazine modifier was synthesized. The surface texture resulting from this modifier was examined using SEM and EDS techniques. The component ratios within concrete, chemical and physical traits derived from the sulfur-2,4-dinitrophenylhydrazine modifier, chemical and corrosion resistance of concrete, concrete stability against water absorption, concrete resilience against freezing, physical and mechanical p

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Wed Dec 01 2021
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Enhancement of Electron Temperature under Dense Homogenous Plasma by Pulsed Laser Beam
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The applications of hot plasma are many and numerous applications require high values of the temperature of the electrons within the plasma region. Improving electron temperature values is one of the important processes for using this specification in plasma for being adopted in several modern applications such as nuclear fusion, plating operations and in industrial applications. In this work, theoretical computations were performed to enhance electron temperature under dense homogeneous plasma. The effect of   power and duration time of pulsed Nd:YAG laser   was studied on the heating of   plasmas  by inverse bremsstrahlung  for  several values for the electron density ratio. There results for these ca

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Sun Jun 01 2014
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Solution of Second Kind Volterra Integral Equations Using Non-Polynomial Spline Functions
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In this paper we use non-polynomial spline functions to develop numerical methods to approximate the solution of 2nd kind Volterra integral equations. Numerical examples are presented to illustrate the applications of these method, and to compare the computed results with other known methods.

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