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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 Jul 06 2022
Journal Name
International Journal Of Biomaterials
Extracellular Enzyme of Endophytic Fungi Isolated from Ziziphus spina Leaves as Medicinal Plant
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Endophytic fungi live inside plants or any part of them without creating any visible pathogenic signs. Endophytic fungi are found within medicinal plants and have shown strong biologic activity, such as anticancer and antioxidant activities, as well as producing extracellular enzymes. In this study, different fungal strains were isolated from the leaves of the medicinal plant Ziziphus spina, including Aspergillus flavus, Aspergillus fumigatus, Aspergillus niger, Cladosporium sp., Rhizopus sp., and Mucor sp. Extracellular enzymes have been quantified using agar plate-based methods in which fungi were grown in specified growth media to detect the enzymes produced. The results showed that A. niger has the highest ability to produce amy

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Publication Date
Wed Dec 30 2020
Journal Name
Journal(of(materials(and( Environmental(science
Adsorption of dyes by activated carbon surfaces were prepared from plant residues: Review
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The process of discharging the quantities of dyes resulting from industrial processes with wastewater leads to the occurrence of a serious environmental problem that threatens the environmental health security of humans. Therefore, a number of studies have been addressed that include presenting many physical and chemical treatment methods to get rid or reduce the proportion of pigments such as biological decomposition, ion exchange, and sedimentation. Chemotherapy, reverse osmosis, coagulation, Toxic sludge generation, flocculation. In addition to the above, this review deals with a number of studies that present activated carbon of plant origin, methods of obtaining it, types and advantages of it being cheap and environmentally friendly. A

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Publication Date
Tue Jan 01 2019
Journal Name
Plant Archives
Lignin FT-IR study of Iraqi date palm Phoenix dactylifera frond bases wood‏
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Publication Date
Wed Sep 01 2021
Journal Name
Journal Of Engineering
Thermal Buckling of Laminated Composite Plates Using a Simple Four Variable Plate Theory
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In this study, the thermal buckling behavior of composite laminate plates cross-ply and angle-ply all edged simply supported subjected to a uniform temperature field is investigated, using a simple trigonometric shear deformation theory. Four unknown variables are involved in the theory, and satisfied the zero traction boundary condition on the surface without using shear correction factors, Hamilton's principle is used to derive equations of  motion depending on a Simple Four Variable Plate Theory for cross-ply and angle-ply, and then solved through Navier's double trigonometric sequence, to obtain critical buckling temperature for laminated composite plates. Effect of changing some design parameters such as, ortho

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Publication Date
Wed Jun 01 2022
Journal Name
Iraqi Journal Of Physics
Evaluation of Mechanical Properties for Epoxy reinforced with palm oil /Zinc oxide composites
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Sat Aug 31 2024
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Prevalence of exoU/exoS genotype among Pseudomonas aeruginosa isolated from burn wound infections
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Publication Date
Sat Dec 14 2019
Journal Name
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Utilizing an Artificial Neural Network Model to Predict Bearing Capacity of Stone Columns
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ABSTRACT: Ultimate bearing capacity of soft ground reinforced with stone column was recently predicted using various artificial intelligence technologies such as artificial neural network because of all the advantages that they can offer in minimizing time, effort and cost. As well as, most of applied theories or predicted formulas deduced analytically from previous studies were feasible only for a particular testing environment and do not match other field or laboratory datasets. However, the performance of such techniques depends largely on input parameters that really affect the target output and missing of any parameter can lead to inaccurate results and give a false indicator. In the current study, data were collected from previous rel

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Publication Date
Wed Jul 31 2019
Journal Name
Journal Of Engineering
Buckling Analysis of Laminated Composite Plate with Different Boundary Conditions using modified Fourier series
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Buckling analysis of a laminated composite thin plate with different boundary conditions subjected to in-plane uniform load are studied depending on classical laminated plate theory; analytically using (Rayleigh-Ritz method). Equation of motion of the plates was derived using the principle of virtual work and solved using modified Fourier displacement function that satisfies general edge conditions. The eigenvalue problem generated by using Ritz method, the set of linear algebraic equations can be solved using MATLAB for symmetric and anti-symmetric, cross and angle-ply laminated plate considering some design parameters such as aspect ratios, number of layers, lamination type and orthotropic ratio. The results obtained g

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Sun Jan 01 2023
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8th Engineering And 2nd International Conference For College Of Engineering – University Of Baghdad: Coec8-2021 Proceedings
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