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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
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
A Modified Organic Method for Preparation of Ibuprofen Microcapsules As a Sustained Release Solid Dosage Form
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ABSTRACT:
Microencapsulation is used to modify and retard drug release as well as to overcome the unpleasant effect
(gastrointestinal disturbances) which are associated with repeated and overdose of ibuprofen per day.
So that, a newly developed method of microencapsulation was utilized (a modified organic method) through a
modification of aqueous colloidal polymer dispersion method using ethylcellulose and sodium alginate coating materials to
prepare a sustained release ibuprofen microcapsules.
The effect of core : wall ratio on the percent yield and encapsulation efficiency of prepared microcapsules was low, whereas
, the release of drug from prepared microcapsules was affected by core: wall ratio ,proportion of coa

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Publication Date
Fri Jan 01 2016
Journal Name
Aip Conference Proceedings
Analysis of performance measures with single channel fuzzy queues under two class by using ranking method
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Wed Jun 19 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Disclosure of deferred taxes according to IAS-12: بحث تطبيقي في الهيئة العامة للضرائب قسم الشركات
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The research aims to clarify the importance of adoption of International Accounting  Standard No. (12) "Income Taxes" as a tool for the measurement and disclosure of income taxes in the financial statements، and how to deal with the differences that arise as a result of difference in net profit accounting for net tax profit ،The problem of the research focused on the disparity between the income tax estimate in Iraq in accordance with the accounting standards and financial reporting and assessment of income tax in accordance with the tax laws and legislation, this discrepancy has led to the emergence of differences between accounting profit and tax profit (temporary differences and permanent differences) and these differences of w

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Thu Oct 01 2020
Journal Name
Journal Of Engineering Science And Technology
GEOMETRIC NONLINEAR TIME DOMAIN SPECTRALMATCHING SEISMIC ANALYSIS OF BASE ISOLATED HIGHRISE BUILDINGS INCLUDING P-DELTA EFFECT
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Thu Dec 01 2011
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OPTIMAL DESIGN OF MODERATE THICK LAMINATED COMPOSITE PLATES UNDER STATIC CONSTRAINTS USING REAL CODING GENETIC ALGORITHM
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The objective of the current research is to find an optimum design of hybrid laminated moderate thick composite plates with static constraint. The stacking sequence and ply angle is required for optimization to achieve minimum deflection for hybrid laminated composite plates consist of glass and carbon long fibers reinforcements that impeded in epoxy matrix with known plates dimension and loading. The analysis of plate is by adopting the first-order shear deformation theory and using Navier's solution with Genetic Algorithm to approach the current objective. A program written with MATLAB to find best stacking sequence and ply angles that give minimum deflection, and the results comparing with ANSYS.

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Dimensional stability of heat-activated acrylic resin at different time intervals by different flask cooling methods
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This study was design to investigate the dimensional stability of heat-activated acrylic resin with different methods of flask cooling (15 minutes rapid cooling, one hour bench cooling, four hours delayed deflasking, and 24 hours delayed deflasking) at different time intervals (immediately, two days, seven days, 30 days) after deflasking. Heat-activated acrylic resin was used to prepare acrylic samples. Then, measurement of the distances where achieved between the centers of selected marks in the acrylic samples. They were measured at different time intervals for different methods of flask cooling. The results showed that the group samples of the four hours and 24 hours of delayed deflasking was insignificantly different from the control an

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Engineering
Efficient Energy Management for a Proposed Integrated Internet of Things-Electric Smart Meter (2IOT-ESM) System
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In this work, an efficient energy management (EEM) approach is proposed to merge IoT technology to enhance electric smart meters by working together to satisfy the best result of the electricity customer's consumption. This proposed system is called an integrated Internet of things for electrical smart meter (2IOT-ESM) architecture. The electric smart meter (ESM) is the first and most important technique used to measure the active power, current, and energy consumption for the house’s loads. At the same time, the effectiveness of this work includes equipping ESM with an additional storage capacity that ensures that the measurements are not lost in the event of a failure or sudden outage in WiFi network. Then then these

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This paper is an attempt to investigate the syntactic and semantic features of the English phrasal verbs. In this paper, phrasal verbs were classified into subgroups according to their syntactic and semantic characteristics. After giving a survey of literature written on the meaning and definition of phrasal verbs, two sections have been devoted to tackle the most important issues in this category of English verbs. Section one sheds light on the basic definitions of the term ‘phrasal verb’ which are, according to the researcher’s point of view, sufficient to cover the area of the study. In addition, it studies the number and the importance of phrasal verbs in English. Section two deals with the syntactic and semantic features of Engli

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