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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
Sun Jan 01 2023
Journal Name
8th Engineering And 2nd International Conference For College Of Engineering – University Of Baghdad: Coec8-2021 Proceedings
Finite element modeling of concavely curved soffit RC beams externally strengthened with FRP
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Publication Date
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Women's knowledge about Family Planning Methods at Omer Sawi Teaching Hospital
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Objectives:This study aimed to identify women perception and experience regarding family planning(FP) methods

 Methodology:Descriptive cross-sectional hospital based study,was conducted at Omer Sawi teaching hospital,from august to September 2019.Sample of 320 women, were selected randomly after their agreement.Data were collected through interview questionnaire and analyzed using a statistical package for social sciences (SPSS)and descriptive and inferential statistical methods were used.With accepted P.< 0.05.for the correlation significant. 

Results:Age group between 21-25 years represent (53.1%),most common education levels were secondary school 56%.Majority of women had 2-5 children.Half of the wo

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Publication Date
Wed Dec 15 2004
Journal Name
Iraqi Journal Of Laser
Interstitial Photocoagulation of Low Anal Fistula using 810 nm Diode Laser: Prospective Study
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Many conservative sphincter-preserving procedures had been described to be effective in
healing of anal fistula without excision or de roofing.
Objective: To verify the outcome of mere photocoagulation of the fistula tract on healing of low anal
fistula.
Materials and Methods: Using 810nm diode laser, the tracts of low anal fistulae in a cohorts of six male
patients (mean age of 32 yr) had been photocoagulated by retrograde application of laser light through an
orb tip optical fiber threaded in to the tract. Swabs for culture and sensitivity testing were obtained before
and after laser application. Patients were followed up regularly to announce fistula healing.
Results: Mean laser exposure time was 6.6 min., mean

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Publication Date
Mon Sep 04 2023
Journal Name
2023 International Conference On Advanced Mechatronic Systems (icamechs)
Performance Analysis of Finite-Time Generalized Proportional Integral Observer for Uncertain Brunovsky Systems
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This paper proposes a novel finite-time generalized proportional integral observer (FTGPIO) based a sliding mode control (SMC) scheme for the tracking control problem of high order uncertain systems subject to fast time-varying disturbances. For this purpose, the construction of the controller consists of two consecutive steps. First, the novel FTGPIO is designed to observe unmeasurable plant dynamics states and disturbance with its higher time derivatives in finite time rather than infinite time as in the standard GPIO. In the FTGPO estimator, the finite time convergence rate of estimations is well achieved, whereas the convergence rate of estimations by classical GPIO is asymptotic and slow. Secondly, on the basis of the finite and fast e

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Publication Date
Mon Jan 18 2021
Journal Name
Materials Science And Engineering
Properties of engineered cementitious composite concrete (bendable concrete) produced using Portland limestone cement
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Bendable concrete, also known as Engineered Cementitious Composite (ECC) is a type of ultra-ductile cementitious composites reinforced with fibres to control the width of cracks. It has the ability to enhance concrete flexibility by withstanding strains of 3% and higher. The properties of bendable concrete mixes (compressive strength, flexural strength, and drying shrinkage) are here assessed after the incorporation of supplementary cementitious materials, silica fume, polymer fibres, and the use of ordinary Portland cement (O.P.C) and Portland limestone cement (IL). Mixes with Portland limestone cement show lower drying shrinkage and lower compressive and flexural strength than mixes with ordinary Portland cement, due to the ratio o

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Publication Date
Tue Nov 15 2022
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
A-mechanical properties of engineered cementitious composite concrete produced from Portland limestone cement
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Conventional concretes are almost unbending, and even a small amount of strain potential leaves them brittle. This lack of bendability is a major source of strain loss, and it has been the main goal behind the development of bendable concrete, often known with engineered ce ment composites, or ECC. This form of concrete has a lot more flexibility than regular concrete. Micromechanical polymer fibers are used to strengthen ECC. In most cases, ECC uses a 2% amount of thin, separated fibers. As a result, bendable concrete deforms but unlike traditional concrete, it does not crack. This study aims to include this kind of concrete, bendable concrete, which can be used to solve concrete problems. Karasta (CK) and Tasluja (CT) Portland Lime

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Publication Date
Sun Dec 30 2018
Journal Name
Journal Of Engineering
Abrasive Wear Characteristics of Composite Material (AA 7075 / SiC) Synthesized by Stir Casting
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Aluminum Metal Matrix Composites (ALMMCs) was prepared by using stir casting technique for AA 7075 aluminum alloy as a matrix reinforced with SiC particles at various percentages (3, 6, 9 and 12 wt. % ) and 75µm in grain size. The prepared composite material can be used for many applications such as aerospace, automobiles and many industrial sectors. Abrasive wear test was carried out by two stages: the first stage was done by changing the emery papers at various grit sizes 180, 320, 500, and 1000µm with constant applied load 15N. While the second stage was carried out by changing the applied loads 5, 10, 15, 20 and 25N with constant emery paper at 320 µm grit size. Microstructure examination, hardness test and roughn

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Sun Jan 01 2023
Journal Name
Brazilian Dental Science
Wound healing effect of a one-week Aloe Vera mouthwash: a pilot study
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Publication Date
Fri Nov 01 2019
Journal Name
Indian Journal Of Public Health Research & Development
Prevalence of β-lactam Resistant Klebsiella Pneumoniae Isolates among Clinical Specimensin Baghdad Hospitals
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One hundred forty three of Klebsiellapneumoniae isolates had been collected from some hospitals in Baghdad city. The isolates were taken from different clinical specimens.Antimicrobial susceptibility test was carried out towards fifteen antimicrobial agents by using Vitek2 system with Antimicrobial susceptibility test cards. The results of antibiogram showed that the local isolates were possess highly resistance towards most antimicrobial agents under study. The high resistance wastoAmpicillin while the low resistance was to Imipenem.Two methods were used for detection of Extended Spectrum Beta Lactamases (ESBLs) production; first methods by using of Vitek2 system,thesecondmethods by using of polymerase chain reaction (PCR) technique to dis

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Publication Date
Fri Jun 23 2023
Journal Name
Journal The College Of Basic Education / Al-mustansiriyah University
Numerical Solution of Non-linear Delay Differential Equations Using Semi Analytic Iterative Method
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We present a reliable algorithm for solving, homogeneous or inhomogeneous, nonlinear ordinary delay differential equations with initial conditions. The form of the solution is calculated as a series with easily computable components. Four examples are considered for the numerical illustrations of this method. The results reveal that the semi analytic iterative method (SAIM) is very effective, simple and very close to the exact solution demonstrate reliability and efficiency of this method for such problems.

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