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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 Jun 24 2020
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIVE DIATOM SPECIES IDENTIFIED BY USING POTENTIAL APPLICATION OF NEXT GENERATION DNA SEQUENCING
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   Molecular barcoding was widely recognized as a powerful tool for the identification of organisms during the past decade; the aim of this study is to use the molecular approach to identify the diatoms by using the environmental DNA. The diatom specimens were taken from Tigris River. The environmental DNA(e DNA) extraction and analysis of sequences using the Next Generation Sequencing (NGS) method showed the highest percentage of epipelic diatom genera including Achnanthidium minutissimum (Kützing) Czarnecki, 1994 (21.1%), Cocconeis placentula Ehrenberg, 1838 (21.3%) and Nitzschia palea (Kützing) W. Smith, 1856 (16.3%).

   Five species of diatoms: Achnanthidiu

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Publication Date
Sat Nov 03 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Nursing Care Management for Diabetes Mellitus Patient with Total Hip Replacement
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Objective: The aim of the study to evaluate the nursing care management for diabetes mellitus patient
with total hip replacement after fractured hip.
Methodology: A field study carried out on patients with diabetes mellitus and have total hip
replacement after fractured hip in orthopedic ward at the hospital of surgical specialization (malefemale)during
January 2002 to January 2003.Physical and psychological nursing
assessment
immediately after the surgery was done for the both subjects (control and experimental) and then a
scientific management with daily nursing care were provided to the experimental subject with daily
nursing care to the patient condition by using a scientific and practical methods and leave th

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Publication Date
Tue May 21 2019
Journal Name
The Journal Of Engineering
Performance of a tubular machine driven by an external‐combustion free‐piston engine
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Publication Date
Tue Oct 02 2018
Journal Name
Iraqi Journal Of Physics
Gas sensitivity properties of TiO2/Ag nanocomposite films prepared by pulse laser deposition
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In this study, a double frequency Q-switching Nd:YAG laser beam (1064 nm and λ= 532 nm, repetition rate 6 Hz and the pulse duration 10ns) have been used, to deposit TiO2 pure and nanocomposites thin films with noble metal (Ag) at various concentration ratios of (0, 10, 20, 30, 40 and 50 wt.%) on glass and p-Si wafer (111) substrates using Pulse Laser Deposition (PLD) technique. Many growth parameters have been considered to specify the optimum condition, namely substrate temperature (300˚C), oxygen pressure (2.8×10-4 mbar), laser energy (700) mJ and the number of laser shots was 400 pulses with thickness of about 170 nm. The surface morphology of the thin films has been studied by using atomic force microscopes (AFM). The Root Mean Sq

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Publication Date
Fri Nov 29 2019
Journal Name
Iraqi Journal Of Physics
Gas Sensing of (SnO2)1-x(ZnO)x Composite Associating with Electrical Properties
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Abstract

Semiconductor-based gas sensors were prepared, that use n-type tin oxide (SnO2) and  tin oxide: zinc oxide composite (SnO2)1-x(ZnO)x at different x ratios using pulse laser deposition at room temperature. The prepared thin films were examined to reach the optimum conditions for gas sensing applications, namely X-ray diffraction, Hall effect measurements, and direct current conductivity. It was found that the optimum crystallinity and maximum electron density, corresponding to the minimum charge carrier mobility, appeared at 10% ZnO ratio. This ratio appeared has the optimum NO2 gas sensitivity for 5% gas concentration at 300 °C working temperat

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Publication Date
Tue Mar 31 2015
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Performance of Corrosion Inhibitors Blend for Simulated Industrial Cooling Waters under Dynamic Conditions
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   The inhibitive action of a blend of sodium nitrite/sodium hexametaphosphate (SN+SHMP) on corrosion of carbon steel in simulated cooling water systems (CWS) has been investigated by weight loss and electrochemical polarization technique. The effect of temperature, velocity, and salts concentrations on corrosion of carbon steel were studied in the absence and presence of mixed inhibiting blend. Also the effect of inhibitors blend concentrations (SN+SHMP), temperatures, and rotational velocity, i.e., Reynolds number (Re) on corrosion rate of carbon steel were investigated using Second-order Rotatable Design (Box-Wilson Design) in performing weight loss and corrosion potential approach. Electrochemical polarization measurements

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Publication Date
Sat Aug 01 2020
Journal Name
Journal Of Engineering
Computation of Critical Submergence Depth to Avoid Surface Vortices at Vertical Pumps Intakes
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The pumping station became widely used in many fields. Free surface vortices at intakes of pumps are not favorable. It may cause noise, excessive vibration, damage to the pumping structure, reduction in efficiency and flow for hydro-turbines, etc. One of the important problems encountered during the pump intake design is the depth of submergence and other design parameters to avoid strong free-surface vortices formation. This study aims to compute the critical submergence depth with some geometrical and hydraulic limitations by using Computational Fluid Dynamic (CFD) package. The mathematical model was validated with a laboratory model that had been conducted. The model of three intake pipes was investigated under five d

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Publication Date
Sat Jan 01 2011
Journal Name
Journal Of Engineering
TREATMENT OF A HIGH STRENGTH ACIDIC INDUSTRIAL CHEMICAL WASTEWATER USING EXPANDED BED ADSORBER
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Treatment of a high strength acidic industrial wastewater was attempted by activated carbon
adsorption to evaluate the feasibility of yielding effluents of reusable qualities. The experimental
methods which were employed in this investigation included batch and column studies. The
former was used to evaluate the rate and equilibrium of carbon adsorption, while the latter was
used to determine treatment efficiencies and performance characteristics. Fixed bed and expanded
bed adsorbers were constructed in the column studies. In this study, the adsorption behavior of acetic acid onto activated carbon was examined as a function of the concentration of the adsorbate, contact time and adsorbent dosage. The adsorption data was mo

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Publication Date
Mon Dec 30 2002
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Vapor Phase Oxidation of Benzoic Acid to Phenol using Nickel-Iron Oxides Catalysts
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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Engineering
Hydrodesulfurization of Iraqi Atmospheric Gasoil by Ti-Ni-Mo/γ-Al2O3 Prepared Catalyst
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This study investigates the improvement of Iraqi atmospheric gas oil characteristics which contains 1.402 wt. % sulfur content and 16.88 wt. % aromatic content supplied from Al-Dura Refinery by using hydrodesulfurization (HDS) process using Ti-Ni-Mo/γ-Al2O3 prepared catalyst in order to achieve low sulfur and aromatic saturation gas oil. Hydrodearomatization (HDA) occurs simultaneously with hydrodesulfurization (HDS) process. The effect of titanium on the conventional catalyst Ni-Mo/γ-Al2O3 was investigated by physical adsorption and catalytic activity test.Ti-Ni-Mo/γ-Al2O3 catalyst was prepared under vacuum impregnation condition to ensure efficient pr

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