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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
Mon Aug 01 2011
Journal Name
Journal Of Engineering
INVESTIGATION OF TWISTED TAPE TURBULATOR FOR FIRE TUBE BOILER Part I. Heat Transfer
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The present work presents a new experimental study of the enhancement of turbulent
convection heat transfer inside tubes for combined thermal and hydrodynamic entry length of one
popular “turbulator” (twisted tape with width slightly less than internal tube diameter) inserted for
fire tube boilers. Cylindrical combustion chamber was used to burn (1.6 to 7kg/h) fuel oil #2 to
deliver hot gases with ranges of Reynolds number (10500 to 21700), and (11400 to 24150) for both
empty and inserted tube respectively.A uniform wall temperature technique was used by keeping
approximately constant water temperature difference (25ºC) between inlet and exit cooling water in
parallel flow shell and tube heat exchanger. The test

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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Engineering
Behavior of Reinforced Concrete Deep Beams Strengthened with Carbon Fiber Reinforced Polymer Strips
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This research is concerned to investigate the behavior of reinforced concrete (RC) deep beams strengthened with carbon fiber reinforced polymer (CFRP) strips. The experimental part of this research is carried out by testing seven RC deep beams having the same dimensions and steel reinforcement which have been divided into two groups according to the strengthening schemes. Group one was consisted of three deep beams strengthened with vertical U-wrapped CFRP strips. While, Group two was consisted of three deep beams strengthened with inclined CFRP strips oriented by 45o with the longitudinal axis of the beam. The remaining beam is kept unstrengthening as a reference beam. For each group, the variable considered

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Publication Date
Thu Dec 30 2004
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Oil Removal from Wastewater of Al-Bezerqan Crude Oil Fields by Air Flotation
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Publication Date
Wed Sep 01 2010
Journal Name
Al-khwarizmi Engineering Journal
Extraction of Monocyclic Aromatic Hydrocarbons From Petroleum Products Using Sulfolane as Industrial Solvent
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            Liquid – liquid equilibria data were measured at 293.15 K for the pseudo ternary system (sulfolane + alkanol) + octane + toluene. It is observed that the selectivity of pure sulfolane increases with cosolvent methanol but decreases with increasing the chain length of hydrocarbon in 1-alkanol. The nonrandom two liquid (NRTL) model, UNIQUAC model and UNIFAC model were used to correlate the experimental data and to predict the phase composition of the systems studied. The calculation based on NRTL model gave a good representation of the experimental tie-line data for all systems studied. The agreement between the correlated and the experimental results was very good

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Publication Date
Tue Oct 30 2018
Journal Name
Journal Of Engineering
Deep Oxidative Desulfurization of Model fuels by Prepared Nano TiO2 with Phosphotungstic acid
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In this study, nano TiO2 was prepared with titanium isopropoxide (TTIP) as a resource to titanium oxide. The catalyst was synthesized using phosphotungstic acid (PTA) and, stearyl trimethyl ammonium bromide (STAB) was used as the structure-directing material. Characterization of the product was done by the X-ray diffraction (XRD), X-ray fluorescent spectroscopy (XRF), nitrogen adsorption/desorption measurements, Atomic Force Microscope (AFM) and Fourier transform infrared (FTIR) spectra, were used to characterize the calcined TiO2 nanoparticles by STAB and PWA. The TiO2 nanomaterials were prepared in three crystalline forms (amorphous, anatase, anatase-rutile). The results showed that the

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Publication Date
Mon Aug 03 2020
Journal Name
Digest Journal Of Nanomaterials And Biostructures
PREPARATION OF MIXED In2O3 – CdO THIN FILMS BY CSP TECHNIQUE FOR LIGHT SENSING
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In this work, chemical spray pyrolysis deposition (CSP) technique was used to prepare a mixed In2O3-CdO thin films with different CdO content (10, 30 and 50)%volume ratio on glass substrates at 150 ᵒC substrate temperature. The surface morphology and structural properties were measured to find the optimum conditions to improve thin films properties for using as photo detector. Current –Time, the sensitivity and response speed vary for each mixture. Samples with 10% vol. CdO content has square pulse response with average rise time nearly 1s and fall time 1s.

Publication Date
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Discrimination of Malignant from Acute Benign Compression Spinal Fractures with Magnetic Resonance imaging
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Background: Differentiation between malignant and benign vertebral compression fracture is often problematic. This is precisely difficult in elderly who are predisposed to benign compression caused by osteoporosis .Establishing correct diagnosis is of great importance in determining the treatment andprognosis.A study was performed to determine which magnetic resonance imaging findings are useful in discrimination between metastatic and acute osteoporotic compression fractures of the spine. Recently MRI is being increasingly used for evaluation of these fractures.Objectives: The aim of this study is to establish the correct diagnosis of malignant and benign compression vertebral fracture by MRI to determine treatment and prognosis.Methods

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Publication Date
Thu Dec 13 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Clients’ Satisfaction towards Primary Health Care Centers Services at Baghdad City
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Objective: To evaluate the client's satisfaction about the services provided in primary health care centers in the
city of Baghdad and its impact on the improvement of services.
Methodology: A simple random sample consisting of (200) clients to primary health care centers in the city of
Baghdad, (15-20) clients for each center using a questionnaire to evaluate the client's satisfaction for the service
and the use of the direct method of interview, which lasts for (6-10) minutes.
Results: Results of the study show that the number of men visits to primary health care centers, fewer women
This indicates that the most important responsibilities of family members and private health care is the
responsibility of women than

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Publication Date
Mon Dec 18 2017
Journal Name
Al-khwarizmi Engineering Journal
Path Planning of an Autonomous Mobile Robot using Enhanced Bacterial Foraging Optimization Algorithm
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This paper describes the problem of online autonomous mobile robot path planning, which is consisted of finding optimal paths or trajectories for an autonomous mobile robot from a starting point to a destination across a flat map of a terrain, represented by a 2-D workspace. An enhanced algorithm for solving the problem of path planning using Bacterial Foraging Optimization algorithm is presented. This nature-inspired metaheuristic algorithm, which imitates the foraging behavior of E-coli bacteria, was used to find the optimal path from a starting point to a target point. The proposed algorithm was demonstrated by simulations in both static and dynamic different environments. A comparative study was evaluated between the developed algori

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Publication Date
Thu Jun 30 2016
Journal Name
Iraqi Geological Journal
ASSESSMENT OF GROUNDWATER QUALITY USING WATER QUALITY INDEXIN, AL-HAWIJA AREA, NORTHERN IRAQ
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The quality of groundwater in the Al-Hawija area was assessed using a water quality index. Data of nine physico-chemical parameters of 28 groundwater wells were used to calculate the water quality index (WQI). A heterogeneous water quality was reported, where in close proximity to the Lesser Zab River (LZR), it has low WQI values and permissible for human consumptions due to the dilution processes by fresh water; whereas, it becomes deteriorated in areas located far away the river. The values of WQI ranges from 22 to 336, indicating a good to very poor groundwater quality.

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