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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 Apr 10 2023
Journal Name
The European Physical Journal Plus
Improved performance of D149 dye-sensitized ZnO-based solar cell under solvents activation effect
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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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Publication Date
Sun Apr 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Assisting Students of Al-Quds Open University to Design Computerized Lessons According to ADDIE
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This Action research aimed at Assisting Students of Faculty of Educational Sciences  at Al-Quds Open University to design computerized  lessons using the Power Point software and according to ADDIE model. The study sample consisted of 40 students  who were taking a course titled Technology of Education during the second semester of the 2014-2015 academic year and three academic instructors . To collect the required date  , the researchers used  focus group technique and structured interviews to get information from the 40 students and the three academic instructors involved in the course Technology of Education in QOU /Nablus Branch. In addition to these methods, a workshop with a guiding checklist was employed t

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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Barriers to Baseline Needs for Early Detection of Breast Cancer among Iraqi Female Patients
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Background: Breast Cancer is the most common malignancy among the Iraqi population; the majority of cases are still diagnosed at advanced stages with poor prospects of cure. Early detection through promoting public awareness is one of the promising tools in its control. Objectives: To evaluate the baseline needs for breast cancer awareness in Iraq through exploring level of knowledge, beliefs and behavior towards the disease and highlighting barriers to screening among a sample of Iraqi women complaining of breast cancer. Methodology: Two-hundred samples were enrolled in this study; gathered from the National

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Publication Date
Wed Oct 28 2015
Journal Name
Journal Of Mathematics And System Science
Simulating Particle Swarm Optimization Algorithm to Estimate Likelihood Function of ARMA(1, 1) Model
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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact of Instructional Intervention about Personal Hygiene upon Women who complain Pelvic Inflammatory Disease
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Objective: To determine the impact of personal hygiene on woman who complain pelvic inflammatory disease Methodology: A quasi experimental study in the High Institute Infertility Diagnostic and A.R.T.(assistance reproductive technology) in AL-Kadimya city and al-Emamian al Kadmain medical city hospital. The sample collected during (26th ) January – (30th ) April 2014. A purposive sample of (60) women, (30) of them regard as study group and (30) regard as a control group whom they take routine care in the institute and hospital. The questionnaire consisted of socio-demographic data, reproductive heal

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Publication Date
Thu Nov 01 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Health education which is provided to Postoperative Patients with Gallstone "Obstructive Jaundice"
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Abstract A description study was carried through out the present study aimed to assess health education provided by nurses to patient with gall stone "obstructive jaundice". The study was conducted at 4 teaching hospital, Baghdad teaching hospital, Al-Karama teaching hospital, Al-Yarmook teaching hospital, Al-Kendy teaching hospital where choloecystectomy was performed, in the period from first of June 2004 to end of July 2004. Data were collected through the use of questionnaire an interview from which was developed for the purpose of the present study. A non-probability (purposive) sample which was consist

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Publication Date
Wed Apr 05 2023
Journal Name
Journal Of Engineering
A Developed Model for Selecting Optimum Locations of Water Harvesting Dams Using GIS Techniques
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An integrated GIS-VBA (Geographical Information System – Visual Basic for Application), model is developed for selecting an optimum water harvesting dam location among an available locations in a watershed. The proposed model allows quick and precise estimation of an adopted weighted objective function for each selected location. In addition to that for each location, a different dam height is used as a nominee for optimum selection. The VBA model includes an optimization model with a weighted objective function that includes beneficiary items (positive) , such as the available storage , the dam height allowed by the site as an indicator for the potential of hydroelectric power generation , the rainfall rate as a source of water . In a

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Thermo Elasto-Plastic Analysis of Rotating Axisymmetrical Bodies Using Modified Von-Mises Yield Criterion
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In the present work, the behavior of thick-walled cylinder of elasto-plastic material (polymeric material) has been studied analytically. The study is based on modified Von-Mises yield criterion (for non metallic material). The equations of stress distribution are obtained for the cylinder under general cases of elastic expansion, plastic initiation and elastic-plastic expansion.

        A computer program is developed for evaluating the stress distribution. The solution is carried out for worst boundary conditions when the cylinder is subjected to the combination of pressure load, inertia load, and temperature gradient.

        The results are presente

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Publication Date
Mon Aug 18 2025
Journal Name
Journal Of Genetic And Environment Conservation
Ultrasound application as a new green technology for preservation of table eggs: A review
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In recent years, there has been a significant increase in research demonstrating the new and diverse uses of non-thermal food processing technologies, including more efficient mixing and blending processes, faster energy and mass transfer, lower temperature and selective extraction, reduced thermal and concentration gradients, reduced equipment size, faster response to extraction control, faster start-up, increased production, and a reduction in the number of steps in preparation and processing. Applications of ultrasound technology have indicated that this technology has a promising and significant future in the food industry and preservation, and there is a wide scope for its use due to the higher purity of final products and the

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