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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
Tue Jun 14 2016
Journal Name
Al-academy
Expressive and aesthetic role of the scenes in the initiation speech the picture (Cinema Togravea)
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Construction is the opening of the important pillars of the construction of the film as a whole for this, we find that the first of any narrative of my film begin at the borders of this construction is the window that we look through the contents tale and puzzle narrative is of significance that degrade traveler when reservoirs expression later in reasoning and find justifications ills that came by those initiation, this initiation may be the window that lead us to the core, understanding the story through signals received to the recipient to sail because of the paths of pickling what is which is encoded, but this initiation may serve as keys that understanding the be puppies and signals that beset and surrounded to what He holds inevita

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Publication Date
Sun Apr 26 2015
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Investigate the Microbial Load and Types of Preservatives Yogurt Available In Local Market.: Investigate the Microbial Load and Types of Preservatives Yogurt Available In Local Market.
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The aim of this study to investigate the microbial load and type of preservative for the types of yogurt available in the Iraqi market to ensure the safety of food provided to the consumer and protect through examining the types of yogurt from harmful bacteria as well as to contain ratios acceptable to yeasts and molds is to find out by comparing models curd careless Iraqi standard quality(ISQ) and see how they conform to these specifications have been collecting 12 brands of yoghurt types it was been (Kala, Activia 1, Activia 2, Mazia, Shelan, Aib, Mersin, Morsi, Al-Safi, Zabady, Zakho, Arbil). Bacteriological tests were conducted on samples of yogurt (total bacterial count, coliform count, counting yeasts and molds). The results showed

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Chronic Exposure of Cadmium Chloride in Drinking Water on Structural and Functional Aspects of Thyroid Gland in Mature Male Rabbits
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The effect of chronic exposure to two different levels of cadmium chloride (CdCl2) 30 ppb and 40 ppb in drinking water for 12 weeks on thyroid function of mature male rabbits was studied. Eighteen mature male rabbits  were randomly divided into three groups (each of six ) , control group (group I ): were offered ordinary tap water , and treated groups (II and III ) were offered tap water containing 30ppb and 40 ppb respectively for 12 weeks .Serum concentration of  thyroxin (T4 ) and triiodothyronine (T3) were measured every six weeks ,as an index  of  thyroid function , further more ,  section of thyroid gland were prepared for histological studies. The results showed that  chronic exposure of male rabbits

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Publication Date
Mon Sep 01 2025
Journal Name
Euphrates Journal Of Agricultural Science
Effect of Coating Hatching Eggs with Nanoparticles and Carboxymethyl Cellulose and Storage periods on Hatchability and Quality of Hatched Chicks
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The current research aimed to conducting two experiments to study the effect of coating hatching eggs with nano-titanium dioxide (nano-TiO2) and nano-silica dioxide (nano-SiO2) particles and their mixture with carboxymethyl cellulose (CMC) on the characteristics of hatching percentage, embryo growth inside the egg. The study was conducted in the Department of Animal Production, College of Agriculture, Tikrit University for the period from 19/3/2023 to 17/9/2024. It aimed to evaluate the coating of hatching eggs with Nano-TiO2 and Nano-SiO2 particles and their mixture with carboxymethyl cellulose CMC on the qualities of hatching percentage, embryo growth inside the egg, as well as trying to obtain the best and longest storage method for fert

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Mottos Of Opposition Movements In Iraq During The Umayyad Period and Their Religious and Political Indications
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Mottos Of Opposition Movements In iraq during the umayyad period and their religious and political indications - al shia and al khawarij

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Publication Date
Sun Jan 10 2021
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Comparative Study between Neopterin and Alvarado Score in the Diagnosis of Acute Appendicitis and Its Severity
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BACKGROUND: Acute appendicitis (AA) remains a complex case even for experienced surgeons. Rate of negative appendectomy is 5–40% and delayed intervention result in perforated appendicitis in 5–30% of cases. AIM: The aim of the study was to evaluate NPT as a marker for the diagnosis of AA concerning its severity. And compare the diagnostic value of it with the ALV scoring system. METHODS: One hundred twenty patients presented with signs and symptoms of AA and underwent appendectomy, only 84 patients proved to be AA by histopathological examination, were included in the study. Blood samples for neopterin (NPT) estimation and Alvarado (ALV) score was calculated. Control group consists of 45 healthy individual. RESULTS: NPT levels were s

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Publication Date
Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
Frequency and Wavelength Dependences of the Electro-optic Coefficients r63 and r41 in Congruent KDP Crystals
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The electro-optic coefficient r63 and r41 are determined in congruent KDP crystals, using an experimental method based upon the direct measurement of material. Sénarmont system for electro-optic coefficient measurement and characterization of crystals was modified. This modification allowed us to obtain on the frequency dispersion dependence of the electro-optic coefficients within a frequency range up to 20 MHz and on a new version of modulation depth method. To the best of our knowledge, by using this system, the electro-optic coefficients r63 and r41 in different configurations (transverse and longitudinal) have been measured for the first time within a frequency range up to 20 MHz. The measurements have been investigated as a functi

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Publication Date
Sun Sep 15 2019
Journal Name
Al-academy
Synergy of Modern Technology and Artistic Aesthetics in the Cinema and Television Achievement: براق انس المدرس
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       Most of the cinema and television production relies on the use of modern digital technologies, which today become the as ideal as the artistic expressive style that sends aesthetic values ​​through the use of electronic elements of the language of cinema and television to achieve aesthetic dazzling, and design the digital production for the purpose of persuasion, as well as the use of digital effects and graphics to activate the aesthetic pleasure. The research tries to subject all these aspetcs to study and apply them to a modern sample in order to get the results that confirm this technical and artistic aesthetic synergy that leads to the emergence of a cinema and television achievement the leas

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Publication Date
Mon Jun 30 2025
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Assess the maturity of source rocks and their oil potential in greater Kirkuk and surrounding area
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   The region of Kirkuk and its surrounding areas, including (Baba, Jambour, Qara Chuq, Qaiyarah, Demir Dagh, Bai Hassan, Taq Taq, Makhul, Gilabat as well as southern Mosul and the cities of Erbil and Sulymania, are known as one of the oldest discovered oil fields in northern Iraq. This area presents a significant opportunity for further organic geochemical analysis to describe maturation zones and estimate economically generated hydrocarbons with particular reference to the Sargelu formation, to enhance hydrocarbons productivity. To assess the potential of these oil fields, it is essential to perform correlation, comparisons, and geochemical analyses of the data collected from exploration wells in the surrounding area. This appro

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Publication Date
Wed Oct 07 2020
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
Carbon Dioxide Laser in the Treatment of Oral and Craniofacial Soft Tissue Lesions, Pros and Cons
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Background and objectives: Whether to use a cold scalpel or laser surgery to remove a lesion in the skin of the craniofacial area is the main question the surgeon asks him- or herself to do. The study tried to extend the literature with data that may help the surgeons to choose the right method. Methods: Thirty patients with intra- and extraoral craniofacial skin lesions managed by Carbone dioxide (CO2) laser surgery. Results: The most common type of lesion treated was melanocytic nevi (15 patients; 50%). Conclusion: The main complication of CO2 laser surgery is the remaining permanent hypopigmentation of the treated area; however, the CO2 laser has many advantages (especially at the time of surgery) making it a good choice for the manageme

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