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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
Thu Dec 01 2016
Journal Name
Journal Of Engineering
Experimental Investigation of Natural Convection into a Horizontal Annular Tube with Porous Medium Effects
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In this work, an experimental investigation has been done for heat transfer by natural-convection through a horizontal concentric annulus with porous media effects. The porous structure in gap spacing consists of a glass balls and replaced by plastic (PVC) balls with different sizes. The outer surface of outer tube is isothermally cooled while the outer surface of inner tube is heated with constant heat flux condition. The inner tube is heated with different supplied electrical power levels. Four different radius ratios of annulus are used. The effects of porous media material, particles size and annulus radius ratio on heat dissipation in terms of average Nusselt number have been analyzed.

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Publication Date
Tue Jan 31 2017
Journal Name
Journal Of Engineering
Static Analysis of Laminated Composite Plate using New Higher Order Shear Deformation Plate Theory
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 In the present work a theoretical analysis depending on the new higher order . element in shear deformation theory for simply supported cross-ply laminated plate is developed. The new displacement field of the middle surface expanded as a combination of exponential and trigonometric function of thickness coordinate with the transverse displacement taken to be constant through the thickness. The governing equations are derived using Hamilton’s principle and solved using Navier solution method to obtain the deflection and stresses under uniform sinusoidal load. The effect of many design parameters such as number of laminates, aspect ratio and thickness ratio on static behavior of the laminated composite plate has been studied. The

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Publication Date
Mon Jun 30 2014
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Viscosity Reduction of Sharqi Baghdad Heavy Crude Oil Using Different Polar Hydrocarbons, Oxygenated Solvents
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This work studied the facilitation of the transportation of Sharqi Baghdad heavy crude oil characterized with high viscosity 51.6 cSt at 40 °C, low API 18.8, and high asphaltenes content 7.1 wt.%, by reducing its viscosity from break down asphaltene agglomerates using different types of hydrocarbon and oxygenated polar solvents such as toluene, methanol, mix xylenes, and reformate. The best results are obtained by using methanol because it owns a high efficiency to reduce viscosity of crude oil to 21.1 cSt at 40 °C. Toluene, xylenes and reformate decreased viscosity to 25.3, 27.5 and 28,4 cSt at 40 °C, respectively. Asphaltenes content decreased to 4.2 wt. % by using toluene at 110 °C. And best improvement in API of the heavy crude o

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Publication Date
Fri Sep 02 2022
Journal Name
Military Medical Science Letters
SOLID LIPID NANOPARTICLES AS A PROMISING APPROACH FOR DELIVERY OF ANTICANCER AGENTS: REVIEW ARTICLE
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Cancer disease has a complicated pathophysiology and is one of the major causes of death and morbidity. Classical cancer therapies include chemotherapy, radiation therapy, and immunotherapy. A typical treatment is chemotherapy, which delivers cytotoxic medications to patients to suppress the uncontrolled growth of cancerous cells. Conventional oral medication has a number of drawbacks, including a lack of selectivity, cytotoxicity, and multi-drug resistance, all of which offer significant obstacles to effective cancer treatment. Multidrug resistance (MDR) remains a major challenge for effective cancer chemotherapeutic interventions. The advent of nanotechnology approach has developed the field of tumor diagnosis and treatment. Cancer nanote

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Publication Date
Wed Dec 29 2021
Journal Name
Al-khwarizmi Engineering Journal
Analysis of Magnetorheological Normally Close Directional Control Valve: Magnetorheological normally close directional control valve
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This valve is intended for use in valves for steering movement, using the qualities of the Magneto-rheological (MR) fluid to regulate the fluid, direct contact without the utilization of moving parts like a spool, a connection between electric flux, and fluid power was made, The simulation was done to employ the" finite element method of magnetism (FEMM)" to arrive at the best design. This software is used for magnetic resonance valve finite element analysis. The valve's best performance was obtained by using a closed directional control valve in the normal state normally closed (NC) MR valve, with simulation results revealing the optimum magnetic flux density in the absence of a current and the shedding condition, as well as the optimum

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Publication Date
Sat Sep 02 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Desulphurization of Simulated Oil Using SAPO-11 with CNT's as Adsorbent: A Kinetic Study
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In this study, sulfur was removed from imitation oil using oxidative desulfurization process. Silicoaluminophosphate (SAPO-11) was prepared using the hydrothermal method with a concentration of carbon nanotubes (CNT) of 0% and 7.5% at 190 °C crystallization temperature. The final molar composition of the as-prepared SAPO-11 was Al2O3: 0.93P2O5: 0.414SiO2. 4% MO/SAPO-11 was prepared using impregnation methods. The produced SAPO-11 was described using X-ray diffraction (XRD) and Brunauer-Emmet-Teller (N2 adsorption–desorption isotherms). It was found that the addition of CNT increased the crystallinity of SAPO-11. The results showed that the surface area of SAPO-11 containing 7.5% CNT was 179.54 m2/g, and the pore volume was 0.31

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Publication Date
Sun Mar 15 2026
Journal Name
Arab World English Journal
A Social Semiotic Analysis of Instagram as a Multimodal Platform for Supporting EFL Learners
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Social media has become an essential educational tool nowadays. Most existing research on digital learning in EFL contexts has primarily focused on traditional classroom-based instruction and less attention has been paid to social media platforms. The present study aims to fill the gap by using social semiotics to analyze four Instagram posts: two from BBC Learning English (@bbclearningenglish) and the other two from Learn English with Emma (@englishwithemma). Instagram posts are classified as multimodal texts with participatory and representational elements. The study adopts Kress and van Leeuwen’s (2005) Social Semiotic Multimodal Framework to analyze four purposely selected posters by answering the following research questions

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Publication Date
Sat Mar 30 2024
Journal Name
Iraqi Journal Of Science
Antifungal Activity of Trichoderma orientale FMR 12486 Crude Extract against Some Human Pathogenic Fungi
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This work aimed to investigate the prevalence of pathogenic fungi and evaluate the antifungal activity of Trichoderma orientale FMR12486 crude extract against pathogenic fungi isolated from patients attending the National Center for Thoracic and Respiratory Diseases (having a history of tuberculosis) and consultant of Dermatology of Baghdad hospital, Iraq. A total of 80 clinical specimens were collected: 20 skin scrapings specimens and 60 sputum specimens. The results of direct examination by KOH 10% and culture showed that 11 (55%) cases from 20 skin specimens were positive for fungal infections, while in the sputum specimens, 28 (47%) cases from 60 were positive. Candida albicans represented the most common fungal infection isolat

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Publication Date
Wed Jun 30 2021
Journal Name
International Journal Of Intelligent Engineering And Systems
Promising Gains of 5G Networks with Enhancing Energy Efficiency Using Improved Linear Precoding Schemes
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Publication Date
Thu Sep 28 2023
Journal Name
Iraqi Journal Of Computer, Communication, Control And System Engineering
Distinct Architectures of Feed Forward Neural Network for Implementing A Human Swing Leg System
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The artificial intelligence techniques such as neural networks and fuzzy systems play an important role to disconnect flexion & expansion of the swing leg, the earth response force of the other foot has been redesigned. Under that paper, we think the fuzzy controller plan issue for yield following flawed genuine investigation of nonlinear systems. For examination, an essential fuzzy control plot has been bristly developed dependent on a current methodology delegate under the field. In this paper, the Feedforward Neural Network has been implemented with integer, fixed point and floating point data representations. Additionally, The Fuzzy Logic Controllers in both analog and digital forms has been implemented in hardware. Both designs use les

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