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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
Fri Mar 31 2017
Journal Name
Al-khwarizmi Engineering Journal
Active Vibration Suppression of Smart Cantilever Beam with Sliding Mode Observer Using Two Piezoelectric Patches
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This paper presents a vibration suppression control design of cantilever beam using two piezoelectric ‎patches. One patch was used as ‎an actuator element, while the other was used as a sensor. The controller design was designed via the balance realization reduction method to elect the reduced order model that is most controllable and observable. ‎the sliding mode observer was designed to estimate six states from the reduced order model but three states are only used in the control law. Estimating a number of states larger than that used is in order to increase the estimation accuracy. Moreover, the state ‎estimation error is proved bounded. An ‎optimal LQR controller is designed then using the ‎estimated states with the slid

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Publication Date
Mon Dec 01 2025
Journal Name
Case Studies In Construction Materials
Optimized stress-strain modeling of eco-friendly fiber-reinforced concrete members using meta-heuristic algorithms
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Eco-friendly concrete is produced using the waste of many industries. It reduces the fears concerning energy utilization, raw materials, and mass-produced cost of common concrete. Several stress-strain models documented in the literature can be utilized to estimate the ultimate strength of concrete components reinforced with fibers. Unfortunately, there is a lack of data on how non-metallic fibers, such as polypropylene (PP), affect the properties of concrete, especially eco-friendly concrete. This study presents a novel approach to modeling the stress-strain behavior of eco-friendly polypropylene fiber-reinforced concrete (PFRC) using meta-heuristic particle swarm optimization (PSO) employing 26 PFRC various mixtures. The cement was partia

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Hard-grade asphalt binders, such as AC 20–30, offer excellent resistance to permanent deformation but are inherently brittle, making them highly susceptible to fatigue and low-temperature cracking. While polymer modification addresses these issues, virgin polymers remain expensive. Despite the growing interest in recycled plastics, the rheological impact of complex waste streams, specifically polyvinyl chloride (PVC) derived from flex banners containing plasticizers, on excessively stiff binders within the complete Superpave Performance Grading (PG) framework remains critically underexplored. This study introduces a novel valorization approach by utilizing solvent-extracted flex banner waste (WPVC) as a dual-action modifier. It leverages

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Sat Jan 25 2020
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
A Stereomicroscopic Analysis of Dentinal Micro Cracks after Root Canal Preparation Using Four Different Rotary Instruments.
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A variety of single-engine driven files and inematics have been introduced to improve the clinical performance of NiTi rotary files. The purpose of this in vitro study was to measure and compare the incidence of dentinal defects after root canal preparation with different single file systems.

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Sat Jan 25 2020
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
Bioactivity of Gutta flow II versus Modified Gutta Percha based Silicon Endodontic Sealers by Nanobioactive Fillers
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The success of endodontic therapy is relied on radicular system cleaning, shaping, elimination of micro-organisms, and three dimensional filling of the radicular complex.This study was conducted to develop and assess new root canal sealer incorporating nano-sized bioactive glass into Gutta Flow II. The following concentration was used depend on a pilot study included adding (3%) of 45S5 bioactive glass into the Gutta Flow II. These materials were tested through assessment bioactivity. bioactivity test was undertaken after immersion of the tested samples into PBS for three days, seven days, fourteen days, and twenty eight days using FTIR too. study was found that it’s peaks was appear at level 800-1000 cm-1. The results showed that GFII gr

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Publication Date
Tue Jun 01 2021
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Experimental Investigation of a Single Basin -Single Slope Solar Still Coupled with Evacuated Tube Solar Collector
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This work is an experimental investigation for single basin-single slope solar still coupled with an evacuated tube solar collector. The work is carried out under the climatic conditions of Baghdad city (33.2456º North and East latitude, 44.3337º longitude) through certain days of the months of the year 2019 to study the impact of using evacuated tube solar collector on the daily productivity and efficiency under the outdoors climatic conditions. It was found that using the evacuated tube solar collector increase daily productivity from 2.175 kg/  to 2.95 kg/ for 9 hours (35.63 %) for clear days, also an enhancement about 10.97 % in daily efficiency.

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Publication Date
Mon Mar 23 2020
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Surfactant Cloud Point Extraction as a Procedure of Preconcentrating for Metoclopramide Determination Using Spectro Analytical Technique
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In current article an easy and selective method is proposed for spectrophotometric estimation of metoclopramide (MCP) in pharmaceutical preparations using cloud point extraction (CPE) procedure. The method involved reaction between MCP with 1-Naphthol in alkali conditions using Triton X-114 to form a stable dark purple dye. The Beer’s law limit in the range 0.34-9 μg mL-1 of MCP with r =0.9959 (n=3) after optimization. The relative standard deviation (RSD) and percentage recoveries were 0.89 %, and (96.99–104.11%) respectively. As well, using surfactant cloud point extraction as a method to extract MCP was reinforced the extinction coefficient(ε) to 1.7333×105L/mol.cm in surfactant-rich phase. The small volume of organi

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Sat Sep 01 2018
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Dimensional stability of heat-activated acrylic resin at different time intervals by different flask cooling methods
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This study was design to investigate the dimensional stability of heat-activated acrylic resin with different methods of flask cooling (15 minutes rapid cooling, one hour bench cooling, four hours delayed deflasking, and 24 hours delayed deflasking) at different time intervals (immediately, two days, seven days, 30 days) after deflasking. Heat-activated acrylic resin was used to prepare acrylic samples. Then, measurement of the distances where achieved between the centers of selected marks in the acrylic samples. They were measured at different time intervals for different methods of flask cooling. The results showed that the group samples of the four hours and 24 hours of delayed deflasking was insignificantly different from the control an

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Publication Date
Tue Dec 22 2020
Journal Name
Lecture Notes In Civil Engineering
Geometric Nonlinear Synthetic Earthquake Analysis of Base Isolated Tall Steel Buildings Under Site-Specific Seismic Loading
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