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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
Sun Aug 23 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of the capital increase in the rate of return on stock price: Applied in the study of a sample of Iraqi banks
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The capital banking foundation stone upon which the bank in the practice of business activities, the more capital a good financial adequacy of the increased bank's ability to grant credit and expand the various activities and provide a safety element for depositors and other sources of funding to achieve profits and increase the trading volume of the shares, causing the rise the rate of return for the shares of banks and have the Central Bank as head of the banking system by issuing instructions capital increase banking, according to the requirements of economic development and increase gross domestic product by supporting investment projects that are financed through banks, the research aims to show the extent of the banks commitment to

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Publication Date
Wed Jan 29 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Marketing mix and its role in promoting the status of insurance companies in the customers mind: Exploratory comparative research between the Iraq public insurance company and the private insurance company
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The ability of insurance companies to achieve goals depends on their ability to meet customers' requirements, and this requires them to identify target markets and respond to needs and wishes of the markets, the skill is to convince the company to operate what is in the interest of the customer if he is convinced the customer service provided to him, he would repeat to deal with, and where the cost of maintaining existing customers is less than the cost of attracting new customers, the insurance companies that is working hard to maintain their customers, the more customer satisfaction with the services provided has increased loyalty and weakened the ability of competitors lured.

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Publication Date
Tue Oct 23 2018
Journal Name
Journal Of Economics And Administrative Sciences
“The impact of using the of the Government Finance Statistics Manual (GFSM) on The General Budget in Iraq”
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This research is aiming  to analyze the impacts of the current budget in Iraq by using  the Government Finance Statistics Manual (GFSM) , the research is based on hypothesis: (There is an impact on the using of the Government Finance Statistics Manual (GFSM) In public budget in Iraq) .This hypothesis was demonstrated by using the questionnaire, a number of conclusions were reached, the most important being the lack of terminology adopted in the government accounting system and the Iraqi financial and accounting manual as a result of their adoption of the monetary basis for the lack of accounting terminology that meets t

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Publication Date
Mon Jan 01 2018
Journal Name
Research Journal Of Pharmacy And Technology
Evaluation of Hesperidin Protective Effect on Lipopolysaccharide-Induced Inflammation and lipid Peroxidation in BALB/C Mail Mice
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Publication Date
Mon Jan 01 2018
Journal Name
Research Journal Of Pharmacy And Technology
Evaluation of Hesperidin Protective Effect on Lipopolysaccharide-Induced Inflammation and Lipid Peroxidation in BALB/c male mice
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Publication Date
Fri Jan 15 2010
Journal Name
Anbar Journal Of Agricultural Sciences 8 (1)‏
Effect of Trichoderma spp. in inoculium levels on sour orange (Citrus arantium) seed germination and seedling growth‏
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Publication Date
Tue Jan 24 2017
Journal Name
Journal Of Madenat Alelem College
Effect of Prey Type on Relationship between Reproductive Performance and Female's Age in Macrocyclops albidus (Jurine 1820)
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The present study was conducted to investigate effect of prey type on the relationship between age of females of Macrocyclops albidus and reproductive performance, which included each of mean number of nauplii, age at first brood, and age at first clutch. Results revealed that the correlation coefficient between the age at first brood and clutch and age of females fed on Artemia was significant P <0.05, being 0.65 and 0.81 respectively, while the correlations were not significant P>0.05 in females fed on mosquito larvae (Culex quinquefasciatus) and Paramecium nauplii. It was also found that the correlation coefficients between mean number of the nauplii and longevity in M. albidus were significant P<0.05 whereas, the correlations were not s

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Publication Date
Sat Apr 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Effect of Different Soil Organic Carbon Content in Different Soils on Water Holding Capacity and Soil Health
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Abstract<p>An experiment was carried out to study the effect of soil organic carbon (SOC) and soil texture on the distance of the wetting front, cumulative water infiltration (I), infiltration rate (IR), saturated water conductivity (Ks), and water holding capacity (WHC). Three levels ( 0, 10, 20, and 30 g OC kg-1 ) from organic carbon (OC) were mixed with different soil materials sandy, loam, and clay texture soils. Field capacity (FC) and permanent wilting point (PWP) were estimated. Soil materials were placed in transparent plastic columns(12 cm soil column ), and water infiltration(I) was measured as a function of time, the distance of the wetting front and Ks. Results showed that advance we</p> ... Show More
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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Effect of 1,3-Oxazepine Derivative on Alkaline Phosphatase and Lactate Dehydrogenase Activity in Healthy Iraqi Females Serum
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Background: Heterocyclic compounds and its derivatives have biological activities and used as analgesic, anti-helminthic, antituberculer, antifungal, antiviral, anticancer and inhibitor of some enzymes. Oxazepine (benzodiazepine) derivative used in relief of psychoneuroses characterized by anxiety and tension. Alkaline phosphatase (ALP) hydrolyzes phosphate monoesters, while Lactate dehydrogenase (LDH) catalyses oxidation of L-lactate to pyruvate utilizing NAD+Objective: The study was carried out to know of the impact of 1,3-oxazepine derivative on the ALP and LDH enzyme activity on human serum in vitro.Methods: The study included the effect of synthesized 1,3-oxazepine divertive [(Z)-3-(5-mercapto-1-3,4-Thiadizol-2-yl)-2-(4-nitroph

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Publication Date
Wed Sep 30 2020
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Experimental Study for Assessment of Cutting Density Effect on Hole Cleaning Efficiency in Inclined and Horizontal Wells
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The poor hole cleaning efficiency could causes many problems such as high torque, drag, poor hydraulics and pipe stuck. These inherent problems result in an avoidable high operation cost which this study tried to address.  In this study, the effect of cutting density on hole cleaning efficiency in deviated and horizontal wells was investigated. Experiments were conducted using 40 feet (12 m) long of flow loop made from iron and PVC. However, the test section was made from PVC with (5.1m) long and (4” ID) for outer pipe and (2” OD) inner pipe. The cutting transport ratio (CTR) was determined from weight measurements for each test. Cutting Transport Ratio has been investigated for effects of the following parameters; flow rate, cu

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