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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
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Synergistic Effect of Potassium Clavulanate in Combination withCefamandol and Ceftazidime on B- Lactamase, Extracted From Resistant E.coli
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The aim of this study was to evaluate in-vitro activity of Cefamandol and Ceftazidime, in combination with potassium clavulanate against 10 uropathogenic E.coli isolated from patients with chronic complicated urinary tract infections (UTIs), these isolates were identified by the Api identification systems.The antimicrobial susceptibility tests were determined by Kirby-Bauer method and the minimum inhibitory concentrations of Cefamandol and Ceftazidime, were determined, by tube method. These isolates were resistant to Ampicillin (Amp), Amoxicillin (Amo), Carbenicillin (Cb), Ticarcillin (Tic), Amoxicillin\ Potassium Clavulanate {Augmentin}, (Amo\CA), Ticarcillin\ Potassium Clavulanate {Timentin} (Tic\CA), Cefamandol (Cfm) and Ceftazidime (

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Publication Date
Sun Dec 30 2012
Journal Name
Al-kindy College Medical Journal
Effect of Metformin Therapy on Reducing Leptin Resistance and Enhancing Ovulation in Women with Polycystic Ovary Syndrome
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Background: The relation between insulin resistance ,leptin levels and other hormones in women with polycystic ovary syndrome(PCOS) is still controversial.Metformin therapy is proved effective in reducing insulin resistance and also in some studies it was seen to be effective in reducing leptin levels.
Al- Kindy Col Med J 2012 ; Vol .8 No. (2) p: 65
Objective: to study the effect of metformin on reducing leptin levels and enhancing ovulation in PCOS women.
Methods:metformin 500mg 3 times daily for 3 months was was given to 36 women
with proved PCOS, in addition to that, other parameters were included.
Results:28 women out of 36(77.78%) showed an evidence of ovulation ovulation after 3 months of metformin therapy(p<0.01)

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Publication Date
Mon Dec 18 2017
Journal Name
Al-khwarizmi Engineering Journal
Optimization and Prediction of Process Parameters in SPIF that Affecting on Surface Quality Using Simulated Annealing Algorithm
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Incremental sheet metal forming is a modern technique of sheet metal forming in which a uniform sheet is locally deformed during the progressive action of a forming tool. The tool movement is governed by a CNC milling machine. The tool locally deforms by this way the sheet with pure deformation stretching. In SPIF process, the research is concentrate on the development of predict models for estimate the product quality. Using simulated annealing algorithm (SAA), Surface quality in SPIF has been modeled. In the development of this predictive model, spindle speed, feed rate and step depth have been considered as model parameters. Maximum peak height (Rz) and Arithmetic mean surface roughness (Ra) are used as response parameter to assess th

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Advanced Pharmacy Education And Research
Natural polymer Effect on gelation and rheology of ketotifen-loaded pH-sensitive in situ ocular gel (Carbapol) ‎
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In situ gel can be defined as a polymer solution administered as a liquid and when exposed to some physiologic condition such as thepH, ionic, temperature modulation or solvent and UV induced gelation undergo to phase transition to a semisolid gel. Ketotifenfumarate belongs to the histamine H1 receptor antagonists, and Ketotifen fumarate is used in the treatment of allergic conditions likeconjunctivitis and rhinitis. This work aims to study the natural polymer effects (xanthan gum,gellan gum) on the properties of pH-trigger in situ ocular gel, then compared the drug-releasing rate of optimized formula with the market ketotifen eye drop. Eightformulations (F1-F8) were prepared using different concentrations of xanthan gum, gellan gum with ca

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Publication Date
Tue May 02 2023
Journal Name
Journal Of Physical Education
Designing compound exercises with hardware technology and its impact on some physical and skill abilities of the Airways Club players under (19) years old.
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ER Abbas, AA Jasim, Journal of Physical Education, 2023 - Cited by 1

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Publication Date
Wed Jun 20 2018
Journal Name
Al-academy
The stylistic change in Kandinsky and Mondrian paintings
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The current rasearch which is entitled " The stylistic change in Kandinsky and Mondrian paintings – A Comparative Analytic study-" deals with the nature of change concept, its mechanisms and its constructive disciplines. The research has four chapters: The first chapter deals with the methodological Framework represented by the problem of the research which is concerned with the stylistic change and its role in activating formative disciplines.                                   The research aims at, finding out the stylistic change in Kandinsky and Mondrian Paintings.&

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Publication Date
Wed Mar 30 2016
Journal Name
College Of Islamic Sciences
Intent in the Holy Quran (meanings and connotations)
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The most honorable of science was what was related to the book of God, the Almighty, the Constitution of this nation and the way of its guidance and method of advancement there is no life except for him and safety only by its application and it is no secret to the competent studies of the importance of the subjective studies in the Koranic studies to address issues of great importance enlighten the path of the nation and revive From here comes the importance of the topic covered by the research, which is "Intent in the Holy Quran meanings and semantics", and this topic features features that made it worthy of writing, including the importance of clarifying theories of Qur'anic character of a systematic nature, such as the theory of inten

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
monte carlo simulation in the kinetics and mileculare
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The primary focus of the study factor reverse polymerization styrene polymer kinetics and distribution weight Aljaia in Blma Aldhur free reverse The study was conducted wi Mamahakah and using the Monte Carlo method

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Publication Date
Thu Sep 17 2020
Journal Name
College Of Islamic Sciences
Human values and principles in the three religions
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The laws of the three religions tend to extend the rules and foundations of coexistence, and this is achieved in achieving the values and principles that these laws have nourished in all societies.

Our research deals with a major problem that has broken out in our societies, namely (disturbing the balance of values and behavioral standard between people), and perhaps one of the greatest causes of the problem is to move away from the correct divine discourse and sound approach, as well as corruption of common sense and the violation of its rules and found principles in the hearts of people.

 

 

 

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Publication Date
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
The senses and their role in financial transactions
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This study aimed to clarify the legal provisions concerning the senses and their role in financial transactions, in the light of the definition of all the vocabulary presented by this study (senses - the definition of senses apparent: they are hearing - sight - smell - taste - touch) in the first section. The study deals with the second topic of the reference and writing denominator phrase and includes two requirements, the first requirement: the establishment of the denominator of the phrase, which has two branches: Section I: signal Akhras. Section II: Signal of the Spokesman.
 The second requirement is that writing takes the place of the phrase in financial transactions. The owners argue that the sale of the blind is correct a

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