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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 Sep 30 2001
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Component of Pattern Materials and Its Influence on Physical Properties
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Sun Oct 15 2023
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Bionatura
Effect of cultivars and harvest dates on rice seeds vigore
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A laboratory experiment was carried out according to a completely randomized design with four repetitions on the seeds resulting from a field experiment applied for the two seasons, 2020 and 2021, to find out the effect of the cultivars (Ambar 33, Yasamin, Dijlah, Ambar Al-Baraka and Furat 1) and the harvest dates (at physiological maturity and after 7 and 14, 21 and 28 days of physiological maturity) on the vigour of rice seeds. The results showed the superiority of the seeds of the cultivar Anbar Al-Baraka at first and final counting, dry weight of the seedling, seedling vigor index and electrical conductivity, and the superiority of the seeds of Dijla cultivar at accelerated aging test and cold test without significant difference with th

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Tue Sep 01 2015
Journal Name
Iosr Journal Of Agriculture And Veterinary Science
Biological and physiological effects of Metarhizium anisopliae on Culex quinquefasciatus.
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The results of studying the effects of M. anisopiliae spores on mosquito, C. quinquefasciatus showed a biological effects represented by immature mortality. The mortality increased proportionally with the concentrations of fungal spores, which reached (at high concentration 2×1011 spores / ml), to 86.6, 56.6% in first and late instar larvae, respectively. An important to mention that cumulative death rate was significantly associated with the time, which reached to 56% at 7 day after treatment. In addition, M. anisopiliae had a long period permanence in aquatic habitats; in which the residual effects stay 30 days in aquatic habitats after treatment at laboratory conditions. Interestingly, the long period exposure of fungal spores (30 minut

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Publication Date
Tue May 07 2019
Journal Name
Acm Journal On Emerging Technologies In Computing Systems
Neuromemrisitive Architecture of HTM with On-Device Learning and Neurogenesis
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Hierarchical temporal memory (HTM) is a biomimetic sequence memory algorithm that holds promise for invariant representations of spatial and spatio-temporal inputs. This article presents a comprehensive neuromemristive crossbar architecture for the spatial pooler (SP) and the sparse distributed representation classifier, which are fundamental to the algorithm. There are several unique features in the proposed architecture that tightly link with the HTM algorithm. A memristor that is suitable for emulating the HTM synapses is identified and a new Z-window function is proposed. The architecture exploits the concept of synthetic synapses to enable potential synapses in the HTM. The crossbar for the SP avoids dark spots caused by unutil

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Mon Oct 05 2020
Journal Name
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Adsorption and Kinetic of para-Nitroaniline on Iraqi Siliceous Rocks
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UV-Vis technique has been used to study the adsorption of para-nitroaniline (PNA) on Iraqi siliceous rocks powder. Adsorption isotherms were investigated, temperature effect on adsorption was calculated, Results showed that the adsorption was an exothermic process and the thermodynamic functions were calculated. The effect of the pH on adsorption was studied and the ionic strength effect on adsorption was studied, It was found that adsorption increases with the presence of sodium chloride ions. The kinetic study of adsorption before equilibrium showed that the adsorption was pseudo first order according to according (Lagergren equation).

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Sun Dec 07 2014
Journal Name
Baghdad Science Journal
Effect of NPK fertilizer and root fertilizers Inicium on some physiological characters of Lycopersicon esculentum and its effect on mitotic division index of seedling radical apex
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The experiment was carried out to study the effect of NPK and Inicium using two concentration for each of them 1 and 2 gm/L for NPK and 5 and 10 ml/L for Inicium on some physiological characters of Lycopersicon esculentum and mitotic division index of seedling radical apex. The results showed that all the characters increased plant height, stem diameter, leaves number, length of leaf, lobs number in one leaf, length of root and root diameter. The data showed that the percentage of cell division, mitotic division and Telophase stage increased in seedling radical apex comparison with control plants.

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of The Faculty Of Languages
A Psychological Reading of The Problem of the Black in John Steinbeck’s Of Mice and Men
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Thu Jan 02 2020
Journal Name
Journal Of The College Of Languages (jcl)
A Psychological Reading of The Problem of the Black in John Steinbeck’s Of (Mice and Men)
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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of The College Of Languages (jcl)
(comparative analysis of phraseological units in the lexical-semantic field "on the material of Arabic and Russian languages"): (сопоставительный анализ фразеологических единиц лексико-семантического поля " на материале арабского и русского языков")
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Establishing the systemic character of vocabulary, its relationship with other language systems, their interdependence creates the possibility of a comprehensive scientific study and description of the lexical system of each language, as well as contrastive comparative studies of several languages, including their phraseological composition.

It is known that not all words-components of phraseological units are equivalent in their role in the formation of the semantic content of phraseological units. In this regard, it is necessary to introduce the concept of a lexical dominant. To this we include words, which are kind of centers around which the entire semantic complex of phraseological units, the entire set of its words-componen

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Publication Date
Wed Sep 09 2015
Journal Name
Elixir
Effect Tiers Pressure and Speeds tractor on Performance Chisel and Disc Plows
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Field experiment conducted to measured Slippage, Effective field capacity, Field Efficiency, Soil Volume Disturbed and Specific Productivity Tillage in silt clay loam soil with depth 18 cm in Baghdad- Iraq. Split – split plot design under randomized complete block design with three replications using Least Significant Design 5 % was used. Three factor used in this experiment included Two types of plows included Chisel and Disk plows which represented main plot , Three Tires Inflation Pressure was second factor included 1.1 ,1.8 and 2.7 Bar, and Three forward speeds of the tillage was third factor included 2.35 , 4.25 and 6.50 km/hr. Result show chisel plow recorded best parameters performance