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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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Wed Dec 11 2019
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The degree of the woman’s satisfaction on clothing depends, to a large extent, on the body measurements. If clothing is very wide, it shows her enormous and if it is too tight it may draw attention to the defects of the body. It may also lead to the compatibility or incompatibility of clothing with fashion. Whatever the quality of the garment in terms of sewing and design, the costume which is not suitable for body size may affect the physical style negatively and may give the wearer an improper look. Clothing was carried out without measurements and did not use models (templates). The method of preparation affected the overall appearance because it often did not fit the shape of the body completely. Therefore, people thought in many w

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Thu Sep 01 2011
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The impact of corporate governance on narrowing the expectations gap in the audit work environment (field study)
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The different crises and financial collapses place in many companies, particularly in developed countries as a result of administrative and financial corruption return aspects of the task to the role of the company and the external auditor, both in their emphasis on honesty and fairness of financial statements and the Provisions of accounting information and on the contrary to the truth, you may have to the loss of the rights of stakeholders, particularly existing investors, and the loss of confidence of prospective investors in the accounting information contained in the financial statements of these companies, which led to a crisis of confidence and credibility in the profession of accounting and auditing where the wonder of ma

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Background: Laser is a novel physical therapy technique used to treat various conditions, including wound healing, inhibition of bacterial growth, and postoperative wounds. High-power pulsed alexandrite laser therapy is one of the most prevalent forms of laser therapy, which is a noninvasive method for treating various pathological conditions, thereby enhancing functional capacities and quality of life. It is a modern medical and physiotherapeutic technology. Generally, the Alexandrite laser emits infrared light with a wavelength of 755 nm, allowing it to propagate and penetrate tissues. Objective: This study focused on the application of a high-power pulsed alexandrite laser in vitro to evaluate the effect of a pulsed alexandrite l

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Widespread use of antihypertensive agents in clinical practice necessitates the knowledge of their pleiotropic effects. At the present time there are no sufficient evidences of positive effect of these medications on bone coming from randomized controlled trials; knowledge of additional effects of those drugs on the bone metabolism will allow doctors to choose optimal treatment of hypertension, taking into account the state of bone tissue. At the same time it will also allow to prevent osteoporosis in patients having osteoporosis risk factors or initial signs of bone loss.

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The effect of Dunn Dunn model on students’ achievement in Geography course
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The study seeks to investigate the effect of Dunn Dunn learning style model on students’ achievement. Besides, the way of developing students’ deductive thinking by testing the null hypothesis: there is no significant difference between experimental group who takes Dunn Dunn model as style in studying geography and control group that follows a traditional method in studying geography at the level of (0,05). Additionally, there is no significant difference between experimental group who takes Dunn Dunn model as style in studying geography and control group that follows a traditional method in studying geography at the level of (0,05) on testing developing deductive thinking skills. The researcher adopted a quasi-experimental posttest

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The Effect of Flipped Learning on Overhand Serve Skill Acquisition in Volleyball
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The study aimed to determine the effect of the flipped learning model in improving the acquisition of the overhand serve skill in volleyball among second-year students at the College of Physical Education and Sport Sciences, University of Baghdad, for the academic year 2024/2025. The study used an experimental design with a control group and pre-post testing, on a purposive sample consisting of 12 students. The model relied on watching short videos before class via the SGS application, and practical application in class at a rate of three sessions per week. The results showed a significant improvement in performance, as the calculated value (t = 5.356) exceeded the tabulated value (2.042) at a significance level of 0.05. The percentage of s

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Sat Feb 09 2019
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