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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
Thu Dec 31 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The dimensions of organizational confidence and its relationship to achieving the strategic position of banks: is an applied research on a sample of private Iraqi banks
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The research aims to show the dimensions of organizational trust represented by (administrative policies opportunities for innovation and self innovation and self- realization,availability of information,prevailing organizational values) and its reiationship to achieving the strategic position of banks represented by formation of expectations,buiiding networks,learning operations As the research was applied in each of the banks (middle east)Iraqi investment,Al-Ahly Iraqi, Business Bay, Al- Mansour investment bank),the qusestionnaire was adopted as a tool to collect data and information from the sample number (138)who are in the site (department director, division ,M.division director ,division officer, unit officer)the statistica

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Mon Jan 01 2018
Journal Name
Materials Research Bulletin
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Fri Mar 01 2024
Journal Name
Baghdad Science Journal
Impact of alkaloids extract of Moringa olievera Lam. leaves on the development, fertility and demography of the southern cowpea beetle insect Callosobruchus maculatus (F.) (Coleoptera: Bruchidae)
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The Southern Cowpea Beetle Callosobruchus maculatus (F.) is one of the most widespread insect pests of stored legumes, causing a considerable loss during storage, decreasing the net weight of the crops, and resulting in reduced the quality of the crops. This study has been conducted to determine the lifetime, fertility and life table parameters of C. maculatus by using an alkaloids extract from Moringa oleifera leaves at different concentrations 1000, 2000, and 3000 ppm. The result was shown that the lowest survival rate was 49% at a concentration of 1000, 2000 ppm, as compared with the control which was 77%. The lowest reproductive rate (Ro) was 4.76 female/female/generation at the concentration of 1000 ppm, c

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Sun Jan 01 2012
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Publication Date
Tue Jun 01 2021
Journal Name
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Influence of Laser Energy on the Structural and Optical Properties of (CdO):(CoO) Thin Films Produced by Laser-Induced Plasma (LIP)
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Mon Feb 23 2026
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The effect of nutritional status on mesiodistal and bucco/ lingual or palatal diameters of permanent teeth among fifteen years old students
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Background: Malnutrition during human growth affects the size of the tissues at different stages of life, body proportions, body chemistry, as well as quality and texture of tissues. Teeth are particularly sensitive to malnutrition. Malnutrition may affect odontometric measurement involving tooth size dimensions. The aim of this study was to estimate the effect of nutrition on teeth size dimension measurements among students aged 15 years old. Materials and methods: This study was conducted among malnourished group in comparison to well-nourished group matching with age and gender. The present study included 167 students aged 15 years (83 malnourished and 84 well-nourished). The assessment of nutritional status was done by using body mass

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Mon Sep 01 2025
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The Effect of Environmental Factors on Plant Growth: An Analytical Study of Environmental Variables and Their Physiological Response – A Review Article
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Publication Date
Sun Jan 01 2023
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Comparison consequence of violet and red laser irradiation on the optical properties of cobalt dioxide (CoO2) thin films prepared via (SCSPT)
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Publication Date
Sun Mar 07 2010
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Influence of the Surrounding Plants by Rapeseed Field on Population Density of Cabbage Aphid (Brevicoryne brassicae L.) and its Biological Enemies
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The result revealed that the peak of population density of cabbage aphid Brevicoryne brassicae was 523.20 individuals/plant on 21 March in edges of rapeseed field and was 1141.67 individuals/plant in center of the field. Results revealed that population density of cabbage aphid in rapeseed fields surrounded by cover crops significantly were low compared with that of monoculture rapeseed. The location of rapeseed plants (in edges or in center) significantly affected (p<0.05) the tested pest density, e.g. optimum density was 146.69 individuals/plant in the center of the field. Whereas was 93.32 in the edges. Effect of the interaction between location and surrounding vegetation was significant on aphid density, which their population densit

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Publication Date
Fri Sep 09 2022
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The effects of CuO doping on structural, electrical and optical properties of CdO thin films deposited by pulsed laser deposition technique
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Thin films of (CdO)x (CuO)1-x (where x = 0.0, 0.2, 0.3, 0.4 and 0.5) were prepared by the pulsed laser deposition. The CuO addition caused an increase in diffraction peaks intensity at (111) and a decrease in diffraction peaks intensity at (200). As CuO content increases, the band gap increases to a maximum of 3.51 eV, maximum resistivity of 8.251x 104 Ω.cm with mobility of 199.5 cm2 / V.s, when x= 0.5. The results show that the conductivity is ntype when x value was changed in the range (0 to 0.4) but further addition of CuO converted the samples to p-type.

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