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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
Tue Jul 31 2012
Journal Name
Journal Of Babylon University/pure And Applied Sciences/
An Evaluation of the Effect of Bleaching Agent on Microhardness of a New Silorane-Based Restorative System and Methacrylate-Based Restorative Material
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Abstract Rasha Hameid Jehad Baghdad University Background: The high reactivity of hydrogen peroxide used in bleaching agents have raised important questions on their potential adverse effects on physical properties of restorative materials. The purpose of this in vitro study was to evaluate the effect of in-office bleaching agents on the microhardness of a new Silorane-based restorative material in comparison to methacrylate-based restorative material. Materials and method: Forty specimens of Filtek™ P90 (3M ESPE,USA) and Filtek™ Supreme XT (3M ESPE, USA) of (8mm diameter and 3m height) were prepared. All specimens were polished with Sof-Lex disks (3M ESPE, USA). All samples were rinsed and stored in incubator 37˚C for 24 ho

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Publication Date
Sat Jul 13 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
The Effect of Systemic Proteolytic Enzymes on Postoperative Inflammatory Response and Quality of Life after Surgical Extraction of Impacted Mandibular Third Molar
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Background: The surgical extraction of impacted third molar usually results in postoperative inflammation manifested as pain, facial swelling and trismus which may cause deterioration in the patient’s quality of life. Methods: This randomized controlled study included 56 patients indicated for surgical extraction of IMTM under local anesthesia. These patients were randomly assigned into two groups: a study group that included patients who received Tibrolin® postoperatively and a control group that did not. The predictor variable was whether to use SET or not. Pain measured by the pain numerical rating scale (NRS), facial swelling, and the degree of trismus were the outcome variables. The Arabic version of the Oral Health Impact P

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Publication Date
Tue Jun 01 2021
Journal Name
Political Sciences Journal
The economic dimensions of the railway link between Iraq and Kuwait and the role of national alternatives (Faw port and the dry canal as a model(
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   Decision-makers in each country work to define a list of internal and external interests, goals and threats to their countries according to the nature of their awareness of these interests, goals and threats. 

  Hence, Iraq is not an exception to this rule, and the process of evaluating its interests and the objectives of its foreign policy is subject to the pattern of awareness of decision-makers and the influencing forces in defining its basic interests, which often witness some kind of difference in defining them, evaluating their importance and determining the size of the threats they face. And among these interests and threats that have witnessed a difference in the assessment of their

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The role of corporate merger in achieving synergy (Analytical research in a sample of companies of the Iraqi Ministry of Industry and Minerals)
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The research aims to shed light on the recent experience in the Iraqi business environment, which is the experience of the merger. To evaluate a recent experience in an important sector of the Iraqi business sectors, namely the industrial sector to enable decision-makers to review that experience to judge the extent of its success and address some of the lapses that experience that by measuring synergies can be judged on the success of the merger experience or not. The research community is the governmental industrial sector. The research sample included six cases of merger (14) companies before the merger. The Holt method was used to predict the net sales and total cost values ​​before the merger as if it were not merged. Th

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Publication Date
Wed Sep 28 2022
Journal Name
Journal Of The College Of Education For Women
The Level of Aligning Scientific Research in Omani Universities with the Era of the Fourth Industrial Revolution in the Light of Oman’s 2040 vision and the Ways of its Development
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The current research aims to reveal the reality of coping the scientific research in Omani universities in the Sultanate of Oman with the requirements of the Fourth Industrial Revolution in the light of Oman’s 2040 vision. It also aims derive some suggestions to develop the scientific research in these institutions. The study has adopted a qualitative approach in which interviews were conducted. The sample consisted of (16) leaders of governmental and private higher education institutions, as well as, some experts in the field of Fourth Industrial Revolution. The theoretical significance of the study is represented by its response to Oman’s vison in 2040. It is further in line with the previous international reports and educational s

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Environmental Science And Development
Estimation of the Concentrations of Some Pollutants Resulting from the Use of Arabian Bakhour and Their Effect in Patients with Asthma in the City of Baghdad
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This research focus on studying 3 types of Bakhour in the markets of Baghdad city and assessing their impact on the quality of life for asthmatic whom used Bakhour at their houses through investigating particles physical properties, also estimating the levels of heavy metals (Cd, Cu, Mn, Pb and Zn), Particulate Matter PM2.5, PM10, Total Volatile Organic Compounds (TVOC) and formaldehyde (HCHO). The quality of life for asthmatic patients whom use Bakhour was assessing by Mini Asthma Quality of Life Questionnaire. The results indicated that shapes of Bakhour particles were irregular or spherical. Burning process generated the higher percent of PM ˂1μm. Type 2 Bakhour showed the highest percent of <1μm which was 73%.The amount of

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Publication Date
Sun Dec 01 2019
Journal Name
Al- Mohtaref Journal
Impact of The Use of Electronic Concept Mapping Strategy in Learning and Retaining Some of The Skills of The Ground-Moving Carpet in Women's Artistic Gymnastics
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The study aimed to identify the use of the electronic concept maps method in learning some of the skills of the floor exercises in the artistic gymnastics for third graders ,as well as to identify the best group between the two research groups (experimental And the officer to learn and retain some of the skills of the floor exercises in the artistic gymnastics of the research subject , and the experimental method was used and included the sample research on students of the collage of Physical Education and Sports Sciences/University of Baghdad, third grade, and has selected (10) Students for each group of The experimental and controlling groups randomly by lottery and after the completion of the period of implementation of the experiment wh

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Publication Date
Tue Apr 18 2023
Journal Name
Al–bahith Al–a'alami
The Role of Public Relations in Promoting Tourism from the Public Relations officers’ Point of View in Palestinian Travel and Tourism Companies in Gaza
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The aim of the research is to identify the role of public relations in promoting tourism by the Palestinian tourism and travel companies in Gaza from the public relations officer’s point of view in those companies.
The researcher used the descriptive analytical method as the most appropriate for such studies and implemented the questionnaire as a tool to obtain the required data from the respondents.
The Researcher reached several conclusions:
1- There is a low percentage of women working in the field of public relations in Palestinian tourism establishments in the Gaza Strip, where the percentage did not exceed 5%.
2- The interpersonal communication counted as one of the elements of integra

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Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Information Technology Competency in Activating of Human Resources Management Practices/ Applied Study in the Informatics and Communications Public Company in Iraq
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This research aims to clarify the role of Information Technology Competency (ITC) with dimensions' (IT Usage, IT Knowledge, and IT Operations) as an independent variable in the activation of Human Resources Management Practices (HRM Practices) as a dependent variable with dimensions' (Training and Development, Recruitment, Job Design, and Performance appraisal). Based on this, the correlation and effect relationships between the independent and dependent variables are determined by formulating two main hypotheses. There are a significant relationship and effect of IT competency with HRM practices within the dimensions. Furthermore, the scope and population of this research are the Informatics and Communications P

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Publication Date
Mon Jul 01 2019
Journal Name
Plant Archives
Effect of the level of corticosteron hormone in the blood of local Iraqi chicken mothers on the sex ratio of the produced offsprings
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This study was conducted to investigate the relationship between corticosterone hormone in the blood of local Iraqi white chicken mothers and the sexual ratio of the hatching chicks. A field experiment located at the Poultry Research Station, Livestock Department, Agricultural Research Department, Ministry of Agriculture for the period from 16 of September 2018 to 25 of December 2018. One hundred and forty birds of Iraqi local chicken mothers (100 females+ 40 males) at the age of 28 weeks were provided from the poultry research station. The birds were raised in individual cages and distributed sequentially to the cages after the numbering of the females. Data were recorded in three periods, each period was of 28 days, and then the general a

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