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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
Wed Jun 30 2021
Journal Name
College Of Islamic Sciences
Phonological, dialectical and semantic explanation of the two phenomena of substitution and compulsion in the book of translation Thirty surahs from the Noble Qur’an by Ibn Khallouh d. 370 AH
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This research aims to find out the phonemic, dialect and semantic ailments that were interrogated by the book of the parsing of thirty surahs of the Noble Qur’an by Ibn Khalawiyeh, by examining some phonemic phenomena of Qur’anic expressions and their explanatory relationships that resulted in their occurrence, such as substitution and compression, as the sounds in a word are affected by one another, especially during performance and composition. This influence and influence is the tendency of the human being to the law of ease, facilitation, and the reduction of muscular effort in speech often, all for the purpose of obtaining phonemic harmony for the compound letters; To facilitate pronunciation; And get rid of the muscular effort

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Publication Date
Wed Mar 18 2020
Journal Name
International Journal Of Research In Social Sciences And Humanities
THE EFFECT OF EXERCISE SPECIFIC TO USE DESIGNER (QUALITY RESPONSE) DEVICE TO DEVELOP THE SPEED AND ACCURACY OF THE RECEPTION AND PASSING SKILLS OF FOOTBALL PLAYERS IN AGES (14 YEARS)
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Publication Date
Sat Apr 01 2017
Journal Name
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Digital Communication: The Future of Identity in Arab TV Drama: A Field Study on a Sample of Arab Society in the UAE in 2017
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The digital communication of a product of communication and information revolution. It is characterized by accurate and comprehensive in its services and its effects, which brought changes in the structure of many communities and their organizational structures. They have significant impacts on the social systems and social relations, especially in the Arab societies, which are the focus of the globalized Western media, for many reasons: economical, political , cultural and social.
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Sat Oct 01 2022
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HISTORY AND MODERNITY OF POETRY AS : A Reference Of The Modern Poem In Iraq
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One of the most important intellectual issues, which receive attention is the issue of modernity, it has occupied the scholars of all time. However, modern poetry used to have special care in Iraq and in the Arab countries .. it is not strange that the concept of modernity is linked to history .. or having history as the most important dimension of its dimensions .. because Arab poetry is historical and it is moving into an area of ​​the past that is still active in terms of language and literary image .. When some poets found that changing and modernizing poetry became a necessity of evolution, and one of the fundamentals of modernization, the cultural impact did not respond to the desire of poets, and their impulse in modern poetry

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Publication Date
Mon Apr 01 2019
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CALCULATION OF THE STOPPING POWER OF ALPHA PARTICLES AND ITS RANGE IN BONE TISSU
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With the advancement of modern radiotherapy technology, radiation dose and dose distribution have significantly improved. as part of Natural development, interest has recently been renewed by treatment, especially in the use of heavy charged particles, because these radiation types serve theoretical advantages in all biological and physical aspects. The interactions of alpha particle with matter were studied and the stopping powers of alpha particle with Bone Tissue were calculated by using Zeigler’s formula and SRIM software, also the Range for this particle were calculated by using Mat lab language for (0.01-1000) MeV alpha energy.

Publication Date
Mon Dec 11 2023
Journal Name
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Review of Analytical Methodologies for the Determination of Metronidazole and Trimethoprim in Environmental Samples
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Antibiotics are essential for treating infectious diseases, but their overuse and adverse effects are raising concerns about global public health. The pervasiveness of antibiotic contamination in aquatic environments has drawn increased attention in recent years. The primary concern regarding the release of antibiotics into the environment is the potential for microorganisms to become resistant to antibiotics. This review article summarizes the analytical methods used to determine the presence of trimethoprim and metronidazole in various environmental samples. These antibiotics have traditionally been analyzed using tandem mass spectrometry or high-performance liquid chromatography coupled to mass spectrometry; fluorescence or ultrav

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Publication Date
Wed Mar 10 2021
Journal Name
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Publication Date
Sat Apr 01 2023
Journal Name
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Investigation of Groundwater and The Impact of Over-Pumping in Al-Haydariyah Region, Iraq
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In this study; a three-dimensional model was created to simulate groundwater in Al-Haydariyah area of the governorate of Al-Najaf. A solid model was created to utilize the cross sections of 25 boreholes in the research region, and it was made out of two layers: sand and clay. The steady-state calibration was employed in six observation wells to calibrate the model and establish the hydraulic conductivity, which was 17.49 m/d for sand and 1.042 m/d for clay, with a recharge rate of 0.00007 m/day. The wells in the research region were reallocated with a distance of 1500 m between each well, resulting in 140 wells evenly distributed throughout the study area and with a discharge of 5 l/s, and the scenarios were run for 1000

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Publication Date
Sun Nov 01 2020
Journal Name
Journal Of Engineering
Preparation of Nano Zinc Oxide and its Application in the Photocatalytic Degradation of Ampicillin
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This study was undertaken to prepare Nano zinc oxide (ZnO) by precipitation and microemulsion methods. Scanning electron microscopy (SEM), X-ray diffraction (XRD), FTIR spectrometry, atomic force microscopy (AFM), and Brunauer Emmett Teller (BET) surface area were the techniques employed for the preparation. The particle size of prepared nano ZnO was 69.15nm and 88.49nm for precipitation and microemulsion methods, respectively, which corresponded to the BET surface area 20.028 and 16.369m2/g respectively. The activity of prepared nano ZnO as a photocatalyst was estimated by the removal of ampicillin (Amp) under visible light. This study, therefore, examined the effect of pH in the range of 5-11, initial concen

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Publication Date
Mon Feb 23 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Expression of matrix metalloproteinase-2 in the extracellular matrix of osseointegrated and diseased implants
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Background: Recently with improvement of dental implantology science, osseointegrated implants show a considerable durability, however; failures are not completely avoidable. Matrix metalloproteinase-2 (MMP-2) expression is disturbed in many pathological conditions such as peri-implantitis and periodontitis. This study was carried out to investigate the tissue expression of MMP-2 in the extracellular matrix of osseointegrated and diseased implants. Subjects and methods: Gingival biopsies were collected from six patients having osseointegrated or working implants and twenty with diseased or non osseointegrated implants and (6) controls having no implants. In situ hybridization technique was used to analyze the changes in immunoreactivity of

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