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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
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Community Structure of South Sudan state and its impact on national integration
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South Sudan is known by its tribal and racial variation .Tribal Perception represents the
procedure of dealings in Southern society .And that what make Sudan as a stable country that
suffer from divisions . Everybody wants to rule in spite of his inability and un qualification
which enables the establishment of an urbanized country .the frustration of the state in
handling the interior variety on religious, tribal and racial basis and contracting national
ideality in spared by shared ingredients between gathered groups in one state, all these reasons
make it hard to create a united national identity which is able to unite atheist and religious
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Publication Date
Mon Dec 30 2019
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Adsorption Behavior of Light Naphtha Components on Zeolite (5A) and Activated Carbon
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Light naphtha one of the products from distillation column in oil refineries used as feedstock for gasoline production. The major constituents of light naphtha are (Normal Paraffin, Isoparaffin, Naphthene, and Aromatic). In this paper, we used zeolite (5A) with uniform pores size (5Aº) to separate normal paraffin from light naphtha, due to suitable pore size for this process and compare the behavior of adsorption with activated carbon which has a wide range of pores size (micropores and mesopores) and high surface area. The process is done in a continuous system - Fixed bed reactor- at the vapor phase with the constant conditions of flow rate 5 ml/min, temperature 180oC, pressure 1.6 bar and 100-gram weight o

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Publication Date
Tue Jan 01 2019
Journal Name
International Journal Of Agricultural And Statistical Sciences
Effect of foliar spraying with gibberellic and humic acid on wheat growth
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Publication Date
Sun Jan 01 2017
Journal Name
Pakistan Journal Of Biotechnology
Role of bio fertilization on wheat and water productivity under water scarcity
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Field experiment was conducted by using two fertilization systems (i.e.) biofertilizers (inoculation with Pseudomonas putida and with Azotobacter chroococcum and non - inoculation) and chemical fertilization (100%, 50% and 25% of recommended by Ministry of Agriculture) to study the influence of these system and interaction on water and grain yield productivity, some growth phytohorones and number of bacterial cells in soil rizosphere of root of wheat crop under water scarcity. The result showed that the integrate fertilization (inoculation with Pseudomonas putida and Azotobacter chroococcum bacterial + 50% of the recommended chemical fertilizer) recorded 5.70 and 5.55 t ha-1, respectively with reducing the chemical fertilizer app

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Publication Date
Sun Sep 07 2014
Journal Name
Baghdad Science Journal
Structural and Electrical Properties Dependence on Annealing Temperature of Bi Thin Films
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In this work the effect of annealing temperature on the structure and the electrical properties of Bi thin films was studied, the Bi films were deposited on glass substrates at room temperature by thermal evaporation technique with thickness (0.4 µm) and rate of deposition equal to 6.66Å/sec, all samples are annealed in a vacuum for one hour. The X-ray diffraction analysis shows that the prepared samples are polycrystalline and it exhibits hexagonal structure. The electrical properties of these films were studied with different annealing temperatures, the d.c conductivity for films decreases from 16.42 ? 10-2 at 343K to 10.11?10-2 (?.cm)-1 at 363K. The electrical activation energies Ea1 and Ea2 increase from 0.031 to 0.049eV and

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Publication Date
Mon Apr 01 2019
Journal Name
Biochem. Cell. Arch.
Comparative Histopathological Effects Of Acetamiprid And Its Nanometric Form On Albino Mice
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Formulations based on nanomaterials have the ability to reduce the consuming of hazardous pesticides and theirimpact on human health and environment. The present study focused on a comparative investigation of histological effects of nanocapule acetamiprid (NACMP) in vivoand commercial parental bulk form of acetamiprid (ACMP) on albino mice. Nanoformulations of pesticides have the potential to improve food productivity without compromising with the ecosystem. In the present study, nanocapsules containing acetamiprid were prepared from two natural macromolecules, alginate and chitosan. The characterization of the nanocapsules were investigated by Dynamic Light Scattering(DLS), T ransmission Electron Microscopy (TEM) and Atomic force

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Sun Sep 01 2013
Journal Name
Baghdad Science Journal
Synthesis and Characterization of New phenolic Schiff bases Derivatives Based on Terephthaladehyde
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A variety of new phenolic Schiff bases derivatives have been synthesized starting from Terephthaladehyde compound, all proposed structures were supported by FTIR, 1H-NMR, 13C-NMR, Elemental analysis, some derivatives evaluated by Thermal analysis (TGA).

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Publication Date
Wed Aug 07 2024
Journal Name
Civileng
Experimental and FE Investigations of Backfill Cover on Large-Diameter GRP Pipes
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This paper presents experimental investigations on buried Glass Reinforced Plastic (GRP) pipes with a diameter of 1400 mm. The tested pipes were buried in dense, gravelly sand and subjected to traffic loads to study the effects of backfill cover on pipe deflection. The experimental program included tests on three GRP pipes with backfill covers of 100 cm, 75 cm, and 50 cm. The maximum traffic loads applied to the pipe–soil system corresponded to Iraqi Truck Type 3 (AASHTO H type). Vertical deflections of the pipes were monitored during the application of these loads. The experimental results showed that, as the backfill cover increased, the maximum vertical deflection of the pipe decreased. Deflection reductions were 38.0% and 33.3

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Publication Date
Mon Dec 18 2017
Journal Name
Al-khwarizmi Engineering Journal
Experimental and Numerical Study of Collector Geometry Effect on Solar Chimney Performance
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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
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on the nature of the area, for example be in rural areas is lower than in cities or industrial
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