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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
Sun May 10 2015
Journal Name
Al-academy
Compound Shapes in the work of the artist Max Ernst and Ali Najjar: صاحب جاسم حسن البياتي
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the Research problem entitled: (compound shapes in the work of the artist Max Ernst and Ali Najjar) the nature of the concept of compound shapes and mechanisms of functioning in contemporary art done. The research consisted of(4) four parts: the first part is dealing with the methodological framework of the Search represented the research problem , which is manifested through this study to reveal the technical features of the composite shapes, that linked achievement both artists (Max Ernst) and (Ali Al Najjar). Which is crystallized into two objectives as follows: 1 - Detection of the technical features of the composite shapes in the work of Max Ernst and Ali Al-Najjar.2 - Detection of similarities and differences in the recruitment of

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Publication Date
Thu Oct 09 2025
Journal Name
Frontiers In Dental Medicine
The role of neurogenic inflammation in pulp repair and the techniques used for its assessment (narrative review)
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Neurogenic inflammation is pivotal in dental pulp repair, involving complex interactions between sensory nerves, immune cells, and dental pulp stem cells (DPSCs). This review aimed to identify the favorable pathways of neurogenic inflammation and neurogenic differentiation of DPSCs in the pulpal healing process. Also, to identify the techniques used to evaluate these inflammatory and differentiation processes. Both PubMed and Google Scholar databases were employed in the search strategy using keyword combinations based on MeSH terms. The search was performed for published articles in English from January 2014 to November 2024, including studies with histological and molecular findings. 29 articles only met the inclusion criteria. Neurogenic

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Publication Date
Tue Nov 01 2022
Journal Name
Res Militaris
The Impact of the different methods of Selecting One Group in Calculating the Items Sensitivity Coefficient on the Standard Characteristics of the Criterion-Referenced Test
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AbstractThe research aims to identify the impact of the different methods in calculating the Items sensitivity coefficient on the standard characteristics of the Criterion-Referenced test in the measurement and evaluation material. The research sample consisted of (35) male and female students, who were chosen by the intentional method. The researcher prepared learning-teaching program in constructing the content of the measurement and evaluation material for non-specialized departments, prepared an achievement test in its equivalent forms, identified the results of agreement between the methods used in analyzing the items of the criterion-referenced test, and compared the standard characteristics of the achievement test, both according to

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Publication Date
Sun Dec 09 2018
Journal Name
Baghdad Science Journal
Proposing an Analysis System to Monitoring Weightlifting Based on Training (Snatch and Clean and Jerk)
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Analysis system of sports players is very important for individuals in weightlifting. Assessment of player and strength is important for the performance of weightlifting. This paper proposes an analytical method for weightlifters with check-by-frame video. This analysis system can compute the major steps of seven positions in both snatch and clean and jerk methods in frame-video weightlifting monitoring of movements. Each user can compute the major steps of the seven positions of Hu moments among two frames in the video during training, and the Euclidian distance can be computed for the Hu moment values and lifting moment values in the snatch and clean and jerk methods during training. The outcome of the proposed system shows on efficien

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Publication Date
Thu Apr 01 2021
Journal Name
Biochem. Cell. Arch
Biological Therapy for Patients With Rheumatoid Arthritis and Its Effect on Periodontal and Immunological Parameters
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Rheumatoid arthritis and periodontitis use analogous effector destructive procedures, in that the inflammatory cells and pro-inflammatory cytokines that drive chronic bone erosion in RA and chronic periodontal destruction in Periodontitis are alike. Periodontitis (PD) has appeared as a hazard factor in a number of health situations as rheumatoid arthritis (RA). To determine the effect of anti-tumor necrosis factor alpha biological treatment (methotrexate and Enbrel or infliximab) on periodontal status of patients having rheumatoid arthritis with periodontitis in comparison to those having periodontitis without rheumatoid arthritis and control healthy subjects and to determine the serum levels of anti-cyclic citrullinated peptide (ACCP) in t

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Publication Date
Wed Aug 31 2022
Journal Name
Ieee Access
SHE Networks: Security, Health, and Emergency Networks Traffic Priority Management Based on ML and SDN
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Recently, the increasing demand to transfer data through the Internet has pushed the Internet infrastructure to the nal edge of the ability of these networks. This high demand causes a deciency of rapid response to emergencies and disasters to control or reduce the devastating effects of these disasters. As one of the main cornerstones to address the data trafc forwarding issue, the Internet networks need to impose the highest priority on the special networks: Security, Health, and Emergency (SHE) data trafc. These networks work in closed and private domains to serve a group of users for specic tasks. Our novel proposed network ow priority management based on ML and SDN fullls high control to give the required ow priority to SHE dat

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Publication Date
Thu May 18 2023
Journal Name
College Of Islamic Sciences
ascetic And the pleasures of the worldly life
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Because asceticism has a great impact on educating the human soul properly, according to what was mentioned in the Book and the Sunnah of the Prophet, and keeping it away from vices and what is devolving into it, and this world and its adornments keep the Muslim away from virtues and work with them in order to reach the Hereafter in which is the eternal bliss that God, peace be upon him, has prepared for the obedient. The two pious obedient ones. And because of the impact of this topic on the Islamic community and adorn it with good qualities. Likewise, I saw many Muslims who do not prefer the life of this world over the hereafter, and they began to fight over the world and enjoy its adornments, and they took pride in money, building, an

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Publication Date
Sun Mar 12 2017
Journal Name
Al-academy
the director and the technique of theatrical extemporization
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Extemporization is the ability of the actor to reflect his internal being. It gives a sort of confidence and an ability to show the personal countenance of the role away from tension and rigidity. By extemporization, it is possible to deal with and criticize the real living life so it is an intellectual, emotional, sensual, and perceptive process connected with the psychological energy and the emotional memory and all this goes under the control of the director and his instigations and instructions depending on what the text involves of intellectual, social and psychological motivators so it primarily depends on talent, chance and discussion. The research involves four chapters; the first contains the problem

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Publication Date
Wed Jul 31 2019
Journal Name
Journal Of Educational And Psychological Researches
An Instructional Design According to the constructivism Model for Chemistry Subject and Its Effect on the Life Skill by the Second Intermediate Female Students
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The research aims to identify the effect of teaching-learning design based on the constructivism theory on the life skills of middle stage students. The sample consisted of (60) students from one of the middle schools in Baghdad's governorate. The experimental group and control group consisted of 30 students for each group, the research tool was the life skills scale composed of (78) items. The scale proved its validity and reliability, which was found to be (0.85). The results showed a statistically significant difference in life skills between the two groups of research in favor of the experimental group, which studied the educational design according to models of constructivism theory compared to the usual method of teaching.

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Publication Date
Thu Dec 03 2015
Journal Name
Iraqi Journal Of Science
New multispectral images classification method based on MSR and Skewness implementing on various sensor scenes
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