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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
Mon Dec 18 2017
Journal Name
Al-khwarizmi Engineering Journal
The Effect of Magnetic Field with Nanofluid on Heat Transfer in a Horizontal Pipe
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This work presents an experimental study of heat transfer and flow of distilled water and metal oxide nanofluid Fe3O4-distilled water at concentrations of (φ = 0.3, 0.6, 0.9 %) by volume in a horizontal pipe with constant magnetic field. All the tests are carried out with Reynolds number range (2900-9820) and uniform heat flux (11262-19562 W/m2). The results show that, the nanofluid concentration and magnetic intensity increase, the Nusselt number increases. The maximum enhancement in Nusselt number with magnetic nanofluid is (5.4 %, 26.4 %, 42.7 %) for volume concentration (0.3, 0.6, 0.9 %) respectively. The enhancement is maximized with magnetic intensity (0.1, 0.2, 0.3 tesla) respectively to (43.9, 44

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Publication Date
Sat Feb 28 2026
Journal Name
Modern Sport
The effect of mental speed drills on some visual abilities in shish weapon players
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Achieving high achievement in the sport of fencing requires thinking, awareness and visual tracking, as visual tracking is one of the important visual abilities that a fencing player needs and is considered one of the special visual abilities as it contributes and helps in the correct motor, mental and mental performance and gives the fencing the ability to perfect and accomplished performance in training and competition. Where the research problem lies in the weak skill performance of the fencing players as a result of the weakness in possessing visual and mental abilities. The two researchers used the experimental method in a controlled manner (experimental and control groups) with a pre and post-test. The research community was identifie

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Publication Date
Tue Jan 29 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Impact of Financial Guarantee Assessmeats on Accounting Profite: Apractical Research In Dell Company
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The research specialized in examining the role of guarantees and their impact on accounting benefits quality using statistical analysis to the income before and after the impact of guarantee on the accounting profits.This research depended on the inductive approach, which ensures that companies could manipulate in benefits through a variety of means including the guarantees. As it is possible that the companies can use the policy of guarantee as a strategy in business deal. The research aimed to highlight the different companies' practices on policies guarantee and its impact on accounting benefits. The benefit of Dell Company has been chosen as a sample for the research because of the availability of interim data from the company for te

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Publication Date
Mon Nov 01 2010
Journal Name
Iraqi Journal Of Physics
The Effect of Grain Size-Secondary Electron Emission on Grain Growth in Dusty Plasma
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The calculation of the charge on an isolated dust grain immersed in plasma with different grain sizes is a challenging one, especially under moderately high plasma temperature when secondary electron emission significant. The discrete charging model is used to calculate the charges of dust grain in dusty plasma. In this model, we included the effect of grain size dependence on secondary electron emission. The results show that the secondary electron emission from the glass dust grains due to energetic electron (40eV) can lead to the small grain to be slightly more positive than the large grain. Under these conditions, the smaller and larger grains would be attracted rather than repelled, which possibly lead to enhanced coagulation rates.

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Adapting IFRS 15 on Auditing Procedures for Auditors in Iraqi Environment
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The purpose of the International Financial Reporting Standard (IFRS 15) is to determine the basis for reporting useful information to the users of financial reports on the nature, amount, timing and uncertainty about revenues and cash flows arising from a contract with a customer. It is based on specific conditions for recognizing revenue from the contract. When the two parties to the contract or one of them fulfil the performance obligations, specifically after the customer has the ability to exercise control over the product or service that is the subject of the contract. As a result of the failure of the revenue reporting requirements in the Iraqi environment to provide adequate and honestly representative information on the o

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Tue Oct 01 2024
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A comprehensive review on the use of Ti3C2Tx MXene in membrane-based water treatment
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Sat Jun 15 2024
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THE ROLE OF FUNGAL INFECTIONS IN THE PATHOGENESIS OF DIALYSIS-DEPENDENT AND NON-DIALYSIS-DEPENDENT PATIENTS WITH KIDNEY DISEASE
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Abstract The results of isolation, morphological and microscopic diagnosis, Chromic Agar, Vitik technology and Bact Alert showed that the diagnosis of fungi isolated from blood samples of end-stage renal patients who did not undergo dialysis and those who underwent dialysis was 60 samples for each type. The total number of fungal isolates isolated from people who did not undergo dialysis was 26 pathogenic fungal isolates, with a percentage frequency of 43.33%. In this study, 4 genera of pathogenic fungi were identified: Candida spp, Rhodotorula spp, Cryptococcus spp. and Aspergillus spp. The number of Candida isolates reached 13 isolates, with a frequency of 50%. The results also showed that the diagnosed species from the genus Rhodotorula

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Mon Jan 29 2024
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