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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 Jan 01 2022
Journal Name
Iraqi Journal Of Science
Determination of Magnitudes and Orientation of the Paleostress of Bekhme Structure in Shaqlawa area, Northerneastern Iraq
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This study presents determination of the paleostress magnitudes and orientation of Bekhme Structure in Shaqlawa area northeastern Iraq. Paleostress Analysis of slip-fault measurements is performed using Right dihedral, Lisle diagram and Mohr Circles methods. Depending on Mohr Circles, Bott law and vertical thickness, the magnitudes of the paleostress at the time of the tectonic activity were determined. Firstly, Georient Software was used to estimate the orientation of the paleostresses (σ1, σ2 and σ3). Secondly, using the rupture –friction law, taking into account depth of the overburden and the vertical stress (σv) was calculated to determine the magnitude of the paleostresses (σ1=4500 bars, σ2=1

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Publication Date
Sun Dec 02 2018
Journal Name
Journal Of The College Of Education For Women
Political Thought in Russia During the 21st Century, Targets and Features
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The features of strategic thought transformation in Russia based on attempt confirm the Russian influenced on Region of Eastern Europe through series of common defense treaties and mutual security between USSR and another states this treaties emphasis size on direct Russian supervision on these states in addition, Russia in trusted to formation communism regimes in its vital space, Russia inherited the status of former USSR in political and economic levels.

           Shortly we can see that Russia witnessed large Transformation in political strategic thought as a result of change in internal strategic environment and change of nature understanding which influenced on Russia. This

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Publication Date
Sat Feb 27 2021
Journal Name
Journal Of Engineering
Physical Simulation for the Flow in Straight and Rectangular Loop Manifolds
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The flow in a manifolds considered as an advanced problem in hydraulic engineering applications. The objectives of this study are to determine; the uniformity qn/q1 (ratio of the discharge at last outlet, qn to the discharge at first outlet, q1) and total head losses of the flow along straight and rectangular loop manifolds with different flow conditions. The straight pipes were with 18 m and 19 m long and with of 25.4 mm (1.0 in) in diameter each. While, the rectangular close loop configuration was with length of 19 m and with diameter of 25.4 mm (1.0 in) also. Constant head in the supply tank was used and the head is 2.10 m. It is found that outlets spacing and manifold configuration are the main factors aff

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Publication Date
Tue Jun 20 2023
Journal Name
Baghdad Science Journal
Zooplankton composition and structure in the Indus River Estuary, Sindh, Pakistan
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In this study abundance and composition of zooplanktons in the Indus River Estuary was conducted to examine habitat characteristics and its impact on tiny organisms. Overall 30,656 individuals were identified and segregated into seven major groups including Copepods, Cnidarians, Decapods, Mollusk, Pisces, Amphipods and Chaetognaths. For better understanding they were further divided into eighteen planktonic categories. Among them Lucifer spp. comprises of 52.21% was the most abundant group with a peak appeared in March whereas Chaetognaths were rarely observed in the entire study period. Species diversity exhibited a mixed trend with the highest values (0.776) of dominance observed in spring (March). The results of Canonical Corresponden

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Publication Date
Sun Dec 10 2017
Journal Name
Al-academy
Building aesthetic and expressive long shot in the film contemporary novelist
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The research deals with an important detail of the joints of the film industry and television drama, which is the expression and aesthetic of the long shot, after being popularized by some directors, and that the long shot has been employed since the beginning of the cinema. But the research addresses the contemporary film and how the long shot worked. The researcher identified her goal in identifying the aesthetic and expressive of the long shot in the contemporary film, and then defined the term of the shot and the long shot.
The theoretical framework was based on two topics: the first (aesthetic and artistic expression in cinema) and the second (the long shot and the state of its construction). The researcher then chose LA LA LAND

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Sufian Symbol and its significance in Abd Allah Hamadi's Poetry
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This research paper looks to put its hands on sufi symbols which are applied by the algerian poet د abdallah hammadi د in his poetical works . the symbols it relies on are : ( symbolisme of wine . symbolisme of light . symbolisme of night . sufisme and nature , femal symbols ) .
From these symbols we try to show its range of ability to apply it , with trying to determine its meaningful , dimensions .

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Educational values in the Quran: Surat Luqman and AL- Hujurat model
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The paper has been summarized into the following:
Chapter one: the researcher deals with the problem of the paper, the most important points and the terminology. Chapter two: the researcher deals Surat Luqman from the Aya 12-19 , (the demonstration, the explanations, the values ). In chapter three the researcher deals with Surat AL-Hujurat from Aya 6-12, (the demonstration, the explanations, the values ). Chapter four include (the educational properties for individual and society, the educational applications, and the most important indicators in the texts). Chapter five include the results , the conclusions and the recommendations. One of the basic results that the Quran is a complete educational curriculum, and the texts of Surat Lu

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Publication Date
Tue Mar 02 2021
Journal Name
Psychology And Education Journal
References for Receiving Explicit and Implicit Knowledge in the Holy Quran
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The research aims to explain the References of receiving the explicit and implicit knowledge mentioned in the Noble Qur'an. The two researchers adopted the documentary and inductive approach to study the topic. Among the conclusions of the research: The Noble Qur'an dealt with many terms and concepts that refer to the References of making explicit knowledge available, including books, which were represented by the divine books (the Qur'an, the Torah, the Zabur and the Gospel) and their concepts (the book, the Qur'an, the guidance, the remembrance, the revelation, the light, the newspapers, the plates). He dealt with many concepts that refer to the References of providing tacit knowledge, which was represented by the communication between tw

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Publication Date
Sun Jan 24 2016
Journal Name
Al-academy
Poetics transformation and structure in the film: علاءالدين عبد المجيد جاسم
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is divided into two chapter:Chapter one to ensure asyslematic framework for research amd included aresearch problem and also inchuded on the importance of research and the need for him as well as to clarify. The second chapter inchuded a theoretical framework: theoretical framework has been divided into two section. The first topic: poetics transformations The second topic: poetics and scale of rheloric in the film After the comp of the theoretical framework; so the researcher analyzed the film (Antichrist) has arrived ataset of resuits was including

 

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Publication Date
Wed Aug 19 2020
Journal Name
International Journal Of Research In Social Sciences And Humanities
HUMOUR IN THE AMERICAN AND BRITISH COMEDYEPISODES: A DISCOURSE ANALYSIS STUDY
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DBNRAAK Mohammed, International Journal of Research in Social Sciences and Humanities, 2020

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