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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 02 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Identification of microflora associated with dust falling on Karbala province and seasonal distribution
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Publication Date
Sun Mar 01 2020
Journal Name
Iraqi Journal Of Physics
Optimization Procedures using Effect of Etalon Finesse and Driving Term on Optical Bistability
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        In this work, analytical study for simulating a Fabry-Perot bistable etalon (F-P cavity) filled with a dispersive optimized nonlinear optical material (Kerr type) such as semiconductors Indium Antimonide (InSb). Because of a trade off between the etalon finesse values and driving terms, an optimization procedures have been done on the InSb etalon/CO laser parameters, using critical switching irradiance (Ic) via simulation systems of optimization procedures of optical cavity. in order to achieve the  minimum switching power and faster switching time, the optimization parameters of the finesse values and driving terms on optical bistability and switching dynamics must be studied.

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Publication Date
Sun Sep 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Effect of Shot Peening on Fatigue Properties for Corroded and Uncorroded (CK35) Steel
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The traction property is one of the important mechanical properties, especially the rotary parts which are subjected to constant and variable loads There are many methods used to improve this property, and the shoot peening by metal balls is considered the most critical one. the study focuses on this characteristic of steel CK35 used in many engineering applications as the rotating shafts and railway This study shows that the fatigue strength is improved by14% after shoot peening with metal balls. The study includs the rehabilitation of damaged samples as a result of fatigue corrosion. The standard solution adopted was 36% MgCl­2 with a 30 days immersion period. These samples has been improved by 6% after it decreased by18% d

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Publication Date
Mon Jan 01 2024
Journal Name
Aip Conference Proceedings
Modeling and analysis of thermal contrast based on LST algorithm for Baghdad city
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Publication Date
Tue Jun 15 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
A review on Active Constituents and Pharmacological Effects of Eriobotrya Japonica Lindl. (Loquat)
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Eriobotrya japonica Lindl., named as loquat, is a subtropical fruit tree of the family Rosaceae which is well known medical plant originated in  Japan and China. Loquat portions, like leaves, peels and fruits have been shown to possess various health usefulnesses.  In Chinese classical medicine, it is vastly utilized in many illnesses, like gastroenteric disorders, diabetes mellitus, pulmonary inflammatory diseases and chronic bronchitis. Loquat plant contain many active constituents, such as flavonoids, carotenoids, vitamins, polyphenolic compounds, other that have many biological effects like anti-tumor, anti-diabetic, anti-inflammatory, anti-mutagenic, antioxidant, antiviral, antitussive, hepatoprotective and hypoli

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Engineering
Impact of Preparing HMA with Modified Asphalt Cement on Moisture and Temperature Susceptibility
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Many researchers tried to prevent or reduce moisture damage and its sensitivity to temperature to improving the performance of hot mix asphalt because it is decreasing the functional and structural life of fixable pavement due to the moisture damage had exposed to it.

The main objective of this study is to inspect the effect of (fly ash “3%, 6%, 12%”, hydrated lime”5%, 10%, 20%” and silica fumes”1%, 2%, 4%) referring to previous research by the net weight asphalt cement as a modified material on the moisture and temperature sensitivity of hot mix asphalt. This was done using asphalt from AL-Nasiria refinery with penetration grade 40-50, nominal maximum size (12.5) mm (surface course) of aggregate and on

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Publication Date
Thu Jun 16 2022
Journal Name
Al-khwarizmi Engineering Journal
Path Planning and Obstacle Avoidance of a Mobile Robot based on GWO Algorithm
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planning is among the most significant in the field of robotics research.  As it is linked to finding a safe and efficient route in a cluttered environment for wheeled mobile robots and is considered a significant prerequisite for any such mobile robot project to be a success. This paper proposes the optimal path planning of the wheeled mobile robot with collision avoidance by using an algorithm called grey wolf optimization (GWO) as a method for finding the shortest and safe. The research goals in this study for identify the best path while taking into account the effect of the number of obstacles and design parameters on performance for the algorithm to find the best path. The simulations are run in the MATLAB environment to test the

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Publication Date
Fri Jul 30 2021
Journal Name
Coatings
A Past, Present, and Prospective Review on Microwave Nondestructive Evaluation of Composite Coatings
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Recent years have witnessed an increase in the use of composite coatings for numerous applications, including aerospace, aircraft, and maritime vessels. These materials owe this popularity surge to the superior strength, weight, stiffness, and electrical insulation they exhibit over conventional substances, such as metals. The growing demand for such materials is accompanied by the inevitable need for fast, accurate, and affordable nondestructive testing techniques to reveal any possible defects within the coatings or any defects under coating. However, typical nondestructive testing (NDT) techniques such as ultrasonic testing (UT), infrared thermography (IRT), eddy current testing (ECT), and laser shearography (LS) have failed to p

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Publication Date
Thu Apr 27 2023
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Evaluation of the Effect of Type II Diabetes mellitus on Bone Mineral Density of Upper and Lower Limbs by Dual-Energy X-Ray Absorptiometry
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Background: Bone mineral density has been assessed using Dual-Energy X-Ray Absorptiometry. Bone mineral density is measured according to the results of the Dual-Energy X-Ray Absorptiometry examination of the vertebral column and pelvis. Although diabetes mellitus type II (DM) is known to affect bone mineral density, at the present time this particular relationship is not clear. Objective: The aim of current study was to evaluate the effects of type II diabetes mellitus on bone mineral density of the upper and lower limbs as well as gender differences. Patients and Methods: This study involved 165 patients complaining of bone pain (85 males and 80 females), 85 patients of who suffered from diabetes, involving both genders. In addition,

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Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Impact assessment of strategic goods on government grants and as a result of activity: An analytical study at the General Company of grain trading
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  In Iraq,  government contributions to the public companies have become a very important aspect which contributes to the survival and sustainability of these institutions as it consider  one of the main sources of funding, if not it consider the basis of funding.

  According to  the vital roles assigned to these institutions to follow up, which usually  include important activities in the national economy, the research focused on studying the field reality of the method used in evaluating the stock of total production and purchases of goods for the purpose of selling the strategic commodities of the General Company for Grain Trade.  As a result, the aim of this study came to came to highlight&n

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