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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
Fri Mar 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Impact of Applying the Accounting Islamic Standards on the Cost Efficiency: An applied study in kingdom of Bahrain Islamic banks -Wholesale
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This research highlights the light on the general framework of accounting discloser in the Islamic banks, and show the types and the concepts of Cost Efficiency, In this present study, the sample included Fourteen Islamic banks, where the data was collected from the annual financial reports. Accordingly, the study in order to achieve the aims and access to the results based on the analytical method and the descriptive analysis, and conducted a Simple & Multiple Linear Regression analysis, in order to test hypotheses of the research by using of statistical analysis software (SPSS). The research has arrived to many results such as: the commitment of Islamic banks working in the Kingdome of Bahrain (Wholesale) to the requirements of the

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Publication Date
Tue Mar 03 2026
Journal Name
Al–bahith Al–a'alami
The role of Iraqi newspapers in instilling political culture among the public after 2003, a field study on the audience of the city of Baghdad
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The role of Iraqi newspapers in instilling political culture among the public after 2003, a field study on the audience of the city of Baghdad, University of Baghdad, College of Information, Department of Journalism, 2019,
The problem of research is to investigate the role of Iraqi newspapers in instilling the political culture of individuals after 2003, and monitor this role Through the contents and messages provided by the Iraqi newspapers to the public. the research is classified within descriptive research, it adopts the survey methodology and used the questionnaire tool. In fact, the questionnaire was distributed to a sample of 400 individuals that was selected according to the method of multi-stage cluster sample of those who re

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Publication Date
Tue Mar 03 2026
Journal Name
Journal Of Physical Education
The effect of the Perkins-Blyth model on learning some compound skills in soccer for second intermediate students
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Publication Date
Wed Jun 20 2018
Journal Name
Al-academy
The effect of CORT educational program on creative thinking for the secondary school students in art education subject
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The current research aims to identify (the effect of CORT program on creative thinking for middle school students in the art education history of ancient art subject).

     The research society continue of the5th of scientific students in ALsadreen secondary school of excellence which related of the Directorate of Education al-sader city, for the academic year (2015/2016), The sample was (35) students for each of the two groups (experimental and control). The equivalence between the research groups was carried out in the IQ variable, the age and the level of the father and mother.

     The researcher used the experimental method of partial control and the post-test. If the course of

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Publication Date
Sat Jan 13 2018
Journal Name
Journal Of Engineering
Investigating the Influence of the Cerium loading in prepared Y zeolite from Iraqi kaolin on its Catalytic Performance
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In this study, the effects of different loading doses of cerium in the prepared NaY zeolite from Iraqi kaolin were investigated. Al-Duara  refinery atmospheric residue fluid catalytic cracking was selected as palpation reaction for testing the catalytic activity of cerium loading NaY zeolite.  The insertion of cerium in NaY zeolites has been synthesized by simple ion exchange methods. Three samples of modified zeolite Y have been obtained by replacing the sodium ions in the original sample with cerium and the weight percent added are 0.35, 0.64, and 1.06 respectively. The effects of cerium loading to zeolite Y in different weight percent on the cracking catalysts were studied by employing a laboratory fluidized

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Publication Date
Fri Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Six Thinking Hats Strategy on Improving Creative Thinking Skills" Field research in the Medical City "
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Abstract  

   The research problem focuses on studying the interest of the Medical City Department of the Ministry of Health in improving the creative thinking skills of the administrative leadership through parallel & comprehensive thinking according to the of six thinking hats strategy. The research sample consisted of (170) administrative leaders in the upper & middle organizational levels, The questionnaire was used as a main tool for data collection, In addition to the observation & Interview, The research sought to answer the following questions: What is the extent to which the administrative leadership (Tpp & middle) in the organization investigated the concept of the six thinkin

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Publication Date
Sun Feb 25 2024
Journal Name
Baghdad Science Journal
The Effect Of Optimizers On The Generalizability Additive Neural Attention For Customer Support Twitter Dataset In Chatbot Application
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When optimizing the performance of neural network-based chatbots, determining the optimizer is one of the most important aspects. Optimizers primarily control the adjustment of model parameters such as weight and bias to minimize a loss function during training. Adaptive optimizers such as ADAM have become a standard choice and are widely used for their invariant parameter updates' magnitudes concerning gradient scale variations, but often pose generalization problems. Alternatively, Stochastic Gradient Descent (SGD) with Momentum and the extension of ADAM, the ADAMW, offers several advantages. This study aims to compare and examine the effects of these optimizers on the chatbot CST dataset. The effectiveness of each optimizer is evaluat

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Publication Date
Tue Jan 11 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of Anabasis articulata Stems Extract on Lowering Intraocular Pressure in the Glaucoma Rat Model(Conference Paper )#
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High intraocular pressure (IOP) is a recognized risk factor for glaucoma and optic nerve injury, and it is one of the primary causes of vision loss globally. Anabasis articulata (AA) is a desert plant found in Iraq. The extract of AA is used to cure diabetes, fever, eczema, and kidney infections. The aim of the study is to evaluate the antioxidant effect of methanol extract of AA on intraocular pressure in the glaucoma rat model. Forty-two rats were allocated into seven groups, each with six animals:: group 1 (normal), group 2 (control), in which animals were induced to have elevated IOP by betamethasone suspension injection, groups 3,4 and 5 for evaluating the effect of 50,100 and 150 mg/kg/day of the tested extract, respective

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Publication Date
Sun Mar 10 2024
Journal Name
Journal Of Sport And Health Research
Personal social and self-intelligence and its relationship to the performance of the individual and collective kinetic formation rhythmic gymnastics of school students.
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The study aims to follow modern methods in teaching rhythmic gymnastics skills by directing learners to develop their perceptions and absorb what the world deals with today and develop intelligence among learners, the researchers searched for the strengths of the learner by providing them with an opportunity to form their kinetic formation, hence the problem came by introducing a method of self-intelligence and social to guide the learner in the search for ways and solutions to overcome boredom and economy Time and effort in the educational process in learning and give them the freedom to express their ideas And their skills and here came the role of social and self-intelligence to teach the individual and collective kinetic formati

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Publication Date
Sun Sep 15 2019
Journal Name
Al-academy
Aesthetic and Functional Dimensions of Environmental Waste in the Products of Students of the Department of Art Education: فردوس خضر الجوفي
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The practice of art is an inevitable result imposed by the circumstances surrounding the human being, as he needs some knowledge associated with raw materials, tools and methods to develop skills in the formation of elements of the work of art in new ways that give a decent artistic appearance to the work of art. Through the exploratory study carried out by the researcher, which included asking the following question to the third grade students, Department of Art Education:

What types of materials are used in handicrafts and from which sources are they obtained? Through the answers, the problem of research was founded as follows:

-Are the products of students of the Department of Art Education in the handicraft material d

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