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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
Tue Jan 01 2019
Journal Name
Journal Of Global Pharma Technology
Analysis of fatty acids of liver in the embryo and adult of domesticated chicken gallus gallus domesticus
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The fatty acids in the embryo's liver at ages (7, 11, 14 and 19) days incubation, small chicken aged (14) days after hatching and adult were analyzed, and found (5) fatty acids, the highest concentration of fatty acid in the adult of domesticated chicken and lowest concentration in small chicken age (14) days after hatching. Statistically, there were high significant differences at the probability level (P≤0.001) between all ages together, and the highest concentrations of Oleic acid (C18:1) and Linoleic acid (C18:2) were in embryo age (7) days incubation, while in embryo age (11) days incubation Stearic acid (C18:0) and α-Linolenic acid (C18:3) were higher concentration and Palmitic acid (C16:0) was the highest concentration in the adul

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Effect of existing deposit facilities on the quality of bank liquidity: Applied research in the Central Bank of Iraq for the period (2010 - 2017)
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The research aims at showing the effectiveness of the existing deposit facilities in the liquidity of the Iraqi banking system for the period 2010/2017. The problem of research indicates that the Iraqi banking system enjoys high liquidity levels exceeding the standard rate set by the Central Bank of Iraq amounting to 30% For an appropriate level of liquidity remains a major challenge to the management of the bank because it is a trade-off between profitability and liquidity, and also indicates the existence of funds disabled and not available for credit and investment opportunities, and based on the research hypothesis:

The existence of a significant effect of the deposit facilities existing in the liquidity of the Iraqi banking

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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Using Rational Judgment Strategy in Teaching Science on the Developing of Scientific Thinking at the Male Students of Intermediate Second Grade
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The study aimed to explore the effectiveness of using rational judgment strategy in teaching science to develop scientific thinking for second-grade students. The researcher utilized the quasi-experimental approach based on (the pre/post designing) of two groups: experimental and control. As for tools: a test of scientific thinking prepared by the researcher that proved its verification of their validity and reliability. The test applied on a random sample of (66) students, divided into two groups: (34) experimental, and (32) control. The results showed that the experimental group outperformed the control group in the post-application of the scientific thinking test, In each skill separately, and in the total skills. The study recommende

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Publication Date
Tue Dec 01 2009
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
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Publication Date
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
THE CONCEPT OF LOVE AND MARRIAGE IN ZORA NEALE HURSTON'S THEIR EYES WERE WATCHING GOD
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Zora Neale Hurston's (1891-1960) is an outstanding African American
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Publication Date
Tue Oct 06 2020
Journal Name
College Of Islamic Sciences
Distinctive Voice Features of Al Qalqala Sounds and their Expressive Values in the Holy Qur’an
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  Summary This research, entitled  (Distinguishing Voice Features of Qalqales Voices and their Expressive Values ​​in the Holy Quran), aims to shed light on five of the voices that are characterized by strength and intensity, whose pronunciation requires loud vocal tone, great effort and semantic dimensions.The research consists of two topics .in the first topic. We talked about the voices of Alqalqal , their definition, their degrees, their ranks, and the opinions of scholars about them.

In the second topic, titled Expressive Values ​​for Weak Voices in the Holy Qur’an, we talked about the relationship between sound and meaning, and we clarified in it the expressive values ​​of Qalqa

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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of Pharmaceutical, Chemical And Biological Sciences
Relationship between Chronic Hepatitis B Virus and Pathogenicity of Celiac Disease in the Iraqi Patients
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To determine the relationship between chronic hepatitis B virus and autoimmune celiac disease, seventy five patients with chronic hepatitis B virus of ages (8-70) years have been investigated and compared with 50 healthy individuals. All the studied groups were carried out to measure antiGliadin antibodies IgA and IgG by ELISA test and anti-reticulin antibodies IgA and IgG by IFAT. There were significant elevation (P<0.05) in the concentration of AGA IgA and IgG antibodies compared to control group. The prevalence of AGA antibodies IgA and IgG was 8% and 9.33% respectively. There were a highly significant differences (P<0.01) between studies groups. The prevalence of antireticulin antibodies ARA IgA and IgG was 6.67% and 4.0% respectively i

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Wed Mar 10 2021
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Impact of replacing the old chicken and add soy protein in Alvezaawih qualities Barker beef
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Publication Date
Sat Mar 07 2026
Journal Name
Euphrates Journal Of Agricultural Science
PHYSIOLOGICAL INFLUENCEOFNITROGENFERTILIZERS RESOURCESANDANTI-TRANSPIRATININ SOME QUALITY ATTRIBUTES AND THE CONCENTRATION OF NITRATES IN POTATO TUBERS
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Publication Date
Wed Mar 01 2023
Journal Name
International Journal Of Nonlinear Analysis And Applications
The use of ARIMA, ANN and SVR models in time series hybridization with practical application
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Forecasting is one of the important topics in the analysis of time series, as the importance of forecasting in the economic field has emerged in order to achieve economic growth. Therefore, accurate forecasting of time series is one of the most important challenges that we seek to make the best decision, the aim of the research is to suggest employing hybrid models to predict daily crude oil prices. The hybrid model consists of integrating the linear component, which represents Box Jenkins models, and the non-linear component, which represents one of the methods of artificial intelligence, which is the artificial neural network (ANN), support vector regression (SVR) algorithm and it was shown that the proposed hybrid models in the predicti

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