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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 Jun 01 2021
Journal Name
Political Sciences Journal
Violence and Extremism in Iraq: Approaches to Motives and Means of Confrontation
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     After the year 2003, Iraq went through multiple waves of violence and at different levels on the security, intellectual, political and social levels. Behind that stood several motives and incentives to enable violence that represented the first axis of research, the most important of which was the political motives that circulated an atmosphere that politics against society and transformed power into a field of political brutality against the individual and the group at once. There are also cultural, intellectual, media and economic motives such as weak cultural independence, poverty, marginalization, unemployment and want, and the absence of a media discourse that rejects violence but incites it, on the other ha

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Publication Date
Mon May 25 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
Training for Anaerobic Differential Threshold Stand and its Impact on Lactic Acid Concentration and LDH Enzyme and VO2MaX and Cortisol Hormone for Free 400 m men-runners
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The study aimed at designing a training program by using training for the anaerobic differential threshold stand and the effects of those trainings on the variables of (Concentration of Lactic Acid and LDH Enzyme, VO2 MaX and Cortisol Hormone). The Researchers used the experimental program with one-group style. Also, they used a sample with (8) men-players in a (free 400 m men-runners) and they used many instruments and procedures, most notably the training-program prepared for 10 weeks and for 3 training units weekly, (70-90 min) for each unit. They used the training intensity from 85-100% of the player's ability. After finishing the training program and doing some pre-tests and post-tests then statistically checking the results, the resea

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
The Effect of Leptin Level in Pregnancy Complicated by Intrauterine Growth Restriction on Neonatal Outcome, in an Iraqi Center
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Background: Fifteen percent of small for gestational age are small as a result of fetal growth restriction, which could be due to maternal, placental or fetal factors. It is an important clinical problem associated with increase perinatal mortality and morbidity. Leptin is a protein that produced by many tissues including the placenta (syncytiotropholoast). Dysregulation of leptin metabolism may be implicated in preeclampsia and IUGR pathogenesis.
Aim of the study: To study the trend of leptin level alteration in maternal serum and cord blood in pregnancies complicated by fetal growth restriction and its relation with fetal outcome.
Methods: An Analytic, cross- sectional study conducted in Al-Elwyia Maternity Teaching Hospital and

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
The Impact of Osteoporosis on Teeth Decay in relation to Salivary Vitamin D among Menopause in Baghdad city, Iraq
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Background: Osteoporosis is a systemic skeletal disorder that has an impact on general health, dental health and salivary composition. The mineralization of teeth happens simultaneously with that of the skeleton, but if mineral metabolism is disrupted, tooth failures will resemble those that affect bone tissue. Vitamin D plays a key role in bone and tooth mineralization.

Objective: to evaluate the impact of osteoporosis on teeth decay in relation to salivary vitamin D among menopause in Baghdad city.

Subjects and Methods: This study was cross sectional study. The study group consists of

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Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The of Effect Instructional Design based on Kagan Structure In Generating Information Skills for First Intermediate Student’s In Mathematics
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The aim of the research is to identify the effect of instructional design according to Kagan structure among the first intermediate school student’s, and how skills could help in generating information in mathematics. In accordance with the research objectives, the researcher has followed the experimental research method by adopting an experimental design with two equivalent groups of post-test to measure skills in generating information. Accordingly, the researcher raised two main null hypotheses: there were no statistically significant differences at the level of significance (0.05) between the average scores of the experimental group who studied the material according to Kagan structure and th

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Publication Date
Fri Sep 01 2023
Journal Name
Al-khwarizmi Engineering Journal
A Study on the Effect of Multistage Toolpath in Fabricating a Customized Cranial Implant in Incremental Sheet Metal Forming
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Incremental sheet forming (ISF) process offers a high degree of flexibility in the manufacturing of different sheet parts, which makes it an ideal candidate for prototype parts as well as efficient at fabricating various customized products at low production costs compared to traditionally used processes. However, parts produced in this process exhibit notable geometrical inaccuracy and considerable thickness reduction. In this paper, the single point incremental sheet forming variant of the process has been implemented to manufacture a highly customized cranial implant starting from the computed tomography (CT) scan data of the patient's anatomy. A methodology, from the modeling to the realization of the implant, is presented and discus

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The effect of teaching design in accordance with cluster thinking strategies on First-grade-intermediate students’ achievement in science
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The current study aims to develop a teaching design in accordance with cluster thinking strategies and explore the effect of this teaching design on students’ achievement in science. To this end, the null hypothesis was adopted: there is no statistically significant difference at the level of (0, 05) between experimental group who adopted the teaching design in learning science and control group who follow the traditional method in learning the same subject. To test the null hypothesis, total of (74) students from Al-Alaama Hussain Mahfooth intermediate school were selected intentionally for the academic year 2016-2017. The sample divided into two equal groups when all the variables (age, prior achievement of science,

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Publication Date
Wed Dec 29 2021
Journal Name
Journal Of The College Of Education For Women
Employment and Labor Union Laws in Japan between the 1889 and 1946 Constitutions: A Comparative Study: أفراح محمد علي
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This research is based on the descriptive and analytical methodology. The importance of studying labor laws and labor unions in Japan between 1889 and 1946 constitutions is because Japan was out of a feudal phase, and had no idea about the factory system and industrialization in their modern sense before the Meiji era. Generally, its labor system used to be mostly familial, and the economic system was based on agriculture. This called for the enactment of legislations and laws appropriate for the coming phase in Meiji era. Thus, this paper examines the role of Meiji government in enacting labor legislations and laws when he came to power in 1896, and his new constitution in 1889 and the civil code of 1896. It further examines the way Mei

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Publication Date
Wed Feb 01 2023
Journal Name
Baghdad Science Journal
The Link between Serum Omentin Level and Insulin Resistance Biomarkers, Lipid Profile, and Atherogenic Indices in Iraqi Obese Patients.
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Omentin (or intelectin) is a main visceral fat secretory adipokine.  There is a growing interest to link omentin, obesity and co-morbidity factors. The aim of the present study is to evaluate serum omentin and its association to insulin resistance biomarkers, lipid profile and atherogenic indies. This cross – sectional study was conducted in Obesity Research and Therapy Unit-Alkindy College of Medicine by recruiting (115) individuals; 49 males /66 females. Subjects between (20 to 60) years of age were selected and classified into two groups according to their Body mass index (BMI). Group1 involved healthy lean volunteers (25 male/ 36 female; BMI 18.5 - 24.9). Group2 involved obese subjects; (24 male / 36 female with BMI ≥ 30). The s

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Publication Date
Tue Aug 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Diagnosis the Pseudoperonospora cubensis Causes Downy Mildew in Cucumbers and its Resistance to Potassium Silicate and Extract Eggplant Wild
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Abstract<p>A field experiment was carried out to test the efficiency of potassium silicate and wild eggplant <italic>Solanum eleaegnifolium</italic> normal and nano for the management of downy mildew disease on cucumber caused by <italic>Pseudoperonospora cubensis</italic> under greenhouse conditions by reducing the incidence and severity of the disease and its reflection on the efficiency of the control and the area under the disease progress curve AUDPC compared to the fungicide Energy Previcur (Hcl - Propamocarb and Fosetyl-aluminum). The results of phenotypic and molecular diagnosis using polymerase chain reaction (PCR) technology for the two tested isolates showed that t</p> ... Show More
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