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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
Thu Nov 22 2018
Journal Name
International Journal Of Applied Pharmaceutics
PREPARATION AND IN VITRO EVALUATION OF CYCLODEXTRIN BASED EFFERVESCENT AND DISPERSIBLE GRANULES OF CARBAMAZEPINE
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Objective: Carbamazepine is typically used for the treatment of seizure disorders and neuropathic pain. One of the major problems with this drug is its low solubility in water; therefore the objective of this study was to enhance the solubility of carbamazepine by complexation with cyclodextrin to be formulated as effervescent and dispersible granules.Methods: Solvent evaporation method was used to prepare, binary (Carbamazepine/β-cyclodextrin) complex and ternary (Carbamazepine/β-cyclodextrin/hydroxypropyl methyl cellulose (HPMC E5). The more soluble complex will be further formulated as unit dose effervescent and dispersible granules. The complexes were evaluated for their solubility, drug content, percentage practical yield and

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Publication Date
Sun Jan 01 2017
Journal Name
Aip Conference Proceedings
Localization and counting of CD68-labelled macrophages in placentas of normal and preeclamptic women
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Publication Date
Tue Dec 29 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Impact of Electronic Payment systems on the Profitability of Banks: An applied research on a sample of Iraqi commercial banks
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Due to technological developments in the Iraqi banking sector, which is the use of electronic payment systems within the banking infrastructure. This has led to speed and accuracy in the completion of transactions, reduced costs, increased revenues and efficiency. This research examines the challenges and risks facing the Iraqi banking sector as a result of its use of electronic payment systems. And show its impact on the profitability of commercial banks. The research was based on the main hypothesis that there is a statistically significant moral impact relationship between electronic payment systems and the profitability of banks. Iraqi commercial banks were chosen as a research community, All Iraqi commercial banks that parti

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Publication Date
Thu May 18 2023
Journal Name
College Of Islamic Sciences
Nouns and attributes And what the Kalamayons termed it
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Many people, especially among the youth or scholars, wonder about the position of Islam or the scholars of faith on the terminology used by scholars of theology in a certain period of time, and then circulated by people throughout the times and to the present day, such as the terms (the old, the maker, the updated, the cause and the cause) and so on, and this What I felt myself while teaching this subject from some of the students, some of whom consider it blasphemy, and some of them consider it an innovation of speech, and so there were many questions about this subject, which led me to write and research it, after relying on God Almighty, although the research is not long due to the nature of This topic on the one hand, and because I d

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Publication Date
Fri Oct 28 2022
Journal Name
Political Sciences Journal
Iraq and the US-Iranian conflict, influence and influence
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Iraq enjoys many factors and ingredients that made it “affect and be affected at the same time” by the American-Iranian conflict from the “strategic geographical position” adjacent to Iran as an important point and that Iraq has been part of this conflict since the last period which witnessed the outbreak of the first Gulf War  (1980-1988)  because of border problems and a dispute over Shatt al-Arab, and what followed after that, specifically from 2003 when the United States of America and its allies occupied Iraq’s lands and made a political change by the destruction of its security and military institutions. It increased the importance of Iraq in being a subject of competition between the competing parties in exploiting the

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Publication Date
Mon Jun 15 2020
Journal Name
Journal Of Baghdad College Of Dentistry
Histomorphometric evaluation of the effects of local application of red cloveroil (trifolium pratense) on bone healing in rats
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Background: Red clover oil (Trifolium pratense) has isoflavones bunches which have estrogen-like exercises and may establish an option in contrast to hormone substitution treatment. The present study investigated the impact of Red clover oil on bone healing in rats by histomorphometric study. Materials and Methods: Intra bony defect was performed in right femur of thirty six healthy male albino rats. Then these rats were randomly divided into three groups (12 rats each): one control and 2 experimental groups. For control, the bony defect was left for normal healing; for the experimental (S) group, the defect was treated with hemostatic absorbable gelatin sponge; and for experimental (RS) group, the bony defect was treated with 0.2 ml red

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Effect of Some Herbs on the Level of Some Biochemical Parameters in Blood of Diabetic Patients Type II
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This study included effect of polyherbs mixture treatment of diabetic patients type II for two months. The polyherbs mixture contains Nigella sativa seeds, Boswellia carterri gum, Citrus aurantifolia fruits, Elettaria cardamomum fruits. Also this study included estimation of some biochemical parameters in the serum Diabetes Mellitus (D.M.) patients-type II and knowing the relationship of these parameters with this disease. The parameters are glucose, cholesterol ,High density , Low density lipoproteins( HDL-C, LDL-C) respectively , Triglycerides TG, urea, total protein , albumin , Alkaline phosphatase ALP,Transaminase GOT, GPT enzymes . Take (77) samples of diabetic patients serum type II which included (47) samples for group one: herbs

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Ebusiness And Egovernment Studies
THE ROLE OF STRATEGIC VIGILANCE ON STRATEGIC PERFORMANCE OF OIL INDUSTRY IN IRAQ: MODERATING ROLE OF LEADERSHIP STYLE
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The success of an organization is significantly influenced by strategic performance, a focal point in recent scholarly investigations and regulatory considerations. This study delves into the examination of the impact of strategy formulation, implementation, and evaluation on the strategic performance within the context of the oil industry in Iraq. Additionally, the research explores the moderating influence of leadership style on the relationship between strategy formulation, implementation, evaluation, and strategic performance in the Iraqi oil industry. Data collection involved the utilization of survey questionnaires distributed to selected employees of Iraqi oil companies. Statistical analysis, specifically SPSS-AMOS, was employed to s

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
The Effect of Duration of Stress Urinary Incontinence on developing Signs of Bladder Outlet Obstruction in Urodynamic Study
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Background: Stress urinary incontinence is a frequent urological disease in women; it has a great influence on an individual’s wellbeing and places a significant economic strain on any health service. The placement of urodynamic diagnostic tests in the evaluation route is an important clinical research concern in this field.

Objective: to find out whether the duration of stress urinary incontinence is associated with the finding of bladder outlet obstruction in urodynamic study or not.

Subjects and Methods: A descriptive study. With enrolled female patients had symptomatic Stress urinary incontinence as their primary complain. All the included patients w

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Publication Date
Tue Jan 01 2019
Journal Name
Biochemical And Cellular Archives
Effect of HPV infection on the expression of fibronectin in a group of Iraqi women with cervical carcinoma
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: Cervical malignancy positioned as the fourth most prevalent disease among women around the world. HPVs especially HPV16 are the causative agent of cervical cancer, responsible of about 5% of all human cancers worldwide. Some researchers found that the fibronectin is repressed by the papillomavirus (HPV) type 16 E7 oncoprotein in both HPV-positive nontumorigenic and tumorigenic cell lines, while others found that the HPV oncoprotein increase the levels of fibronectin. The aim is to study the effect of HPV infection on Fibronectin expression and their correlation onthe development of Cervicalcancinoma. The current retrospective study enrolled paraffinized blocks of two groups. The research included 30 cervical carcinomatous tissues as well

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