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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
Sun Aug 01 2021
Journal Name
Journal Of Education And Science
Evaluation of Salivary Alpha-Amylase level in Iraqi children with positive family history of hypertension
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This study accomplished to determine levels of salivary Alpha-Amylase (sAA) in Iraqi children with positive family history of hypertension, Hypertension was believed to be a risk factor in 18% of all deaths in 2010 (9.4 million globally). This study included one hundred children from primary school aged 6 to 13 years, with a focus in child welfare and family health history, with an emphasis on close relatives' hypertension reputations, with hypertension close relatives record categories identified by 1st and 2nd relatives, after documenting the full details, the burden was assessed for the children's families. The influence of age is confirmed by a correlation study of our own numbers, which shows a positive correlation. The disparity betwe

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Publication Date
Thu Mar 03 2022
Journal Name
Rawal Medical Journal
Functional outcome of closed reduction of supracondylar humerus fracture with cross Kirschner wire in children
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Objective: To evaluate the functional outcome of percutaneous cross two K wires fixation for Gartland types II and III fractures of humerus. Methodology: This prospective study included80 patients with supracondylar humeral fracture, who underwent closed reduction and fixation by two crossed Kirschner wires. We included children with age < 15 years with closed fractures with Gartland types II and III, while the patient with vascular injury, open, irreducible fractures were excluded. The patients were following up for 6 months and assessed functionally by Flynn’s criteria. Results: The mean age of patients was 8.1 years. Trauma while child playing was the main mechanism of injury in 43 (59.8%) children and 46 (57.5%) fractures were of the

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Publication Date
Fri Mar 28 2025
Journal Name
Journal Of Physical Education
The effect of the four-pillar strategy on the performance of the transmission and preparation skills in volleyball
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The aim of the research is to prepare practical volleyball lessons by using the four pillars strategy for middle school students, and to identify the effect of the four pillars strategy in performing the transmission and volleyball skills in the second intermediate students, to assume that the two researchers assume that there are no statistically significant differences between the results of my skill performance tests Sending and preparing tribal and remote volleyball for the experimental and controlled groups, and there are no statistically significant differences between the results of the performance of the transmission and preparation skills of the volleyball between the two experimental and control groups, and the research co

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Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Comparing Between Shrinkage &Maximum likelihood Method For Estimation Parameters &Reliability Function With 3- Parameter Weibull Distribution By Using Simulation
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The 3-parameter Weibull distribution is used as a model for failure since this distribution is proper when the failure rate somewhat high in starting operation and these rates will be decreased with increasing time .

In practical side a comparison was made between (Shrinkage and Maximum likelihood) Estimators for parameter and reliability function using simulation , we conclude that the Shrinkage estimators for parameters are better than maximum likelihood estimators but the maximum likelihood estimator for reliability function is the better using statistical measures (MAPE)and (MSE) and for different sample sizes.

Note:- ns : small sample ; nm=median sample

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Publication Date
Sun May 24 2026
Journal Name
Sciences Journal Of Physical Education
Cognitive bias and its relationship to the performance of the two skills of standing on (hands and the human wheel) on the floor movement carpet device in the artistic gymnastics for women
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Publication Date
Fri Dec 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
The Effect of Power Sources in the Agricultural Tractor and the Developed Sprayer System on the Performance of the Electrical and Mechanical Sprayer System and some Performance Indicators of the Engine
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Abstract<p>An experiment was conducted to study the effect of the sprayer type according to the source of power and the size of the spray nozzle concerning the quality of the spray produced and fuel consumption.Two types of sprayers were used: a conventional boom sprayer (S1) and a modified (electrified) boom sprayer (S2), along with three sizes of the XR TeeJet 110 spray nozzle (N). The following technical performance indicators were examined: Density of coverage (drops/cm2) using ImageJ software, a 600dpi business card scanner, specifically the ScanShell 800N by CSSN, Inc, and water-sensitive paper (WSP), rate of spray nozzles discharge (ml/min), and fuel consumption (liters/hectare) using a c</p> ... Show More
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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
Developing the Skill of Friendship for Kindergarten Children in the Light of Bandura's Theory Social Learning: Ministry of Education / Baghdad Directorate of Education, Al/Rusafa
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The current research aims to identify the effect of the program to develop the skill of friendship among kindergarten children, as well as the scope of the impact of the program on the sample. To achieve the objectives of the research, the researcher hypothesizes there is no significant difference between the average scores of the sample members on the friendship skill scale for the dimensional scale according to the experimental and control group. The research sample consisted of (60) girl and boy with age ranges (4-6) who were randomly selected from the Kindergarten Unity at Baghdad city/ Rusafa 1. The children were distributed into an experimental and control group, each group consists of (30) girl and boy. The two groups were chosen

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Publication Date
Thu Sep 26 2019
Journal Name
Al-kindy College Medical Journal
Clinical Significance of Blastocystis Sp. among Children with Leukemia
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Background: Blastocystis spp. distributes world widely and the genus Blastocystis include many subtypes that are isolated from human intestinal tract. It is considered the most common parasite detected in human being.

Objectives: To evaluate the incidence of Blastocystis spp. among leukemic children, to find out its association with the presence of symptoms (diarrhea and abdominal pain), and to assess the efficacy of different staining methods in detection of Blastocystis spp. 

Type of the study: cross-sectional study.

Method: 103 children were enrolled in this study, 53 leukemic patients and 50 healthy con

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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
Constructing a Scale of Emotional Adjustment among Kindergarten Children
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The aim of the current research is to construct a scale of emotional adjustment for kindergarten children and to set a standard for its evaluation. To achieve this, a scale consisting of (19) items was prepared. The mother of the child answered by adopting the method of self-report, which is expressed in the form of reporting terms, as each item represents a situation in the child's life and each situation has three alternatives to answer that represent various responses to the mentioned situation. One of the alternatives represents the emotionally adaptive response, which is given a degree (3), the second response expresses the emotional adjustment partly that took the degree of (2), and the third response expresses the weakness of emot

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Publication Date
Sun Jun 11 2017
Journal Name
Al-academy
The Theory of knowledge And Their Repercussions On the Journalistic Image In Electronic Designs Websites
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represent websites link support of human communicate and cohesion of cultures different depending on their languages and their environments around, it was the evolution of one of the most important means of communication of services for electronic networks, the Internet active role in containing the world Bbodqh science and knowledge to Taatlaqah cultures from which derives its intellectual and cognitive cupboards continuity and as a link language for each those environmental Altdadat, linguistic, religious, political, economic . We all know that these electronic means difficult promise ring intellectual and mental connectivity for the masses polarized without being of the image as an element Kravekaa supporter of the electronic media an

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