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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
Mon Nov 05 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Health Education-oriented Program on Parents' Awareness towards Adolescents' Violence Control in Baghdad City
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Objective: This study aims to determine the effectiveness of health education oriented program on parents' awareness
towards adolescents' violence control.
Methodology: A quasi-experimental study was carried out in Baghdad city form 1st of April, 2008 to 1st of September,
2009. A purposive "non-probability" sample of 60 parents who have adolescents' violence in their families who were
selected according to specific criteria. The researcher divided the samples into two equal groups; the study and control
groups. The health education program, as well as a questionnaire was constructed as tools for data collection by the
researcher for the purpose of the study. Content validity was determined by a panel of experts in diffe

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Effect of a Mediator on Scaffolding EFL Student Teachers’ Teaching Competencies, Self- Efficacy and Self–Awareness
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This study aims to find out the effect of the mediator on scaffolding fourth yearstudent- teachers' teaching competencies and their self-efficacy. The present study combines scaffolding and self-efficacy by using a mediator on scaffolding students affects teaching competencies and selfefficacy and from the results of which the existence of student-teachers’ selfawareness was ensured as an effect of the same independent variable. The model affects their teaching competencies and led them to be aware of the needs of their pupils and themselves. 

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Publication Date
Wed Feb 22 2023
Journal Name
Iraqi Journal Of Science
Miltefosine Efficacy on Leishmania Donovani Promastigote
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In the current study, different concentrations of miltefosine drug, which is the first effective and safe oral treatment for visceral leishmaniasis, was evaluated against L. donovani promastigotes in comparison with pentosam drug. Direct counting microscopic assay was used to find 50% inhibitory concentration (IC50) of miltefosine and pentostam against L. donovani promastigotes. The IC50 of miltefosine drug was 45.42μg/ml, 46.76μg/ml and 36.68μg/ml after 24 hr, 48hr and 72hr respectively, In comparison with IC 50 of pentostam drug was 75.39 μg/ml after 72hr. There were significant differences (P˂0.05) between IC50 values of miltefosine and pentostam drugs from first day to third day.

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Publication Date
Fri Feb 13 2026
Journal Name
Journal Of Physical Education
Comparing Explosive Strength and Speed – Strength in College of Physical Education and Sport Sciences’ Leagues of Basketball and Handball
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Publication Date
Thu Oct 31 2019
Journal Name
Al-kindy College Medical Journal
Assessment of efficacy and safety of dapsone gel 5% in the treatment of acne vulgaris
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ABSTRACTBackground : Acne vulgaris is a
common skin disease, affecting more than 85% of
adolescents and often continuing into adulthood.
People between 11 and 30 years of age and up to
5% of older adults. For most patients acne remains
a nuisance with occasional flares of unsightly
comedones, pustules and nodules. For other less
fortunate persons, the sever inflammatory response
to Propionibacterium acnes (P.acnes) results in
permanent
Methods: Disfiguring scars. (1, 2) Stigmata of sever
acne cane lead to social ostracism, withdrawal
from society and severe psychologic
depression (1-4).
Result Pathogenesis of acne Traditionally, acne
has been thought of as a multifactorial disease of
the fo

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Publication Date
Tue Jun 30 2015
Journal Name
Al-kindy College Medical Journal
Effects of local Infiltration of Bupivacaine in total hip and knee replacement for post - operative analgesia
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Background: Pain is one of the most postoperative complications of surgical wound especially within first 24 hrs. leading to delay hospital discharge, stress gastritis and increasing blood pressure. As wound infiltration with long acting local anesthetic (bupivacaine) has been proved to be effective after orthopedic surgeries especially total hip and knee replacements.Objective: our study was designed to determine theeffectiveness of local infiltration of 0.5% of bupivacainebefore closure of surgical wounds in controllingpostoperative pain and improve patient’s outcome after totalhip and knee replacement surgeries in first 24hrspostoperative period.Methods: Twenty patients from class I (healthy patients) and class II (patients mild sys

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Publication Date
Wed Nov 07 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Types of Violence among Adolescents
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Objective(s): To assess the types of violence among adolescents in Baghdad City.
A descripƟve study which was using the assessment approach was conducted on purposive sample of 60 parents of
adolescent for identify types of adolescents violence in their families, was selected according to specific criteria for
participating in health education program towards adolescents' violence control in Baghdad city.
Methodology: A questionnaire was constructed for the purpose of the study. It was consisted of two parts; the first
part which included the parents' demographic characteristics for parents (sex, age, educational level and socioeconomic
status); the second part included types of adolescent violence that reported by par

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Publication Date
Tue Nov 01 2011
Journal Name
Journal Of The Saudi Society Of Dermatology & Dermatologic Surgery
Treatment of pityriasis versicolor using 1% diclofenac gel and clotrimazole cream (comparative therapeutic study)
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KE Sharquie, HM Al-Hamamy, AA Noaimi, IA Al-Shawi, Journal of the Saudi Society of Dermatology & Dermatologic Surgery, 2011 - Cited by 9

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Publication Date
Sun Sep 06 2009
Journal Name
Baghdad Science Journal
Nitroso-R-salt as a sensitive spectrophotometric reagent for the determination of paracetamol in pharmaceutical preparations
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Nitroso-R-salt is proposed as a sensitive spectrophotometric reagent for the determination of paracetamol in aqueous solution. The method is based on the reaction of paracetamol with iron(III) and subsequent reaction with nitroso-R-salt to yield a green colored complex with maximum absorption at 720 nm. Optimization of the experimental conditions was described. The calibration graph was linear in the concentration range of 0.1 – 2.0 ?g mL-1 paracetamol with a molar absorptivity of 6.9 × 104 L mol-1 cm-1. The method was successfully applied to the determination of paracetamol in pharmaceutical preparations without any interference from common excipients. The method has been statistically evaluated with British Pharmacopoeia method a

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Crossref
Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Manufacturing an Organic Solar Cell and Comparing with Different Dyes
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A solar cell was manufactured from local materials and was dyed using dyes extracted from different organic plants. The solar cell glass slides were coated with a nano-porous layer of Titanium Oxide and infused with two types of acids, Nitric acid and Acetic acid. The organic dyes were extracted from Pomegranate, Hibiscus, Blackberry and Blue Flowers. They were then tested and a comparison was made for the amount of voltage they generate when exposed to sunlight. Hibiscus sabdariffa extract had the best performance parameters; also Different plants give different levels of voltage.

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