\documentclass[twocolumn,twoside]{article}
\makeatletter\if@twocolumn\PassOptionsToPackage{switch}{lineno}\else\fi\makeatother

\usepackage{amsfonts,amssymb,amsbsy,latexsym,amsmath,tabulary,graphicx,times,xcolor}

%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
% Following additional macros are required to function some 
% functions which are not available in the class used.
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\usepackage{url,multirow,morefloats,floatflt,cancel,tfrupee}
\makeatletter


\AtBeginDocument{\@ifpackageloaded{textcomp}{}{\usepackage{textcomp}}}
\makeatother
\usepackage{colortbl}
\usepackage{xcolor}
\usepackage{pifont}
\usepackage[nointegrals]{wasysym}
\urlstyle{rm}
\makeatletter

%%%For Table column width calculation.
\def\mcWidth#1{\csname TY@F#1\endcsname+\tabcolsep}

%%Hacking center and right align for table
\def\cAlignHack{\rightskip\@flushglue\leftskip\@flushglue\parindent\z@\parfillskip\z@skip}
\def\rAlignHack{\rightskip\z@skip\leftskip\@flushglue \parindent\z@\parfillskip\z@skip}

%Etal definition in references
\@ifundefined{etal}{\def\etal{\textit{et~al}}}{}


%\if@twocolumn\usepackage{dblfloatfix}\fi
\usepackage{ifxetex}
\ifxetex\else\if@twocolumn\@ifpackageloaded{stfloats}{}{\usepackage{dblfloatfix}}\fi\fi

\AtBeginDocument{
\expandafter\ifx\csname eqalign\endcsname\relax
\def\eqalign#1{\null\vcenter{\def\\{\cr}\openup\jot\m@th
  \ialign{\strut$\displaystyle{##}$\hfil&$\displaystyle{{}##}$\hfil
      \crcr#1\crcr}}\,}
\fi
}

%For fixing hardfail when unicode letters appear inside table with endfloat
\AtBeginDocument{%
  \@ifpackageloaded{endfloat}%
   {\renewcommand\efloat@iwrite[1]{\immediate\expandafter\protected@write\csname efloat@post#1\endcsname{}}}{\newif\ifefloat@tables}%
}%

\def\BreakURLText#1{\@tfor\brk@tempa:=#1\do{\brk@tempa\hskip0pt}}
\let\lt=<
\let\gt=>
\def\processVert{\ifmmode|\else\textbar\fi}
\let\processvert\processVert

\@ifundefined{subparagraph}{
\def\subparagraph{\@startsection{paragraph}{5}{2\parindent}{0ex plus 0.1ex minus 0.1ex}%
{0ex}{\normalfont\small\itshape}}%
}{}

% These are now gobbled, so won't appear in the PDF.
\newcommand\role[1]{\unskip}
\newcommand\aucollab[1]{\unskip}
  
\@ifundefined{tsGraphicsScaleX}{\gdef\tsGraphicsScaleX{1}}{}
\@ifundefined{tsGraphicsScaleY}{\gdef\tsGraphicsScaleY{.9}}{}
% To automatically resize figures to fit inside the text area
\def\checkGraphicsWidth{\ifdim\Gin@nat@width>\linewidth
	\tsGraphicsScaleX\linewidth\else\Gin@nat@width\fi}

\def\checkGraphicsHeight{\ifdim\Gin@nat@height>.9\textheight
	\tsGraphicsScaleY\textheight\else\Gin@nat@height\fi}

\def\fixFloatSize#1{}%\@ifundefined{processdelayedfloats}{\setbox0=\hbox{\includegraphics{#1}}\ifnum\wd0<\columnwidth\relax\renewenvironment{figure*}{\begin{figure}}{\end{figure}}\fi}{}}
\let\ts@includegraphics\includegraphics

\def\inlinegraphic[#1]#2{{\edef\@tempa{#1}\edef\baseline@shift{\ifx\@tempa\@empty0\else#1\fi}\edef\tempZ{\the\numexpr(\numexpr(\baseline@shift*\f@size/100))}\protect\raisebox{\tempZ pt}{\ts@includegraphics{#2}}}}

%\renewcommand{\includegraphics}[1]{\ts@includegraphics[width=\checkGraphicsWidth]{#1}}
\AtBeginDocument{\def\includegraphics{\@ifnextchar[{\ts@includegraphics}{\ts@includegraphics[width=\checkGraphicsWidth,height=\checkGraphicsHeight,keepaspectratio]}}}

\DeclareMathAlphabet{\mathpzc}{OT1}{pzc}{m}{it}

\def\URL#1#2{\@ifundefined{href}{#2}{\href{#1}{#2}}}

%%For url break
\def\UrlOrds{\do\*\do\-\do\~\do\'\do\"\do\-}%
\g@addto@macro{\UrlBreaks}{\UrlOrds}



\edef\fntEncoding{\f@encoding}
\def\EUoneEnc{EU1}
\makeatother
\def\floatpagefraction{0.8} 
\def\dblfloatpagefraction{0.8}
\def\style#1#2{#2}
\def\xxxguillemotleft{\fontencoding{T1}\selectfont\guillemotleft}
\def\xxxguillemotright{\fontencoding{T1}\selectfont\guillemotright}

\newif\ifmultipleabstract\multipleabstractfalse%
\newenvironment{typesetAbstractGroup}{}{}%

%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%

\usepackage[authoryear]{natbib}



\newif\ifnokeywords\nokeywordsfalse

\makeatletter\input{size10-pointfive.clo}\makeatother%
\definecolor{kwdboxcolor}{RGB}{242,242,242}
\usepackage[hidelinks,colorlinks=true,allcolors=blue]{hyperref}
\linespread{1}                 
\def\floatpagefraction{0.8}

\usepackage[paperheight=11.69in,paperwidth=8.26in,top=1in,bottom=1in,left=1in,right=.75in,headsep=24pt]{geometry}

\usepackage{multirow-custom}

\makeatletter

\def\hlinewd#1{%
  \noalign{\ifnum0=`}\fi\hrule \@height #1%
  \futurelet\reserved@a\@xhline}
\def\tbltoprule{\hlinewd{1pt}\\[-14pt]}
\def\tblbottomrule{\noalign{\vspace*{6pt}}\hline\noalign{\vspace*{2pt}}}
\def\tblmidrule{\hline\noalign{\vspace*{2pt}}}



\let\@articleType\@empty
\let\@journalDoi\@empty
\let\@journalVolume\@empty
\let\@journalIssue\@empty
\let\@crossMarkLink\@empty
\let\@receivedDate\@empty
\let\@acceptedDate\@empty
\let\@revisedDate\@empty
\let\@publishedDate\@empty
\let\@copyrightYear\@empty
\let\@firstPage\@empty
\def\articleType#1{\gdef\@articleType{#1}}
\def\journalDoi#1{\gdef\@journalDoi{#1}}
\def\crossMarkLink#1{\gdef\@crossMarkLink{#1}}
\def\receivedDate#1{\gdef\@receivedDate{#1}}
\def\acceptedDate#1{\gdef\@acceptedDate{#1}}
\def\revisedDate#1{\gdef\@revisedDate{#1}}
\def\publishedDate#1{\gdef\@publishedDate{#1}}
\def\copyrightYear#1{\gdef\@copyrightYear{#1}}
\def\journalVolume#1{\gdef\@journalVolume{#1}}
\def\journalIssue#1{\gdef\@journalIssue{#1}}
\def\firstPage#1{\gdef\@firstPage{#1}}
\let\@issuelogo\@empty%
\let\@issuelogoex\@empty%
\def\issuelogo#1{\gdef\@issuelogo{#1}}
\def\issuelogoex#1{\gdef\@issuelogoex{#1}}


\def\author#1{%
  \gdef\@author{%
    \hskip-\dimexpr(\tabcolsep)\hskip5pt%
    \parbox{\dimexpr\textwidth-1pt}%
    {\fontsize{11}{13}\selectfont\raggedright #1}%
  }%
}


\usepackage{pharmascope-abs}
\usepackage{caption}
\usepackage{lastpage}
\usepackage{fancyhdr}
\usepackage[noindentafter,explicit]{titlesec}
\usepackage{fontspec}

\setmainfont[%
BoldFont=cambriab.ttf,%
ItalicFont=CAMBRIAI.TTF,%
BoldItalicFont=CAMBRIAZ.TTF]{Cambria.ttf}
\lefthyphenmin = 3

\def\title#1{%
  \gdef\@title{%
      \vspace*{-40pt}%
       \ifx\@articleType\@empty\else{\fontsize{10}{12}\scshape\selectfont\hspace{8pt}\@articleType\hfill\mbox{}\par\vspace{2pt}}\fi%
       \minipage{\linewidth}
         \hrulefill\\[-0.7pt]%%{\includegraphics[width=75pt,height=50pt]{ijrps_logo.png}}\hfill
         \mbox{~}\hspace{5pt}\parbox{.1\linewidth}{\IfFileExists{images/\@issuelogo.\@issuelogoex}{\includegraphics[width=79pt,height=61pt]{images/\@issuelogo.\@issuelogoex}}{\includegraphics[width=75pt,height=50pt]{ijrps_logo.png}}}\hfill
         \fcolorbox{kwdboxcolor}{kwdboxcolor}{\parbox{.792\linewidth}{%
          \begin{center}\fontsize{17}{17}\selectfont\scshape\vskip-7pt International Journal of Research in Pharmaceutical Sciences\hfill\end{center}%
          \vspace*{-10pt}\hspace*{4pt}{\fontsize{8}{9}\selectfont Published by JK Welfare \& Pharmascope Foundation\hfill  Journal Home Page: \href{www.ijrps.com}{\color{blue}\underline{\smash{www.ijrps.com}}}}\hspace*{4pt}\mbox{}}}%
       \par\vspace*{-1pt}\rule{\linewidth}{1.3pt}%
       \endminipage%
    \par\vspace*{9.2pt}\parbox{.98\linewidth}{\linespread{.9}\raggedright\fontsize{14}{17}\selectfont #1}%
    \vspace*{-8pt}%
  }
}


\setlength{\parindent}{0pt}
\setlength{\parskip}{0.4pc plus 1pt minus 1pt}

\def\abbrvJournalTitle{Int. J. Res. Pharm. Sci.}

\fancypagestyle{headings}{%
  \renewcommand{\headrulewidth}{0pt}%
  \renewcommand{\footrulewidth}{0.3pt}
  \fancyhf{}%
  \fancyhead[R]{%
    \fontsize{9.12}{11}\selectfont\RunningAuthor,\ \abbrvJournalTitle,\ \ifx\@journalVolume\@empty X\else\@journalVolume\fi%
    \ifx\@journalIssue\@empty\else(\@journalIssue)\fi%
    ,\ \ifx\@firstPage\@empty 1\else\@firstPage\fi-\pageref*{LastPage}%
  }%
  \fancyfoot[LO,RE]{\fontsize{9.12}{11}\selectfont\textcopyright\ International Journal of Research in Pharmaceutical Sciences}%
  \fancyfoot[RO,LE]{\fontsize{9.12}{11}\selectfont\thepage}
}\pagestyle{headings}

                                                         
\fancypagestyle{plain}{%
  \renewcommand{\headrulewidth}{0pt}%
  \renewcommand{\footrulewidth}{0.3pt}%
  \fancyhf{}%
  \fancyhead[R]{%
    \fontsize{9.12}{11}\selectfont\RunningAuthor,\ \abbrvJournalTitle,\ \ifx\@journalVolume\@empty X\else\@journalVolume\fi%
    \ifx\@journalIssue\@empty\else(\@journalIssue)\fi%
    ,\ \ifx\@firstPage\@empty 1\else\@firstPage\fi-\pageref*{LastPage}%
  }%
  \fancyfoot[LO,RE]{\fontsize{9.12}{11}\selectfont\textcopyright\ International Journal of Research in Pharmaceutical Sciences}%
  \fancyfoot[RO,LE]{\fontsize{9.12}{11}\selectfont\thepage}
  \ifx\@firstPage\@empty\else\setcounter{page}{\@firstPage}\fi
}


\def\NormalBaseline{\def\baselinestretch{1.1}}
\usepackage{textcase}
\setcounter{secnumdepth}{0}

\titleformat{\section}[block]{\bfseries\boldmath\NormalBaseline\filright\fontsize{10.5}{13}\selectfont}
{\thesection}
{6pt}
{\MakeTextUppercase{#1}}
[]
\titleformat{\subsection}[block]{\bfseries\boldmath\NormalBaseline\filright\fontsize{10.5}{12}\selectfont}
{\thesubsection}
{6pt}
{#1}
[]
\titleformat{\subsubsection}[block]{\NormalBaseline\filright\fontsize{10.5}{12}\selectfont}
{\thesubsubsection}
{6pt}
{#1}
[]
\titleformat{\paragraph}[block]{\NormalBaseline\filright\fontsize{10.5}{10}\selectfont}
{\theparagraph}
{6pt}
{#1}
[]
\titleformat{\subparagraph}[block]{\NormalBaseline\filright\fontsize{10.5}{12}\selectfont}
{\thesubparagraph}
{6pt}
{#1}
[]

\titlespacing{\section}{0pt}{.5\baselineskip}{.5\baselineskip}  
\titlespacing{\subsection}{0pt}{.5\baselineskip}{.5\baselineskip}  
\titlespacing{\subsubsection}{0pt}{.5\baselineskip}{.5\baselineskip}  
\titlespacing{\paragraph}{0pt}{.5\baselineskip}{.5\baselineskip}  
\titlespacing{\subparagraph}{0pt}{.5\baselineskip}{.5\baselineskip}

\captionsetup[figure]{skip=1.4pt,font=bf,labelsep=colon,justification=raggedright,singlelinecheck=false}
\captionsetup[table]{skip=1.4pt,font=bf,labelsep=colon,justification=raggedright,singlelinecheck=false}

\def\bibyear#1{#1}
%\def\bibjtitle#1{#1}   %%Publisher request
\def\bibauand{}
\setlength\bibsep{3pt}
\setlength\bibhang{8pt}

\makeatother
\date{}


\usepackage{float}

\begin{document}


\def\RunningAuthor{Rizaldy Taslim Pinzon and Tifany Edfa Susanto}
\firstPage{1788}
\articleType{Original Article}
\receivedDate{05 Jun 2021}
\acceptedDate{14 Jul 2021}
\revisedDate{11 Jul 2021}
\journalVolume{2021, 12}
\journalIssue{3}
\journalDoi{ijrps.v12i3.4838}
\copyrightYear{2021}
\def\authorCount{2}
\def\affCount{1}

\def\journalTitle{International Journal of Research in Pharmaceutical Sciences}

\title{\textbf{Comparison of intravenous ibuprofen and intravenous ketorolac effectivity for non-specific acute musculoskeletal pain }}
\author{Rizaldy~Taslim~Pinzon\textsuperscript{*}, 
            Tifany~Edfa~Susanto~\\[5pt]{Department of Neurology, Faculty of Medicine, Duta Wacana Christian University, Wahidin Sudirohusodo street number 5-25, Yogyakarta 55224, Indonesia}}

\begin{abstract}
Acute musculoskeletal pain is an illness of muscle, bone, joint, and muscle tissue that is caused by an injury or inflammation. Ibuprofen and Ketorolac are Non-Steroid Anti-Inflammatory Drugs or NSAID that are usually used for non-specific acute musculoskeletal pain. The purpose of the study is to compare the pain relief of non-specific acute musculoskeletal pain between intravenous Ibuprofen and intravenous Ketorolac therapy. This study uses a quasi-experimental, non-randomized, non-equivalent, active comparator, open-label study. The total sample for this study is 60 subjects, divided into two groups (n-30), subjects are required by using purposive sampling. Pain measured by Numeric Pain Scale. The mean baseline of the pain intensity were 63.33 \ensuremath{\pm} 8.841 for the Ibuprofen group and 59.33 \ensuremath{\pm} 12.847 for the Ketorolac group. There was not any differences between both of group (p = 0.107) after the medication were given all measurement shows significant differences between two groups (p = {\textless}0.05) that Ibuprofen group shows better results. Intravenous Ibuprofen has better effectivity rather than intravenous Ketorolac as a treatment of non-specific acute musculoskeletal pain. 
\end{abstract}\def\keywordstitle{Keywords}

\begin{keywords}Non-specific acute musculoskeletal pain,\newline pain intensity,\newline intravenous Ibuprofen,\newline intravenous Ketorolac
\end{keywords}
\twocolumn[ \maketitle {\printKwdAbsBox}]
\makeatletter{\raggedright\textsuperscript{*}Corresponding Author\par Name:\ Rizaldy~Taslim~Pinzon~\\ Phone:\ +62-81294638229~\\  Email:\ drpinzon17@gmail.com
        \par}\vspace*{-11pt}\hrulefill\par{\fontsize{12}{14}\selectfont ISSN: 0975-7538}\par% 
        \textsc{DOI:}\ \href{https://doi.org/10.26452/\@journalDoi}{\textcolor{blue}{\underline{\smash{https://doi.org/10.26452/\@journalDoi}}}}\par%
        \vspace*{-11pt}\hrulefill\\{\fontsize{9.12}{10.12}\selectfont Production and Hosted by}\par{IJRPS |~\href{www.ijrps.com}{www.ijrps.com}}\par%
        \vspace*{-2pt}{\fontsize{9.12}{10.12}\selectfont\textcopyright\ \@copyrightYear\ $|$ All rights reserved.}\par%
        \vspace*{-11pt}\rule{\linewidth}{1.2pt}
        \makeatother
        
    
\section{Introduction}
Musculoskeletal pain is the type of pain that often occurs, There are 20\%-30\% of people in the world who experience musculoskeletal pain and there are more than 150 diagnoses of muscle, joint, and connective tissue such as tendon and ligament that are associated with pain \unskip~\citep{1158038:22709754}. 

Patients with musculoskeletal pain have clinical features such as decreased activity, stiffness, weakness, pain on movement, and decreasing range of motion which is not associated with joint \unskip~\citep{1158038:22709752}. 

Musculoskeletal pain therapy in general is NSAIDs (non-steroidal anti-inflammatory drugs), anticonvulsants, opioids, opioid analgesics or nonopioids \unskip~\citep{1158038:22709749}. 

The therapy should work quickly so that NSAIDs with a fast onset of action such as Ketorolac and Ibuprofen are often the choice. 

NPS or Numeric Pain Scale is an instrument to assess pain intensity. NPS was chosen because it has been tested for reliability and validity and describes the pain felt by the patient. NPS could also be used for repeated measurements.

The purpose of this study was to compare the effectiveness of pain reduction between intravenous administration of Ibuprofen and Ketorolac.
    
\section{Materials and Methods}
This study used a quasi-experimental method with non-randomized, non-equivalent, active comparison, and open-label study. This study consisted of 60 samples conducted by the purposive sampling method. The samples were divided into two groups, namely the Ibuprofen and Ketorolac therapy groups (n = 30). Therapy is given intravenously at a dose of 800 mg for Ibuprofen and 30 mg for Ketorolac.

This research is registered in the research register of the Ministry of Health's clinic with the title \textit{Comparison of Intravenous Ibuprofen and Ketorolac for Acute Musculoskeletal Pain from Various Etiologies}. This research has received ethical eligibility from the Health Research Ethics Committee of the Faculty of Medicine, Duta Wacana Christian University (ethical eligibility Number: 1146 / C.16 / FK / 2020)
    
\section{Results and Discussion}
In the study, 60 subjects were divided into two groups (n = 30) with more male subjects than women. The mean age in the Ibuprofen group was 58.50 \ensuremath{\pm} 10.487 and the Ketorolac group 52.9 \ensuremath{\pm} 18.626. The mean initial pain intensity in the Ibuprofen therapy group was 63.33 \ensuremath{\pm} 8.841 and in the Ketorolac group 59.33 \ensuremath{\pm} 12,847 (Table~\ref{tw-ddfe6cd1f894}). 


\bgroup
\fixFloatSize{images/dd2307da-ab61-4311-be6b-f60f07f32442-upicture1.png}
\begin{figure}[!htbp]
\centering \makeatletter\IfFileExists{images/dd2307da-ab61-4311-be6b-f60f07f32442-upicture1.png}{\includegraphics{images/dd2307da-ab61-4311-be6b-f60f07f32442-upicture1.png}}{}
\makeatother 
\caption{\boldmath {Graph of Decreased Pain Intensity Between Two Groups}}
\label{f-125c255309eb}
\end{figure}
\egroup

\begin{table*}[!htbp]
\caption{\boldmath {Baseline Characteristics Between Two Groups} }
\label{tw-ddfe6cd1f894}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.17005714285714287\linewidth-2\tabcolsep}p{\dimexpr.24715714285714284\linewidth-2\tabcolsep}p{\dimexpr.12875714285714288\linewidth-2\tabcolsep}p{\dimexpr.10720000000000004\linewidth-2\tabcolsep}p{\dimexpr.12745714285714289\linewidth-2\tabcolsep}p{\dimexpr.10021428571428576\linewidth-2\tabcolsep}p{\dimexpr.1191571428571429\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}\multicolumn{2}{p{\dimexpr(.41721428571428575\linewidth-2\tabcolsep)}}{\cAlignHack Baseline Characteristics} & \cAlignHack Ibuprofen Groups  & \cAlignHack \% & \cAlignHack Ketorolac Groups & \cAlignHack \% & \cAlignHack P-value\\
\rowcolor{kwdboxcolor}\cAlignHack  & \cAlignHack  & \cAlignHack (n=30) & \cAlignHack  & \cAlignHack (n = 30) & \cAlignHack  & \cAlignHack \\
\tblmidrule 
\cAlignHack Gender &
  \cAlignHack Male &
  \cAlignHack 18 &
  \cAlignHack 60 &
  \cAlignHack 16 &
  \cAlignHack 53.3 &
  \cAlignHack 0.794\\
\cAlignHack  &
  \cAlignHack Women &
  \cAlignHack 12 &
  \cAlignHack 40 &
  \cAlignHack 14 &
  \cAlignHack 46.7 &
  \cAlignHack \\
 &
   &
   &
   &
   &
   &
  \\
\cAlignHack Age &
  \cAlignHack Mean \ensuremath{\pm} SD &
  \multicolumn{2}{p{\dimexpr(.23595714285714294\linewidth-2\tabcolsep)}}{\cAlignHack 58.50 \ensuremath{\pm} 10.487} &
  \multicolumn{2}{p{\dimexpr(.22767142857142865\linewidth-2\tabcolsep)}}{\cAlignHack 52.9 \ensuremath{\pm} 18.626} &
  \cAlignHack 0.297\\
 &
   &
   &
   &
   &
   &
  \\
\cAlignHack Location of  &
  \cAlignHack Back &
  \cAlignHack 14 &
  \cAlignHack 46.7 &
  \cAlignHack 18 &
  \cAlignHack 60.0 &
  \cAlignHack 0.438\\
\cAlignHack Pain &
  \cAlignHack Knee &
  \cAlignHack 7 &
  \cAlignHack 23.3 &
  \cAlignHack 4 &
  \cAlignHack 13.3 &
  \cAlignHack 0.505\\
\cAlignHack  &
  \cAlignHack Neck &
  \cAlignHack 9 &
  \cAlignHack 30.0 &
  \cAlignHack 5 &
  \cAlignHack 16.0 &
  \cAlignHack 0.360\\
 &
   &
   &
   &
   &
   &
  \\
\cAlignHack Initial pain intensity &
  \cAlignHack Mean \ensuremath{\pm} SD &
  \multicolumn{2}{p{\dimexpr(.23595714285714294\linewidth-2\tabcolsep)}}{\cAlignHack 63.33\ensuremath{\pm} 8.841} &
  \multicolumn{2}{p{\dimexpr(.22767142857142865\linewidth-2\tabcolsep)}}{\cAlignHack 59.33\ensuremath{\pm} 12.847} &
  \cAlignHack 0.107\\
 &
   &
   &
   &
   &
   &
  \\
\cAlignHack Comorbid disease &
  \cAlignHack Yes &
  \cAlignHack 20 &
  \cAlignHack 66.7 &
  \cAlignHack 12 &
  \cAlignHack 40.0 &
  \cAlignHack 0.070\\
\cAlignHack  &
  \cAlignHack Not &
  \cAlignHack 10 &
  \cAlignHack 33.3 &
  \cAlignHack 18 &
  \cAlignHack 60.0 &
  \cAlignHack \\
 &
   &
   &
   &
   &
   &
  \\
\cAlignHack Comedication &
  \cAlignHack Yes &
  \cAlignHack 21 &
  \cAlignHack 70.0 &
  \cAlignHack 10 &
  \cAlignHack 33.3 &
  \cAlignHack 0.010\\
\cAlignHack  &
  \cAlignHack Not &
  \cAlignHack 9 &
  \cAlignHack 30.0 &
  \cAlignHack 20 &
  \cAlignHack 66.7 &
  \cAlignHack \\
 &
   &
   &
   &
   &
   &
  \\
\cAlignHack  &
  \cAlignHack Antihypertensive agents &
  \cAlignHack 13 &
  \cAlignHack 43.4 &
  \cAlignHack 5 &
  \cAlignHack 16.7 &
  \cAlignHack 0.049\\
\cAlignHack Types of  &
  \cAlignHack Anti Diabetic agent &
  \cAlignHack 1 &
  \cAlignHack 3.3 &
  \cAlignHack 4 &
  \cAlignHack 13.3 &
  \cAlignHack 0.350\\
\cAlignHack comedication &
  \cAlignHack Anti Platelet Agent &
  \cAlignHack 13 &
  \cAlignHack 43.3 &
  \cAlignHack 2 &
  \cAlignHack 6.7 &
  \cAlignHack 0.003\\
\cAlignHack  &
  \cAlignHack \textit{Proton pump inhibitor}/H2 blocker &
  \cAlignHack 17 &
  \cAlignHack 56.7 &
  \cAlignHack 4 &
  \cAlignHack 13.3 &
  \cAlignHack 0.001\\
\cAlignHack  &
  \cAlignHack Vitamin &
  \cAlignHack 16 &
  \cAlignHack 53.3 &
  \cAlignHack 0 &
  \cAlignHack 0 &
  \cAlignHack {\textless}0.001\\
\cAlignHack  &
  \cAlignHack Steroid &
  \cAlignHack 7 &
  \cAlignHack 23.3 &
  \cAlignHack 0 &
  \cAlignHack 0 &
  \cAlignHack 0.016\\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Comparison of Pain Intensity Between Two Groups} }
\label{tw-2c90024891f6}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.19296666666666663\linewidth-2\tabcolsep}p{\dimexpr.14036666666666672\linewidth-2\tabcolsep}p{\dimexpr.2137333333333334\linewidth-2\tabcolsep}p{\dimexpr.11960000000000004\linewidth-2\tabcolsep}p{\dimexpr.22060000000000006\linewidth-2\tabcolsep}p{\dimexpr.11273333333333335\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}\cAlignHack Assessment time & \cAlignHack Ibuprofen group & \cAlignHack  Mean \ensuremath{\pm} SD & \cAlignHack Ketorolac group & \cAlignHack Mean\ensuremath{\pm}SD & \cAlignHack P-value\\
\tblmidrule 
\cAlignHack Early &
  \cAlignHack  &
  \cAlignHack 63.33\ensuremath{\pm} 8.841 &
  \cAlignHack  &
  \cAlignHack 59.33\ensuremath{\pm} 12.847 &
  \cAlignHack 0.107\\
 &
   &
   &
   &
   &
  \\
\cAlignHack 8 hours after  &
  \cAlignHack  &
  \cAlignHack 38.67 \ensuremath{\pm} 10.417 &
  \cAlignHack  &
  \cAlignHack 42.00 \ensuremath{\pm} 8.052 &
  \cAlignHack 0.003\\
\cAlignHack treatment &
  \cAlignHack  &
  \cAlignHack \ensuremath{\Delta } 24.67\ensuremath{\pm}10.080 &
  \cAlignHack  &
  \cAlignHack \ensuremath{\Delta }17.33\ensuremath{\pm} 7.849 &
  \cAlignHack 0.003\\
 &
   &
   &
   &
   &
  \\
\cAlignHack 16 hours after  &
  \cAlignHack  &
  \cAlignHack 31.67 \ensuremath{\pm} 11.769 &
  \cAlignHack  &
  \cAlignHack 38.00 \ensuremath{\pm} 7.144  &
  \cAlignHack 0.006\\
\cAlignHack treatment &
  \cAlignHack 30 &
  \cAlignHack \ensuremath{\Delta } 31.67\ensuremath{\pm}12.888 &
  \cAlignHack 30 &
  \cAlignHack \ensuremath{\Delta } 21.33\ensuremath{\pm} 9.371 &
  \cAlignHack 0.002\\
 &
   &
   &
   &
   &
  \\
\cAlignHack 24 hours after &
  \cAlignHack  &
  \cAlignHack 24.33 \ensuremath{\pm} 13.047  &
  \cAlignHack  &
  \cAlignHack 34.67 \ensuremath{\pm} 7.303  &
  \cAlignHack \textless\ 0.001\\
\cAlignHack treatment &
  \cAlignHack  &
  \cAlignHack \ensuremath{\Delta } 39.00\ensuremath{\pm} 12.959 &
  \cAlignHack  &
  \cAlignHack \ensuremath{\Delta } 24.67 \ensuremath{\pm} 11.366 &
  \cAlignHack \textless\ 0.001\\
 &
   &
   &
   &
   &
  \\
\cAlignHack 48 hours after &
  \cAlignHack  &
  \cAlignHack 17.33 \ensuremath{\pm} 13.880  &
  \cAlignHack  &
  \cAlignHack 26.67 \ensuremath{\pm} 7.581  &
  \cAlignHack 0.006\\
\cAlignHack treatment &
  \cAlignHack  &
  \cAlignHack \ensuremath{\Delta } 46.00\ensuremath{\pm} 16.316 &
  \cAlignHack  &
  \cAlignHack \ensuremath{\Delta } 32.67\ensuremath{\pm} 10.148 &
  \cAlignHack 0.001\\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Comparison of Rescue Medication Between Two Groups} }
\label{tw-9ab09c999c52}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.21985714285714284\linewidth-2\tabcolsep}p{\dimexpr.09665714285714285\linewidth-2\tabcolsep}p{\dimexpr.17125714285714288\linewidth-2\tabcolsep}p{\dimexpr.11684285714285718\linewidth-2\tabcolsep}p{\dimexpr.16777142857142863\linewidth-2\tabcolsep}p{\dimexpr.10965714285714288\linewidth-2\tabcolsep}p{\dimexpr.1179571428571429\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}\multicolumn{2}{p{\dimexpr(.31651428571428568\linewidth-2\tabcolsep)}}{\cAlignHack Rescue Medication} & \cAlignHack Ibuprofen Group (N=30) & \cAlignHack \% & \cAlignHack  Ketorolac Group (N=30) & \cAlignHack \% & \cAlignHack P-value\\
\tblmidrule 
\cAlignHack Patients receive  &
  \cAlignHack Yes &
  \cAlignHack 23 &
  \cAlignHack 76.7 &
  \cAlignHack 17 &
  \cAlignHack 56.7 &
  \cAlignHack 0.171\\
\cAlignHack Rescue Medication &
  \cAlignHack No &
  \cAlignHack 7 &
  \cAlignHack 23.3 &
  \cAlignHack 12 &
  \cAlignHack 43.3 &
  \cAlignHack \\
 &
   &
   &
   &
   &
   &
  \\
\cAlignHack Type of  &
  \cAlignHack Oral &
  \cAlignHack 18 &
  \cAlignHack 13.9 &
  \cAlignHack 6 &
  \cAlignHack 3.4 &
  \cAlignHack 0.207\\
\cAlignHack Medication &
  \cAlignHack Injection &
  \cAlignHack 5 &
  \cAlignHack 3.8 &
  \cAlignHack 11 &
  \cAlignHack 6.2 &
  \cAlignHack \\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Comparison of Adverse Events between Two Groups} }
\label{tw-7848b8e89e36}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.21275714285714287\linewidth-2\tabcolsep}p{\dimexpr.13815714285714284\linewidth-2\tabcolsep}p{\dimexpr.1736571428571429\linewidth-2\tabcolsep}p{\dimexpr.10971428571428575\linewidth-2\tabcolsep}p{\dimexpr.16182857142857145\linewidth-2\tabcolsep}p{\dimexpr.09068571428571433\linewidth-2\tabcolsep}p{\dimexpr.11320000000000002\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}\multicolumn{2}{p{\dimexpr(.3509142857142857\linewidth-2\tabcolsep)}}{\cAlignHack Adverse Event} & \cAlignHack Ibuprofen Group (N=30) & \cAlignHack \% & \cAlignHack Ketorolac Group (N=30) & \cAlignHack \% & \cAlignHack P-value\\
\tblmidrule 
\cAlignHack Patient who  &
  \cAlignHack Yes &
  \cAlignHack 0 &
  \cAlignHack 0.0 &
  \cAlignHack 11 &
  \cAlignHack 36.7 &
  \cAlignHack 0.001\\
\cAlignHack Adverse Event &
  \cAlignHack No &
  \cAlignHack 30 &
  \cAlignHack 61.2 &
  \cAlignHack 19 &
  \cAlignHack 63.3 &
  \cAlignHack \\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}
There was no significant difference between the initial pain intensity of the two groups (p = 0.107) with the mean pain intensity of the Ibuprofen group 63.33 \ensuremath{\pm} 8,841 and the Ketorolac group 59.33 \ensuremath{\pm} 12,847. The pain intensity after giving therapy in the two groups showed a significant difference (p = {\textless}0.005) with the mean pain intensity in the Ibuprofen group and the Ketorolac group, respectively, after 8 hours 38.67 \ensuremath{\pm} 10.417 and 42.00 \ensuremath{\pm} 8052, after 16 hours 31.67 \ensuremath{\pm} 11.769 and 38.00 \ensuremath{\pm} 7.144, 24 hours 24.33 \ensuremath{\pm} 13.047 and 34.67 \ensuremath{\pm} 7.303, and after 48 hours 17.33 \ensuremath{\pm} 13.880 and 26.67 \ensuremath{\pm} 7,581 (Table~\ref{tw-2c90024891f6}). There was a significant difference in reduction of pain intensity between the two groups within hours (Figure~\ref{f-125c255309eb}).

Rescue medication was administered to 40 study subjects, namely the Ibuprofen group 23 (76.7\%) subjects and 17 (56.7\%) Ketorolac subjects (Table~\ref{tw-9ab09c999c52}).

Adverse events in this study occurred in the Ketorolac therapy group with a total of 11 (36.7\%) subjects and no adverse events in the Ibuprofen therapy group (Table~\ref{tw-7848b8e89e36}).

The basic characteristics of this study indicated that men experienced more acute musculoskeletal pain than women, but this difference did not have a significant effect on pain intensity and therapy effectiveness (p = 0.794). The mean age of the patients in the two groups did not have a significant difference, namely 58.50 in the Ibuprofen group and 52.9 in the Ketorolac group \unskip~\citep{1158038:22709755}. Comedication in the form of vitamins and steroids was significant in the Ibuprofen group, and this comedication could have a better effect on reducing pain intensity in the Ibuprofen group. 

Vitamins including vitamins C, D, and B complex are known to have a role in pain improvement \unskip~\citep{1158038:22709756,1158038:22709753,1158038:22709759}. Steroids have functions as an anti-inflammatory agent that can inhibit the synthesis of nerve mediators such as PGE2 \unskip~\citep{1158038:22709750}. 

In this study, five measurements of the Numeric Pain Scale (NPS) were taken, the first measurement taken before giving therapy and the fourth measurement after therapy. The mean of the pain intensity on the Ibuprofen group before giving the therapy was 63.33 \ensuremath{\pm} 8,841 and the Ketorolac group 59.33 \ensuremath{\pm} 12,847, and there was no significant difference in pain intensity in the two groups (p = 0.107). The final measurement after 48 hours, Ibuprofen group showed 17.33 \ensuremath{\pm} 13,880 and the Ketorolac group was 26.67 \ensuremath{\pm} 7,581, and the amount of reduction in pain intensity in the Ibuprofen group was 46.00 \ensuremath{\pm} 16,316, and the Ketorolac group was 32.67 \ensuremath{\pm} 10,148. The mean pain intensity and the mean reduction in pain intensity in the two groups showed a significant difference (p = 0.006, p = 0.001). The results obtained indicate that Ibuprofen has better effectiveness in reducing acute musculoskeletal pain compared to Ketorolac.

There was no significant difference in giving rescue medication to the two groups (p = 0.171). In the Ibuprofen therapy group, 23 subjects needed rescue medication in the form of pain relief due to pain that arose between the times of giving Ibuprofen therapy. Intravenous ibuprofen 800 mg has a maximum concentration time of 30 to 60 minutes and a maximum concentration time of 0-4 hours depending on the subject's metabolism \unskip~\citep{1158038:22709757}. 

In the Ketorolac therapy group, there were 17 subjects who received rescue medication, 30 mg intravenous ketorolac could reach a maximum concentration in 1 to 2 hours, and the effects can last for 6 to 8 hours \unskip~\citep{1158038:22709760,1158038:22709758}.

Adverse events occurred only in the Ketorolac therapy group. Intravenous ketorolac can be given in a dose of 10 mg to 30 mg with a maximum dose of 1 day in adults is 120 mg. The higher the intravenous ketorolac dose, the greater the chance for adverse events to occur. In this study, Ketorolac was administered every 12 hours as much as 30 mg, thus allowing adverse events to occur \unskip~\citep{1158038:22709755}. Adverse events that can be identified in this study were disorders of the gastrointestinal tract in the form of pain. Subject experiencing Gastrointestinal pain is given therapeutic treatment in the form of proton pump inhibitors or PPIs. The absence of an adverse event in the Ibuprofen therapy group can be influenced by comedication in the form of PPIs or H2 blockers, which can prevent pain from occurring to gastrointestinal bleeding \unskip~\citep{1158038:22709751}

The limitation faced by the researcher is that this study uses a non-randomized quasi-experimental method in which the subjects are not randomly divided into each group, this causes a bias in the intensity and reduction of pain felt by the subject due to various pain etiologies. In this study was also conducted with non-blinding, namely, there is no disguise in the administration of therapy so that researchers know the drugs given to the research subjects.
    
\section{Conclusion}
Intravenous ibuprofen has better effectiveness in treating non-specific acute musculoskeletal pain than intravenous Ketorolac. Intravenous Ibuprofen has shown superiority in safety that proven in the adverse event, although intravenous ibuprofen group has higher needs of rescue medication. 

\textbf{Funding Support}

The authors declare that they have no funding support for this study.

\textbf{Conflict of Interest}

The authors declare that they have no conflict of interest.
    

\bibliographystyle{pharmascope_apa-custom}

\bibliography{\jobname}
\end{document}
