Background: Venous leg ulcers (VLUs) affect 1-3% of the population and impose substantial pain-related morbidity, yet vascular pain remains underrecognized in clinical practice and research. Objectives: This narrative review synthesizes current evidence on the pathophysiology, clinical manifestations, and management strategies for VLU-associated pain. Methods: A comprehensive literature search was conducted across PubMed/MEDLINE, Scopus, Embase, and Web of Science (January 2015-July 2025) following SANRA guidelines. Search terms included "vascular pain", "venous leg ulcer", "chronic venous disease" and related terminology. Studies addressing pathophysiology, clinical characteristics, diagnostic approaches, and therapeutic interventions were included. Results: VLU pain demonstrates complex pathophysiology encompassing nociceptive, neuropathic, and nociplastic components driven by venous hypertension, chronic inflammation, and central sensitization. Pain prevalence ranges from 50-87% in VLU patients, significantly impacting quality of life and functional status. Evidence supports a five-strategy management framework: (1) treating underlying venous pathology through early ablation, (2) optimized compression therapy achieving ~40 mmHg ankle interface pressure, (3) procedure-specific local anesthesia using topical agents, (4) multimodal systemic analgesia targeting neuropathic features, and (5) adjunctive venoactive drugs. Patient-reported outcome measures reveal substantial psychosocial burden beyond wound-related symptoms. Conclusion: VLU pain represents a distinct clinical entity requiring mechanism-based, multidisciplinary approaches. Early venous intervention, evidence-based compression protocols, and targeted analgesic strategies show promise for improving outcomes. Critical research gaps include dedicated pain-focused clinical trials, standardized outcome measures, and personalized treatment algorithms. Enhanced recognition and systematic management of vascular pain could substantially improve patient-centered outcomes in chronic venous disease.
An adaptive nonlinear neural controller to reduce the nonlinear flutter in 2-D wing is proposed in the paper. The nonlinearities in the system come from the quasi steady aerodynamic model and torsional spring in pitch direction. Time domain simulations are used to examine the dynamic aero elastic instabilities of the system (e.g. the onset of flutter and limit cycle oscillation, LCO). The structure of the controller consists of two models :the modified Elman neural network (MENN) and the feed forward multi-layer Perceptron (MLP). The MENN model is trained with off-line and on-line stages to guarantee that the outputs of the model accurately represent the plunge and pitch motion of the wing and this neural model acts as the identifier. Th
... Show MoreIn Production and Operations Management the specialists have tried to develop a strategy to counter the risks arising from the activities of the organization and of waste of various types and therefore the risk management in the contemporary framework represents a phenomenon of new quality, and can not be this phenomenon to take practical dimensions, but the development of culture of the organization towards the risks and deal with all aspects and paint ways to address them within an integrated program, and requires new skills and systems provide accurate information capable of coordination between the various parties within the organization.
The research aims to develop a blu
... Show MoreAtheists have spread in the modern era, so that atheism has become a bad phenomenon in the world in general and in Islamic societies in particular, so the research aims to study the individual and social effects left by atheism on the atheists themselves, and the research included multiple axes: atheism linguistically and idiomatically, atheism in the Qur’an Noble and Modern (and Contemporary) Atheism Statistics: and the reasons for atheism: Studying the phenomenon of atheism in Iraq as a model, then studying the effects of atheism: on the individual first, then atheism and its impact on society, then the conclusion, recommendations, sources and references
ABSTRACT Pulmonary alveolar microlithiasis is rare infiltrative pulmonary disease characterized by intra-alveoli deposition of microliths. We present a familial case of an adult female with complaint of progressive shortness of breath on exertion. Chest radiograph showed innumerable tiny dense nodules, diffusely involving both lungs mainly the lower zones. High-resolution CT scan illustrated widespread intra-alveolar microliths, diffuse ground-glass attenuation areas and septal thickening predominantly in the basal regions. Chest radiograph is all that is needed for the diagnosis of this case but CT scan was done to demonstrate the extent and severity of this disease
The current research deals with spatial relations as a tool to link urban landmarks in a homogeneous composition with monumental sculptures, by identifying these landmarks and the extent of their impact on them, which constitutes an urgent need to evaluate the appropriate place and its effects on them, so that this analytical study is a critical approach adopted in artistic studies of monumental models in Arabcapitals .The current research came in four chapters, the first chapter of which dealt with the research problem, its importance and the need for it, then its objectives that were determined in revealing the spatial relations and their impact on
... Show MoreLeap Motion Controller (LMC) is a gesture sensor consists of three infrared light emitters and two infrared stereo cameras as tracking sensors. LMC translates hand movements into graphical data that are used in a variety of applications such as virtual/augmented reality and object movements control. In this work, we intend to control the movements of a prosthetic hand via (LMC) in which fingers are flexed or extended in response to hand movements. This will be carried out by passing in the data from the Leap Motion to a processing unit that processes the raw data by an open-source package (Processing i3) in order to control five servo motors using a micro-controller board. In addition, haptic setup is proposed using force sensors (F
... Show MoreThe advent of UNHCR reports has given rise to the uniqueness of its distinctive way of image representation and using semiotic features. So, there are a lot of researches that have investigated UNHCR reports, but no research has examined images in UNHCR reports of displaced Iraqis from a multimodal discourse perspective. The present study suggests that the images are, like language, rich in many potential meanings and are governed by clearly visual grammar structures that can be employed to decode these multiple meanings. Seven images are examined in terms of their representational, interactional and compositional aspects. Depending on the results, this study concludes that the findings support the visual grammar theory and highlight the va
... Show MoreLet R be a 2-torision free prime ring and ?, ?? Aut(R). Furthermore, G: R×R?R is a symmetric generalized (?, ?)-Biderivation associated with a nonzero (?, ?)-Biderivation D. In this paper some certain identities are presented satisfying by the traces of G and D on an ideal of R which forces R to be commutative
Background There is an increasing need for pharmacists to incorporate more patient care targeting. Consequently, the productivity of pharmacy programs can be enhanced by evaluating the advantages and disadvantages of pharmacy curriculum. Objectives To assess the beliefs, perceptions, and challenges of the College of Pharmacy –The University of Baghdad PharmD graduates regarding the PharmD program. Method Qualitative research methodology was implemented. Graduate PharmD candidates were interviewed either inperson or via telephone. The interviews were conducted in a semi-structured format, utilizing a predetermined interview guide that included open-ended questions. Thematic analysis was implemented to analyze the data. Results A total of 2
... Show MoreVaried uses of international rivers in the past few decades dramatically, resulting in this multiplicity of uses and all associated with it for the occurrence of freshwater scarcity activities, and thus an increase in conflicts and disputes around on the rights of each of the riparian countries to benefit from the waters of the river at various purposes, particularly the establishment of dams on some of them as is the case (Renaissance Ethiopian) big impact on downstream countries Dam (Egypt and Sudan), due to the Oukuahma at the end of the Nile Valley made them vulnerable to environmental fluctuations, political crises facing the Nile basin countries, and any reduction in the proportion of water is not only the Nile River, but for all r
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