Mixed pain, defined by the concurrent involvement of nociceptive, neuropathic, and sometimes nociplastic mechanisms, poses a significant diagnostic and therapeutic challenge within modern pain medicine. This complex pain phenotype is increasingly recognized as a prevalent and burdensome clinical entity, yet it remains substantially underdiagnosed and sub-optimally managed across diverse healthcare settings. Epidemiological data indicate that mixed pain affects a substantial proportion of patients with chronic pain syndromes and is consistently associated with more severe symptomatology, prolonged pain duration, functional impairment, diminished quality of life, and escalated healthcare resource utilization compared to pain of a single mechanism. In response to this unmet clinical need, the present recommendations aim to provide a structured, evidence-informed framework for the diagnosis and management of mixed pain. Developed through a rigorous process involving systematic literature review and multidisciplinary expert consensus, this document emphasizes the importance of mechanism-based therapeutic strategies tailored to the individual patient’s pain profile. Central to the approach is the implementation of multimodal and interdisciplinary care models that address the biological, psychological, and functional dimensions of mixed pain. These recommendations are intended for a broad spectrum of healthcare professionals, including primary care physicians, pain specialists, neurologists, oncologists, physiatrists, nurses, pharmacists, physical and occupational therapists, and clinical psychologists. The target population encompasses patients affected by mixed pain conditions such as chronic low back pain with radiculopathy, cancer-related pain, persistent post-surgical pain, and osteoarthritis complicated by central sensitization. By facilitating accurate diagnosis and integrated treatment planning, these recommendations seek to advance clinical practice, reduce the burden of mixed pain, and enhance patient-centered outcomes. This guidance aims to transform mixed pain care by promoting mechanism-based, multidisciplinary strategies with direct clinical applicability.
Background: five clinical phases were described in patients with chronic (HBV) infection: HBeAg- positive HBV infection, HBeAg- positive chronic HB, HBeAg negative HBV infection, HBeAg-negative CHB and occult HBV infection. Aim: This study aimed to determine the incidence of the unclassified phase (gray zone) in chronic hepatitis B patients and its significant in the clinical practice. Patients and methods: The study was conducted retrospectively on 109 patients' who have HBsAg positive for more than 6 months. The data recorded include; HbeAg and anti-HBe Ab, ultrasound of the abdomen, HBV DNA load and alanine aminotransferase (ALT), accordingly; we classify the patients to known clinical phases. Patients who were unfit one of these phases
... Show MoreBackground: The strategy for eliminating measles from Iraq includes conducting mass immunization campaign against measles, within the framework of the national strategic plan for the elimination of this disease. Awareness about this campaign is fundamental for their success.Objective: The study aims at finding out the knowledge, attitudes and practices regarding vaccination against measles among two groups of students in two different colleges ( medical and engineering) .To report uptake of Measles vaccine and reasons for declining the vaccine among medical and non-medical students in the campaignMethod: Across sectional study has been conducted at Al-Kindy College of Medicine/ Baghdad University and University of Technology for the peri
... Show MoreThis study aims to measure the basic foundations of organizational health in the General Company for Food Products and to indicate the extent of its presence or not within the company under investigation.
This research was completed using a descriptive and analytical approach using a sample of 97 employees from the General Company for Petroleum Products. Calculating the arithmetic mean, standard deviation, coefficient of variation, and confirmatory factor analysis are all part of the data processing process.
Background : To assess the actual practice of breast self-examination (BSE), as an early detection tool for breast cancer, among a sample of patients affected with breast cancer in Iraq.Methods: A random sample of 200 female patients with breast cancer was analyzed to evaluate the extent of their actual practice of breast self-examination before the diagnosis of the disease. The examined variables included the age of the patients, marital status, education, occupation, smoking habit, family history of cancer, frequency of gravidity, parity and abortions. Results: The age of patients ranged from (24-70) years with a mean age of 48 years. The highest frequency of the examined sample
... Show MoreBackground Epilepsy is one of the most widespread neurological illnesses in the world with a prevalence rate of 2.8–19.5 per 1000 of the general population, and it is more prevalent in childhood. The understanding of the teachers about epilepsy has a significant impact on the academic performance and social skills of schoolchildren with epilepsy. Aim of Study This study aimed to assess teachers’ knowledge, attitude, and practice regarding epilepsy in schoolchildren and the association of certain studied variables with the level of schoolteachers’ knowledge, attitude, and practice. Subjects and Methods This was a cross-sectional study that included 402 participants and was conducted in Al-Rusafa/Baghdad during the period from November
... Show MoreBackground: Self-medication is a practice or action taken by individuals for themselves in order to achieve and maintain health, as well as to avoid and protect against disease. The aim of this study is to evaluate the knowledge, attitudes, and practice of self-medication among medical students at Sudan International University.
Subjects & Methods: This was a prospective study that involved 288 out of 1000 students in the Faculty of Medicine at Sudan International University. Data were collected using a self-administered questionnaire from January to March 2022 to evaluate the self-medication knowledge, attitude, and practice among first, second, and third-ye
... Show MoreBackground Antimicrobial resistance (AMR) is a growing global health concern, with inappropriate antibiotic use in dentistry significantly contributing to this problem. While regional studies have examined dental students' antibiotic-related knowledge and practices, comprehensive evidence from Iraq remains limited. Objective The objective of this study is to evaluate the level of knowledge and awareness of antimicrobial stewardship principles and prescribing practices among Iraqi dental students and interns. Methods A cross-sectional, questionnaire-based study was conducted among dental students in the clinical phase of education (fourth and fifth years) and dental interns from multiple Iraqi universities. The survey was distributed fr
... Show MoreNew complexes of M(II) with mixed ligand of 5-Chlorosalicylic acid (CSA) C7H5ClO3 as primary ligand and L- Valine (L-Val) C5H11NO2 as a secondary ligand were prepared and characterized by elemental analysis (C.H.N), UV., FT-IR, magnetic susceptibility, µeff (B.M) as well as the conductivity measurements (Λm ). In the complexes, the 5-chlorosalicylic acid is bidentate in all complexes coordinating through –OH- and –COO- groups; also L-Valine behaves as a bidentate ligand in all complexes through –NH2 and –COO- groups. These five mixed ligand complexes formulated as Na3[M(CSA)2(L-Val)]. The proposed molecular structure for all complexes is octahedral geometries. The synthesis complexes were tested in vitro for against four bacteria
... Show MoreNew complexes of M(II) with mixed ligand of 5-Chlorosalicylic acid (CSA) C7H5ClO3 as primary ligand and L- Valine (L-Val) C5H11NO2 as a secondary ligand were prepared and characterized by elemental analysis (C.H.N), UV., FT-IR, magnetic susceptibility, μeff (B.M) as well as the conductivity measurements (Λm ). In the complexes, the 5-chlorosalicylic acid is bidentate in all complexes coordinating through –OH- and –COO- groups; also L-Valine behaves as a bidentate ligand in all complexes through –NH2 and –COO- groups. These five mixed ligand complexes formulated as Na3[M(CSA)2(L-Val)]. The proposed molecular structure for all complexes is octahedral geometries. The synthesis complexes were tested in vitro for against four bacteria
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