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.
Finding orthogonal matrices in different sizes is very complex and important because it can be used in different applications like image processing and communications (eg CDMA and OFDM). In this paper we introduce a new method to find orthogonal matrices by using tensor products between two or more orthogonal matrices of real and imaginary numbers with applying it in images and communication signals processing. The output matrices will be orthogonal matrices too and the processing by our new method is very easy compared to other classical methods those use basic proofs. The results are normal and acceptable in communication signals and images but it needs more research works.
The research on coordination polymers chemistry based on organic-metal framework with bridging ligands has accelerated during the past two decades. It is an interested hot topic in the synthetic inorganic chemistry, which allowed the fabrication of a variety of interested materials. These materials have shown a range of applications including light harvesting and magnetic properties. The thesis is divided in three chapters. The first chapter gives a general introduction on the development of self-assembled polymeric species based on transition metal. It is also covered a summary of the literature review on the current state of the art on self-assembled coordination ploymers. Furthermore, it includes a description on various relevant topics
... Show MoreThe study aimed to identify the E-leadership practice at Princess Nora Bint Abdul Rahman University and to explore the obstacles that are facing the leaders in the implementation of E-leadership, in addition to find mechanisms to improve the practice of electronic driving at the university in light of the Corona pandemic. A descriptive analytical approach was used by depending on a questionnaire to collect the needed data. The study sample consisted of (139) heads of departments, attorneys' colleges and support Deanships universities. The study results showed that E-leadership employment recorded a medium to high degree. Especially at university, that publishing decisions electronically and uses technical means in providing its services.
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The present study aims to assess the knowledge, attitude, and experience of off-label prescribing practice among physicians in Baghdad city hospitals. This cross-sectional study was performed through the period from November 1st 2018 to March 2019 at 17 hospitals, a self-administered questionnaire was utilized to collect data from the physicians, and the targeted hospitals were randomly selected at different regions in Baghdad City area. Out of the 400 distributed questionnaires to the physicians, 383 of them were returned completed, 57.2% indicated that they were reasonably familiar with the term “off label drug”, 57.7% mentioned that the most common medical reasons for the prescribing o
... Show MoreBackground: Occupational exposure to hazardous drugs occurs in all aspects of anticancer drug handling. Proper recommendations and guidelines should be applied to control and reduce exposure. Objective: To assess pharmacists' knowledge and practice regarding the safe handling of anticancer drugs. Methods: A cross-sectional study was conducted at seven major hospitals in Baghdad City, Iraq, from December 2023 to February 2024. A pre-designed questionnaire was given to pharmacists who handled anticancer drugs in chemotherapy units. The questionnaire comprises sociodemographic data, knowledge of the safe handling of cytotoxic drugs and thoughts about exposure and risk, practices for safely handling cytotoxic drugs, and challenges for s
... Show MoreThis research aims to studying and analyzing the theoretical
framework of the environmental auditing in industrial environment to its a broad and danger environmental effects . It aims to contribute in setting and testing a proposed procedure framework for environmental auditing in that vital activity .The practical aspect focused on testing a proposed framework within practice it in a one Iraqi industrial company that has a huge effect on environmental activity, represented by Iraqi state company
Background:-Osteoarthritis (OA) is the most common form of arthritis and the leading source of physical disability in elderly people. The Prevalence of OA is increasing and will continue to do so as the population gets older. The OA is predominantly managed in primary care centers by primary health care physicians and much can be done to alleviate symptoms from osteoarthritis by combinations of therapeutic options including pharmacological and non-pharmacological treatments.
Objectives of study :- To assess the knowledge, attitude and practice of Iraqi PHCC physicians in Baghdad, AL-Rusafa, regarding the management of osteoarthritis patient, and it's association with sociodemogra
... Show MoreBackground: Treatment of invasive prolactinoma, which has several characteristics including invasive growth into cavernous sinuses and formation of giant adenomas compressing adjacent neural structures, resulting in neurological dysfunction, has been very challenging. There are relatively few reports available describing long-term treatment outcome.
Aims of the study: In this study we evaluate the results of cabergoline administration as initial treatment during 4 years follow up period.
Methods: We prospectively categorized 36 patients into four groups according to the results of 3 months of cabergoline treatment: group 1, tumor volume reduction (TVR) ˃25% with normaliz
... Show MoreBackground: 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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