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Mixed pain: clinical practice recommendations
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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.

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Publication Date
Thu Aug 08 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Novel Technique for Alveolar Ridge Expansion: A Comparative Clinical Study
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Background: Piezosurgery improved the split approach by making it safer, easier, and less prone to complications when treating extremely atrophic crests. Densah drills, with their unique design, expand the ridge by densifying bone in a reverse, non-cutting mode. Objective: To assess the effectiveness of sagittal piezosurgery, which involves cutting bone to the full implant depth and then expanding it using osseodensification drills. We use this technique to expand narrow alveolar bones and simultaneously place dental implants in the maxillary and mandibular arches. Methods: Fourteen patients received 31 dental implants. The maxillary arch received 19, and the mandible received 12 dental implants. This study will include patients who

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Publication Date
Tue Jan 01 2019
Journal Name
The Turkish Journal Of Endocrinology And Metabolism
Cell-free DNA as a Clinical Indicator in Maternal Blood
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As many expensive and invasive procedures are used for the diagnosis or follow-up of clinical conditions, the measurement of cell-free DNA is a promising, noninvasive method, which considers using blood, follicular fluid, or seminal fluid. This method is used to determine chromosomal abnormalities, genetic disorders, and indicators of some diseases such as polycystic ovary syndrome, pre-eclampsia, and some malignancies. Cell-free DNA, which are DNA fragments outside the nucleus, originates from an apoptotic process. However, to be used as a marker for the previously mentioned diseases is still under investigation. We discuss some aspects of using cell-free DNA measurements as an indicator or marker for pathological conditions.

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Publication Date
Wed Sep 07 2011
Journal Name
International Journal Of Pharmacy And Pharmaceutical Sciences
CLINICAL EFFICACY OF LOCALLY INJECTED CALCITRIOL IN ORTHODONTIC TOOTH MOVEMENT
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Orthodontic treatment has two major problems: being lengthy and costly procedure. The present study was designed to evaluate the clinical efficacy of locally injected vitamin D3 Keywords: Orthodontic, Calcitriol, Local injection, OTM (calcitriol) in accelerating orthodontic teeth movement (OTM) and reducing treatment time and cost in humans. The study was performed on 15 Iraqi adult orthodontic patients within the age range 17-28 years, they are randomly allocated into three groups, each of five patients and treated with either 15 pg, 25 pg, or 40 pg/0.2ml calcitriol diluted with 10% dimethylsulfoxide (DMSO). The maxillary arch of every patient was divided into control (right) and experimental (left) sides. In addition to force application,

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Publication Date
Wed Oct 01 2008
Journal Name
Journal
Acanthosis Nigricans in Iraqi Patients Clinical, Histopathological and Theraputic Study
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KE Sharquie, AA Noaimi, AH Muhammad Ali, 2008 - Cited by 3

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Publication Date
Tue May 08 2018
Journal Name
Journal Of Dental Research
Self-Limiting versus Conventional Caries Removal: A Randomized Clinical Trial
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A single-blind randomized controlled clinical trial in patients with deep caries and symptoms of reversible pulpitis compared outcomes from a self-limiting excavation protocol using chemomechanical Carisolv gel/operating microscope (self-limiting) versus selective removal to leathery dentin using rotary burs (control). This was followed by pulp protection with mineral trioxide aggregate (MTA) and restoration with glass ionomer cement and resin composite, all in a single visit. The pulp sensibility and periapical health of teeth were assessed after 12 mo, in addition to the differences in bacterial tissue concentration postexcavation. Apical radiolucencies were assessed using cone beam computed tomography/periapical radiographs (CBC

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Publication Date
Tue Jan 01 2019
Journal Name
Reviews In Medical Microbiology
Virulence factors genotyping of Klebsiella pneumoniae clinical isolates from Baghdad
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Seventy of Klebsiella pneumoniae isolates had been collected from some Hospitals in Baghdad city from October to December 2017. The 70 isolates were taken from diverse clinical specimens. All K. pneumoniae isolates were identified based on API 20 E and Vitek2 compact system. Antibiotics sensitivity test was carried out toward 10 antibiotics using discs diffusion method. The level of antibiotics resistance was 81.42% for Ceftriaxone, whereas the low level of antibiotics resistance was 37.14% for Piperacillin. K. pneumoniae isolates were typed genotypically by using two different methods of amplification, multiplex-PCR and enterobacterial repetitive intergenic consensus (ERIC)-PCR typing methods. Results showed that out of 70 isolates, there

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of Child Science
Clinical and Genetic Varieties of Gaucher Disease in Iraqi Children
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Abstract<p>Gaucher disease (GD), which is due to a deficiency in the lysosomal enzyme β-glucocerebrosidase, is a rare genetic disorder. It is characterized by a wide variety of clinical manifestations and severity of symptoms, making it difficult to manage. A cross-sectional hospital-based genetic study was undertaken with 32 pediatric patients. We recruited 21 males and 11 females diagnosed with GD, with a male-to-female ratio of 1.91:1. The mean age of the study population was 8.79 ± 4.37 years with an age range from 8 months to 17 years. We included patients on clinical evaluation from 2011 to 2019. An enzyme assay test was used to measure β-glucosidase enzyme activity in leukocytes and the GBA gene s</p> ... Show More
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Publication Date
Wed Sep 28 2022
Journal Name
Journal Of The College Of Education For Women
A Proposed Program from the Perspective of the General Practice of Social Work to Overcome Husbands' Violence Against Their Wives
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Husbands’ violence towards their wives is one of the greatly important issues in social sciences. Accordingly, the current study aims at determining the levels of violence practiced by husbands towards their wives to propose a professional program from the perspective of the general practice of social work to overcome such a phenomenon. The study is descriptive in nature, where the researcher has used a comprehensive social survey method. To achieve the goal of the study, the researcher has prepared a questionnaire that consisted of two parts. The first part contains the primary data of the two sections, and the second contains (38) phrases distributed over four axes to measure the levels and types of violence among the sample’s memb

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Publication Date
Fri Apr 30 2021
Journal Name
International Medical Journal
Knowledge, Attitude, and Practice of Infection Control by Dental Students at Pedodontic Clinic, College of Dentistry, University of Baghdad, Iraq
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Objectives: This study explored knowledge, attitude, and practice of infection control by dental students at College of Dentistry/ University of Baghdad, Iraq. Material and Methods: Three hundred dental students participated in this study. A self administrated questionnaire with 21 close ended questions related to use of personal protective equipments, infection control awareness, vaccination status, percutaneous exposures, and attitude towards treatment of patients with hepatitis B (HBV)/ or human immunodeficiency virus (HIV) was distributed to dental students. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21. Fisher exact and Chi-square test were used with significance level set to 0.05. Results: The

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Publication Date
Mon Apr 02 2012
Journal Name
Eastern Mediterranean Health Journal
Knowledge, attitude and practice regarding breast cancer and breast self-examination among a sample of the educated population in Iraq
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This cross-sectional, questionnaire-based study evaluated the knowledge, attitude and practice towards breast cancer and breast self-examination [‎BSE]‎ among 387 [‎302 females and 85 males]‎ educated Iraqis affiliated to 2 Iraqi universities. The participants were categorized into 3 occupations: student [‎71.3%]‎, teaching staff [‎10.3%]‎ and administrative staff [‎18.3%]‎. About half of the participants had a low knowledge score [‎< 50%]‎; only 14.3% were graded as [‎Good]‎ and above. Almost 75% of the participants believed that the best way to control breast cancer was through early detection and other possible preventive measures. Most participants [‎90.9%]‎ had heard of BSE, the main source of informatio

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