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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 Feb 01 2024
Journal Name
Baghdad Science Journal
Association of pvc genes expression with Biofilm formation in Clinical Isolates of Pseudomonas aeruginosa
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PvcABCD are cluster of genes found in Pseudomonas aeruginosa. The research was designed to examine the relationship between the pvc genes expression and cupB gene, which plays a crucial role in the development of biofilm, and rhlR, which regulates the expression of biofilm-related genes, and to investigate whether the pvc genes form one or two operons. The aims were achieved by employing qRT-PCR technique to measure the gene expression of genes of interest. It was found that out of 25 clinical isolates, 21 isolates were qualified as P.aeruginosa. Amongst, 18(85.7%) were evaluated as biofilm producers, 10 (47.6%), 5 (23.8%), and 3 (14.2%) were evaluated as strong, moderate and weak producers respectively, while, 3 (14.2%) were considered

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Publication Date
Tue Aug 01 2023
Journal Name
European Heart Journal
Routine electronic health record-based clinical trials: what should an early-career trialist know?
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Publication Date
Thu Feb 19 2026
Journal Name
International Journal Of Surgery Open
Secondary trigeminal neuralgia: an in-depth review of etiopathology, clinical manifestations, and management approaches
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Secondary trigeminal neuralgia (STN) results from an identifiable underlying pathology, including tumor compression, multiple sclerosis, arteriovenous malformations, hypertension, structural lesions, inflammation, trauma, or familial genetic conditions. This study, through a comprehensive review of the literature in PubMed, Google Scholar, Web of Science, and the Cochrane Library, explores the multifaceted aspects of STN. This study delves into the diverse etiological factors, focusing on the pathophysiological mechanisms that lead to trigeminal nerve dysfunction. The clinical manifestations of STN often overlap with those of primary trigeminal neuralgia, creating diagnostic challenges and necessitating a thorough evaluation that in

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Publication Date
Tue Sep 08 2020
Journal Name
Baghdad Science Journal
Convergence Analysis for the Homotopy Perturbation Method for a Linear System of Mixed Volterra-Fredholm Integral Equations
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           In this paper, the homotopy perturbation method (HPM) is presented for treating a linear system of second-kind mixed Volterra-Fredholm integral equations. The method is based on constructing the series whose summation is the solution of the considered system. Convergence of constructed series is discussed and its proof is given; also, the error estimation is obtained. Algorithm is suggested and applied on several examples and the results are computed by using MATLAB (R2015a). To show the accuracy of the results and the effectiveness of the method, the approximate solutions of some examples are compared with the exact solution by computing the absolute errors.

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Publication Date
Sat Jan 16 2016
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Synthesis, Characterization And Biological Evaluation of New Schiff Bases Mixed Ligand Metal Complexes of Some Drug Substances
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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Electronics,computer Networking And Applied Mathematics
Comparison of Some Estimator Methods of Regression Mixed Model for the Multilinearity Problem and High – Dimensional Data
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In order to obtain a mixed model with high significance and accurate alertness, it is necessary to search for the method that performs the task of selecting the most important variables to be included in the model, especially when the data under study suffers from the problem of multicollinearity as well as the problem of high dimensions. The research aims to compare some methods of choosing the explanatory variables and the estimation of the parameters of the regression model, which are Bayesian Ridge Regression (unbiased) and the adaptive Lasso regression model, using simulation. MSE was used to compare the methods.

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Publication Date
Thu Apr 29 2010
Journal Name
Journal Of The First Specialized National Conference In Chemistry 29-30 April 2010 University Of Thi-qar College Of Science
Preparation and Characterization of Mixed ligand complexes of Lanthanum (III) with 8- hydroxyqinoline and some amino acids
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Publication Date
Sat Jan 01 2011
Journal Name
Journal Of Engineering
MIXED CONVECTION PHENOMINA AFFECTED BY RADIATION IN A HORIZONTAL RECTANGULAR DUCT WITH COCENTRIC AND ECCENTRIC CIRCULAR CORE
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The numerical investigation has been performed to study the radiation affected steady state laminar mixed convection induced by a hot inner varied positions circular core in a horizontal rectangular channel for a fully developed flow. To examine the effects of thermal radiation on thermo fluid dynamics behavior in the eccentric geometry channel, the generalized body fitted co-ordinate system is introduced while the finite difference method is used for solving the radiative transport equation. The governing equations which used are continuity, momentum and energy equations. These equations are normalized and solved using the Vorticity-Stream function. After validating numerical results for the case without radiation, the detailed rad

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Publication Date
Sat Jul 01 2023
Journal Name
Aip Conf. Proc. 2290
Synthesis, characterization and antimicrobial studies of mixed ligand from phthalic acid and 1,10-phenanthroline with their complexes
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In the present work, the phthalic acid (phthH2) and 1.10 phenonthroline (phen), and their complexes were synthesized and isolated as [M(phth)(phen)2], Mn(II), Fe(II), Co(II), Ni(II) Cu(II), Zn(II), and Cd(II) ions. These complexes were characterized by elemental analysis, melting point, conductivity, percentage metal, UV–Vis, FT-IR, and magnetic moment measurements. The molar conductance indicates that all the metal complexes in DMSO are nonelectrolytic. phthalic acid (phtha), and 1,10-Phenanthroline (phen), behaved as bidentate, coordinating to the metal ion through their two oxygen and two pyridinyl nitrogen atoms respectively, as corroborated by. Electronic spectra, FTIR, spectroscopy amusement indicated that all the metal complexes ad

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Publication Date
Sat Jan 01 2011
Journal Name
Journal Of Engineering
MIXED CONVECTION PHENOMINA AFFECTED BY RADIATION IN A HORIZONTAL RECTANGULAR DUCT WITH COCENTRIC AND ECCENTRIC CIRCULAR CORE
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The numerical investigation has been performed to study the radiation affected steady state laminar mixed convection induced by a hot inner varied positions circular core in a horizontal rectangular channel for a fully developed flow. To examine the effects of thermal radiation on thermo fluid dynamics behavior in the eccentric geometry channel, the generalized body fitted co-ordinate system is introduced while the finite difference method is used for solving the radiative transport equation. The governing equations which used are continuity, momentum and energy equations. These equations are normalized and solved using the Vorticity-Stream function. After validating numerical results for the case without radiation, the detailed radiatio

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