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.
This research includes the study of dual data models with mixed random parameters, which contain two types of parameters, the first is random and the other is fixed. For the random parameter, it is obtained as a result of differences in the marginal tendencies of the cross sections, and for the fixed parameter, it is obtained as a result of differences in fixed limits, and random errors for each section. Accidental bearing the characteristic of heterogeneity of variance in addition to the presence of serial correlation of the first degree, and the main objective in this research is the use of efficient methods commensurate with the paired data in the case of small samples, and to achieve this goal, the feasible general least squa
... Show MoreThis research sought to present a concept of cross-sectional data models, A crucial double data to take the impact of the change in time and obtained from the measured phenomenon of repeated observations in different time periods, Where the models of the panel data were defined by different types of fixed , random and mixed, and Comparing them by studying and analyzing the mathematical relationship between the influence of time with a set of basic variables Which are the main axes on which the research is based and is represented by the monthly revenue of the working individual and the profits it generates, which represents the variable response And its relationship to a set of explanatory variables represented by the
... Show MoreIn the present article, mixed ligand metal (II) complexes have been synthesized with Schiff base (1E, 5Z, 6E)-1,7 bis (4-hydroxy-3- methoxyphenyl)-5-(3-hydroxyphenyl) imino) hepta-1,6-dien-3-one derived from Curcumin and 3-aminophenol as primary ligand and L-dopa as a secondary ligand. The Schiff base act as bidentate and arrange to the metals through the azomethine (C=N) nitrogen and (C=O) oxygen atom. The mode of bonding of the Schiff base has been affirmed on the infrared by the UV-Visible, 1H, and 13C NMR spectroscopic techniques. The magnetic susceptibility and the UV-Vis data of the complexes propose octahedral geometry around the central metal ion. The information appears that the complexes have the structure of [L-M-(L-dopa)] system
... Show MoreNew complexes of the [M(Ura)(Phen)(OH2)Cl2]Cl.2H2O type, where (Ura) uracil ; (Phen) 1,10-phenanthroline hydrate; M (Cr+3 , Fe+3 and La+3) were synthesized from mix ligand and characterized . These complexes have been characterized by the elemental micro analysis, spectral (FT-IR., UV-Vis, 1HNMR, 13CNMR and Mass) and magnetic susceptibility as well the molar conductive mensuration. Cr+3, Fe+3 and La+3- complexes of six–coordinated were proposed for the insulated for three metal(III) complexes for molecular formulas following into uracil property and 1,10-phenanthroline hydrate present . The proposed molecular structure for all metal (III) complexes is octahedral geometries .The biological activity was tested of metal(III) salts, liga
... Show MoreNew complexes of the [M(Ura)(Phen)(OH2)Cl2]Cl.2H2O type, where (Ura) uracil ; (Phen) 1,10-phenanthroline hydrate; M (Cr+3 , Fe+3 and La+3) were synthesized from mix ligand and characterized . These complexes have been characterized by the elemental micro analysis, spectral (FT-IR., UV-Vis, 1HNMR, 13CNMR and Mass) and magnetic susceptibility as well the molar conductive mensuration. Cr+3, Fe+3 and La+3- complexes of six–coordinated were proposed for the insulated for three metal(III) complexes for molecular formulas following into uracil property and 1,10-phenanthroline hydrate present . The proposed molecular structure for all metal (III) complexes is octahedral geometries .The biological activity was tested of metal(III) salts, ligands
... Show MoreThe study aims to verify the independence of auditors working in companies and offices of the Iraqi audit, and measure the level of accounting conservatism in the financial statements of banks and insurance companies listed on the Iraq Stock Exchange, as well as a statement after the independence of the auditor on accounting conservatism in the financial statements of banks and insurance companies listed on the market Iraq Stock Exchange, as it has been measuring the independence of the auditor using the survey form was auditors working in the Iraqi audit firms were measured the level of accounting conservatism for companies sample using a form( Basu) was a statement after variables through the use of statistical models in a mann
... Show MoreBackground: Folic acid (vitamin B9) is one of the important vitamins that are necessary for growth and development of the embryo and preventing the occurrence of congenital malformations which are one of the important health problems in the developing countries and the world as it has a direct effect on the affected babies, their families and the community. It affects an estimated 3% of newborns worldwide.Periconceptional supplementation with folic acid (before conception and during the first 12 weeks of pregnancy) was found to decrease many important types of these anomalies. Objectives: The aim of this study is to assess knowledge, attitude and practice of periconceptional use of folic acid in pregnant women who are attending antenatal
... Show MoreThese deposits take many forms like current acc, deposits in order to growth and serve national economy Various in varicose perspectives .
The problem of this paper its concern with un applied the mathematical models that used in profitability analysis of current acc , and deposits in view of risk, profit efficiency and financial leverage for this reason the paper discussion use the cumulate mathematical model to solve these problem, that content three variables that be used to measuring profitability by consequent replacement method by stable base and by moving base for 2007 – 2009 applied the data collect from Iraq middle east bank. &nbs
... Show MoreAbstract
This Study aimed to investigate the reality of the application of the degree of management practice by Walking Around, namely (discovery of facts, improvement of communication, motivation, development, creativity and feedback) and Its role in achieving organizational justice (procedural justice, distributive justice, Interactional Justice),The availability of the core principles of this system from the point of view of the senior management personnel in the Directorate of Anbar Education, and the importance of research in the philosophical rooting of the nature of the variables as a modern administrative terminology, the research dealt with a problem expressed by a number of intellectual and appl
... Show MoreKE Sharquie, JR Al-Rawi, AA Noaimi, MM Jabir, Iraqi Postgraduate Medical Journal, 2009