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.
The research (Relationship of Communities of practice in adoption of, Strategic Change choices) aims to diagnose and interpretation of correlation nature between Communities of practice deportation (participation and spreading knowledge, confidence, social capital build) deportation strategic change choices (reengineering business process, business re-structuring, business innovation) in construction companies in the Iraqi Ministry of Construction and Housing, the research tested 4 construction companies working in investing sector in Iraq, the research applied on a sample of 102 persons who participated in Communities of practice distributed in several administrative levels (directors, division directors, projec
... Show MoreABSTRACT: Objectives: To study the level of knowledge , attitude and practice of primary health care providers about herbs , and their relation with certain demographic variables Methods : A cross sectional study was conducted using questionnaire administered to Health Care providers at ten Primary Health Care Centers in Baghdad. Results: Four handed participants were recruited, the most common source of knowledge in the medical group were books , while the paramedical group were getting their knowledge mostly from media, attitude of the medical group was neutral (53%) while among paramedical group attitude was positive (65%), the most common purposes for using herbs were energy boosting and preventive. Conclusion: healthcare providers in B
... Show MoreThe topic of the partnership between the public and private sectors with great interest by researchers around the world after making sure that the process of economic and social development depends on a combination of resources and energies and expertise of both the public and private sectors in the creation and operation of the various projects , the economic development of the growing proved the failure of both sectors in achieving greater economic growth Klaaly separately in many countries , especially developing countries with a socialist approach , led one way or another to adopt most of the countries economic reform programs promoted by international organizations and institutions ( such as the IMF and the World Bank ) of i
... Show MoreThe research aims at introducing accountability creative and the factors influencing or helping to Do in Iraqi companies, was launched two assumptions first that he was effect with significance to a number of factors in the direction of departments in Iraqi companies to practice creative accounting , were selected (9) factors believed to researchers it's most influential, and second that there importance of significance for a number of ways or methods to prevent or combat creative accounting , and the purpose of testing hypotheses have been designed questionnaire was distributed to a sample of 48 individual practitioners accountable in Iraqi companies and auditors in charge of auditing the accounts of those companies , after anal
... Show MorePostmodern arguments, formed a critic case of what modernity brought in several levels. Postmodern practice was considered as a proactive case having amorphous concepts and features to what entiled as an intellectual trends postmodern philosophically and intellectually. But, what postmodernism architecture broughts in it essence, was not isolation from the intellectual context and entrepreneurship case, and it was not disconnecting from the intellectual and philosophical era of that period. Lliteratures and philosophical argument precede what (Robert Venturi) and (Charles A Jencks) had brought, albeit it was closer to critics and correction the path of modernity from crystallizing a direction that exceeds modrinity to wh
... Show MoreThis study aimed to know the attitudes and practice of pharmacists regarding the management of minor ailments in Iraqi community pharmacies. A cross-sectional study for 320 community pharmacists was conducted during February 2020 using a newly developed and validated questionnaire. Only 4.4% of pharmacists prefer not to deal with minor ailment cases. Minority (15.6%) of participated pharmacists refer more than half of minor ailment cases they face to the physician. Regarding the assessment of minor ailments using WWHAM technique, what are the symptoms are the most commonly asked questions by pharmacists. Only 49.1% mentioned that they ask all WWHAM questions. On the other hand, most pharmacists (90%) educate their patients about the dosi
... Show MoreBackground: Primary Health care (PHC) is unanimous to be the cornerstone of a person-centered health system. While the adoption of a well-function, two-way, and organized referral system is the mainstay in the development of an efficient healthcare delivery system.
Objective: To Assess the practice & opinion of doctors in the hospitals toward the referral system. to determine the doctors in the hospital's commitment to referral system instructions and guidelines.
Subjects and Methods: A cross-sectional study with analytic elements was conducted in nine Iraqi governorates. Eight doctors from each health directorate, resulting in a tot
... Show MoreThis narrative review provides updated insights into pharmacy education, research, and professional practice in Iraq.
Secondary data were collected from peer-reviewed literature via Google Scholar, government reports, and official records provided by the Syndicate of Iraqi Pharmacists between November and December 2025.