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.
Some metal ions (Mn+2, Co+2, Ni+2, Cu+2,Zn+2 and Cd+2) complexes of quodridentats Schiff base derived from (2-hydroxy benzaldehyde and 4,4'-methylenedianiline as primary ligand and 3-picoline (3-pic) secondary ligand have been synthesized and characterized on the basis of their 1H ,13C-NMR, FT-IR, UV-Vis spectroscopy, conductivity measurements, elemental analysis, and magnetic moments, metal to ligands ratio in all complexes has been found to be (1:1:2) (M:Schiff base:3-pic), Schiff base behaves as neutral tetra dentate ligand with (N2,O2) system from the results obtained, the following general formula has suggested for the prepared complexes [M+2(2-mbd)(3-pic)2] and octahedral stereochemistry, Where M+2 = (Mn , Co , Ni , Cu , Zn and Cd), 2
... Show MoreThe aim of the work is synthesis and characterization of bidentate ligand [3-(3-acetylphenylamino)-5,5-dimethylcyclohex-3-enone][HL], from the reaction of dimedone with 3-amino acetophenone to produce the ligand [HL], the reaction was carried out in dry benzene as a solvent under reflux. The prepared ligand [HL] was characterized by FT-IR, UV-Vis spectroscopy, 1H, 13C-NMR spectra, Mass spectra, (C.H.N) and melting point. The mixed ligand complexes were prepared from ligand [HL] was used as a primary ligand while 8-hydroxy quinoline [HQ] was used as a secondary ligand with metal ion M(Π).Where M(Π) = (Mn ,Co ,Ni ,Cu ,Zn ,Cd and Pd) at reflux ,using ethanol as a solvent, KOH as a base. Complexes of the composition [M(L)(Q)] with (1
... Show MoreA condense study was done to compare between the ordinary estimators. In particular the maximum likelihood estimator and the robust estimator, to estimate the parameters of the mixed model of order one, namely ARMA(1,1) model.
Simulation study was done for a varieties the model. using: small, moderate and large sample sizes, were some new results were obtained. MAPE was used as a statistical criterion for comparison.
The aim of the work is synthesis and characterization of bidentate ligand [3-(3-acetylphenylamino)-5,5-dimethylcyclohex-3-enone][HL], from the reaction of dimedone with 3-amino acetophenone to produce the ligand [HL], the reaction was carried out in dry benzene as a solvent under reflux. The prepared ligand [HL] was characterized by FT-IR, UV-Vis spectroscopy, 'H, 8C-NMR spectra, Mass spectra, (C.H.N) and melting point. The mixed ligand complexes were prepared from ligand [HL] was used as a primary ligand while 8-hydroxy quinoline [HQ] was used as a secondary ligand with metal ion M(IT).Where M(IT) = (Mn ,Co ,Ni ,Cu ,Zn ,Cd and Pd) at reflux ,using ethanol as a solvent, KOH as a
... Show MoreThe free Schiff base ligand (HL1) is prepared by being mixed with the co-ligand 1, 10-phenanthroline (L2). The product then is reacted with metal ions: (Cr+3, Fe+3, Co+2, Ni+2, Cu+2 and Cd+2) to get new metal ion complexes. The ligand is prepared and its metal ion complexes are characterized by physic-chemical spectroscopic techniques such as: FT-IR, UV-Vis, spectra, mass spectrometer, molar conductivity, magnetic moment, metal content, chloride content and microanalysis (C.H.N) techniques. The results show the formation of the free Schiff base ligand (HL1). The fragments of the prepared free Schiff base ligand are identified by the mass spectrometer technique. All the analysis of ligand and its metal complexes are in good agreement with th
... Show MoreBackground: Antibiotic resistance is a problem leading to difficulty in treating microbial infections thatmay occur due to many causes. For the important pharmacist role as a reference for the information and theability to access to medications, they are vital members in lowering the development of antibiotic resistance,and also they support the proper use and control of antibioticsmisuse. Our goal is comparing the knowledge,attitude, practice of undergraduate and postgraduate pharmacy students and their perceptions about thecausing factors of antibiotic resistance in Iraq.Method: A cross sectional study was conducted involving the final year bachelor and postgraduate (masterand Philosophical doctor) students from different private
... Show MoreMicrobial activity of Ellagic acid when mixed with some types of candy toward Streptococcus mutans microorganism was studied. The main purpose of carrying out this study is to produce a new type of candy that contains Ellagic acid in addition to xylitol instead of sucrose to prevent dental caries. The results show that the inhibitory action of Ellagic acid was more effective when mixed with this type of candy for the purpose of reducing Streptococcus mutans microorganisms, while sensory evaluation was applied in this study to 20 volunteers to that candy sample evaluated which contain (5 mg/ml) Ellagic acid with 100g xylitol to determine consumers acceptability of this sample of candy. The results were expressed as mean value, slandered d
... Show MoreBackground: Tooth extraction is one of the most commonly performed procedures in dentistry. It is usually a traumatic process often resulting in immediate destruction and loss of alveolar bone and surrounding soft tissues. Various instruments have been described to perform atraumatic extractions which can prevent damage to the paradental structures. The physics forceps is one of those innovations in dental extraction technologies that claim to provide an efficient means for atraumatic dental extractions. Materials and method: A randomized clinical trial was conducted to compare the physics forceps with the conventional forceps for the removal of 28 mandibular single rooted teeth under the following parameters: incidence of crown, root, b
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