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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
Wed Oct 01 2025
Journal Name
Central Asian Journal Of Medical And Natural Sciences
The Gastrointestinal Manifestations in Patients with COVID-19 and their Clinical Correlates in An Adult Iraqi Population Sample
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The gastrointestinal system is one of the many organs in the body that have been affected by the new viral illness known as coronavirus disease 2019 (COVID-19). To find out the GIT symptoms are into patients with Covid-19 and how they correspond with the severity of the illness. At the Al-Shifaa facility, 172 patients infected with COVID-19 participated in our study. A clinical examination, laboratory tests (CRP, D.Dimer, and serum ferritin), a chest CT scan, and a medical history were performed on each patient. The severity of the illness and other factors were taken into consideration while evaluating the gastrointestinal symptoms. Data collection from 172 patients, 91 patients infected with COVID-19 infection, 91 patients (52.9%) had GIT

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Publication Date
Mon Feb 15 2021
Journal Name
Nursing Open
Recitation of quran and music to reduce chemotherapy‐induced anxiety among adult patients with cancer: A clinical trial
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Abstract<sec><title>Aim

The aim of this study was to assess the effectiveness of listening to music or Quran in reducing cancer patients’ anxiety before chemotherapy administration. Reducing anxiety in people with cancer, prior to chemotherapy administration, is a crucial goal in nursing care.

Design

An experimental comparative study was conducted.

Methods

A simple randomization sampling method was applied. Two hundred thirty‐eight people with cancer who underwent chemotherapy were participated. They are assigned as Quran, music and control groups.

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Publication Date
Tue Nov 07 2023
Journal Name
Circulation
Abstract 18956: Knowledge of and Attitude Towards Clinical Trials Among Women in Rural Areas: A Survey-Based Study
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Introduction: In evidence-based era of cardiology with emerging of potential therapies, it is crucial to include diverse population in terms of (geography, gender, race, and economic status) in clinical trials (CT) to enhance generalizability of trials results. Such inclusion necessitates exploring barriers and motivators of diverse population for participation in CT. There is lack of data from Middle Eastern countries regarding perspectives of population about CT. Furthermore, there is no data about perceptions of Iraqi population in general and women in particular regarding CT.

Research question: We

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Publication Date
Fri May 23 2025
Journal Name
Reproductive Health Of Woman
Molecular detection of Rubella virus (1E genotype) in clinical sample of pregnant women, and it’s related to abortion
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Pregnant women who have rubella may potentially pass the infection on to their unborn offspring. A congenital rubella infection can result in a miscarriage, stillbirth, and congenital rubella syndrome. The only member of the Togaviridae family’s Rubivirus genus, the Rubella virus (RV) is a positive-polarity, single-stranded RNA virus genome surrounded by a lipoprotein envelope with spike-like, hemagglutinin-containing surface projections.The objective: to determine the Rubella virus (1E genotype) in pregnant woman and its relation to spontaneous miscarriage.Materials and methods. A total of 174 women which visited Al-Elweya Teaching Hospital, Baghdad, Iraq, were screened according to the following criteria: women with a history of

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Publication Date
Fri Dec 20 2024
Journal Name
Iraqi Journal Of Pharmaceutical Sciences
Impact of Clinical Pharmacist-Led Interventions on Short Term Quality of Life among Breast Cancer Women Taking Chemotherapy
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Abstract: Background: Drug toxicity and chemotherapeutic side effects negatively impact the quality of life of breast cancer patients. Objectives: to evaluate the efficacy of pharmaceutical Interventions (PI) on quality of life (QOL)Among chemotherapy intake breast cancer women.  Method: A pre-post interventional study was carried out at the chemotherapy ward of Alhabobi Hospital in Alnasiriyah City. Eligible patients received comprehensive pharmaceutical care and a self-compiled Breast Cancer Patients Medication Knowledge Guide pamphlet. Each patient received two sessions, the first at baseline and the second after 7, 14, or 21 days depending on the next taking dose of chemotherapy. Each session lasted for approximately 15-30 minutes. Par

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Indian Academy Of Oral Medicine And Radiology
The Degenerative Condylar Change in Temporomandibular Joint Disorder of Iraqi Population and their Variability Based on Clinical Diagnosis
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Background: As a multifactorial disorder, temporomandibular joint (TMD) is difficult to diagnose, and multiple factors affect the joint and cause the temporomandibular disorder. Standardization of clinical diagnosis of TMD should be used to reach a definite clinical diagnosis; the condylar bone may degenerate in accordance with these disorders. Aims: Evaluate the correlation between the clinical diagnosis and degenerative condylar change (flattening, sclerosis, erosion, and osteophyte). Materials and Methods: A prospective study with a study group of 97 TMD patients (total of 194 joints) aged 20 to 50. Patients were sent to cone beam computed tomography (CBCT) to assess the degenerative condylar change. Results: No association was found bet

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Publication Date
Wed Nov 01 2017
Journal Name
Research Journal Of Pharmaceutical, Biological And Chemical Sciences
Preparation, Spectral studies and Biological Efficiency of Metal (II) Mixed Ligand Complexes Schiff Base derived from (Benzaldehyde and OAminoaniline) with 8-Hydroxyquinoline
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fication of benzaldehyde (C6H5CHO) and O- amino aniline O-C6H4(NH2)2 in ethanol with 8- Hydroxyquinoline (8HQ) . Formed compounds were acquired of 1:1:2 molar proportion reactions for metal ions and ligands (L) and 2(8HQ) during reaction for MCl2 .nH2O salt products complexes conformable into the forms [M(L)(8HQ)2] ,where M = Mn(II),Co(II) and Ni(II). Whole the compounds were identified during the basis of their; FT-IR and U.V spectrum, melting point, molar conduct, identify of the percentage from the metal at the complexes via flame (AAS), C, H and N content of the Schiff base (L) and metal complexes were analysis and magnetic susceptibility menstruations. A hexagonal coordinated metal complexes were proposed to the separated complexes of

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Publication Date
Sun Jan 01 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Scienc
Synthesis, Spectral and Bacterial Studies of Mixed Ligand Complexes of Schiff Base Derived from Methyldopa and Anthranilic Acid with Some Metal Ions
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Bidentate Schiff base ligand 3-(3,4-Dihydroxy-phenyl)-2-[(4-dimethylamino-benzylidene)-amino]-2-methyl-propionic acid was prepared and characterized by spectroscopic techniques studies and elemental analysis. The Cd(II), Ni(II), Cu(II), Co(II), Cr(III),and Fe(III) of mixed-ligand complexes were structural explicate through Moler conductance , [FT-IR, UV-Vis & AAS], chloride contents, , and magnetic susceptibility measurements. Octahedral geometries have been suggested for all complexes. The Schiff base and its complexes were tested against various bacterial species, two of {gram(G+) and gram(G-)} were shown weak to good activity against all bacteria.

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Publication Date
Tue Jan 26 2021
Journal Name
Journal Of Antimicrobial Agents
Antifungal Activity Evaluation of Co(II), Ni(II), Cu(II), Zn(II) and Fe(III) Mixed Ligand Complexes with Different Schiff Bases
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Publication Date
Wed Nov 07 2018
Journal Name
Journal Of Education And Scientific Studies
Synthesis and Characterization of Schiff Base Metal Complexes Derived from Trimethoprim and mixed ligands with 8-hydroxy quinolone and study biologically activity
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Schiff base obtained from the reaction (Trimethoprim) with (sodiumpyruvate ) to produce the ligand [NaL], the reaction was carried out in methanol as a solvent under reflux. The prepared ligand [NaL] was characterized by FT-IR, UV-Vis spectroscopy, 1H,13C-NMR spectra, mass spectra, and melting point.A new mixed ligand complexes have been prepared between ( 8- hydroxyquinolone) and the ligand [NaL] withMn(II).Co(II),Ni(II),Cu(II), (Zn(II) ,(Cd(II)and Pd(II). All the complexes were characterized by spectroscopic methods (FT-IR, UV-Vis spectroscopy), chloride content and melting point ,molar conductance and magnetic susceptibility.These measure- ments showed octahedral geometry around(,Mn2+, Co2+, Ni2+, Cu2+, Zn2+ and Cd2+) ions and square pla

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