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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
Tue Oct 04 2022
Journal Name
International Journal Of Dentistry
Comparison between Rolled and Nonrolled U-Shaped Flap in the Second Stage of Dental Implant Surgery: A Randomized Clinical Trial
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Background. The presence of black triangles around the dental implant-supported prosthesis and the failure to construct adequate papillae around them bothers dental implantologists. Peri-implant surgical soft tissue management will improve esthetics, function, and implant survival. Aim. To compare the effects of rolled and nonrolled U-shaped flaps combined with a temporary crown in enhancing the soft tissue around dental implants. Materials and Methods. Forty patients were included in this study; all patients were operated on by the same maxillofacial surgeon at Al-Iraq specialized dental clinics from January 2019 to January 2020. Patients were divided randomly into two groups: group A: at the second stage of implant surgery, a U-sh

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Publication Date
Sun Jan 04 2026
Journal Name
Iraqi Journal Of Biotechnology
The Frequency of Some Colibactin Genes Amongst the Clinical Strains of E. coli Isolated From Urinary Tract Infections in Iraq
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Escherichia coli has been recognized worldwide as the most common causative agent for severe infections of the urinary tract. Colibactin is a genotoxin produced through a gene cluster called polyketide synthase (pks) island by members of Enterobacteriaceae. Limited information is available about the frequency of colibactin in E. coli isolates in Iraq. Hence, this study aimed to examine the frequency of some colibactin genes (CIbA and CIbQ) in clinical isolates of E. coli obtained from urinary tract infections (UTIs) in Iraq. Between October 2023 and January 2024, 120 urine samples were collected from females diagnosed with UTIs in Iraqi hospitals. 70 E. coli isolates were isolated after identification by biochemical methods and confirmed by

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Publication Date
Tue Nov 19 2024
Journal Name
Review Of Clinical Pharmacology And Pharmacokinetics - International Edition
Clinical use of tumor necrosis factor-alpha inhibitors in Iraq: a review of their documented efficacy, safety, and associated genetics
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This comprehensive review examines the efficacy and safety of tumor necrosis factor-alpha (TNF-α) inhibitors in treating various autoimmune diseases, and focuses on their application in Iraqi patients. Elevated TNF-α levels are linked to autoimmune disorders, leading to the development of anti-TNF-α therapies such as infliximab, etanercept, adalimumab, certolizumab pegol, and golimumab, which have gained FDA approval for conditions like psoriasis, in¬flammatory bowel disease, ankylosing spondylitis, and rheumatoid arthritis. While these therapies demonstrate sig¬nificant therapeutic benefits, including improved quality of life and disease management, they also carry risks, such as increased susceptibility to infections and pote

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Comparison between the empirical bayes method with moments method to estimate the affiliation parameter in the clinical trials using simulation
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In this research the Empirical Bayes method is used to Estimate the affiliation parameter in the clinical trials and then we compare this with the Moment Estimates for this parameter using Monte Carlo stimulation , we assumed that the distribution of the observation is binomial distribution while the distribution with the unknown random parameters is beta distribution ,finally we conclude that the Empirical bayes method for the random affiliation parameter is efficient using Mean Squares Error (MSE) and for different Sample size .

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Publication Date
Wed Jun 10 2026
Journal Name
Adolescência E Saúde
Assessment Of The Effect Of 3-Caffeoyl Quinic Acid On Biofilm Formation By Kocuria Kristinae Clinical Isolates From Ear Infections
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Background: Kocuria kristinae (earlier known as Rothia kristinae) is a relatively new opportunistic pathogen responsible for ear infections. The ability of this organism to form biofilms increases its resistance to therapy and promotes the development of antimicrobial resistance, necessitating new treatment methods. Objective: To assess the effect of 3-caffeoylquinic acid on K. kristinae isolated from patients with ear infections. Methods: Isolation of five clinical strains was done by conventional microbiological procedures. The ability of K. kristinae to form biofilms was determined by the crystal violet method (absorbance at OD₅₇₀) before and after 3-caffeoylquinic acid exposure; statistical data analysis was done using a

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Publication Date
Sat Mar 30 2019
Journal Name
Journal Of Pure And Applied Microbiology
Antibiotic Resistance of Isolated Gram Negative Bacilli from Different Clinical Sample in a Central Teaching Hospital of Pediatric in Baghdad
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The number of infections caused by microorganisms is increasing significantly over the last few years. A total of 140 patients admitted to the central teaching hospital of pediatrics from the 1st of Jun 2017 to 31 October 2017. The Clinical samples was processed from culture and sensitivity testing. Antibiotic discs used for gram negative isolates. The most prevalent gram negative isolates included Escherichia coli 63 (45.0 %), Pseudomonas spp. 21 (15.0 %), Klebsiella spp. 19 (13.6 %) predominantly. Escherichia coli were the most prevalent isolates from urine 45 (71.4 %), Klebsiella spp. 11 (57.9 %) and Enterobacter spp. 11 (68.8 %) followed by Escherichia coli 10 (15.9 %) predominant from blood. 68 (48.6 %) of specimens were urine, 47 (33.

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Publication Date
Sun Nov 01 2020
Journal Name
Am J Clin Res Rev
Clinical and histopathological findings in patients with follicular dermatoses: all skin diseases starts in the hair follicles as new hypothesis
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KE Sharquie, AA Noaimi, RA Flayih, Am J Clin Res Rev, 2020 - Cited by 4

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Publication Date
Wed Jan 01 2025
Journal Name
Academic Science Journal
Role of efflux pump genes in the antibiotic resistance of Klebsiella pneumoniae bacteria isolated from clinical cases: A Review Paper
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Publication Date
Wed Dec 15 2021
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of Recipient Jaw and Implant Dimensions on Pre- and Post- Loading Dental Implant Stability: A Prospective Clinical Study
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Background: Implant stability is a mandatory factor for dental implant (DI) osseointegration and long-term success. The aim of this study was to evaluate the effect of implant length, diameter, and recipient jaw on the pre- and post-functional loading stability. Materials and methods: This study included 17 healthy patients with an age range of 24-61 years. Twenty-two DI were inserted into healed extraction sockets to replace missing tooth/ teeth in premolar and molar regions in upper and lower jaws. Implant stability was measured for each implant and was recorded as implant stability quotient (ISQ) immediately (ISQ0), and at 8 (ISQ8) and 12 (ISQ12) weeks postoperatively, as well as post-functional loading (ISQPFL). The pattern of implant

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Publication Date
Tue Jan 03 2017
Journal Name
World Journal Of Experimental Biosciences
Effect of Soil Extracts on Ability of Clinical Isolates of Pseudomonas aeruginosa and Staphylococcus aureus to Produce Biofilm in vitro
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In present study the effect of soil extracts of different types of soil on ability of two clinical isolates, Pseudomonas aeruginosa and Staphylococcus aureus to form biofilm. The extract of soil was done by using sterile phosphate buffer saline and analyzed by Fourier Transform Infrared Spectroscopic (FTIR). Spectrophotometric method was used to check ability of the studied isolated bacteria to form biofilm on polystyrene microtiter plates. The data of FTIR showed very little difference was observed among extracts of three types of soil (soil contaminated with hydrocarbons; garden soil collected from gardens of al-jadrea, Baghdad and containers soil), but the highest difference was observed in the extract obtained from peat moss clay soil.

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