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 on coordination polymers chemistry based on organic-metal framework with bridging ligands has accelerated during the past two decades. It is an interested hot topic in the synthetic inorganic chemistry, which allowed the fabrication of a variety of interested materials. These materials have shown a range of applications including light harvesting and magnetic properties. The thesis is divided in three chapters. The first chapter gives a general introduction on the development of self-assembled polymeric species based on transition metal. It is also covered a summary of the literature review on the current state of the art on self-assembled coordination ploymers. Furthermore, it includes a description on various relevant topics
... Show MoreBackground: Psychological stress is considered the major etiological factor precipitating myofacial pain and temporomandibular disorders.It is known that stress induce various adaptational responses of physiologic systems. The process includes increase in the activity of the hypothalamic-pituitary-adrenal axis which promotes cortisol secretion. Salivary cortisol has been used as a measure of free circulating cortisol levels.The use of salivary biomarkers has gained increased popularity since collecting samples is non-invasive and painless. The aim of thisstudy was to evaluate the level of cortisol in saliva among sample of university students having myofacial pain, during the final exam period and whether this finding could have a significa
... Show MoreIntroduction: Inadequate pain assessment and management is a problem in hospitalized patients that impairs their wellbeing. Intensive care unit nurses’ pain practices are affected by several barriers and enablers. Objectives: The objectives of this study were to determine the level of nurses’ practices and perceived barriers related to pain assessment in critically ill patients. Methodology: A cross-sectional design study was used. Purposive sampling technique was employed, including 100 nurses recruited from 8 intensive care units in Baghdad city, Iraq. The study was conducted from September 1st to October 20th, 2022. The pain assessment and management for critically ill patients survey was used to collect data. Descriptive sta
... Show MoreBACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is common, yet no curative treatment identified. Cinnamon is a herbal substance, which has many applications in medicine. AIM: The aim of the study was to study the effect of cinnamon on patients with chronic pelvic pain syndrome. METHODS: Sixty patients with documented CP/CPPS randomized into two groups during 2018 and 2019 in Baghdad. The first group received 60 capsules each contained 1 g of cinnamon. The other group received 60 capsules each contained 1 g of sugar powder (placebo). All the patients instructed to take one capsule twice daily for 1 month. National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) was reported for bot
... Show MoreObjective: To compare two insertion techniques of intramedullary interlocking nails (medial parapatellar versus intrapatellar insertion) in patients with tibial fractures. Methodology: This study was performed at Al-Kindy Teaching Hospital from August 2020 until March 2022. All 32 patients with tibial fractures (29 males and 3 females) were included for tibial closed nail fixation and then followed up for 6 months. We categorized these patients into two groups; Group A (16 patients), those treated by medial parapatellar insertion of an interlocking nail, and Group B (16 patients) with transpatellar tibial nail insertion. All patients were treated by the same surgical team. Results: The range of movement in two weeks (from extension
... Show MoreTemporomandibular Disorders (TMD) refer to a group of symptoms where pain is the most leading cause to demand a treatment by the patient. Light therapies are of great importance at current times due to its biosafety and non-invasive quality when used for the management of TMD symptoms. This study aimed to evaluate the efficacy of red LED light with low-level LASER in treating TMD patients.
A double-blind randomized clinical study was conducted and included 60 patients along 3 groups (20 for e
Background: Treatment of invasive prolactinoma, which has several characteristics including invasive growth into cavernous sinuses and formation of giant adenomas compressing adjacent neural structures, resulting in neurological dysfunction, has been very challenging. There are relatively few reports available describing long-term treatment outcome.
Aims of the study: In this study we evaluate the results of cabergoline administration as initial treatment during 4 years follow up period.
Methods: We prospectively categorized 36 patients into four groups according to the results of 3 months of cabergoline treatment: group 1, tumor volume reduction (TVR) ˃25% with normaliz
... Show MoreBackground: Blastocystis spp. distributes world widely and the genus Blastocystis include many subtypes that are isolated from human intestinal tract. It is considered the most common parasite detected in human being.
Objectives: To evaluate the incidence of Blastocystis spp. among leukemic children, to find out its association with the presence of symptoms (diarrhea and abdominal pain), and to assess the efficacy of different staining methods in detection of Blastocystis spp.
Type of the study: cross-sectional study.
Method: 103 children were enrolled in this study, 53 leukemic patients and 50 healthy con
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