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.
Abstract Daily dressing changes cause distress and pain for victims of burn injuries. The study aimed to determine the effect of music in reducing the pain and anxiety of thermally burned children during routine dressing changes. This quantitative study employed a randomized controlled trial design. The participants comprised 80 children at the Specialized Burns Hospital, in Baghdad, Iraq who were divided into two groups. The intervention group were exposed to three generic musical pieces (children’s music, nature sounds, and classical music) for 10-15 minutes. The researchers used the Objective Pain Scale, State-Trait Anxiety Inventory, and physiological parameters to measure the children’s responses immediately before the dressing cha
... Show MoreDiabetes mellitus represents a chronic illness distinguished by sustained elevations in blood glucose concentrations, and it ranks as the sixth foremost cause of mortality globally.
This randomized controlled experimental study was conducted consisted of 105 patients divided into three groups (36 vibration group, 38 coughing technique group, and 31 control group) who applied subcutaneous insulin injections in hospitalized adults’ patients with type 2 diabetes between September 2024 and January 2025 to examine the effect of the cou
Due to the increasing interest in the quality of auditing by writers, researchers and regulators of the auditing profession. The matter necessitated a statement of the extent to which the auditor practices professional skepticism, because of its significant impact in discovering errors and material misrepresentations contained in the financial statements in order to give the financial community confidence in them and the success of the audit process. The research aims to clarify the concept and importance of the practice of professional skepticism and its effect on the quality of the auditor's performance in Iraq. To achieve the research objectives, the two re
... Show MoreBackground: Most primary Health Care Centers (PHCCs) in Iraq have a referral system records; however, this mechanism does not function well because of the lack of other requirements for an efficient referral system.
Objective: To assess the practice & opinion of doctors in PHCs toward the referral system, and to determine the doctors in PHC's commitment to referral system instructions and guidelines.
Subjects and methods: A cross-sectional study with analytic elements was conducted in nine health directorates in Iraq, from the 1st October 2018 – 30th June 2019.One PHC was selected randomly form each sector in every governorate, A questionnaire was used to collect the required information.
... Show MoreBackground: Routine supplementation of vitamin D to infants is justifiable since vitamin D deficiency, and its consequences are highly prevalent not only in developing countries but worldwide. Maintaining a normal level of vitamin D is crucial in order to have a normal skeletal, as well as, extra-skeletal health. Knowledge of mothers regarding importance of vitamin D supplementation affect the health of their babies in a positive manner if accompanied by appropriate practice.
Objective: To determine the level of knowledge, attitude and practice of Iraqi mothers of under or equal 12 months old infants in Baghdad, AL-Rusafa, regarding vitamin D supplementation for their infants.
Typ
... Show MoreBackground The appropriate disposal of medication is a well-recognized issue that has convened growing recognition in several contexts. Insufficient awareness relating to appropriate methods for the disposal of unneeded medicine may result in notable consequences. The current research was conducted among the public in Iraq with the aim of examining their knowledge, attitude, and practices regarding the proper disposal of unused and expired medicines. Methods The present study used an observational cross-sectional design that was community-based. The data were obtained from using an online questionnaire. The study sample included people of diverse genders, regardless of their race or occupational status. The study mandated that all pa
... Show MoreIntroduction: Infection control or hospital-acquired infections are the major concern of the health care system and agencies. Critical care nurses are on the first-line contact with the patients, so on, they are most vulnerable to acquired infections. It is really important to regularly check their knowledge and practices concerning infection control. Objectives: The study aims to identify the impact of years’ experience on nurses’ knowledge and practices concerning infection control in three hospitals and center (Baghdad teaching hospital, Ibn Al-Nafees hospital, and Ibn al-Bitar center) Methodology: Cross-sectional study was conducted, the study starting from 4th of July 2020 to 13th of November 2020. Non-probability (purposive) sampl
... Show MoreKE Sharquie, SA Al-Mashhadani, AA Noaimi, WM Katof, THE IRAQI POSTGRADUATE MEDICAL JOURNAL, 2013 - Cited by 6
Background: Piezosurgery improved the split approach by making it safer, easier, and less prone to complications when treating extremely atrophic crests. Densah drills, with their unique design, expand the ridge by densifying bone in a reverse, non-cutting mode. Objective: To assess the effectiveness of sagittal piezosurgery, which involves cutting bone to the full implant depth and then expanding it using osseodensification drills. We use this technique to expand narrow alveolar bones and simultaneously place dental implants in the maxillary and mandibular arches. Methods: Fourteen patients received 31 dental implants. The maxillary arch received 19, and the mandible received 12 dental implants. This study will include patients who
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