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.
This study was conducted to evaluate the hydrocarbon biodegradation abilities of Enterobacter cloacae, Staphylococcus aureus, Sphingomonas paucimobilis, and Pentoae species which were isolated from different diesel-contaminated soil samples. The isolates were identified by the Vitek 2 system. Fourier-transform spectroscopy (FT-IR) tested the potential of these isolates to biodegrade the diesel according to the peak areas, a significant decrease in the area of the peaks at 2856-2928 cm−1 corresponds to aliphatic hydrocarbons. The appearance of small peaks at 900-1032 cm−1 refers to substituted benzene derivative compounds. An appearance of some new peaks at 3010- 3030 cm−1 which indicate the presence of alcohol (-OH) and ketones (RC=O)
... Show MoreProductivity estimating of ready mixed concrete batch plant is an essential tool for the successful completion of the construction process. It is defined as the output of the system per unit of time. Usually, the actual productivity values of construction equipment in the site are not consistent with the nominal ones. Therefore, it is necessary to make a comprehensive evaluation of the nominal productivity of equipment concerning the effected factors and then re-evaluate them according to the actual values.
In this paper, the forecasting system was employed is an Artificial Intelligence technique (AI). It is represented by Artificial Neural Network (ANN) to establish the predicted model to estimate wet ready mixe
... Show MoreDrastic threat to the natural system is caused by the uncontrolled release of synthetic pollutants, including azo dyes. This study centered on the decolorization and biodegradation of water soluble azo dye reactive blue (RB) in a batch mode sequential anaerobic-aerobic processes. A local sewage treatment plant was the source where activated sludge was collected to be used as non-adapted mixed culture with both free and the alginate immobilized cells for RB biodegradation. Under anaerobic conditions, the free and immobilized mixed cells were proved to completely decolorize 10 mg/ L of RB within 20 and 30 h, respectively. Alginate- immobilized mixed cells, resulted in 88%, 87%, and 87% maximum COD removals with samples con
... Show MoreFour mixed ligand complexes were prepared from 1,10-phenanthroline (Phen), 5-chlorosalicylic acid (CSA), and anthranilic acid (Anthra) dissolved in aqueous ethanol at a ratio of (1:1:1:1) M: Phen:CSA: Anthra, M(II)= Cu, Zn, Cd, and Hg. The prepared compounds were analyzed by flame atomic absorption, FT-IR, UV-Vis, and spectroscopic methods, as well as conductivity measurements and magnetic properties. After analyzing the prepared compounds using the acquired data, the complexes formed by mixing ligands were concluded to adopt an octahedral geometry. That study has been conducted to test the inhibitory effectiveness of the complexes (1,10-Phenanthroline (Phen), 5-Chlorosalicylic acid (CSA), Na[Cu(Phen)(CSA)(Anthra), Na[Zn(Phen)(CSA)(Anthra
... Show MoreObjectives: This study explored knowledge, attitude, and practice of infection control by dental students at College of Dentistry/ University of Baghdad, Iraq. Material and Methods: Three hundred dental students participated in this study. A self administrated questionnaire with 21 close ended questions related to use of personal protective equipments, infection control awareness, vaccination status, percutaneous exposures, and attitude towards treatment of patients with hepatitis B (HBV)/ or human immunodeficiency virus (HIV) was distributed to dental students. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21. Fisher exact and Chi-square test were used with significance level set to 0.05. Results: The
... Show MoreHusbands’ violence towards their wives is one of the greatly important issues in social sciences. Accordingly, the current study aims at determining the levels of violence practiced by husbands towards their wives to propose a professional program from the perspective of the general practice of social work to overcome such a phenomenon. The study is descriptive in nature, where the researcher has used a comprehensive social survey method. To achieve the goal of the study, the researcher has prepared a questionnaire that consisted of two parts. The first part contains the primary data of the two sections, and the second contains (38) phrases distributed over four axes to measure the levels and types of violence among the sample’s memb
... Show MoreThis cross-sectional, questionnaire-based study evaluated the knowledge, attitude and practice towards breast cancer and breast self-examination [BSE] among 387 [302 females and 85 males] educated Iraqis affiliated to 2 Iraqi universities. The participants were categorized into 3 occupations: student [71.3%], teaching staff [10.3%] and administrative staff [18.3%]. About half of the participants had a low knowledge score [< 50%]; only 14.3% were graded as [Good] and above. Almost 75% of the participants believed that the best way to control breast cancer was through early detection and other possible preventive measures. Most participants [90.9%] had heard of BSE, the main source of informatio
... Show MoreAmebiasis, related to the pathogenic parasite Entamoeba histolytica, is a prominent cause of diarrhea globally. Amebiasis is primarily a disease of impoverished communities in developing nations, although it has recently arisen as a significant infection among returning tourists and immigrants. Severe cases are linked to a high case fatality rate. Although polymerase chain reaction (PCR)-based diagnosis is becoming more widely available, it is still underutilized. Treatment with nitroimidazoles is now suggested, however novel parasite medication research is a top priority. To avoid problems, amebiasis should be considered before corticosteroid therapy. Because there is no effective vaccination, sanitation and availability to clean w
... Show MoreBackground: Parotid gland tumors account for 80% of all salivary gland neoplasms, 20% of these are malignant, but in daily clinical practice most parotid masses are operated on before obtaining the final histological diagnosis. This clinical setting further complicates the critical point of parotid surgery, which is the management of the facial nerve. Materials and methods: 45 patients underwent parotidectomy for benign and malignant neoplasms. A complete history is collected from the patients with the duration and the site of the tumor, the facial nerve examined and its associations, a medical consultation done for opinion and management. Clinical examination with facial nerve was mandatory to avoid any mistakes that may occur. The most si
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