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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 Jan 01 2020
Journal Name
Iraqi Journal Of Veterinary Sciences
Incidence of cutaneous and subcutaneous tumors of dogs from Baghdad city: Clinical, cytological and histopathological features
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The present study was conducted to estimate the incidence, clinical findings, cytological and histopathological characteristics of spontaneously occurring skin neoplasms in dogs. A total of 40 grossly suspected cases of cutaneous and subcutaneous tumors were gathered during the period from July 2016 to August 2018 from male and female dogs in Baghdad city. Dogs with skin neoplasia revealed various clinical signs, and their ages were older than 5 years to 15 years. German shepherd 30% followed by Terrier dogs 25% were more influenced than other breeds. Concerning tumor features, the majority of neoplasms had solitary lesion 70%, regular shapes 65% with black color 55%. The tumors frequently occurred on fore-limbs and abdomen, and 80% of them

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Publication Date
Sat Sep 30 2017
Journal Name
Pharmacy Practice
Physician-pharmacist agreement about off-label use of medications in private clinical settings in Baghdad, Iraq
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Publication Date
Fri Sep 27 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Clinical Assessment and Cytomorphometric Analysis of Buccal Mucosal Cells in Behçet’s Disease Patients
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Background: Behçet’s disease (BD) is a disorder of systemic inflammatory condition. Its important features are represented by recurrent oral, genital ulcerations and eye lesions. Aims. The purpose of the current study was to evaluate and compare cytological changes using morphometric analysis of the exfoliated buccal mucosal cells in Behçet’s disease patients and healthy controls, and to evaluate the clinical characteristics of Behçet’s disease. Methods. Twenty five Behçet’s disease patients have been compared to 25 healthy volunteers as a control group. Papanicolaou stain was used for staining the smears taken from buccal epithelial cells to be analyzed cytomorphometrically. The image analysis sof

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Publication Date
Sat Dec 24 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Therapeutic Effects of Vitamin E in Non-alcoholic Fatty Liver Disease: An Open-Labeled Clinical Trial
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Abstract: non-alcoholic fatty liver disease (NAFLD) is one of the widespread chronic liver diseases; it is ranging from simple fat buildup in the liver (steatosis) to non-alcoholic steatohepatitis (NASH) presence of inflammation and hepatocyte injury.                                                                                                                                        &nb

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Publication Date
Thu Sep 04 2025
Journal Name
The Open Dentistry Journal
Clinical and Salivary Antioxidant Effects of Matcha Tea in Patients with Gingivitis: A Randomized Controlled Trial
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Introduction

Gingivitis, the initial stage of periodontal disease, is characterised by inflammation driven by dental biofilm and associated with oxidative stress. Matcha tea, a powdered green tea rich in antioxidants, has shown potential health benefits. This study aimed to investigate the effect of Matcha tea consumption on clinical periodontal parameters and salivary antioxidant levels in patients with gingivitis.

Methods

A randomised controlled clinical trial was conducted with 41 participants diagnosed with gingivitis.

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Publication Date
Mon Dec 31 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
ESTIMATION OF ELLAGIC ACID ACTIVITY WHEN MIXED WITH SOME TYPES OF CANDY AGAINST Streptococcus mutans ISOLATED FROM ADULT PATIENTS IN BAGHDAD CITY: ESTIMATION OF ELLAGIC ACID ACTIVITY WHEN MIXED WITH SOME TYPES OF CANDY AGAINST Streptococcus mutans ISOLATED FROM ADULT PATIENTS IN BAGHDAD CITY
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Microbial activity of Ellagic acid when mixed with some types of candy toward Streptococcus mutans microorganism was studied. The main purpose of carrying out this study is to produce a new type of candy that contains Ellagic acid in addition to xylitol instead of sucrose to prevent dental caries. The results show that the inhibitory action of Ellagic acid was more effective when mixed with this type of candy for the purpose of reducing Streptococcus mutans microorganisms, while sensory evaluation was applied in this study to 20 volunteers to that candy sample evaluated which contain (5 mg/ml) Ellagic acid with 100g xylitol to determine consumers acceptability of this sample of candy. The results were expressed as mean value, slandered d

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Publication Date
Sun Sep 01 2019
Journal Name
Journal Of Global Pharma Technology
Spectrophotometric determination of loratadine in syrup and study viscosity conductivity and thermodynamic of binary mixed systems of surfactants with loratadine"
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Publication Date
Wed Dec 24 2025
Journal Name
Baghdad Science Journal
Synthesis, Spectroscopic Characterization, and Biological Evaluation of Mixed Ligands Complexes From Schiff Base and 1,10-Phenanthroline With Multivalent Metal Ions
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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Preparation, Characterization & Biological activity for Some Iron(II) Complexes Containing Mixed Ligands (Benzilazine & Semicarbazone) & Study of Laser Effect on Them
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The research included preparation of new iron(II) complexes with mixed ligands including benzilazine(BA) and semicarbazone ligands {benzilsemicarbazone- BSCH or benzilbis(semicarba-zone)- BBSCH2 or salicylaldehydesemicarbazone- SSCH2 or benzoinsemicarbazone- B'SCH2}.by classical and microwave methods. The resulted complexes have been characterized using chemical and physical methods. The study suggested that the above ligands form ionic complexes having formulae [Fe(SCHi)(BA)(Cl)m](Cl)2-m {where SCH, BSCH, BBSCH2, SSCH¬2 or B'SCH2 ligands; m=1 or 2}. Hexacoordinated mononuclear complexes have been investigated by this study and having octahedral geometries. The effect of laser ray type visible region have been studied on solid ligands and

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Role of single and mixed culture of Pseudomonas aeruginosa and Serratia ficaria in utilization of petroleum wastes of Dora- refineries.
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The ability of single and mixed bacterial culture to utilize Dora-refineries petroleum wastes was compared. Pseudomonas aeruginosa and Serratia ficaria mixed culture consumed the wastes better than the single bacterial cultures. The highest log. number of viable cells in mixed culture was 6.842 , while in single bacterial cultures it was 6.683 and 5.631, respectively. after 3 days in API medium containing the refinery wastes. The effect of some environmental conditions on the degradation of petroleum wastes was studied included aeration , NaCl concentration , pH and temperature. The growth of bacteria in the agitated culture was higher than stagnant culture the log. of cell no. was 6.021 in the first culture. The h

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