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.
Background: Alveolar ridge expansion is proposed when the alveolar crest thickness is ≤5 mm. The screw expansion technique has been utilized for many years to expand narrow alveolar ridges. Recently, the osseodensification technique has been suggested as a reliable technique to expand narrow alveolar ridges with effective width gain and as little surgical operating time as possible. The current study aimed to compare osseodensification and screw expansion in terms of clinical width gain and operating time. Materials and methods: Forty implant osteotomies were performed in deficient horizontal alveolar ridges (3–5 mm). A total of 19 patients aged 21–59 years were randomized into two groups: the screw expansion group, which invo
... Show MoreFrom different hospitals in Baghdad city, 25 clinical isolates of Proteus spp. were collected from different clinical samples, all isolates were identified as Proteus mirabilis by using bacteriological and biochemical assays in addition to Vitek-2 identification system. 15 (60%) isolates were identifying as Proteus mirabilis. The susceptibility of P. mirabilis isolates towards cefotaxime and ceftazidime was (66.6 %), (20%) consecutively; while extended spectrum β-lactamases producing P. mirabilis percentage was (30.7 %). Because blaVEB-1 was documented as an important indicator for increasing risk of extended spectrum beta ßlactamases producing P. mirabilis isolates that began to spread from many geographic area to Far east which inc
... Show MoreBackground: A diverse group of bacteria live in biofilms in the oral cavity. On dental surfaces biofilms form plaque that is potentially involved in caries and periodontal diseases. Periodic studying of plaque microflora and their antimicrobial sensitivity patterns strongly affects the clinical practice in plaque-induced oral diseases. Materials and methods: Dental plaque samples were collected from 22 patients having ages ranged between 33 and 49 years with gingivitis that met the study criteria. Plaque, gingival and gingival bleeding indices (PI, GI, GBI) were measured for each patient. Laboratory procedures included microbiological examination of plaque samples followed by antibiotic sensitivity testing using disc diffusion method were
... Show MoreAbstract Asthma is a complex disease defined by chronic airway inflammation and airflow limitation causing variable respiratory symptoms which include shortness of breath (SOB), wheezing, chest tightness and cough. Asthma guidelines advocate adding a second long acting bronchodilator to medium doses of inhaled corticosteroids (ICS) rather using high doses of ICS alone to control moderate to severe persistent asthma. The aim of this study was to evaluate the clinical outcomes of three medication regimens indicated for Iraqi patients suffering from persistent asthma. This study was interventional randomized clinical study conducted on a sample of adult Iraqi asthmatic patients in Baghdad City. The study com
... Show MoreAs major nosocomial pathogens,
In this study, 20
Thirteen isolates were collected from various clinical sources during the periodfrom 22/10/2017 to 22/12/2017. All the isolates were diagnosed based on the microscopic and biochemical propertiesby Vitek-2 Compact system. All isolates formed biofilm 100%, with 30% of isolatesbiofilm produced strongly and 70% on medium. The results of the present study have shown the presence of Curli fimbriae genes in E. cloacae bacteria from cases of urinary tract infections, infected patient with blood bacteremia and inflammation of wounds. Curli fimbriae is considered to be an important factor in the virulence of E.cloacae bacteria, which plays an important role in adhering and combining cells on solid surfaces to form the biofilmand helps in the adhesion
... Show MoreKE Sharquie, AA Noaimi, E Abdulqader, WK Al-Janabi, J Dermatol Venereol, 2020 - Cited by 6
An analytical and clinical study has been applied for measure the bioavailability of Zinc in serum of twenty adults healthy volunteers, using flame atomic absorption spectrophotometer (FAAS) at 213.9 nm. The calibration graph is linear in the ranges of 0.25-1.5 μg.mL-1 with correlation coefficient (R) 0.09996)μg.mL1-and molar absorpitivites 22957.76(L.mol1-cm-1.The concentration of Zinc determined in serum of all volunteers before and after administered orally a tablet of 50 mg zinc sulphate, produced by Samara drugs company (SDI). All data were subjected to statistical analysis by calculating accuracy, precision in addition to other parameters. The results indicate that the average maximum concentration (C-max ± SD) of blood zinc was 0.
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