Translation and cultural adaptation of the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale into Arabic for use with patients with diabetes in Libya.

In Libya neuropathic pain is rarely assessed in patients with diabetes. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale is used worldwide to screen for neuropathic pain. There is no Arabic version of LANSS for use in Libya. The aim of this study was to develop an Arabic version of LANSS and to assess its validity and reliability in diabetic patients in Benghazi, Libya. LANSS was translated into Arabic by four bilingual translators and back translated to English by a university academic. Validity and reliability of the Arabic LANSS was assessed on 110 patients attending a Diabetes Centre in Benghazi. Concurrent validity was tested and compared with the Self-completed Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS). Test-retest reliability was conducted 1-2 weeks later. Internal consistency and inter-class correlation (ICC) between LANSS and S-LANSS was also tested. Internal consistency within first completion of the Arabic LANSS was acceptable (Cronbach's alpha = 0.793) and similar to the Arabic S-LANSS (0.796) and the second completion of the Arabic LANSS (0.795). ICC between the Arabic LANSS and the Arabic S-LANSS was 0.999 (p 0.95, p < 0.0001). We concluded that the Arabic version of LANSS pain scale was valid and reliable for use on Libyan diabetic patients. This study provided results suggesting that the S-LANSS could also be used on diabetic patients

The epidemiology of chronic pain in Libya: a cross-sectional telephone survey.

BACKGROUND: Chronic pain is a public health problem although there is a paucity of prevalence data from countries in the Middle East and North Africa. The aim of this study was to estimate the prevalence of chronic pain and neuropathic pain in a sample of the general adult population in Libya. METHODS: A cross-sectional telephone survey was conducted before the onset of the Libyan Civil War (February 2011) on a sample of self-declared Libyans who had a landline telephone and were at least 18 years of age. Random sampling of household telephone number dialling was undertaken in three major cities and interviews conducted using an Arabic version of the Structured Telephone Interviews Questionnaire on Chronic Pain previously used to collect data in Europe. In addition, an Arabic version of S-LANSS was used. 1212 individuals were interviewed (response rate = 95.1 %, mean age = 37.8 ± 13.9 years, female = 54.6 %). RESULTS: The prevalence of chronic pain ≥ 3 months was 19.6 % (95 % CI 14.6 % to 24.6 %) with a mean ± SD duration of pain of 6 · 5 ± 5 · 7 years and a higher prevalence for women. The prevalence of neuropathic pain in the respondents reporting chronic pain was 19 · 7 % (95 % CI 14 · 6-24 · 7), equivalent to 3 · 9 % (95 % CI 2 · 8 to 5 · 0 %) of the general adult population. Only, 71 (29 · 8 %) of respondents reported that their pain was being adequately controlled. CONCLUSIONS: The prevalence of chronic pain in the general adult population of Libya was approximately 20 % and comparable with Europe and North America. This suggests that chronic pain is a public health problem in Libya. Risk factors are being a woman, advanced age and unemployment. There is a need for improved health policies in Libya to ensure that patients with chronic pain receive effective management

A cross-sectional study to estimate the point prevalence of painful diabetic neuropathy in Eastern Libya.

BACKGROUND: Painful Diabetic Neuropathy (PDN) is a complication that affects up to one third of people living with diabetes. There is limited data on the prevalence of PDN from countries in the Middle East and North Africa. The aim of this study was to estimate the point prevalence of PDN in adults in Eastern Libya using the self-report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale. METHODS: We invited patients attending the Benghazi Diabetes Centre who had diabetes for ≥ 5 years to take part in the study. Patients provided consent and completed the Arabic S-LANSS. Anthropometrics, marital status, socioeconomic and education information was recoded and fasting plasma glucose concentration determined. RESULTS: Four hundred and fifty participants completed the study (age = 19 to 87 years, BMI = 17.6 to 44.2 kg/m2, 224 women). One hundred and ninety five participants (43.3%) reported pain in their lower limbs in the previous 6 months and 190/195 participants (97.4%) reported a S-LANSS score of ≥ 12 suggesting they had neuropathic pain characteristics. Thus, 42.2% (190/450) of participants with diabetes were categorised as experiencing pain with neuropathic characteristics. Mean ± SD duration of diabetes for participants with PDN (20.4 ± 6.5 years) was significantly higher compared with those without PDN (11.1 ± 4.6 years). Participants with PDN smoked tobacco for more years than those without pain (7.9 ± 12.3 years versus 1.1 ± 3.9 years respectively); had significantly higher fasting plasma glucose concentration (143.6 ± 29.3 mg/dl versus 120.0 ± 17.3 mg/dl) and had a significantly higher levels of education and employment status. The most significant predictors of PDN were duration of diabetes (OR = 25.85, 95% CI = 13.56-49.31), followed by smoking for men (OR = 8.28, 95% CI = 3.53-9.42), obesity (OR = 3.96, 95% CI = 2.25-6.96) and high fasting plasma glucose concentration (OR = 3.51, 95% CI = 1.99-6.21). CONCLUSION: The prevalence of PDN in people with diabetes in Eastern Libya was 42.2%. Risk factors for developing PDN were high fasting plasma glucose concentration, long duration of diabetes, and higher level of educational and employment status

Optimum clustering of active distribution networks using back tracking search algorithm

A microgrid has become the main building block of future distribution networks, demanding a systematic procedure for its optimal construction. Large distribution systems can be divided into clusters of distributed energy resources serving a group of distributed loads, known as microgrids to facilitate powerful control and operation. This paper compares the clustering of smart distribution systems into a set of microgrids based on two different objective functions. The probabilistic nature of intermittent distributed generators and loads is considered by performing a probabilistic Backward-Forward sweep power flow. The probabilistic approach aims to determine the optimal virtual cut set lines that split the system into self sufficient microgrids. The Back Tracking Search optimization algorithm is used to cluster a 69-bus distribution system with optimally allocated distributed generation units. The design concept, problem formulation, solution algorithms, probabilistic model and other graph related theories are presented in this paper

A probabilistic approach for maximizing the islanding success in microgrids

With Increasing electricity demand, microgrids nowadays play an important role in smart grids which demand a systematic approach for its optimal design and performance enhancement. Microgrids development is propitious for the electric energy industry from several aspects including environmental aspects, improvement of system operation and power quality, cost saving and other market related issues. In the IEEE Standard 1547.4, splitting large distribution networks into a number of smaller networks can provide enhanced operation and control. In this paper, a distribution test system is considered for optimum design of microgrids. The design considers maximizing the success indicant of the constructed microgrids. The islanded operation of microgrids requires serving important loads when the main supply fails. Thus, the success of the islanding process can be a challenging issue for planners to enhance the distribution system reliability. The indicant formulated in this paper incorporates the crucial conditions for successful operation of microgrids such as power imbalance and voltage constraints. A radial distribution system of 69 buses is chosen for this research. The selected system has a typical fuel mix of distributed generators such as biomass generators, photovoltaic units and wind turbines. The design problem is solved using the recently developed back tracking search optimization algorithm. The intermittent nature of distributed generators is taken into consideration through a probabilistic approach