Nutritional Status and Dietary Behaviors of Children with Intellectual or Developmental Disabilities in Saudi Arabia: A Systematic Review.

Children with intellectual or developmental disabilities are susceptible to malnutrition. This systematic review was conducted to assess the nutritional status and dietary behaviors of children with intellectual or developmental disabilities in Saudi Arabia. The target population was children from Saudi Arabia aged 18 years or younger and diagnosed with intellectual or developmental disabilities. Appropriate research studies that were published from inception up to December 2023 were obtained and reviewed. The outcomes of interest, including anthropometric data, laboratory data, dietary intake data, and dietary behaviors data, were collected and organized in relevant tables. The methodological quality and bias risk for the involved studies were evaluated. Out of 286 screened articles, 31 research articles were selected. The review results show that the rates of overweight and obesity were significantly higher among children with intellectual or developmental disabilities compared to typically developing children. The laboratory data revealed that they were more likely to have nutritional deficiencies. Low intake of energy, protein, and several micronutrients is frequently reported among them. Moreover, they are anticipated to have unhealthy dietary behavior. In conclusion, the findings suggested that children with intellectual or developmental disabilities were at higher risk of malnutrition including deploying obesity and nutritional deficiencies. Healthy and balanced nutrition that considers dietary requirements and food preferences is critical to maintaining the optimal development of these children. This review could invite researchers and policy-makers in Saudi Arabia to put more effort into integrating individuals with disability into the healthcare system and community. Further research is required to determine the types of intervention measures that can be taken to reduce the risk of malnutrition. Additional action is needed to monitor the implementation of national policies and programs that target this part of society.

Posterobasal left ventricular aneurysms: surgical treatment and long-term outcomes.

This retrospective study analyzes short- and long-term outcomes in 18 patients who underwent repair of posterobasal left ventricular aneurysm from January 1993 through December 2009. As concomitant procedures, mitral reconstruction was performed in 4 patients, ventricular septal defect repair in 2 patients, and coronary artery bypass grafting in 17 patients. In regard to surgical technique, 10 patients underwent patch repair and 8 underwent closure by linear suture. The in-hospital mortality rate was 11% (2 patients). An intra-aortic balloon pump was placed postoperatively in 1 patient. One patient underwent reoperation for mediastinitis and 2 for bleeding. The 1-, 5-, and 10-year survival rates were 82%, 76%, and 52%, respectively. Posterobasal left ventricular aneurysm repair can be performed with low short-term mortality rates and good long-term outcomes. It must be judged whether a linear repair or patch repair is better, in accordance with aneurysm size and the concomitant operative procedure, if any.

Implantation of a left ventricular assist device with mini-pericardiotomy technique.

The left ventricular assist device may be a lifesaving therapy for a patient awaiting a heart transplant. The most common complications of this device are mediastinal bleeding, infections, embolic events, right-sided heart failure, and mediastinal adhesions. We are reporting a patient who had a Levitronix left ventricular assist device implanted with mini-pericardiotomy technique for bridging to heart transplant.

Hybrid coronary revascularization for the treatment of left main coronary artery disease in high-risk patients.

OBJECTIVE: Hybrid coronary revascularization is an alternative for treatment for high-risk patients with coronary artery disease. We evaluated the efficacy of staged hybrid coronary revascularization for the treatment of unprotected left main coronary artery disease in high-risk patients. METHODS: Patients with left main or proximal left anterior descending coronary artery stenosis who are not good candidates for percutaneous coronary intervention and who had suitable lesions in the right coronary and circumflex arteries were considered for staged hybrid therapy if they had poor left ventricular functions (ejection fraction <0.40) and comorbid illnesses. From January 2008 through December 2010, 11 patients (8 men, 3 women; mean age: 66.1 ± 9.1 years) were treated with off-pump coronary artery bypass grafting combined with staged percutaneous coronary intervention. Nine patients had left main coronary artery stenosis together with circumflex or right coronary artery stenosis, and 2 patients had proximal left anterior descending artery stenosis and right coronary artery stenosis. RESULTS: After off-pump coronary artery bypass grafting, procedure-related complications did not occur, and there was no in-hospital death. Coronary re-angiography after a median of 16 days revealed patent and functioning left internal mammarian artery grafts in all patients. Applying subsequent percutaneous transluminal coronary angioplasty and occasional stenting (n = 14), a total of 14 lesions were treated successfully. Procedure related complications did not occur. All patients remained angina-free, and no stress electrocardiographic changes were recorded. CONCLUSION: Our preliminary results indicate that a "staged hybrid" approach to the treatment of left main coronary artery disease in high-risk patients is safe and effective. Hybrid coronary revascularization enables complete revascularization and may be an alternative method of treating left main coronary artery disease in selected high-risk patients.