Abdulaziz Alkhathaami

Background/Objectives: Nutritional-risk screening at admission is mandatory in many hospitals but is rarely audited. We audited routine Nutritional-Risk Screening 2002 (NRS-2002) records entered by nurses with mandatory training and credentialed access in hospitalized adults with diabetes. Methods: Retrospective, records-based audit of all eligible admissions (2020–2025) at a Saudi tertiary center. Routine items were extracted verbatim, and dietitians re-scored each admission from the same record using a common written procedure. Results: Of 650 admissions assessed, 131 were excluded (46 with no form opened; 85 with incomplete clinical data). Of 519 analyzed forms, 446 (85.9%) carried zero on every item and 22 (4.2%) contained any substantive item; of 73 non-zero totals, 41 comprised the age item alone and 11 could not be derived from their items. Among 83 admissions in which a charted body-mass index below 20.5 kg/m² made the full screen mandatory, 79 (95.2%) had no substantive item. Any entry was present in 70.8% of patients aged ≥70 years versus 5.9% of younger patients, although indications for the full screen were less frequent in older patients. Re-scoring classified 124 admissions (23.9%, 95% CI 20.4–27.7) at NRS-2002-defined risk versus one routinely; 123 (99.2%) were unrecognized. Scoring diabetes itself as disease severity 1 left this unchanged; an extreme lower-bound rule gave 57 (11.0%), none recognized. Conclusions: Routine documentation was strongly suggestive of incomplete NRS-2002 implementation despite mandatory training. Its causes cannot be determined from the records; workflow-embedded completion, automated referral, and routine audit warrant prospective evaluation.

The capability of bariatric surgery (BS) and lifestyle intervention (LSI) in ameliorating obesity-associated altered gastric myoelectric activity (GMA) in relation to body composition is underinvestigated. This work studied GMA during weight loss via sleeve gastrectomy and multimodal lifestyle intervention. Seventy-nine participants with morbid obesity were assigned into three groups: bariatric surgery (BS group, n = 27), in which laparoscopic sleeve gastrectomy was performed; lifestyle intervention (LS group, n = 22), in which a calorie-deficit balanced diet with gradual physical activity and personalized behavioral modification were carried out; and waitlist control (C group, n = 30). For all participants, multichannel electrogastrography (EGG) with water-load testing and bioelectric impedance body composition analysis were done at baseline, after three months, and at six months. In the BS group, the water-load volume was decreased but without improvement in the bradygastria. In the LS group, preprandial bradygastria were reduced and some postprandial normogastria were increased throughout the study period. Except for fat-free mass and total body water, the parameters of body composition changes were superior in the BS group. In the LS group, the amount of fat-mass loss was negatively correlated with bradygastria times and positively correlated with preprandial and the early postprandial average dominant frequency (ADF). In addition, in the BS group, fat-mass loss was positively correlated with the ADF at late postprandial times. In conclusion, compared to BS, LS produced moderate normalization of GMA with the preservation of fat-free mass. The GMA changes were significantly associated with the amount of fat loss, regardless of the method of obesity management.

Background and Objectives: Obesity is a chronic inflammatory condition and is considered a major risk factor for cardiovascular disease (CVD). The effects of obesity management via sleeve gastrectomy (SG) and lifestyle intervention (LS) on inflammatory cytokines, redox status, and CVD risk were studied in this work. Materials and Methods: A total of 92 participants (18 to 60 years old) with obesity (BMI ≥ 35 kg/m² were divided into two groups: the bariatric surgery (BS) group (n = 30), and the LS group (n = 62). According to the achievement of 7% weight loss after 6 months, the participants were allocated to either the BS group, the weight loss (WL) group, or the weight resistance (WR) group. Assessments were performed for body composition (by bioelectric impedance), inflammatory markers (by ELISA kits), oxidative stress (OS), antioxidants (by spectrophotometry), and CVD risk (by the Framingham risk score (FRS) and lifetime atherosclerotic cardiovascular disease risk (ASCVD)). Measurements were taken before and after six months of either SG or LS (500 kcal deficit balanced diet, physical activity, and behavioral modification). Results: At the final assessment, only 18 participants in the BS group, 14 participants in the WL group, and 24 participants in the WR group remained. The loss in fat mass (FM) and weight loss were greatest in the BS group (p < 0.0001). Levels of IL-6, TNF-a, MCP-1, CRP, and OS indicators were significantly reduced in the BS and WL groups. The WR group had significant change only in MCP-1 and CRP. Significant reductions in the CVD risk in the WL and BS groups were detected only when using FRS rather than ASCVD. The FM loss correlated inversely with FRS-BMI and ASCVD in the BS group, whereas in the WL group, FM loss correlated only with ASCVD. Conclusions: BS produced superior weight and fat mass loss. However, both BS and LS produced a similar reduction in the inflammatory cytokines, relief of OS indicators, and enhancement of antioxidant capacity, and consequently reduced the CVD risk.