Coronary artery bypass grafting (CABG) is an essential operation for patients who have severe coronary artery disease (CAD). Both open and minimally invasive CABG methods are used to treat CAD. This in-depth review looks at the latest research on the effectiveness of open versus minimally invasive CABG. The goal is to develop evidence-based guidelines that will improve surgical outcomes. This systematic review used databases such as PubMed, MEDLINE, and Web of Science for a full electronic search. We adhered to the PRISMA guidelines and registered the results in the PROSPERO. The search method used MeSH phrases and many different study types to find papers. After removing duplicate publications and conducting a screening process, we collaboratively evaluated the full texts to determine their inclusion. We then extracted data, including diagnosis, the total number of patients in the study, clinical recommendations from the studies, surgical complications, angina recurrence, hospital stay duration, and mortality rates. Many studies that investigate open and minimally invasive CABG methods have shown that the type of surgery can have a large effect on how well the patient recovers and how well the surgery works overall. While there are limited data on the possible advantages of minimally invasive CABG, a conclusive comparison with open CABG is still dubious. Additional clinical trials are required to examine a wider spectrum of patient results.

Inguinal hernia repair (IHR) is a common surgical procedure among neonates and infants; the time of surgery is one of the major factors affecting its outcomes. Our systematic review aims to evaluate the effects of surgical timing on outcomes in inguinal hernia repairs in the newborn and infant population to establish evidence-based guidelines for optimal surgical timing. A systematic search was performed in PubMed, MEDLINE, and Web of Science databases, following PRISMA guidelines. Studies evaluating neonates and infants undergoing IHR with outcomes of recurrence, complications, and postoperative recovery were included. Data were collaboratively extracted, including patient demographics, surgical approaches, perioperative complications, and long-term outcomes. Early repair (0–28 days of life) decreased the risk of hernia incarceration but also increased the risk of preoperative complications. Delayed repair (29 days to 1 year of life) showed fewer preoperative complications but increased the risk of incarceration. The outcomes were affected by variables including patient maturity and comorbidities, along with hernia severity. Neonates with a high risk for incarceration are best treated with early repair, while stable infants can be managed safely with delayed repair. More randomized trials are needed to develop standardized guidelines that balance the associated risks of neonatal versus infant repair strategies to maximize benefits.

Background: The maternal microbiota serve as a key regulator of neonatal immune development and early-life health outcomes. This systematic review aims to find out how the makeup of the maternal microbiota affects newborn immunity and the risk of allergies, identify which microbes are linked to a higher or lower chance of allergies, and assess treatments that could improve newborn immune health. Methods: We conducted a systematic search in PubMed, MEDLINE, and Web of Science, adhering to the PRISMA guidelines. We included randomized controlled trials (RCTs), cohort studies, and observational studies that looked at how the makeup of the maternal microbiota affects newborn immune responses or allergic outcomes in early life. We conducted a systematic search, and the quality of the studies was evaluated using the GRADE system and tools to check for bias (RoB 2, Newcastle–Ottawa Scale, MINORS). Results: We included a total of 74 studies. The main findings showed that having a cesarean delivery and using certain antibiotics during pregnancy increased the risk of allergies, while breastfeeding, taking probiotics, and changing the mother’s diet helped to protect against allergies. Maternal stress had a negative association with the microbiota composition (OR = 1.9–2.4) and neonatal immune regulation. Moreover, the study noted significant geographic variation in the microbiota’s influence, underscoring the importance of contextualized interventions. Conclusions: The composition of the maternal microbiota has a major impact on neonatal immunity and the risk of early-life allergy. Adverse factors include cesarean birth, antibiotic exposure, and maternal stress, all of which have been associated with alterations in neonatal immunity. More studies are required to validate promising microbiota-targeted strategies and develop evidence-based guidelines to improve maternal and neonatal immune health.

Vaccine hesitancy remains a challenge to achieving optimal childhood immunization coverage. This systematic review examined parental vaccine hesitancy in Saudi Arabia, with emphasis on paternal determinants and their association with vaccination uptake. Following PRISMA 2020 guidelines, databases were searched between January 2000 and January 2025. Hesitancy toward routine childhood vaccines was generally low (3%-20%), whereas hesitancy toward newer or non-mandatory vaccines, including COVID-19, influenza, and HPV, exceeded 50% in some settings. Studies reporting father-specific data indicated higher hesitancy among fathers, particularly regarding safety, novelty, and possible long-term effects. Common determinants included safety concerns, misinformation, social media influence, and low confidence in vaccine effectiveness. Hesitancy was associated with delayed schedules, incomplete immunization, and reduced uptake of optional vaccines. Vaccine hesitancy in Saudi Arabia appears vaccine-specific and influenced by sociocultural factors, with paternal attitudes playing a measurable role in immunization decision-making.

Objectives: To assess the safety and efficacy of adenotonsillectomy (AT) for treating uncomplicated pediatric obstructive sleep apnea (OSA) in children of different ages. Methods: A systematic search was conducted in four electronic databases, and 71 studies with a total of 9087 participants were included in the analysis. The studies were all before-and-after studies, cohort studies, and randomized controlled trials. Surgical results were analyzed according to age, disease severity, and follow-up duration. Results: Children younger than 7 years at the time of AT had a significantly greater decrease in disease severity, a greater decrease in hypoxemic burden, improved sleep quality, and improved cardiovascular function than children older than 7 years. Both cognitive and behavioral performance improved postoperatively, although these changes were more significantly associated with the duration of follow-up than with age at surgery. Notably, the rate of surgical complications was much greater in children under the age of 3. Conclusions: The current evidence indicates that AT is performed optimally between the ages of 3 and 7 years, offering the greatest chance of disease resolution and remission of associated conditions, balanced with a reduction in surgical risk. We highly recommend conducting high-quality randomized controlled trials to further inform the clinical guidelines for pediatric AT.

Background: Adenotonsillectomy (AT) is a common surgical procedure among pediatrics, usually performed to treat obstructive sleep apnea (OSA), recurrent tonsillitis, and chronic adenoid hypertrophy. The aim of our systematic review is to evaluate the relationship between AT and postoperative weight gain in children to guide clinicians in optimizing surgical outcomes. Methods: A systematic search was conducted following the PRISMA guidelines in PubMed, MEDLINE, and Web of Science databases. Studies evaluating weight, BMI, and growth parameters before and after AT were included. Data were collaboratively extracted, including patient demographics, baseline weight status, comorbidities, and long-term outcomes. Results: Underweight children (less than the 3rd percentile on the growth chart) who underwent AT often experienced “catch-up growth” in weight, while obese children (above the 95th percentile on the growth chart) had postoperative weight gain that exacerbated pre-existing obesity. These outcomes were affected by factors such as baseline weight, age, and comorbid conditions. Conclusions: AT can improve the quality of life in underweight children, while overweight or obese children need careful monitoring and nutrition counseling postoperatively to mitigate excessive weight gain. More randomized trials are needed to better understand the metabolic and growth implications of AT and to refine clinical guidelines.