Background and Aim: The study objective was to assess chaotic global metrics in malnourished children following power spectral manipulations. Methods: We evaluated the complexity of heart rate (HR) variability (HRV) in malnourished subjects via six power spectra (Welch, multi-taper method (MTM), Burg, covariance, Yule-Walker, and periodogram) and then, when adjusted by the MTM parameters, for further refinement. Seventy children were split equally (controls & malnourished) and the HR was monitored for 20 min; 1000 RR-intervals were attained for HRV analysis. Results: The results stipulate that CFP1 (chaotic forward parameter) and CFP3 are the best metrics to distinguish the two groups. The most appropriate power spectra were Welch, MTM, and Yule-Walker. Results indicate that CFP3 calculated using MTM power spectra is the best combination to discriminate between the two groups. Yet, if the RR intervals are set to 400, discrete prolate spheroidal sequences (DPSS) to 3, and Thomson’s nonlinear combination to ‘adaptive’, a greater level of significance can be achieved (Cohen’s ds = -1.57). This significantly outperforms that under default conditions (Glass’s ∆ Delta = -1.06, and Cohen’s ds = -0.95). Conclusion: Malnourished children have a lower response to chaotic global metrics than the control group. CFP3 with the aforementioned settings is the best combination to discriminate between these groups on the basis of RR intervals. It has the greatest significance by Cohen’s ds. Our data suggest impaired autonomic function in malnourished children, which may have consequences for cardiovascular risks.

Aim/Hypothesis: Children and adolescents with type 1 diabetes mellitus are often motivated to fast during Ramadan despite the challenges and multiple risks. This study aimed to demonstrate the impact of fasting during Ramadan on metabolic control in children and adolescents with type 1 diabetes mellitus in Tabuk city. Methods: This prospective cross-sectional study enrolled children and adolescents aged 11–18 years with type 1 diabetes mellitus who chose to fast during Ramadan 1442/2021 (Hijri/Georgian year, 30 days). The study consisted of three stages: assessment and planning before Ramadan, daily advice and communication during Ramadan, and assessment one month after Ramadan. Details about weight, insulin dose, HbA1c, home glucose records, and type of glucose monitoring (GM) were recorded. Results: Among 26 patients, 65% were female (35% male); 69% completed Ramadan fasting (fasting group) and 31% did not (broke-fasting group). In the fasting group, 88.9% used flash GM, whereas in the broke-fasting group, 11.1% used self-GM. The home glucose records before Iftar (sunset) were significantly different between the fasting and broke-fasting groups (p < 0.01). Conclusion: Fasting during Ramadan in children and adolescents with type 1 diabetes mellitus is possible. Pre-Ramadan management of type 1 diabetes mellitus has a significant impact on glucose control; however, large-scale population-based studies across the country are required to further validate these results.