In this issueSystematic ReviewOriginal ArticleCase Report
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# Systematic Review {#article-title-2}

**Olfactory dysfunction among patients with COVID-19**

Alkholaiwi et al passess the frequency of olfactory dysfunction (OD) among individuals afflicted with coronavirus disease of 2019 (COVID-19). Based on eligibility criteria, 84 articles were included from 27 countries, comprising 36,903 patients, of whom 58.1% were females. The generality rates of olfactory impairment alone was 34.60% and in conjunction with GD was 11.36%. Patients with OD were subclassified into various categories, and the prevalence of anosmia was 20.85%, 5.04% for hyposmia, 8.88% for anosmia or hyposmia, 1.84% for parosmia, 0.78% for phantosmia, and 0.02% for hyperosmia, among COVID-19 patients. They concluded that clinical features associated with OD, either isolated or in combination with GD, are common in patients with COVID-19 and consider important signs of COVID-19 that may guide clinicians in the early phase of the disease.

![Figure1](http://smj.org.sa/https://smj.org.sa/content/smj/44/11/1069/F1.medium.gif)

[Figure1](http://smj.org.sa/content/44/11/1069/F1)

Classification of the type of studies included in the systematic review (n=84).

***see page 1085***

# Original Article {#article-title-3}

**Prognostic value of neutrophil to lymphocyte ratio and platelet counts during chemotherapy in patients with advanced gastric cancer**

Li et al investigate the predictive significance of dynamic changes in the neutrophil to lymphocyte ratio (NLR) and platelet counts (PLTs) in patients with advanced gastric cancer (GC) during chemotherapy. A total of 259 advanced GC patients receiving chemotherapy are enrolled and grouped by high or low NLR with a cut value of 2.5 and PLT with cut value of 300×109/L. The Kaplan-Meier survival model and the Log-rank test are carried out to determine the comparison on the overall survival differences. Cox regression analysis is employed to carry out both univariate and multivariate regression studies, aiming to explore potential prognostic factors acting independently. They concluded that high post-chemotherapy NLR and post-chemotherapy PLT might be adverse prognostic markers in advanced GC patients undergoing chemotherapy.

![Figure2](http://smj.org.sa/https://smj.org.sa/content/smj/44/11/1069/F2.medium.gif)

[Figure2](http://smj.org.sa/content/44/11/1069/F2)

Clinical outcomes corresponding to NLR.

***see page 1104***

**Socio-demographic determinants of influenza vaccination uptake behavior.** *A nationwide cross-sectional study in Saudi Arabia*

Javed et al investigate the sociodemographic determinants of flu vaccine uptake among the Saudi population. A nationwide cross-sectional study is carried out in Saudi Arabia in December 2020, with 1,650 participants taking the survey. Data are collected electronically using a structured questionnaire. Logistic regression analysis is carried out to establish the association between vaccine uptake behavior and sociodemographic characteristics of the study participants. They concluded that efforts to increase flu vaccine uptake should focus on increasing awareness and education regarding the benefits of vaccination, particularly among young individuals.

![Figure3](http://smj.org.sa/https://smj.org.sa/content/smj/44/11/1069/F3.medium.gif)

[Figure3](http://smj.org.sa/content/44/11/1069/F3)

Uptake of flu (influenza) vaccine among the study participants (N=1650).

***see page 1132***

# Case Report {#article-title-4}

**Gastric ectopic pancreas adenocarcinoma.** *A case report and literature review*

Qian et al present a single case with invasive adenocarcinoma caused by the ectopic pancreas (EP) in the stomach. Computed tomography scan shows a pyloric obstruction and thickening of the gastric wall in the gastric antrum; a digestive endoscopic examination shows mucosal congestion, swelling in the anterior pyloric area, and pyloric canal stenosis. A 5.5 x 5.4 cm round-like mass is found during surgery. Pathological examination suggest invasive submucosal adenocarcinoma located under the gastric antrum mucosa. They provide additional clinical experience for diagnosing EP with canceration in the stomach.

![Figure4](http://smj.org.sa/https://smj.org.sa/content/smj/44/11/1069/F4.medium.gif)

[Figure4](http://smj.org.sa/content/44/11/1069/F4)

The first contrast-enhanced axial CT scan of the upper abdomen.

***see page 1174***

*   Copyright: © Saudi Medical Journal

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