In this issueReview ArticleSystematic ReviewOriginal ArticleCase Report
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# Review Article {#article-title-2}

**Molecular pathology of colorectal cancer. *The Saudi situation in perspective***

Alfahed presents an evaluation of the molecular pathology research of colorectal cancer emanating from Saudi Arabia. The verdict is that the data on the molecular alterations in CRC from Saudi patients is at best modest. This dearth of molecular pathology data is aptly reflected in the paucity of molecular markers recommended for testing by the Saudi National Cancer Centre guidelines for CRC management. He concluded that large scale multi-institutional and multiregional translational studies were required to generate molecular data that would inform diagnostic, prognostic, and risk-stratification guidelines for Saudi CRC patients.

***see page 836***

# Systematic Review {#article-title-3}

**Epidemiology of lean/non-obese nonalcoholic fatty liver disease in China. *A systematic review and meta-analysis***

Zhang et al assesses the prevalence and metabolic characteristics of lean/nonobese-nonalcoholic fatty liver disease in China. The prevalence together with clinical features of L/NO-NAFLD in China is analyzed using a random/fixed effects model. Lean or nonobese participants are characterized by the cut-offs of BMI used in original studies. Heterogeneity is identified using meta-regression and subgroup analyses. They included 25 studies for the final analysis comprising 229091 L/NO Chinese adults and 22641 diagnosed with NAFLD. They concluded that the prevalence of NAFLD was slightly lower among the L/NO-NAFLD Chinese population than the global level but has obviously increased recently. In addition, the metabolic profile of L/NO-NAFLD patients was generally better compared to OW/O-NAFLD patients.

![Figure1](http://smj.org.sa/https://smj.org.sa/content/smj/44/9/823/F1.medium.gif)

[Figure1](http://smj.org.sa/content/44/9/823/F1)

The geographical regions of China included in this meta-analysis.

***see page 848***

# Original Article {#article-title-4}

**Comparison of laboratory biomarkers for the prediction of in-hospital mortality and severity of acute pulmonary embolism. *A multi-center study***

Alsubhi et al assesses the specificity and sensitivity of prognostic biomarkers in individuals diagnosed with acute pulmonary embolism. Pulmonary embolism patients are classified into survivor and non-survivor groups. Neutrophil-to-lymphocyte ratio, platelet lymphocyte ratio, and red blood cell distribution width are all recorded and are compared between the groups. The evaluation of mortality prediction, sensitivity, and specificity are carried out by employing ROC. They concluded that multiple parameters have been implicated in the mortality and severity of PE. Their study revealed a statistically significant association between NLR, RDW, and PE mortality. These tests are easily accessible and may provide insights into the mortality associated with PE.

![Figure2](http://smj.org.sa/https://smj.org.sa/content/smj/44/9/823/F2.medium.gif)

[Figure2](http://smj.org.sa/content/44/9/823/F2)

Comparison of RDW in patients with acute PE based on the survival and mortality.

***see page 898***

# Case Report {#article-title-5}

**Wound myiasis by housefly in a patient with pemphigus vulgaris in Riyadh, Saudi Arabia**

Alsaedi et al report a case of scalp wound myiasis in a patient with pemphigus vulgaris caused by M. domestica in Riyadh, Saudi Arabia. Cases of M. domestica myiasis are limited in the literature. They concluded that awareness should be raised regarding the possibility of cutaneous myiasis in Musca domestica in Riyadh, Saudi Arabia. At risk individuals need to be educated regarding wound dressing and prevention of such infestations. Therefore, neglected wounds, chronic necrotic cutaneous lesions, and poor hygiene are favorable conditions for housefly myiasis.

![Figure3](http://smj.org.sa/https://smj.org.sa/content/smj/44/9/823/F3.medium.gif)

[Figure3](http://smj.org.sa/content/44/9/823/F3)

Multiple moving maggots extracted from the ulcer.

***see page 940***

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