Omicron, a severe acute respiratory syndrome coronavirus-2 variant, has spread around the globe, causing dramatic increases in infection rates. Viral mutant antigens were responsible for the strong infectivity, fast replication, and high reinfection rates reported from all ages. Omicron causes clinical symptoms mostly related to the upper respiratory tract with minimal symptoms from the lower respiratory tract besides an urgent presentation of cases that resembled a fatal illness, epiglottitis. Not to mention the long coronavirus disease 2019, which rises exponentially in the Omicrons era. Apparently, the disease has a less aggressive course than earlier variants with lower death rates; however, the infection is not trivial. Severe infection was raised among pediatrics, unvaccinated, and the elderly. Complete vaccine protection is urgently needed to protect the most vulnerable community members. Additionally, self-protective strategies such as wearing a mask and safe social distancing cannot be omitted.

AIM: To determine the value of the combination of thin-section 3 mm ‎coronal and standard ‎axial DWI and their impact in facilitating the diagnosis of ‎‎acute brainstem infarction. METHODS: A cross-sectional study conducted from the 1st of April 2017 to the end of February 2018 on 100 consecutive patients (66% were male, and 34% were female) with isolated acute ischemic infarction in the ‎brainstem. The abnormal MRI findings concerning the ischemic lesions were interpreted on standard axial 5 mm and thin-section coronal 3mm DWI. RESULTS: The mean age of the studied group was 69.2 ± 4.3 for male and 72.3 ± 2.5 years. The standard axial DWI can diagnose 20%, 6.7% and 6.7% of the infarctions in midbrain, pons and medulla oblongata respectively, while both axial and thin coronal sections together can diagnose 80% of midbrain infarctions, 93.3% of pons infarctions and 93.3% of medulla oblongata infarctions. Furthermore, the thin section coronal 3 mm section can diagnose very smaller ischemic lesion volume in comparison to the standard axial 5mm section (3.4 ± 0.45 / cm3 versus 4.6 ± 0.23 / cm3, P < 0.001) CONCLUSION: The addition of thin-section coronal DWI can facilitate the detection of brainstem ischemic lesions. We suggest its inclusion in the stroke MRI protocol.

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Background: Early detection of aortic aneurysms is challenging in hypertensive patients due to the high risk of life-threatening ruptures. Limited studies on the relationship between coronary artery calcium and aortic diameter are present. This study evaluated the correlation between coronary artery calcium score (CACS) and maximal thoracic and abdominal aortic diameters in hypertensive patients, using a noncontrast CT scan. Material and methods: We prospectively enrolled 180 hypertensive patients older than 45 who had no aortic aneurysm or heart disease. We split the study population into five classes according to CACS (0, 1-10, 10-100, 100-400, and > 400). We calculated coronary artery calcium and maximal diameters of the ascending thoracic aorta (ATA MAX ), descending thoracic aorta (DTA MAX ), and abdominal aorta (AA MAX ) using native computed tomography imaging. Results: Coronary artery calcium score was high in patients with high abdominal aorta diameter but not with the high diameters of the thoracic aorta. The cut-off point of the abdominal aorta's maximum diameter was 34 mm, so AA MAX > 34 mm is predictive of a diagnosis of CACS category five (CACS > 400). There were no differences in ascending and descending thoracic aorta measurements between patients with a coronary artery calcium score of more than 400 (category 5) and the rest. Conclusion: Screening for an abdominal aortic aneurysm is essential in hypertensive patients as the coronary artery calcium score is associated significantly with increased abdominal aorta diameter. However, the necessity for thoracic aortic aneurysm screening is not apparent in these patients as no significant association is found between CACS and thoracic aorta diameter.