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Objective To assess interleukin 23 (IL-23) levels in the sera of psoriatic arthritis (PsA) patients and to determine the relationship of IL-23 with different disease activity indices, physical function and quality of life (QoL). Methods Fifty PsA patients and 46 matched healthy controls were included in this study. Data including a detailed history, a thorough clinical examination, skin severity based on the Psoriasis Area and Severity Index (PASI), the Disease Activity index for Psoriatic Arthritis (DAPSA) and the Composite Psoriatic Disease Activity Index (CPDAI) were obtained for all patients. Physical function was assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI) and health-related QoL was assessed using the Short Form Health Survey (SF-36), Psoriatic Arthritis Quality of Life (PsAQoL) and the Dermatology Life Quality Index (DLQI) were also assessed. Serum IL-23 levels were measured in the studied groups. Results The study included 23(46%) females and 27 (54%) males with a mean age of 42.78±12.33 years. The mean serum IL-23 level was significantly higher in PsA patients (50.89±13.86 pg/ml) than in controls (43.88±6.34 pg/ml) (p=0.006). There were significant correlations between serum IL-23 levels and different grades of DAPSA activity (p=0.007) and PASI (p=0.015). No significant correlations could be detected between serum IL-23 levels and (HAQ-DI, DLQI, SF-36 or PsAQoL). CPDAI and DAPSA were significantly correlated with DLQI, SF-36 and PsAQoL. Conclusion IL-23 is a useful biomarker for identifying joint activity or skin severity but not QoL or physical function.

INTRODUCTION: trauma of the zygomaticomaxillary complex (ZMC) has functional and aesthetic consequences. Management of ZMC fractures is considered one of the most debatable issues regarding classification, diagnosis and surgical technique.Precise management of the ZMC fractures needs accurate diagnosis, accessible exposure, and precise rigid fixation OBJECTIVES: To compare between ultrasound guided closed reduction and open reduction of zygomatic arch in cases of ZMC fracture. MATERIALS AND METHODS:This study was conducted on a sample of twenty patients who had fracture repair of ZMC. Ten of them (study group) were treated via direct peri-orbital approach with the use of intra-operative ultrasound to guide zygomatic arch reduction. While the other ten patients (control group) via coronal approach with open reduction of zygomatic arch. Postoperative patient evaluation was performed with specific attention paid towards zygomatic arch reduction, nerve function, wound healing, and postoperative ocular complications. RESULTS: Radiographic follow up showed no statistical significant difference between normal side and reduced side of zygomatic arch which reflect satisfactory arch reduction among both groups. CONCLUSION: Ultrasonography is an effective method for guiding zygomatic arch reduction with other minimal incisions in cases of ZMC fracture. On the other hand, coronal incisions have advantages of giving excellent access to ZMC fracture with direct reduction of zygomatic arch but with considerable disadvantages.

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Background: Hepatocellular carcinoma (HCC) is the commonest primary cancer of the liver. Incidence is increasing and HCC has risen to become the 5th commonest malignancy worldwide and the third leading cause of cancer related death. According to the BCLC staging system image-guided tumor ablation is recommended in patients with early stage HCC. Microwave ablation (MWA), is a thermal ablative technique that has recently emerged as a new therapeutic option. The aim of this study was to evaluate the use of microwave ablation in hepatocellular carcinoma treatment and to assess the outcome. Methods:This study was carried out on 52 patients proved to have HCC who presented to Radiology Department in Alexandria University Hospitals. Microwave ablation was performed percutaneously under real-time ultrasound guidance using a GE LOGIQ 5 Pro US scanner (USA) with a 3.5-5 MHz probe, to completely destroy the tumor, as well as the surrounding 0.5-1.0 cm normal appearing liver tissue (safety margins). The patients were observed two hours before discharge.Contrast-enhanced triphasic CT imaging needed to be performed at 1 month after the ablation.Results: All patients completed the procedure safely. The outcome, as determined by dynamic CT performed 1 month after percutaneous MWA, was achieved in 66 (97%) of 68 lesions. The technical success rates for tumors smaller than 3 cm and those 3-5 cm were 97.2% (35 of 36 nodules) and 96.9% (31 of 32 nodules), respectively Conclusion: Thermal ablation, including radiofrequency ablation (RFA) and microwave ablation (MWA), have been shown to be effective for treating HCC. Microwave ablation is a safe, effective and