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Background: Acute Myeloid Leukemias (AMLs) are neoplastic proliferations arising in hematopoietic precursor cells in the bone marrow resulting in overgrowth of myeloblasts and other cells of myeloid lineage. Notch-1 receptor is a transmembrane protein of type I. Interactions between Notch-1 and its ligands Jagged-1 and Dll-1 result in proteolytic cleavages inside the receptor, followed by the release and nuclear translocation of the intracellular domain (Notch-1-IC). Notch-1 expression was also found in CD34+ bone marrow progenitors and other cells in peripheral blood and bone marrow. Jagged-1 and Delta-like1 (Dll-1) seem to be functionally opposing members of the Notch-1 ligand family; however, their precise methods of action in AML are unknown. Methods: Using flow cytometry, the expression of the Notch-1 intracellular domain and the surface expression of Jagged-1 and Dll-1 ligands on leukemic blasts from newly diagnosed AML patients was evaluated. In addition, protein expression was associated with clinical data, laboratory data, responsiveness to therapy, Disease-Free (DFS) and Overall Survival (OS). Results: Notch-1 was positively expressed in 20% of studied patients. Positive Notch-1 expression was associated with shorter OS (6.1 months) and DFS (3.1 months). Higher Notch-1 expression levels were significantly associated with lower remission and higher relapse rates. In contrary, Jagged-1 protein marker weas positively expressed in 56% studied patients, those patients showed shorter OS (6.6 months) and longer DFS (3.6 months) compared to negatively expressed ones. Higher Jagged-1 expression levels were significantly associated with higher remission and lower relapse rates. Positive Dll-1 expression was recorded in 30 % patients, yet with no significant relationship with OS and DFS rates as well as clinical outcome after therapy. Conclusion: Both Notch-1 receptor and its ligands, Jagged-1 and Dll-1, seem to be implicated in AML pathogenesis, however Jagged-1 has a greater impact on clinical findings than Dll-1. A better prognosis is related with high Jagged-1 surface expression in individuals with AML. Hence, further research is required to acquire a greater knowledge of the modes of action of Notch-1 and its ligands in AML.

Background: Diabetes mellitus (DM) leads to multiple complications that include macrovascular and microvascular complications. Proper management will result in decreased morbidity and mortality. The aim of this study was to evaluate the impact of Physicians and patients’ education on diabetes outcome in primary health care units, Al-Gharbiya Governorate, Egypt. Methods: The study was carried out on primary health care physicians and their assigned patients in Al-Gharbiyah Governorate from October 2015 till October 2017. Study was carried-out in 2 phases. Phase 1 (Physician's phase): A sum of forty of primary health care physicians working in primary health care were recruited in the study. Phase 2 (Patient's phase): Those 200 patients were engaged in an educational program for self-management of diabetes using IDF (International Diabetes Federation) education maps. Results: Knowledge and attitude of physicians were significantly higher after completion of educational program than Baseline. The mean Body mass index (BMI), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP)and Glycated HaemoglobinHbA1cafter 1 year and after 6 months were significantly lower than before and after 1 year than after 6 months. The number of patients who have exercised activities after 1 year and after 6 months were significantly higher than before and after 1 year than after 6 months. Conclusions: The educational program applied in this study led to significant improvement of physician’s knowledge and attitude which helps in providing better care of diabetic patients. The educational program applied in this study led to significant improvement of diabetic patients’ lifestyle and outcome, which will subsequently lead to reduction in diabetic complications.