Introduction The postpartum period is one of the important transitional phases in women's life (1). Following serious changes of delivery and transition to parenthood, primigravidas undergo significant physical, social and psychological changes (2). With important physiological and psychological changes such as adapting to changes in the body, woman face maternal role and support of certain people (3). Therefore, mother needs to adapt to new life and newborn care (4). Most of them aren't ready to take care of themselves and their baby with plentiful needs (5). During this stage of adjustment, mother experiences psy-chosocial social imbalances that lead to severe stress (6). The true prevalence of postpartum stress among women is unknown, but studies show that 10% to 15% of women are affected by mental issues including depression, anxiety and stress after delivery (7). Webb et al showed that 69% of women have at least one physical complaint after childbirth (8). Based on the results, 25.71% to 32.38% of women have mild mental disorders during the first 6 weeks after delivery (9) and, in some studies; this figure has even reached up to 44.4% (10). In Iran, 47.5% of nul-liparous women and 67.1% of multiparous are not in a good mental health status (11) and 32% of women experience postpartum stress disorder after delivery (12). Overall , postpartum stress in Iranian women is higher than other countries and is inversely related to social protection (13). Many diseases and problems of women in this period are related to stress or their inability to cope with changes (14). Stress can be a component of any disease. Therefore, understanding the stressors and improving the capacity of the person to be compatible with them is very important (3). Episiotomy and perineal pain, back pain, breast swelling and pain, incontinence, constipation, fatigue, sleep problems and breast problems are the most important physical stressors and the pressure to return to pre-pregnancy weight, sexual changes, concerns about the maternal role, problems regarding the infant (e.g., feeding, crying, care, bathing, unpredictable behaviors of the baby, sucking , neonatal jaundice, sleep disorders, flatulence, inadequate weight gain, eye infection and umbilical infection), relationships with partners and lack of social support are psychological stressors (15-17). Baby care, sexual relationships , self-care, family planning and mental health are women's concerns and educational needs in the postpar-tum period (18). Based on the analysis of various factors, Hung et al found that three factors of maternal role attainment , lack of social support and physical changes are important in the occurrence of postpartum stress (5). Postpartum stresses are determinants of women's health and even threaten child-parent relationship and child Abstract Objectives: Planned interventions can facilitate the maternal role for primiparous women by reducing postpartum stress. The present study aims to determine the effect of home-based supportive-educational counseling on...

ORIGINAL ARTICLE PURPOSE We aimed to evaluate the effectiveness of diffusion-weighted magnetic resonance imaging (DW-MRI) and apparent diffusion coefficient (ADC) values in the diagnosis of acute appendicitis and differentiation of perforated and nonperforated appendicitis cases, with histopathologic correlation. MATERIALS AND METHODSSixty consecutive patients (34 males, 26 females; mean age, 35.6±15.5 years; range, 17-83 years) with a presumptive diagnosis of acute appendicitis were included in this prospective study. With a 1.5 Tesla MRI unit, DW-MRI examinations were performed with b values of 50, 400, and 800 s/mm 2 . The mean ADC values of case and control groups, as well as in perforated and nonperforated groups were compared. RESULTSOf the 60 cases, 44 had a radiological diagnosis of acute appendicitis, and 16 were regarded as normal. Of the 40 patients who underwent surgical operation, 12 had a histopathological diagnosis of perforated appendicitis, and 28 had nonperforated appendicitis. Mean ADC value in patients with acute appendicitis (1.01±0.26×10 -3 mm 2 /s) was lower than the control group (1.85±0.13×10 -3 mm 2 /s) (P < 0.001). Mean ADC value of the perforated group (0.79±0.19×10 -3 mm 2 /s) was lower than the nonperforated group (1.11±0.22×10 -3 mm 2 /s) (P < 0.001). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate of DW-MRI in the diagnosis of acute appendicitis were 97.5%, 100%, 97.5%, 100%, and 98.1%, respectively. CONCLUSION DW-MRI and ADC quantification are effective in the diagnosis of acute appendicitis, both in perforated and nonperforated cases. Magnetic resonance imaging (MRI) is the radiological imaging technique offering the highest soft tissue contrast resolution. Currently, in addition to conventional MRI, other MRI techniques are commonly and routinely used, including diffusion-weighted MRI (DW-MRI). DW-MRI is a functional imaging technique that relies on the measurement of the accelerated or slowed microscopic diffusion movements of protons of water molecules. The images are obtained in short interval times and without the requirement for any contrast medium (1).Recently, studies have reported the use of DW-MRI to show active inflammatory lesions in the bowel. In these reports, the mean apparent diffusion coefficient (ADC) of the inflamed bowel segments were compared with the ADC of normal segments, and statistically significant difference was demonstrated (1, 2). Only one study has been investigated the use of DW-MRI for the diagnosis of patients with acute appendicitis (3). However, this study did not focus on the differential diagnosis of perforated and nonperforated appendicitis cases.The aim of this study was to evaluate the effectiveness of DW-MRI and quantitative measurement of ADC values in the diagnosis of acute appendicitis, and in the differentiation between perforated and nonperforated appendicitis cases, with histopathologic correlation. Materials and methods Patient selectionThis prospective study was performed betw...

Objective: This study aims to examine the association between 18F-fluorodeoxyglucose PET/CT (18F-FDG PET/CT) metabolic parameters of lymph node-positive and lymph node-negative breast carcinomas. Material and method: We included breast carcinomas patients who underwent 18F-FDG PET/CT imaging at our department between May 2018 and December 2019. A total of 108 female breast cancer patients were included (aged 48.8 ± 13.6years; range, 28-84 years). PET scanning was performed in 3D mode from the skull ceiling to the half of the thigh. According to pathology reports, we divided the patients into two groups: a lymph node-positive group of patients and a lymph node-negative group of patients. We calculated the sensitivity and specificity for determining the PET/CT pathological lymph node. Metabolic parameters like TLG (Total lesion glycolysis), MTV (Metabolic tumor volume), SUVmean, and SUVmax values were calculated. Result: The lymph node-positive group’s body weight and body mass index(BMI) were statistically higher than the lymph node-negative group (p=0,027,p=0,022 respectively). SUV max and SUV mean of the lymph node-positive group were statistically higher than the lymph node-negative group (p=0.008, p=0,009, respectively). Both TLG and MTV of the lymph node-positive group were statistically higher than the lymph node-negative group (p=0.01, P= 0.01, respectively). Ki-67(%) of the lymph node-positive group was not statistically different from the lymph node-negative group. We calculated the PET/CT’s sensitivity and specificity as 78,57% and 59,09%, respectively.  For the positive predictive value of PET/CT, we found 55%, and for the negative predictive value, it was 81.25%. Conclusions: PET/CT metabolic parameters of patients with lymph node-positive breast cancer were higher than patients with lymph node-negative. High body weight and BMI appears to increase the possibility of metastases of lymph node. The sensitivity of PET/CT can be considered to be useful in determining the pathological lymph node, but the specificity of PET/CT is not very good.

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Background. Insulin resistance is routinely measured by homeostasis model assessment of insulin resistance (HOMA-IR).Positron emission tomography of 18F-fluorodeoxyglucose combined with computed tomography (18F-FDG PET/CT) is a valuable assessment tool for patients with cancer or staging tumors. 18F-FDG PET/CT imaging can also be utilised to detect the metabolic activity of glucose in the adipose tissue, liver and muscles. The aim of this study was to determine insulin sensitivity in the liver, muscle visceral adipose and subcutaneous adipose tissue separately via18F-FDG PET/CT. Materials and method. Sixty three adult patients who underwent whole body 18F-FDG PET/CT scanning for clinical purposes (diagnosis or staging of cancer) between July and August of 2016 were included in the study. Patients were divided into two groups according to their BMI (Group 1: BMI<25kg/m 2 , Group 2: BMI>25kg/ m 2). HOMA-IR,fasting glucose,insulin, triglycerides, total cholesterol, HDL levels were measured. We calculated SUV as the tissue activity of the ROI (MBq/g)/(injected dose [MBq]/ body weight [g]) on PET images and measured the maximum SUVs (SUVmax) of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT),liver and rectus muscle ROIs (2 cm). SUV corrected by blood glucose level (SUVgluc) was calculated as SUVmax×blood glucose level/100. Student-t test, Chi-square test and Pearson correlation test were used for statistical analysis. Results. Mean glucose,insulin,HOMA-IR levels of the group-2 were statistically higher than of group-1. Muscle SUVmax and liver SUVmax of group-1 were statistically higher than of group-2. Muscle SUVgluc of group-1 was statistically higher than of group-2. HOMA-IR was negatively correlated with both SUVmax(r=-0.340, p=0.01) and muscle SUVmax(r=-0.373, p=0.005) Conclusion. 18F-FDG PET/CT has shown that the muscle tissue maximum FDG uptake was lower in the insulin resistance group. Therefore, 18-FDG PET/CT could be a valuable tool for diagnosing insulin resistance.