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Background & aim: Sacrococcygeal teratoma (SCT) is one of the most common neoplasms diagnosed during pregnancy. Sacrococcygeal teratoma is classified into four types according to the location of the lesion. Type 4 tumors are usually diagnosed in the postpartum period and have a higher potential for malignancy. The aim of the present study was to report a case of prenatal diagnosis of sacrococcygeal teratoma. Case report: The patient was a forty-year-old woman with her second pregnancy, who had a cystic lesion in the fetal abdomen without any symptoms in the routine screening ultrasound of the second trimester, and was referred to our center due to this lesion at the gestational age of 21 weeks and 5 days. In the ultrasound performed in this center, a lesion with dimensions (39.5 x 14.3 x 8.62 mm) was detected in the fetal pelvis in front of the sacrum, tumor growth and fetal heart failure were followed up with serial ultrasound. A caesarean section was performed at the 39th week of pregnancy due to the previous caesarean section of the mother, and the baby's surgery was successfully performed 72 hours after birth. The answer to the pathology of adult cystic teratoma was reported and follow-ups of the control indicated the normal and healthy growth of the child. The early diagnosis and monitoring and treatment of the disease were done by using Prenatal ultrasound evaluation. Conclusion: Prenatal ultrasound evaluation was important in both diagnosis and monitoring of tumor growth in order to detect perinatal complications such as heart failure and fetal hydrops. These prenatal assessments can lead to accurate diagnosis and appropriate treatment.

Background & Aims: Moral distress in the nursing profession leads to adverse complications in the workplace. Nurses experiencing moral distress may show symptoms such as confusion, fear, anxiety, and powerlessness, which lead to job dissatisfaction and failure. The present study aimed to assess the correlation between moral distress and demographic characteristics of the critical care nurses in selected teaching hospitals in Tehran, Iran. Materials & Methods: This cross-sectional, descriptive-correlational study was conducted on 200 nurses engaged in the critical care units of selected teaching hospitals in Tehran. The participants were selected via proportionate stratified sampling. Data were collected using the Corley questionnaire, and data analysis was performed in SPSS version 16. Results: The mean frequency of moral distress was 48.96 ± 18.21, which was close to the mean score of the instrument (49). The mean intensity of moral distress was 52.04 ± 18.43, which was higher than the mean score of the instrument (49). In addition, a significant correlation was observed between the frequency of moral distress and department of work (P=0.014). The frequency of moral distress was significantly lower in the ICU-OH compared to the CCU (P=0.040) and ICU (P=0.018), while the difference between ICU and CCU was not significant in this regard. A significant association was also observed between the severity of moral distress and the ward of employment (P=0.030). Moreover, the severity of moral distress was significantly lower in the ICU-OH compared to the CCU (P=0.005) and ICU (P=0.008), while no significant difference was observed between the CCU and ICU. No significant correlations were denoted between moral distress and other demographic characteristics. Conclusion: According to the results, moral distress in the critical care nurses was moderate, which could adversely affect patient care and health of other staff. Therefore, it is recommended that nursing managers and authorities adopt proper strategies for the reduction of moral distress in critical care nurses.

Background & Aims: Failure in proper endotracheal suctioning may lead to hemorrhage, lesions in the tracheal mucosa, infections, atelectasis, and hypoxia, which are associated with increased mortality, length of hospital stay, and treatment costs in hospitalized neonates. Considering that nurses play a key role in the prevention of these complications, the present study aimed to assess the effect of training on the performance of nurses in the endotracheal suctioning of neonates. Materials & Methods: This quasi-experimental was conducted with control groups on 80 nurses, who were selected via continuous sampling, at selected hospitals affiliated to Tehran University of Medical Sciences and Iran University of Medical Sciences (two control hospitals and two intervention hospitals) in 2016. Before the training intervention, the performance of nurses was evaluated using a researcher-made checklist, which was developed with a demographic section and nursing performance section with 30 items based on guidelines and expert opinions. The contents of the checklist and educational contents were assessed and approved by a panel of experts. The performance of nurses was observed by the researcher in three stages. One month after the intervention, the performance of the same nurses was evaluated again by the same researcher in three stages. Results: The score of nursing performance before and after the intervention was 51.38±8.70 and 72.19±4.16, respectively, which indicated a statistically significant difference (P

In this paper, the performance of the buffer layer of Cadmium Telluride (CdTe) thin film solar cell was optimized using SCAPS software. At first, five different buffer layers including CdS, In2S3, ZnO, ZnSe and ZnS with variable thicknesses from 10 to 100 nm have been replaced in the structure of the solar cell and it has been observed. As the thickness of the buffer layer is increased, the efficiency decreases.Due to the increase of thickness light absorption in the structure is increased and less light is absobed in CdTe layer. The reason behinf this incident is described physically. Then the performance of the solar cell with different buffer layers is compared, and the effect of each of the layers on the four main parameters of the solar cell has been investigated. Simulation results show that the ZnS buffer layer has a higher efficiency in all thicknesses than other materials which originates from the fact that the bandgap of this material is bigger than other materials.

Abstract Background & Aim: The birth of a preterm infant is a stressful event for parents and affects the quality of life especially in mothers. The present study aimed to compare the quality of life and sense of coherence among the mothers with term and preterm infants. Methods & Materials: This is a comparative study conducted on 50 mothers with term infant and 50 mothers with preterm infant. Data collection instruments were the WHO Quality of Life questionnaire and SOC-13 questionnaire which were evaluated in the two groups. T test, exact Fisher test, Chi-square and analysis of variance were used to analyze the data on the SPSS software version 19. Results: The study revealed that the sense of physical health among the mothers with term infant was higher than that of the mothers with preterm infant (P

Introduction: Parry-Romberg syndrome, a rare syndrome, is characterized by progressive atrophy affecting one side of the face. This disease can include the skin, subcutaneous tissue, muscles, cartilage, and underlying bony structures. Case Presentation: A 27-year-old female was admitted to the outpatient clinic of dermatology of Farshchian Hospital, with chief complaint of asymmetric facial appearance. The asymmetry started at the age of 16 and developed over a period of 4 years, then stopped. A physical examination revealed that the right side of her face, especially her chin was smaller than the left side, and there was loss of subcutaneous fat, which was associated with skin tightness. There were no systemic symptoms of other illnesses or other signs. Conclusion: The disease is self-limiting, yet, can be associated with systemic involvement such as neurological disorders. Clinical symptoms are the keys of diagnosis. A muli-lateral approach is essential to control the disease.

Abstract Background & Aim: Child sexual abuse is a serious social problem which is a priority health issue in many countries due to profound impact on child’s growth and personality. This study was conducted to explain the effect of child sexual abuse prevention education program on knowledge, attitudes and practices of parents with children aged 6 to 12 years. Material & Methods: A quasi-experimental study was conducted with a pretest-posttest design with the control group. A convenience sampling method was used to recruit a sample of parents referring to Health Centers in Aligoudarz, Iran. Participants were recruited and enrolled in the experimental (n = 50) or control group (n = 50). This study was conducted using Persian version of “Child Sexual Abuse” (CSA) questionnaire. The experimental group received education about identifying different types of child sexual abuse and preventing methods, focused on the importance of family and the role of parents in the prevention of sexual abuse and providing self-protection training for children. Different methods including questions and answers, group discussion, lecture, educational film, brochures and booklet were used to educate parents during the four (60 minutes) sessions. Data collecting took 6 weeks after intervention from parents in both groups and data analyzing have been done via paired and independent samples t-test, chi-square and fisher tests using SPSS software (version 16). Results: The results showed significant difference in terms of the mean scores of knowledge and performance of parents after 6 weeks of training (P

Abstract Background & Aim: Children under mechanical ventilation are at risk of developing pneumonia, due to the lack of cough reflex, swallowing and immobility. Many of the pneumonia preventing strategies related to ventilation are direct responsibilities of clinical nurses. The aim of the study was to evaluate the performance of nurses in the field of oral care in the children under mechanical ventilation. Method & Materials: The research was a cross-sectional- descriptive study and 100 nurses from pediatric intensive care unit were selected by using convenience sampling, during 2015. The instruments were including the demographic characteristics form and three types of performance checklist related to oral care guideline in the children under mechanical ventilation. The performance of each nurse was observed and examined by one of the three check lists for three times in different shifts. Then the performance of nurses was classified at three levels including less than 50%, between 50% - 74.9% and also 75% and above. Statistical analysis was performed using descriptive statistics. Results: More than half of nurses (67%) obtained below 50% of the mean performance score, 24% of them received 50% -74.9% of the mean and only 9% of them reached to 75% mean performance score. The most items related to wearing gloves (0.98) and the lowest was brushing (0%). Conclusion: The nurse’s performance in oral care was poor, hence it is necessary to design education course for nurses, provide proper facilities of evidence-based protocols in improvement of the quality of clinical care and conduct research about the causes of poor performance in nurses.

BACKGROUND AND OBJECTIVE: Menopause plays a pivotal role in women’s life comprising of approximately one third of it. Nevertheless, few studies have focused on the significance of this period. This study aimed to determine the age of menopause and its associated factors in postmenopausal women in Babol, Iran METHODS: This cross-sectional study was conducted by cluster sampling on 300 postmenopausal women identified by doorstep questioning of the homes in selected areas. The questionnaires consisted of information on the menopause age, body mass index (BMI), age at menarche, first pregnancy age, duration of hormonal contraceptive use, left-handedness, occupation, menstrual regularity, exercise, smoking habits, couple’s education degree, marital status, family size and the number of births and abortions. The collected data were registered into checklists and The Holmes & Rahe Stress Scale was used for the assessment of the variables. FINDINGS: In total, the average age of menopause was 50.02±0.21 years, the average length of marriage was 42.10±0.63 years, age at last pregnancy was 35.15±0.35 years and the lactation duration was 106.02±3.5 months. A significant correlation was found between the length of marriage, age at last pregnancy, stress scores, lactation duration and the menopause age (p

Abstract Background & Aims: Sexual abuse is the most damaging type of abuse which has been increased significantly in recent decades so prevention of sexual abuse is crucial. This study aimed to determine the knowledge, attitude and practices of parents regarding child sexual abuse prevention program in elementary school and preschool children. Material & Methods: In this descriptive study, 536 parents of elementary and preschool children in schools of Arak, were enrolled by cluster random sampling. Data was collected by child sexual abuse (CSA) questionnaire and analyzed descriptive statistics using SPSPC (v. 16). Results: The results showed that of all parents, 343 (66%) had good knowledge and 177 (34%) had poor knowledge about the prevention of sexual abuse of children. Of all parents, 383 (80.63%) had good attitude and 92 (19.37%) had poor attitude toward prevention education of sexual abuse. Also 456 parents (85.71%) had good performance and 76 parents (14.29%) had poor performance regarding prevention of sexual abuse. Conclusion: Considering the poor knowledge a one third of the parents regarding the prevention of sexual abuse, providing strategies to increase their knowledge seem necessary.

Abstract Background & Aim: Nowadays hospitals bear with the financial and human costs because of nurses’ turnover. Many factors affect nurses’ turnover and work-family conflict is one of these variables. Thus, the purpose of this study is determining the relationship between work-family conflict and intention to leave among nurses. Material & Methods: It was a descriptive, cross-sectional study. A total of 257 nurses working in Emam Khomeini, Firouzgar, and Day & Hashemi Nejad hospitals in Tehran who were selected by stratified random sampling participated in the study. Data was gathered via Carlson et al. and Tei & Yamazakei standard questionnaires. Data analysis performed by Structural Equation Modeling, Path Analysis, and Independent T-Test via LISREL and SPSS-PC (v.16). Results: Path Analysis showed that work-family conflict had a positive significant relationship (β= 0.9 ) with intention to leave among nurses (P

Abstract Background & Aims : Leukemia as the most common childhood cancer, not only for children, has created a serious challenge for the whole family, especially parents, it could change their quality of life. This study aimed to examine quality of life of parents of children with leukemia and related factors. Material & Methods : This was a descriptive study in 2012 on parents of 200 children with leukemia referred to the hospital affiliate d to Tehran University of Medical Sciences, selected by consecutive sampling. Data were collected using the Caregiver Quality of Life Index Cancer Persian (CQOLC-P) and demographic questionnaires of parents and children with 1 to 15 years old. Outcomes analyzed using descriptive statistics (independent t -test, ANOVA and linear regression) in SPSS- PC version 16. Results: The results showed that the mean of quality of life of subjects is less than 50% of total score of quality of life . Furthermore, there was significant relationship between gender, income job status and quality of life (p ≤0.05) . Discussion and Conclusion: According to the finding, inappropriat e quality of life of parents of children with leukemia, education of parent about way of care of child and recognizing their problem for specific guidance for dealing and coping with the situation are essential. Received: 6 March 2013 Accepted: 28 May 2013

In this research, MCM-41 molecular sieve was synthesized, and was characterized by XRD, FT-IR, TG and BET techniques. The ability of the adsorbent towards Sr2+ was then investigated. In order to increase the adsorption capacity of the molecular sieve, the sample was modified by 3-amino propyltrimethoxysilane. The modified MCM-41 was used for the Sr2+ removal at different experimental conditions. The effect of different parameters including pH of the solution, contact time, initial concentration of Sr2+ and temperature were also studied. We concluded that the adsorption of Sr2+ increases as the initial pH of the solution increases. The maximum adsorption capacity of 6.0 mg/g obtained.

BACKGROUND AND OBJECTIVE: The postpartum period is associated with great changes in womens quality of life. These changes can influence mother-baby health. Regarding the importance of quality of life and postpartum, and effective factors on postnatal quality of life including the mode of delivery, this study was conducted to compare quality of life in women after vaginal delivery and cesarean section at 8 weeks postpartum. METHODS: In this prospective analytic study 420 pregnant women aged 16-35 years who referred to health center without history of general medical conditions, psychological and pregnancy problems, drug intake, and without experiencing stress at 9 past months were recruited using nonprobability sampling. Subjects completed Edinburgh Postnatal Depression Scale (EPDS) during the third trimester pregnancy and subjects with EPDS score>12 were excluded from the study. From 290, 148 in normal vaginal delivery group and 142 in cesarean section group were followed up at 8 week postpartum. Quality of life in physical, psychological, social, environmental and overall domains was assessed and compared using WHOQOL BREF questionnaire. FINDINGS: At 8 weeks postpartum in NVD group the mean score of quality of life was 75.01±11.74 for physical domain that was significantly higher than the mean score of QOL for physical domain in C/S group (70.54±10.48) (p=0.000). In NVD group the mean score of quality of life was 73.14±14.71 for psychological domain that was significantly higher than the mean score of QOL for psychological domain in C/S group (69.23±13.71) (p=0.024). There was no statistically significant difference between two groups in social, environmental and Overall domains.CONCLUSION: According to the results of this study, the score of quality of life in NVD group was better than C/S group on physical and psychological domains health care provider for correct choice of mode of delivery can be effective in reducing elective cesarean and improving quality of life after delivery.

Introduction & Objective: There are too many disagreements about the effects of gender and sex hormones on the behavioral responses to noxious stimuli and morphine analgesia. The purpose of this study was to determine the different effects of testosterone and gonadectomy conditions on pain and morphine-induced analgesia, using the formalin test. Materials & Methods: The present study was conducted at Razi University, in Kermanshah. Sixty three male NMRI mice were divided into nine groups (n=7). The effects of gonadectomy and testosterone on responses to noxious stimuli were evaluated in five groups (G1 to G5). The effects of these factors on morphine-induced analgesia were investigated in other groups (G6 to G9). According to grouping, each group received normal saline, testosterone, testosterone solvent or morphine and some groups were also gonadectomized and separately received these agents. Finally, the formalin test was taken from all groups. Data were statistically analyzed by one-way ANOVA. Results: The results showed that the response to the painful stimuli had no significant difference in 5 minutes (acute pain) in all groups. Testosterone increased the response to the noxious stimuli in sub acute pain (10-30 minutes) and chronic phase (15-60 minutes) stages. This increase was significant in the group receiving testosterone compared with the gonadectomized group in both stages. In the presence of morphine, there were no significant differences in response to painful stimulus in 5 minutes (acute pain) in all groups. But testosterone in the presence of morphine caused an increased in pain score in sub acute pain (10-30 minutes) and chronic phase (15-60 minutes) stages. Conclusion: Testosterone increased the response to the painful stimuli in sub acute and chronic pain stages. Testosterone also reduced morphine-induced analgesia in peripheral and chronic pain stages in mice.

Prenatal care utilization is a very important factor in improving pregnancy outcomes and maternal health infant. In fact, barriers to prenatal care utilization have been linked to inadequate prenatal care and poorer health outcomes. The purposes of this study were to assess prenatal care utilization and factors affecting to receive prenatal care. The aim was to examine the relationships between demographic variables and other selected variables to the adequacy of prenatal care utilization (APNCU) among women. The design of study was descriptive cross-sectional study. The pupolution of the study was recepient of prenatal care that attending to the two Health Centers of Iran University of Medical Sciences. The samples size was 400 women that were selected consecutively from the year of 1383 to 1384. The age of children of the subjects was maximum 1 year old. In this study, the prenatal care utilization (APCU) was assessed by Kotelchuck’s index. The finding indicated that 83% of the women had inadequate or intermediate utilization of prenatal care services. According to the factors affecting the prenatal care utilization, women who agreed that prenatal care was important, utilized the services significantly more than other women (P=0.005). There were significant relationships between utilization of the services with women age (P=0.001), husbands' age (P=0.016), job (P=0.000), number of family members (P=0.002), number of children (P=0.006), income level (P=0 . 053) and gestational age (P=0.000). Despite improvements in prenatal services, a great number of women do not receive prenatal care adequately. Some of the factors from the subjects perspectives were, lack of information concerning how to obtain care, time of providing care and lack of confidence of care providers. Barriers to prenatal care varied by demographic group therefore, identifying the characteristics of the recipients (clients) who need prenatal care seems important, regarding to reduce barriers of utilization prenatal care.

Sleep pattern has changed dranatically during recent centuries. In fact the lack of coordination between children’s sleep pattern and school time schedule, expose them to insomnia which daily fatigue and influence on their health. The design of this study was cross sectional. The aim of the study was assessing sleep pattern in school age children and the relationship between sleep pattern and some variables such as age, and sex. The study analysis based on the results of 900 school age children for whom mothers have completed a related questionnaire and participated in an interview. The result indicated that Mean and standard deviation of bed time 10.53 (0.90)h and wake- up time in the morning was 6.69(0.73). The mean and standard deviation of total sleep time was 8.82(1.23). A considerable proportion of the children (49.2%) have been sleeping less than 9 hours during nights. In addition, there were significant relationships between the variables of the sex and age with the children's sleep pattern. To conclude, the findings showed that the children don’t have normal amount of sleep. Therefore, it would be necessary that the time of school hours being matched with the developmental stages of children and it was recommended that to investigate sleep pattern of children in different ages in the future studies.

Daytime fatigue and somnolence may be the results of parasomnias, and when they occur frequently the problem gets worse, therefore, to examine the prevalence of parasomnias and it’s relationship with, age, gender, parental educational level and parental stress, we performed a cross sectional study with the participation of 900 children for whom, their mothers completed questionnaires. The most frequent types of parasomnias were restlessness (36.7%), somniloquy (27.9%), and bruxim (26.9%), and some types were related to age, gender, parental education and stress (P=0.005). Overall, as a great majority of children experience parasomnias at least once a weak, the researchers recommend a study in which, the duration of sleep and daytime fatigue to be assessed, and also, behavioral disorders of children with parasomnias to be evaluated .

The quality and quantity of sleep is mainly based on sleep habits. Improper sleep habits are hazardous for health and wellbeing even in adulthood and after that. So, to determine the prevalence of sleep habits and the relations between these habits and factors such as age, gender, parental education, stress and sleep disturbances, a cross sectional study was conducted with the participation of 900 children between the age of 6-11. The CSHQ questionnaire was the tool for data gathering and both mothers and children filled it up. According to the findings daytime sleepiness with the score of (13.67±2.77) was the most prevalent habit and the need to be awakened by the parents was the most prevalent behavior (86%). There were significant relations between some habits and age, gender, parental educational level, parentral interrelationship and their sleep disturbances (P

With dramatic increasing number of sudden deaths from coronary artery diseases and the importance of time saving in those with cardiac arrest, public teaching about basic resuscitation is a vital issue. So, to assess the impact of basic cardiopulmonary resuscitation training on knowledge and skill level of grade 3 high school students, a quasi-experimental study with 90 subjects of case and control groups was conducted. As the result we found statistically significant difference between scale mean of knowledge and skill in case and control groups after training (P=0.000) and the same result was shown between pre and post tests in case group (P=0.000), as a whole, 53.32% of the case group were able to do step by step cardiopulmonary resuscitation in a correct way. According to the results we suggest a cooperation between ministries of health and education to provide rescue educational programs.

Background: Stress incontinence is the most common types of urinary incontinence in women and the second factor for permanent incontinence in old women, which effects on their health and quality of life. Basic treatment for this problem is pelvic floor exercises. Usage of vaginal cones is an effective intervention for prevention and treatment of urinary stress incontinence. Objective: To determine the effect of cone therapy on urinary stress incontinence. Design: This was a before– after clinical trial without control group. In which subject, used vaginal cones (20 to 70 gram) twice a day each time for 15 minutes during 3 months except on menstrual period. Data were evaluated by assessing the pelvic floor strength, through perineometery, and the number and amount of leakage during stress, through self reporting before and after cone therapy. Sample: 53 patients were selected consecutively. Result: The findings indicated a significant decrease in frequencies and amount of urine leakage after cone therapy (P< 0.0001), and 45.3 percent of subjects cured completely. Conclusion: The results showed that cone therapy is an effective method for the treatment of urinary stress incontinence. Therefore, it is recommended that cone therapy be used as a supportive treatment for this problem.

Background : Hospitalization is an anxiety producing event for children and their families, There are many strategies to reduce the anxiety of hospitalized child one of which is play. Objective : To determine the effect of Play on the anxiety of hospitalized children. Design : This study was a randomized clinical trial with control group. At the beginning of trial the anxiety of both groups were measured by "spiel Berger's questionnaire". Then the children of trial group had the chance of playing in play room for half an hour. One and five hours after playing both groups completed the same questionnaire again. Samples : 92 school age children in hospital were randomly assigned in two groups. 46 in control group. Results : The findings indicated that the play reduced the anxiety of children in case group after one hour, but the effect of play did not last long (5 hours afterwards).. Conclusion : We can decrease the anxiety of hospitalized children by providing play room. Nurses should provide opportunity for hospitalized children to play. For the continuity of play it is suggested that the hospitals' play rooms be active during day. It id recommended that effect of play on anxiety of hospitalized children who are isolated or on complete bed rest or are in ICU be assessed

Background : Child hospitalization is one of the anxiety producing factors for both the child and his/her parents. Anxiety will delay the child recovery and decrease the parent's abilities in caring for their children. The anxiety may be present long after discharge. Objective : To determine the level of maternal anxiety after child's hospitalization and also before and after child's discharge from hospital. Design : This was a longitudinal study. The level of mother's anxiety was measured using spilbarger questionnaire at three stages of after hospitalization, before and after child's discharge . Samples : 70 mothers of hospitalized children (age 1-3) were selected through continuo's sampling. Results : There was a significant difference between the level of mother's anxiety after child hospitalization and before and after his/her discharge (PV= 0.000). Conclusion : According to mother's anxiety in three stage (after hospitalization, before and after discharge) researcher recommend that nurses, take a complete demographic history of mothers at the time of admission so that they can plan a program to decrease mother's anxiety and also provide them with a telephone number so that in case of any question they can in touch after their child's discharge.

Background : Hospitalization is a fear producing even in children and their families. There are many ways to reduce the fear of hospitalized children, one of which is play, but it's effect is not longstanding. Objective : To determine the effect of play on the fear of hospitalized children. Design : This study was a randomized clinical trial with control group. At the beginning of trial the fear intensity of both groups were measured by Broom's questionnaire. Then the children of trial group had the chance of playing in play room for half an hour. One and five hours after playing both groups answered questionnaire again. Samples: 82 school age hospitalized children were randomly assigned in two groups. Forty six children in control group (without play) and 46 in case group (with play). Results : The finding indicated that the play reduced the fear of children in case group after one hour (p= 0.026), but the effect did not lasts long (5 hours afterwards). Conclusion : By providing play room in children's ward we can decrease the fear and anxiety of hospitalized children. Play is the ''work'' of children. Nurses should provide opportunity for hospitalized children to play. For the continuity of play it is suggested that the hospitals, play rooms be active during the day.

Background: Growth monitoring (GM) is an internationally accepted tool for early, detection of growth disorders and prevention of malnutrition. GM is a systematic process composed of five parts, weighing the child, drawing the growth chart and interpreting it, and consulting mothers about caring for their children with normal growth and also educate those whose children have abnormality with their growth. . Objective: To determine the growth monitoring skills of the health workers in health centers in west of Tehran. Design: This was a descriptive study in which the data were collected about GM skills of the health workers by directly observing them and indirectly asking the mothers whose children were monitored. Sample: 36 health workers from 24 health centers in west of Tehran were observed while monitoring 112 children. Results: Considering the five parts of growth monitoring process only one of the health workers scored 100% and did all parts correctly. 22.4% did non of the parts correctly. 75% had difficulty performing at least one of the five parts correctly. Conclusion: GM is an important strategy in primary health care delivery. By highlighting the strengths and the weaknesses of the health workers in this study continuing education and also further evaluation of their performance in different areas and different levels are suggested.

Regulation of body heat and it's relation to the neonatal mortality and morbidity rate is of great importance, considering the high incidence of hypothermia amongst neonates specially preterm infants. As a whole the knowledge and skills of health team personnel play an important role in regulating infant's body tempreture. Maintaining the right tempreture of neouatal unit, screening the neonates at risk and caring for those who need to be cared is of a special value. The question of hyperthermia following hypothermia needs a great deal of attention in neonatal units.