in this paper, we consider an M-STEP (M³3) i.e., multiple STEP-stress accelerated life testing (ALT) experiment with unequal duration of time ti (t1<t2<…<tm-1). It is assumed that the time to failure of a product follows Rayleigh distribution with a log- linear relationship between stress and lifetime and also we assume a generalized Khamis- Higgins model for the effect of changing stress levels. Taking into account that the problem of choosing the optimal time for 3-STEP STEP-stress TESTS under compound linear plan was initially attempted by [17]. We ever first have developed a generalized compound linear plan for multiple-STEP STEP-stress setting using variance-optimality criteria. Some numerical examples are discussed to illustrate the proposed procedures.

Cardiorespiratory fitness TESTS have been always paramount and comprehensive evaluator for the different fitness levels. However, these are sophisticated techniques, time consuming, and usually expensive. Design and manufacture of various sport equipments, especially in the field of cardiorespiratory fitness have exceptional importance. The aim of the present study was to design and manufacture a portable multifunction device for estimating the cardiorespiratory fitness for the STEP TESTS. 110 physically active young men (age: 18 to 22 years) have been chosen and divided into 11 experimental (Strand-Rhyming, Billi-Mirwald, Techomesh, Cotton, Queens, McArdle, East-Michigan, Hodkins-Scobik, OSU, YMCA, Harvard STEP test) groups and each group performed a test by the device. Microcontroller-based hardware was designed and programmed with the Basic language. In this device, 11 different standard STEP test programs designed. In order to assess the agreement of the instrument during the different STEP TESTS, the estimated value obtained by the designed device and the routine method (manual procedure and calculations). To assess the reliability of estimated values in different TESTS, the test-retest method was implemented. Results of statistical method using Bland-Altman and Intraclass Coefficient Correlation (ICC) showed that estimated cardiorespiratory fitness using designed device has very high agreement to the criterion (P≤ 0. 001). According to the results, it can be concluded that designed multifunction device can be used as an accurate portable alternative system for estimating cardiorespiratory fitness in STEP TESTS.

Background and aims: The maximum aerobic capacity or VO2max is a measure of the maximum volume of oxygen that can be absorbed by respiratory system and delivered to the acting muscles through blood flow. The aims of this study were to determine the correlation between the two methods of treadmill and STEP TESTS in estimating the maximum aerobic capacity and it's affecting factors among students of Qazvin University of Medical Sciences. Methods: This cross-sectional study conducted among 68 students (47 males and 21 females) who participated voluntarily. First, the participants completed Physical Activity Readiness Questionnaire (PAR-Q) and demographic characteristics, and if they met inclusion criteria, STEP and treadmill TESTS were performed according to Gerkin and ASCM protocols, respectively. Results: The results showed that the mean and standard deviation of maximum aerobic capacity estimated from ACSM and Gerkin protocols were 2. 86± 0. 66 and 1. 86± 0. 32, respectively. Significant and positive correlation were estimated between two TESTS for maximum aerobic capacity via two protocols of ASCM and Gerkin (r=0. 74 and p<0. 001). Also, there were significant associations among maximum aerobic capacity with age, sex, weight, height, and BMI in both ACSM and Gerkin protocols. Conclusion: According to the results of almost the same ACSM and Gerkin TESTS, STEP test can be used instead of the treadmill test to estimate the maximum aerobic capacity. Additionlly, physiological characteristics of the human such as sex, age, height and weight have main roles in maximum aerobic capacity.

60 mesial roots of first and second mandibular molars and 60 buccal roots of first and second maxillary molars with curve angles ranging 10-40 degree were divided into 4 groups of 30. The canals were instrumented as follows: group 1, "STEP back +k-type file"; group 2, "STEP back + k-flex file"; group 3 "Passive STEP back + k-type file"; and grup 4, "Passive STEP back + k-flex type". Then the canal curve angles were measured again with the same method (P<0.01). There was significant difference between "Passive STEP back + K -flex type" compared with the other groups.    

A 25 - years- old man was admitted to the hospital because of fever, chills and jaundice after return from Pakistan. On physical examination he had fever (40' c) and BP of 120170,respiratory rate and pulse rate were 24 and 100 respectively. Heart sounds were normal and there wasn't any pathologic sound in lungs. The sclera was icteric yet there wasn't any signs of anemia 'and no adenopathy was found. In abdomen, hepatosplenomegalywas present and right upper quadrant had tenderness on examination, however, there wasn't ascitis and collateral circulation. Laboratory TESTS performed and revealed leukopenia (3500) and thrombocytopenia (70000) but no anemia, increased liver function TESTS and bilirubin, though normal PT and PTT. Wright, 2 ME, widal was negative. Sonography of abdomen revealed hepatosplenomegaly, still other findings were normal. Because of high fever blood culture performed and parenteral antibiotic started. For bicytopenia and increased liver function TESTS, bone marrow aspiration and additional TESTS, also, carriedout. Markers of viral hepatitis (HAV. HBV. HCV. CMV HBV.HSV) and autoimmune hepatitis were negative and BMA was normal. After five days of admission when the patient was on parenteral ceftriaxone and did not have any fever and felt much better, the result of blood culture reported as salmonella typhi.As a result in patients with fever, jaundice and hepatosplenomegaly it is essential to consider typhoid fever, although the widal test is negative.

The etiology of polyneuropathies varies in the pediatric population, where hereditary or metabolic disorders are far more common than in adults. However, treatable polyneuropathies, also prevalent in these settings, are those to prioritize. Moreover, diagnosing subacute and chronic symptoms in children can be challenging compared to adults. Therefore, selecting the best and most relevant laboratory investigations and paraclinical studies is critical. This taskcan be relatively challenging in countries with limited resources or insurance coverage. This study describe the various types of polyneuropathies found in children and their characteristics and suggest an algorithm for using the best laboratory TESTS in the context of the Iranian healthcare system.

A 46 years old gentleman was admitted to hospital following a 10 months history of sever diarrhea. On examination, the patient appeared as mildly dehydrated though his vital sings were within normal limits. important result TESTS were:Bun=55 mg/dl Na=149 mEq/dl WBC=11.6*103/mlHemoglobin=16.2 g/dCr=3 mg/dl K=3.9 mEq/dl HCT=49.7% Plt=324*103 Tbo/ulNeutr=74%After ten days administration of IV fluid, BUN and createnine gradually became normal (Cr=1.1mg/dl, BUN=14mg/dl).There was no macroscopic or microscopic gastrointestinal pathology in upper and lower endoscopy. We took biopsies even from ileum terminal.We suspected endocrine tumors and pancreatic disorders, so we requested abdominal and pelvic CT scan (IV and oral contrast) and hormonal TESTS such as serum cortisole, metanephrin, normetanephrine, which were all normal. We therefore did an octrotide scan which was again normal.Because almost all organic etiologies of chronic diarrhea were excluded, we focused on neurological and psychological causes of chronic diarrhea. Therefore we consulted with neurologist & psychiatrist and they recommended brain CT scan and EEG which were normal. After complete interview, the psychiatrist diagnosed PTSD and depressive disorder NOS and prescribed imipramin 25 mg/day. After 10 days the chronic diarrhea improved.As we excluded all the organic causes, we concluded likely the patient had IBS with PTSD and depressive disorder NOS.

A 54-year-old woman Para 5 was admitted to the hospital because of increasing abdominal enlargment. She felt well until a year ago, when abdominal distention gradually developed.In abdominal ultrasongraphy a coarse, echogenic liver and ascites was detected, the spleen was enlarged and other intraabdominal organs were normal. Abdominal paracentesis was performed. Serum-ascites albumin gradient was greater than 1.1 gr/dl (high serum-ascites albumin gradient).Laboratory-TESTS for evaluating the etiology of cirrhosis revealed: HBs Ag: Neg , HBc Ab: Neg , Hcv Ab: Neg , Anti HBs: Pos.ASMA (anti smooth muscle antibody):NegANCA (anti neutrophilic cytoplasmic antibody):NegANA (anti nuclear antibody):NegAMA (anti mitochondrial antibody):NegSPEP (serum protein electrophoresis):Normal range The patient had no history of hepatotoxic drug usage.In upper GI endoscopy two columns grade II varicose veins were seen.Based on the history and para clinic evaluation cryptogenic cirrhosis was the most probable diagnosis.The patient underwent medical therapy with furosemide and spironolactone, and in regular follow up amount of ascites was under control.A month ago the amount of ascites increased and several therapeutic paracentesis were performed.Ascites analysis showed high serum-ascite albumin gradient and negative cytology for malignancy.Ultrasonography reported multiple focuses on peritoneal surface with seeding like appearance, cirrhotic liver, enlarged spleen and massive ascites, normal kidneys and uterus and ovaries. Tumour markers measurement revealed:CEA=0.3 (Normalrange=0 - 5ng/ml)aFP=0.4 (Normalrange=0 - 10IU/ml)CA 125=244 (Normalrange= 0 - 35 IU/ml)Abdominal and pelvic CT scan didn't show any tumoural lesion and no paraaortic lymphadenopathy. Trans vaginal sonography reported normal uterus and ovaries. Further tumour marker analysis revealed:Elevated serum level of CA 125to 414 IU/ml CV'CA 15- 3 = 27 (normal = up to 40 IU/ml)JLJCA 19- 9 = 25 (normal = up to 40 IU/ml)A week later level of CA 125 decreased to 262. Therefore we obtained fluctuating level of CA 125, normal CT scan and normal level of other tumour markers.We found in papers from other countries in the same situation that they performed laparotomy but they found nothing except cirrhosis (l).In some articles CA 125 presented as a marker of ascites in patients with liver cirrhosis (2). Some authors suggested that quantification of CA 125 in peritoneal fluid (PCAI25) and serum (SCA125) can differentiate between cancer cases and non cancer disease, and they found that ratio of PCA125 to SCA125 (PIS CA125) was significantly lower in non cancer patients than that in cancer ones. (lf the ratio is upper than five the risk of malignancy increased) (3). We quantified CA125 level simultaneously in peritoneal fluid and serum: PCA125 = 210, SCAl25 = 250, PIS CA125 = 0.84.The ratio of 0.84 was predictive of a benign disease. In an overview to our patient, we had one sonography that reported seeding like appearance in peritoneal surface, but in CT scan no lesion was detected. Fluctuating level (increase decrease) of CA125 and low PIS ratio, normal level of other tumour markers, made us to come to the final STEP oflaparoscopic examination and biopsy to determine whether it is malignant or benign.In laparoscopic examination no cancerous lesion or fibrin deposit or tuberculosis granolurna with normal omentum and cirrhotic liver detected.Multiple biopsies were taken from peritoan beside liver which reported normal (no: 159104).We came to this conclusion that in cirrhotic patient with ascites the elevated level of CA125 with normal level of other tumour markers and low PIS ratio and no malignant finding in imaging is suggestive of a benign process, as described in other articles.More studies on this matter should be performed in order to prevent the unnecessary laparatomies.