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Synacthen test: ACTH promotes secretion from adrenal cortex. Synthetic ACTH is used in synacthen test. this help to identify problem in cortisol deficiency due to adrenal cause or due to central ACTH secretion. Short synacthen test detect problem in cortisol secretion due to adrenal gland defect or ACTH deficiency. Long synacthen test differentiate between them. Short Synacthen test  Principle:: Administration of tetracosactrin [synthetic adrenocorticotrophic hormone (ACTH) or ‘synACTHen’] allows the acute adrenal response to ACTH to be assessed. In addition to promoting cortisol secretion, it also increases the production of other ACTH-dependent steroids (eg androgens) in the biosynthetic pathway and hence can be used to exacerbate the enzyme block in differing types of congenital adrenal hyperplasia (CAH) thereby helping to confirm/exclude the diagnosis in patients with equivocal basal values. Indications • 1.Diagnosis of primary (and secondary) adrenal insufficiency. 2.Diagnosis...

Human Papilloma Virus HPV vaccination readers instruction: 1. all the information are from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/147832/Green-Book-updated-140313.pdf 2. important points are highlighted, just go through these. Human papillomavirus (HPV) is a double stranded DNA virus , that infects squamous epithelia including the skin and mucosae of the upper respiratory and anogenital tracts. There are approximately 100 types of HPV, of which about 40 infect the genital tract (McCance, 2004). Although most infections are asymptomatic and self-limiting, genital infection by HPV is associated with genital warts and anogenital cancers in both men and women. HPV viruses are classified as either ‘high-risk’ or ‘low-risk’ types depending on their association with the development of cancer. Genital HPVs are transmitted by sexual contact with an infected individual, primarily through sexual intercourse. The risk therefore,...