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If the LP needle is inserted too far anteriorly, CSF can be contaminated by chondrocytes or bone marrow cells from the intervertebral disc or vertebral body, respectively. [3] Other non-neoplastic cellular elements that may be seen in the CSF include squamous cells, meningothelial cells, brain fragments, choroidal cells, ependymal cells, and hematopoietic elements from bone marrow or peripheral blood. [...]this case is highlighted to alert cytopathologists to the presence of extraneous cartilage in CSF which is a potential mimicker of malignancy and thus a diagnostic pitfall.

Cardiovascular diseases (CVDs) are evolving as a cause of mortality and morbidity among young adults. Young adults, particularly those pursuing professional courses in colleges, face unique challenges that may influence their risk of developing CVD. Despite screening guidelines, CVD risk factors often go undetected in the young population, highlighting the need for increased awareness among adolescents. Sleep is an essential indicator of well-being, and its impact on cardiovascular risk factors is increasingly being recognized. An observational cross-sectional study was conducted among young adults aged 18 to 24 years pursuing professional courses in Dehradun, Uttarakhand, India. A total of 156 participants were recruited through multistage, systematic random sampling, and snowball sampling. Data on sleep patterns and cardiovascular morbidity were collected using a pretested questionnaire. Among the study participants, 46.8% reported having less than four hours of sleep on average, and 25% were suffering from sleep problems. The prevalence of diagnosed CVDs was low, with 6.14% reporting arrhythmias and 3.84% reporting hypertension. An association was found between sleep duration, sleep problems, and the presence of CVDs. Participants with shorter sleep durations and more severe sleep problems had a higher prevalence of CVDs. The findings suggest that sleep duration and sleep problems may be modifiable risk factors for CVDs among young adults. Effective health promotion activities focusing on behavior and lifestyle modifications are essential to preventing CVDs from an early age. The study emphasizes the importance of early intervention and health promotion strategies to reduce CVD risk factors in this population. Community-based research and behavior change communication initiatives are recommended to promote healthy sleep habits and prevent cardiovascular diseases among young adults beyond the college setting.

Objective Evaluation and management of small bowel disorders have always been challenging due to the limitations of the existing technology. Motorized power spiral enteroscopy (PSE) is an innovative new technique that offers easier, faster, and more complete small bowel evaluation with the ability to perform therapeutics. We aimed to evaluate the safety and efficacy of PSE in various indications. Methods Retrospective analysis of prospectively collected data of consecutive patients, who underwent PSE at a tertiary care center. Primary outcome measures were technical success rate, pan‐enteroscopy rate, diagnostic and therapeutic yield, and the secondary outcomes measures were the depth of maximal insertion, median insertion time, and adverse events. Results Fifty‐four patients (mean age of 49.38 ± 16.26 years) underwent PSE for small bowel evaluation. Technical success rate was 95.55% (antegrade route) and 93.10% (retrograde route).  Pan‐enteroscopy rate is 46.29% and antegrade enteroscopy to the cecum was achieved in eight patients.  Overall diagnostic and therapeutic yields were 85.18% and 30.76%, respectively. The most common findings were ulcero‐stricturing lesions (51.92%) followed by vascular lesions (9.61%). The most common histopathologic diagnosis was Crohn's disease in 29.62%. Median depth of maximal insertion was 400 cm (range 150–550 cm; antegrade route) and 180 cm (range 50–350 cm; retrograde route). The median insertion time to depth of maximal insertion was 70 min (range 30–110 min; antegrade route) and 45 min (range 20–70 min; retrograde route).  PSE‐associated major adverse events occurred in one patient and minor adverse events were seen in 48.14%. Conclusion PSE is a safe and effective modality for the evaluation of small bowel disorders with a high diagnostic yield.

{Figure 2} Pilomatrixoma (PMX), also known as “pilomatricoma” or “calcifying epithelioma of Malherbe,” is an uncommon benign slow-growing neoplasm originating from pluripotential cells of the outer sheath cell of the hair follicle root. The clinical differential diagnosis for head and neck pilomatricoma includes a sebaceous cyst, ossifying hematoma, chondroma, degenerating fibroxanthoma, giant cell tumor, foreign body reaction, dermoid cyst, osteoma cutis, squamous cell carcinoma, basal cell carcinoma, amelanotic malignant melanoma, and metastatic bone formation. [...]the present case highlights the importance of considering pilomatricoma as a differential diagnosis of any dermal/subcutaneous nodule in any age and locations other than head and neck.

The Government of India has promoted the expansion of access to and uptake of intrauterine devices (IUDs), during both the interval (IIUD) and postpartum (PPIUD) periods, as part of its Family Planning 2020 initiative. This study, conducted by EngenderHealth as part of the Expanding Access to IUD Services in India project, examines IIUD and PPIUD continuation rates over time and investigates factors associated with IUD continuation. We recruited respondents (N = 5024) through a repeated cross-sectional household study between February and December 2019. We identified respondents using IUD client data from public health facility registers in 20 districts of Gujarat and Rajasthan. We compared continuation rates for IIUD and PPIUD adopters and used regression analyses to measure the association between continuation and demographic, quality of care, and counselling variables. IIUD continuation rates decreased from 85.6% to 78.3% and PPIUD rates decreased from 78.5% to 70.7% between month 3 and month 12. Clients experiencing side effects or other problems were 15 times more likely to discontinue IUD use than clients who did not. Clients who received IUD counselling prior to insertion were more likely to continue than those who did not. IUD continuation increased significantly in cases where both partners jointly selected the method compared to situations where women decided alone. Several sociodemographic factors were associated with continuation. Our study demonstrates the value and benefits of programmes offering IUD services emphasising quality counselling and client-centred care to increase access, uptake, and continuation.

Background: To accelerate progress toward Family Planning 2020 (FP2020) goals, the government of India focused on improving the quality of intrauterine device (IUD) services. EngenderHealth, an international sexual and reproductive health and rights organization, has been supporting the governments of Gujarat and Rajasthan since 2014 through the Expanding Access to IUD Services in India (EAISI) project by building the capacity of service providers, monitoring compliance with standard practices, and strengthening health systems. This study sought to assess whether EAISI-trained providers offer higher quality IUD services than non-EAISI-trained providers, as indicated by a reduction in confirmed IUD complications. Methods: The study team conducted an analytical cross-sectional study of secondary data collected from follow-up registers at 176 intervention facilities (38 in Gujarat and 138 in Rajasthan) during Phase I of the EAISI project. The analysis included follow-up clients who returned to the same facility between April 2018 and March 2019. We performed a multivariate logistic regression to determine factors associated with IUD complications. Results: During the period of assessment, 56,733 clients received IUD insertions, and 10,747 (18.9%) clients returned for follow-up services. Of the returning clients, 49.4% (N=5,305) had received IUDs from EAISI-trained providers, while 50.6% (N=5,442) had received IUDs from non-EAISI-trained providers. A total of 4.0% (N=432) of all returning clients experienced complications (expulsion: 1.3%, missing strings: 1.7%, infection: 1.1%). Clients who received IUDs from non-EAISI-trained providers were 55.5% more likely (95% CI [26.2%, 91.5%], p<0.0005) to have experienced complications than clients who received insertions from EAISI-trained providers. The type of IUD, the timing of the insertion, and the timing of the follow-up visit also affected complication prevalence. Conclusion: Our findings indicate that intensive, practical clinical skills training for IUD insertion can reduce the prevalence of complications.

Background: For accelerating its progress towards FP2020 goals, the Government of India has focused on improving the quality of intrauterine device (IUD) services. EngenderHealth has supported the Governments of Rajasthan and Gujarat since 2014 through its Expanding Access to IUD Services in India (EAISI) project by building the capacity of service providers, monitoring their compliance with standard practices, and strengthening health systems. This study sought to assess whether EAISI trained providers provide a better quality of IUD services as compared to non-EAISI trained providers, as indicated by a reduction in confirmed IUD complications? Methods: This study was an analytical cross-sectional study of secondary data collected from the follow-up registers of 176 intervention facilities (138 in Rajasthan and 38 in Gujarat) during Phase I of EAISI project. The analysis included clients who returned between April 2018 and March 2019 to the same facility for a follow-up visit. Multivariate logistic regression was performed to determine factors associated with IUD complications. Results: A total of 56,733 IUD insertions were conducted, and 10,747 (18.9%) client follow-ups were documented. Of these, 49.4% (N=5,305) clients received IUDs from EAISI-trained providers, while 50.6% (N=5,442) received IUDs from non-EAISI trained providers. A total of 4.0% (N=432) of clients experienced complications (Expulsion: 1.3%, Missing Strings: 1.7%, Infection: 1.1%). Clients who received IUDs from non-EAISI-trained providers were 55.5% more likely [95% CI (26.2%, 91.5%), p<0.0005] to have complications compared to clients who received insertions from EAISI-trained providers. Other significant factors include the type of IUD, timing of the follow-up visit and timing of the insertion. Conclusion: The findings demonstrate that intensive, hands-on training of providers to improve clinical skills for IUD insertions can have a positive impact on the reduction of post-insertion complications.