Government Dharmapuri Medical College

Inflammatory arthritis and crystal-associated arthropathies frequently present with overlapping clinical features, creating diagnostic and phenotypic challenges when conventional imaging findings are inconclusive. Dual-energy computed tomography (DECT) extends standard CT by enabling material-specific characterization, allowing differentiation of monosodium urate and calcium-containing deposits, and supporting selected applications beyond crystal detection. This narrative review synthesizes evidence from a curated set of PubMed-indexed studies to examine DECT principles, workflow considerations, interpretation pitfalls, and clinical utility across gout, calcium pyrophosphate deposition disease (CPPD), rheumatoid arthritis (RA), psoriatic arthritis (PsA), axial spondyloarthritis (axSpA), and osteoarthritis (OA). The focus is practical and clinically oriented, emphasizing qualitative evidence synthesis rather than quantitative pooling. DECT has its most established and evidence-supported role in gout, where it provides non-invasive crystal detection, burden mapping, and therapy monitoring. In CPPD, it functions primarily as a problem-solving adjunct when radiographs or ultrasound is inconclusive. In RA and PsA, applications such as iodine overlay imaging and virtual non-calcium reconstruction remain adjunctive and exploratory, with magnetic resonance imaging continuing as the reference standard for inflammatory assessment. In axSpA, DECT strengthens structural staging and may offer selective adjunct marrow evaluation, while in OA, its use is limited to targeted phenotyping in suspected crystal-overlap scenarios. Overall, DECT delivers the greatest clinical value when applied in a disease-specific, question-driven manner within multimodality imaging pathways and interpreted with attention to standardized protocols and potential artifacts.

Background: In India, most women know about contraception, but many still do not use it. This results in a large unmet need for family planning. Knowing the local reasons helps plan better interventions. Objectives: 1. To assess the prevalence of contraceptive use among married women of reproductive age. 2.To identify determinants and barriers contributing to unmet contraceptive need. Methods: A community-based cross-sectional study was done for six months in the field practice area of a tertiary care teaching hospital in Tamil Nadu. Using systematic random sampling, 360 married women aged 15–49 years were included. Information was collected using a pretested structured proforma. Results: The mean age of participants was 24.34 ± 3.69 years. Most women were aware of contraception (78.1%), but only a smaller proportion were currently using it (28.3%). The main reasons for use were financial reasons (98.0%) and spacing between pregnancies (98.0%). The common barriers were feeling that contraception was “not important” (50.4%) and family influence (44.2%). Socioeconomic status was significantly related to contraceptive use (p=0.007). After adjustment, women from the upper middle class were less likely to use contraception (AOR 0.26; 95% CI: 0.08–0.81), while graduates were more likely to use contraception (AOR 3.64; 95% CI: 1.53–8.68). Conclusion: There is a clear difference between knowing about contraception and actually using it. Education and socioeconomic status strongly affect contraceptive use. Family-based counseling and locally suitable behavior-change interventions are needed to reduce unmet need.

Background: Alcohol dependence and personality disorder are each independently linked to suicide risk, but their combined influence on suicidal behaviour remains poorly characterized. Objective: To compare the presence, pattern and severity of suicidal behaviour between male alcohol dependent individuals with and without personality disorder. Materials and Methods: A comparative cross-sectional study was done among consecutive male patients admitted in a deaddiction ward were screened; 50 with a confirmed personality disorder (cases) and 50 without (controls) were enrolled from 370 individuals screened. Alcohol dependence severity was assessed using the AUDIT and SADQ; personality disorder was diagnosed using the International Personality Disorder Examination (IPDE) and suicidal behaviour was assessed using the Columbia-Suicide Severity Rating Scale (C-SSRS). Group comparisons used the chi-square test and the Mann-Whitney U test. Results: Suicidal behaviour was present in 58% of cases versus 16% of controls (χ²=18.9, p=0.001). Emotionally unstable personality disorder accounted for 72% of case-group diagnoses (borderline subtype 50%), and suicidal behaviour occurred in 72 % of the borderline subtype. Cases showed significantly more frequent multiple attempt methods (p=0.01), non-suicidal self injurious behaviour (p=0.04), preparatory acts (p=0.02), and family history of suicide (p=0.01), with numerically higher lethality, despite no significant difference in alcohol dependence severity between groups. Conclusion: Comorbid personality disorder, particularly the borderline and impulsive subtypes is associated with more frequent, lethal and premeditated suicidal behaviour in male alcohol dependent individuals. Systematic personality assessment alongside suicide risk screening is warranted in alcohol deaddiction settings.

Maternal health is a key indicator of universal health coverage (UHC) and an essential component of health security, particularly among marginalized populations in India. Despite programmatic expansion, inequities in maternal and child health (MCH) service utilization persist due to socio-economic and behavioural determinants. This study assessed health-seeking behaviour and factors influencing MCH service utilization among tribal women in Tamil Nadu, A community-based cross-sectional study. Selected tribal village in Tamil Nadu, India. A total of 415 married women who had experienced at least one childbirth. Full antenatal care (ANC) utilization was 49.4

Background: Vitamin D is a Neurosteroid hormone that plays a role in neuroprotection, neurotransmitter modulation, and neurodevelopment. The pathophysiology of schizophrenia and the intensity of related psychotic symptoms have been linked to its insufficiency. Objectives: The purpose of this study is to evaluate blood vitamin D levels between individuals with schizophrenia and age- and sex-matched healthy controls. Additionally, the Positive and Negative Syndrome Scale (PANSS) will be used to correlate vitamin D status with symptom profile. Materials and Methods: At a tertiary care teaching hospital in Tamil Nadu, India, this hospital based case-control study recruited 30 drug-naive patients with schizophrenia (diagnosed according to ICD-10 criteria) and 30 healthy, age- and sex-matched controls between the ages of 25 and 40 over the course of a year. Electrochemiluminescence immunoassay (ECLIA) was used to measure the amount of 25-hydroxyvitamin D in fasting serum. PANSS was used to gauge the severity of the symptoms. For statistical analysis, the chi-square test, independent-samples t-test, one-way ANOVA, and Pearson correlation were employed. Results: Compared to controls (19.57 ± 5.46 ng/mL; t = 4.01, p = 0.001), the mean blood vitamin D was considerably lower in cases (14.13 ± 5.03 ng/mL). Compared to 40.0% of controls, 83.3% of patients had inadequate or deficient vitamin D status (χ² = 12.08, p = 0.002). Positive PANSS scores (r = −0.465, p = 0.010) and total PANSS scores (r = −0.506, p = 0.001) were significantly and negatively linked with vitamin D levels, but not negative PANSS (r = −0.329, p = 0.076) or general psychopathology scores (r = −0.006, p = 0.976). Conclusion: In this cohort, low blood vitamin D is linked to schizophrenia and corresponds with overall symptom severity and positive symptom load, but not with negative or general psychopathology symptoms. Patients with schizophrenia may benefit from routine metabolic evaluations that include vitamin D assessments, and treating deficiencies may help manage symptoms.