Sexual Disturbances Research Articles

OS09.6.A Factors predicting mood disorders, health related quality of life and sexual disturbances in adults with glioma: a retrospective study

Abstract Background It is not clear whether Mood Disorders (MD) and poor Health Related Quality of Life (HRQoL) in glioma patients correlate with clinical and histomolecular features of the tumor or with secondary symptoms associated with treatment. This study assessed the prevalence of MD and decline in HRQoL (with a specific interest in sexuality) in glioma patients, identifying the clinical, imaging and treatment factors associated with these variables. Material and Methods 260 glioma patients (190 lower grade) were evaluated. Patients were prospectively followed-up from admission to 12 months after surgery, for MD and HRQoL assessment. 115 were asked to fill a questionnaire for sexual life investigation. Clinical, imaging, histomolecular features as well as cognitive functions were evaluated. Variables associated with MD,low HRQoL and sexual life impairment were identified by bivariate analysis. Results Factors associated with MD and low HRQoL were different in LGGs and HGGs over the course of the disease. In LGGs the effect of adjuvant treatments was prominent in determining the prevalence of MD and poor HRQoL from the third month after surgery onward. In HGGs, MD and poor HRQoL were associated with older age. In both, cognitive deficits were associated with MD. 42% of patients showed dissatisfaction for their sexual life and decrease of sexual intercourses, which were linked to a reduction of libido (22%), astenia (39%), pharmacological therapy (23%), and self-image insecurity(22%). Patients undergoing adjuvant treatments showed a lower sexual satisfaction. Conclusion Overall the data suggest that worsened quality of life, Incidence of Mood disorder and worsening in sexual life affect a relevant amount of patients affected by glioma. Lack of recovery from functional deficits (language, attentive/executive and motor deficits) and adjuvant therapies (expecially radiotherapy) play a crucial role in determining the emergence of Mood Disorders, low HRQoL and worsened sexual life.

Female sexual behavior is disrupted in a preclinical mouse model of PCOS via an attenuated hypothalamic nitric oxide pathway

Women with polycystic ovary syndrome (PCOS) frequently experience decreased sexual arousal, desire, and sexual satisfaction. While the hypothalamus is known to regulate sexual behavior, the specific neuronal pathways affected in patients with PCOS are not known. To dissect the underlying neural circuitry, we capitalized on a robust preclinical animal model that reliably recapitulates all cardinal PCOS features. We discovered that female mice prenatally treated with anti-Müllerian hormone (PAMH) display impaired sexual behavior and sexual partner preference over the reproductive age. Blunted female sexual behavior was associated with increased sexual rejection and independent of sex steroid hormone status. Structurally, sexual dysfunction was associated with a substantial loss of neuronal nitric oxide synthase (nNOS)-expressing neurons in the ventromedial nucleus of the hypothalamus (VMH) and other areas of hypothalamic nuclei involved in social behaviors. Using invivo chemogenetic manipulation, we show that nNOSVMH neurons are required for the display of normal sexual behavior in female mice and that pharmacological replenishment of nitric oxide restores normal sexual performance in PAMH mice. Our data provide a framework to investigate facets of hypothalamic nNOS neuron biology with implications for sexual disturbances in PCOS.

Domestic Abuse in Caryl Churchill's The Hospital at the Time of the Revolution

This study aims at analysing Churchill's The Hospital at the Time of the Revolution. It explores Child Abuse and the reasons behind family abuse to their children. Furthermore, the study investigates the issues that incited child abuse. To achieve the objectives of the study, the researcher makes use of “Urie Bronfenbrenner in the Bioecological Model of Human Development theory". The present study is significant because it is concerned with everyday activities due to which children are subjected to parental abuse, in other words, the emotionally painful events that cause psychological, physical, and sexual disturbances in children. The current study builds a clear image of child abuse in Caryl Churchill's selected play.

Surveillance of Post-Vaccination Side Effects of COVID-19 Vaccines among Saudi Population: A Real-World Estimation of Safety Profile.

Vaccines are considered to be the most beneficial means for combating the COVID-19 pandemic. Although vaccines against SARS-CoV-2 have demonstrated excellent safety profiles in clinical trials, real-world surveillance of post-vaccination side effects is an impetus. The study investigates the short-term side effects following the administration of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines in Saudi Arabia. A cross-sectional quantitative study was conducted among the general population with age ≥ 18 years, from five regions (Central, Northern, Eastern, Southern, and Western Regions) of Saudi Arabia for a period of 6 months (July to December 2021). A self-administered study instrument was used to record the side effects among the COVID-19 vaccine recipients. Of the total 398 participants (males: 59%), 56.3% received Pfizer and 43.7% were vaccinated with AstraZeneca. Only 22.6% of respondents received the second dose of the COVID-19 vaccines. The most commonly reported side effects were pain at the injection site (85.2%), fatigue (61.8%), bone or joint pain (54.0%), and fever (42.5%). The average side effects score was 3.4 ± 2.2. Females, young people, and Oxford-AstraZeneca recipients had a higher proportion of side effects. The Oxford-AstraZeneca vaccine recipients complained more about fever (p < 0.001), bone and joint pain (p < 0.001), fatigue (p < 0.001), loss of appetite (p = 0.001), headache (p = 0.008), and drowsiness (p = 0.003). The Pfizer-BioNTech vaccinees had more pain and swelling at the injection site (p = 0.001), and sexual disturbance (p = 0.019). The study participants also reported some rare symptoms (<10%) including heaviness, sleep disturbance, fainting, blurred vision, palpitations, osteomalacia, and inability to concentrate. This study revealed that both Pfizer-BioNTech and Oxford-AstraZeneca administration was associated with mild to moderate, transient, short-lived side effects. These symptoms corroborate the results of phase 3 clinical trials of these vaccines. The results could be used to inform people about the likelihood of side effects based on their demographics and the type of vaccine administered. The study reported some rare symptoms that require further validation through more pharmacovigilance or qualitative studies.

The hypothalamic-pituitary-gonad axis in male Cushing's disease before and after curative surgery.

Gonadal and sexual disturbances are commonly encountered in patients with Cushing's disease. Nevertheless, the prevalence of hypogonadism in male Cushing's disease, the risk factors as well as the recovery time have been scarcely reported. Therefore, we aimed to explore the prevalence of hypogonadism at baseline and its determinants. In addition, the recovery time of hypogonadism and risk factors for unrecovered gonadal axis in male Cushing's disease with biochemical remission were investigated. We reviewed medical records of males with Cushing's disease managed between 2010 and 2020. Fifty-two male patients were enrolled according to the criteria. Each case attained biochemical remission after transsphenoidal surgery. Demographic details, clinical features, 24-hour UFC, hormonal profile [serum PRL, FSH, LH, TT, ACTH, cortisol, TT4/FT4, TT3/ FT3, TSH and IGF-1] were measured at baseline and during follow-up. The maximal tumor diameter on MRI was recorded at diagnosis. Hypogonadotropic hypogonadism was observed in thirty-nine patients (75%) at diagnosis. Total testosterone was negatively correlated with ACTH and 24-hour UFC. Midnight serum ACTH level at diagnosis was significantly associated with hypogonadism after adjusting for confounding factors. Thirty-two (80%) patients achieved eugonadism within 12 months after the surgery, of which twenty-eight (87.5%) achieved eugonadism within 3 months. Seven patients were persistently hypogonadal during the follow-up (≥1 year), mainly due to the hypopituitarism as a complication of the therapies such as surgery. Hypogonadotropic hypogonadism is frequent in male Cushing's disease, but it is reversible in most cases within one-year follow-up after remission.

Sexual Functioning of Transgender Females Post-Vaginoplasty: Evaluation, Outcomes and Treatment Strategies for Sexual Dysfunction.

Transfeminine genital reconstructive surgery is an important part of gender affirmation for many transgender women. Sexual health post-vaginoplasty is an important aspect of quality of life that can have a significant impact on overall well-being. The objective of this review is to provide a summary of the literature on the sexual outcomes of transgender females post-vaginoplasty and identify treatment strategies for those experiencing sexual dysfunction. A literature review was conducted with a focus on sexual health outcomes in transgender females post-vaginoplasty as well as treatment options for sexual dysfunction. Penile inversion vaginoplasty with or without free skin grafts or local tissue flaps and intestinal vaginoplasty are the options available to patients interested in transfeminine genital reconstructive surgery with a neovagina. Sexual satisfaction post-vaginoplasty is high regardless of the vaginoplasty technique, however up to 29% of patients may be diagnosed with a sexual dysfunction due to associated distress with a sexual function disturbance. Hormone treatment, pelvic floor physical therapy, sex therapy, and sex surrogacy are treatment options for patients with sexual dysfunctions. Patient reported outcome measures appropriately validated for this patient population are necessary to better understand sexual function outcomes, sexual dysfunction and treatment options for post-vaginoplasty patients. Schardein JN, Nikolavsky D. Sexual Functioning of Transgender Females Post-Vaginoplasty: Evaluation, Outcomes and Treatment Strategies for Sexual Dysfunction. Sex Med Rev 2022;10:77-90.

The pathophysiology of sexual dysfunction in Parkinson's disease: An overview.

Sexual dysfunction is a common, poorly recognized, poorly discussed (often because of cultural perceptions and sensitivities), bothersome and neglected aspect of the range of non-motor symptoms of Parkinson's disease (PD). The spectrum of sexual dysfunction in PD ranges from hyposexuality-based disturbances to hypersexuality-dominated behaviors in the context of drug-induced impulse control disorder. The pathophysiological mechanisms underlying PD-related sexual dysfunction, specifically for hyposexual disorders, are thus heterogeneous and still not fully understood. However, central and peripheral neural mechanisms secondary to the hallmark pathological alterations of the disease (alpha-synuclein deposition and nigrostriatal degeneration) and to the associated network and neurotransmitter dysfunctions, together with the effects of dopaminergic therapies, seem to play an important role in the development of sexual disturbances. In this chapter, we therefore review the neuroanatomical and neurophysiological basis of sexual function in humans, and we provide insights on the pathophysiological mechanisms of hyposexuality and hypersexuality in PD.

Psychological Outcome of Women with Morbidly Adherent Placenta Following Hystrectomy: Prospective Matched Case-control Study

Abstract Background Placenta accreta (Morbidly adherent placenta) is a condition in which all or part of the placenta is adherent to the uterine wall because of myometrial invasion by chorionic villi. It may occur when there is either a primary deficiency of or a secondary damage to chorionic villi or Nitabuch’s layer. Women often consider the uterus to be a sexual organ, and the controller and regulator of important physiological functions in the body, as well as the source of youth, energy, activity, and a symbol of child-bearing capacity. Aim of the work The purpose of this study is to investigate the risk of postoperative psychiatric disorders of depression, anxiety outcomes and sexual dysfunctions and self esteem disturbance in women with morbidly adherent placenta following hysterectomy. Methods The study included 120 subjects divided into 3 groups including Group A which included 40 women who underwent caesarean hysterectomy, Group B which included women who underwent lower segment caesarean section and Group C which included 40 women who underwent spontaneous vaginal delivery with inclusion and exclusion criteria. All patients who delivered from 4 to 6 months ago, will be subjected to fulfill Questionnaire after obtaining informed consent from the patients who are invited to participate in the research. Results Self-esteem was statistically signifciantly highest in cases underwent CS with no statistical significant difference between CH and VD. Anxiety was non- statistically significantly most frequent in CH and least frequent in VD. Depression was non- statistically signifciantly most frequent in CH and least frequent in VD. Severe depression was statistically signifciantly most frequent in VD and least frequent in CH. Different dysfunctions were statistically significantly highest in CH research group. Desire, Arousal, Lubrication and pain dysfunctions were statistically significantly lowest in VD group. Orgasm and Satisfaction dysfunctions were signifciantly lowest in CS group. Analyzing the current research data results and considering previous research efforts in female sexual dysfunctions in correlation to obstetric clinical scenarios reveal that the female sexual normal activity is a critical issue when affected could result in serious sequale not only affecting the female as regards self-esteem and psychiatric health status but could affect the male partner due to reduced sexual functional capacity, future research efforts are recommended to be multi-centric in fashion taking in consideration more detailed aspects particularly the male partner satisfaction from sexual activities with his female counterpart after cesarean, vaginal deliveries. Conclusion Analyzing the current research data results and considering previous research efforts in female sexual dysfunctions in correlation to obstetric clinical scenarios reveal that the female sexual normal activity is a critical issue when affected could result in serious sequale not only affecting the female as regards self-esteem and psychiatric health status but could affect the male partner due to reduced sexual functional capacity, future research efforts ere recommended to be multicentric in fashion taking in consideration more detailed aspects particularly the male partner satisfaction from sexual activities with his female counterpart after cesarean, vaginal deliveries.

Advancing Knowledge About Sexual Harassment Is a Critical Aspect of Organizational Development for All Employees

Sexual harassment remains prevalent in the workplace as well as a significant financial burden for organizations. Given the cost associated with sexual harassment, reputational damage, and internal disturbances, sexual harassment is a mounting apprehension because senior managers are responsible for bestowing an organizational culture that is intolerant to such engrossed behavior. It is imperative to explore how workplace stories and office talk are influenced by organizational culture and how organizational culture affects the workers' perceptions of Me Too and consequences of sexual harassment. Understanding the phenomenon of sexual harassment at work is vital to shaping organizational culture, behavior, and policies aimed at reducing sexual misconduct at work. Existing research indicates that 81% of women and 43% of men have experienced an aspect of sexual harassment. This study uses a content analysis exploration of the literature to better understand the impact and solutions to sexual harassment in the workplace.

New needs for menopausal women during COVID-19 pandemic. A physician-based investigation

It was evaluated whether the COVID-19 pandemic may have influenced the manifestation of menopausal symptoms. In a web interview, 143 physicians, experts on the menopause, were asked to rate their perceived prevalence of hot flush, sleep disorder, sexual disturbance, anxiety and depression as ‘rare’, ‘seldom’, ‘frequent’ and ‘very frequent’ in patients they managed prior to and during the COVID-19 pandemic. According to physicians, there was no major change in the prevalence of hot flush, sleep disorder and sexual disturbance but prevalence of anxiety (39-8% vs 75.5%;p < 0.0001) and depressive (35.6% vs 72.0%;p < 0.0001) symptoms increased during COVID-19 pandemic. COVID-19 pandemic has changed the composite picture of menopausal symptoms, challenging physicians to adjust their therapeutic approach to the new need. Approaches capable to treat vasomotor symptoms but also highly effective on mood disturbance should be preferred. © 2021, EDRA S.p.A. All rights reserved.

MP47-08 LESSONS FROM ADULTS WITH UNTREATED DISTAL HYPOSPADIAS: FUNCTIONAL AND AESTHETIC CONCERNS

You have accessJournal of UrologyPediatric Urology III (MP47)1 Sep 2021MP47-08 LESSONS FROM ADULTS WITH UNTREATED DISTAL HYPOSPADIAS: FUNCTIONAL AND AESTHETIC CONCERNS Nicol Bush, and Warren Snodgrass Nicol BushNicol Bush More articles by this author , and Warren SnodgrassWarren Snodgrass More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002068.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The benefit of distal hypospadias repair has been questioned by studies of unoperated adults suggesting most adapt with few functional or aesthetic complaints (Fichtner 1995, Dodds 2008). Nearly all presented for unrelated urologic complaints and many were not aware of their anomaly. However, men self-identifying with uncorrected hypospadias in an on-line survey (Schlomer 2014) reported more difficulty with voiding and sexual function than unaffected men. We reviewed complaints in consecutive men with unoperated distal hypospadias to determine functional and aesthetic concerns. METHODS: Men with unoperated hypospadias were identified from a prospectively maintained database. Each was queried at presentation about his urinary stream, straightness of erections, sexual dysfunction and aesthetic concerns. RESULTS: From 2017-2020 a total of 25 men, mean age 42 years (18-63), presented with nonoperated distal hypospadias classified as MIP (8), coronal (6), subcoronal (8) and distal shaft (3). 14 (64%) were circumcised. Representative photos are shown. Of these, 20 (80%) had urine spraying. 9 (36%) had ventral or lateral (2) curvature, causing difficult penetration (1) and discomfort to their sexual partner (3). Altogether 8 (32%) reported painful sexual activity, including 3 with irritation of the exposed urethral mucosa and 1 whose scrotal web irritated his wife. 15 men (40%) were bothered by their appearance. Of all 25 men, 23 complained of an abnormal stream and/or appearance, and the other 2 experienced sexual dysfunction. CONCLUSIONS: Rather than adapting to their condition, all 25 men reported functional problems with voiding and/or sexual activity their entire adult life, and nearly half stated their different appearance currently bothered them. The denominator of men with uncorrected hypospadias is unknown, but the internet survey identified 52 with untreated hypospadias from 736 respondents, and they also reported significantly greater voiding concerns, penile curvature, and sexual disturbances. Even if our patients do not represent the entire population of men with uncorrected distal hypospadias, the adverse impact causing them to request repair even in middle age supports the conclusion that it cannot be dismissed as only a “cosmetic” problem or something men ultimately become accustomed to. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e826-e826 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicol Bush More articles by this author Warren Snodgrass More articles by this author Expand All Advertisement Loading ...

Personality Disorder Traits, Rorschach Performance, and Neuropsychological Functioning in the Case of a Serial Killer: The Importance of a Multilevel Approach in the Assessment of Personalities Associated with Extreme and Repetitive Violence

The present paper utilized the case study of an incarcerated serial killer (“Keith”) to demonstrate how combining three assessment techniques (the Structured Clinical Interview for DSM-IV Axis II Personality Disorders, the Rorschach task, and a comprehensive battery of neuropsychological measures) within a multilevel personality assessment framework might elucidate possible personality-based underpinnings of extreme and repetitive violence—representing a “next wave” of serial killer research while also highlighting the empirical and clinical value of an empirically-neglected multilevel assessment approach. Gacono and Meloy’s multimethod “levels” model was selected as a multilevel framework, and Leary’s recommended examination of inter-level consistency was utilized as an integrative strategy. Results indicated marked divergencies among Keith’s data levels in areas of executive abilities, psychotic symptoms, affective/emotional disconnectivity, and sexual disturbance that suggested areas for potential change (perhaps in therapy), while consistencies among levels in social cognition and object relations suggested more stable characteristics that may be resistant to modification. The application of multilevel personality assessment methods to extremely and repetitively violent persons represents an important clinical approach worthy of future study—potentially having implications for research, clinical and forensic assessment, and treatment, and advancing empirical and clinical understandings of the continuum of interpersonal violence.

P203 Sexual Dysfunction in Chronic Inflammatory Bowel Disease: Myth or Reality?

Abstract Background Sexual dysfunction is often associated with impaired body image and quality of life in patients. However, little data exists on sexual dysfunction (SD) in patients with Chronic Inflammatory Bowel Disease (IBD). The aim of this study was to assess the prevalence and risk factors for sexual dysfunction in patients with IBD. Methods This is a cross-sectional study of all patients followed for IBD. Sexual function was assessed by the Female Sexual Index Function (FSIF) for women and the International Index of Erectile Function (IIEF) for men. Sexual dysfunction was confirmed when the total FSIF score was less than 26, or the IIEF score less than 26. Crohn’s disease (CD) activity was assessed by the Harvey-Bradshaw index (HBI), and that of ulcerative colitis (UC), by the clinical Mayo scores. Results We collected 100 patients, with a mean age of 42.18 ± 15.71 and a sex ratio (M / F) = 1.5. Sixty eight patients had CD and 32 patients had UC. Ano-perineal manifestations were present in 38.2% of cases. Severe disease activity was noted in 14 patients (20.6%) with CD and 10 patients (31.3%) with UC. Twelve patients had proctitis. 38% of patients had surgical treatment: 18.75% for patients with UC and 47.05% for those with CD. Total colectomy was performed in 12% of cases. At the time of the study, 20% of patients were on systemic corticosteroid therapy, 22% on Azathioprine, 4% on Salazopyrine, 8% on 5-ASA and 46% on Anti-TNFα. Sexual dysfunction was reported by 42.9% of women: 57.14% (UC) vs 38.46% (CD) (p = 0.042). On the other hand, sexual dysfunction was reported by 27.6% of men: 22.2% of men with UC and 28.57% with CD, with no statistically significant difference (p = 0.78). A significant association was found between sexual dysfunction and the degree of disease activity (p &amp;lt;0.001 for CD, p = 0.003 for UC), as well as pancolitic involvement in women with UC (p = 0.002). However, the presence of anoperineal manifestations, rectal involvement and history of surgery were not significantly associated with the frequency of sexual disturbances. Conclusion Our study showed a high prevalence of sexual dysfunction in patients with IBD. Training gastroenterologists in the management of sexual dysfunction would make it possible to satisfy patient expectations.

Sexual Dysfunction in Ostomized Patients: A Systematized Review.

The impact of an ostomy has a negative influence on sexuality. Healthcare professionals focus the care on surgery, and consider the sexual life is little relevant to the patient recovery. The aim of this systematized review is to give visibility to the sexual problems that ostomy patients have, to know what kind of sexual dysfunction occurs in this patients, to give information to the nursing staff about sexual disturbances and to recommend some resources to restart sexual activity. The research was conducted following de PRISMA guidelines and performed in several databases. Twelve papers were used to perform the systematized review. After ostomy, sexual dysfunction is different in men and women. It is related by the psychological aspects (low self-esteem, body image deterioration, etc.), the physical aspects (type of resection, complications, etc.) and the acceptance by the partner. A personalized sexual education focused on sexual problems that appear in ostomy patients is necessary to implement. In this way, adequate support, information and resources before and after surgery could be given for both, patients and their partners.

Trauma symptoms as factors associated with early motherhood among young women who had contact with child protective services

Young women who had contact with child protective services (CPS) are two to three times more likely to become young mothers than their peers in the general population. Adverse life events, such as maltreatment and placement instability, are associated with an increased risk of early motherhood. Adverse events may lead to trauma symptoms, which could contribute to the circumstances that lead young women to become mothers. In this study, we explored the association between trauma symptoms and early motherhood, after controlling for the effects of maltreatment, placement instability, and risky sexual behaviors, among 112 young women who had contact with CPS. The results of a multivariate binary logistic regression analysis showed that symptoms of trauma related to sexual disturbance were associated with an increased risk of early motherhood while anger and suicidality as trauma symptoms were associated with a decrease in this risk. These results suggest that the long-term consequences of adverse events, such as trauma symptoms, should be considered in the study of early motherhood. Furthermore, a trauma-sensitive approach focused on the links between traumatic events and behavioral dysfunction could be helpful in supporting young women who had contact with CPS and are preparing for early motherhood.

Cauda Equina Syndrome Retention Type –Late Intervention Can also give Excellent Results

Introduction: Cauda Equina Syndrome (CES) is an acute stenosis of lumbar spinal canal leading to compression of neural elements below the level of L1 mostly due to disc herniation but other causes exist. Intervention within 48 hours prevent permanent sensorimotor, sphincter and sexual disturbances. We reporttwelvecases of Cauda Equina Syndrome with complete sensorimotor deficit, bladder, bowel dysfunction intervened at least 1 month after initiation of symptoms with complete recovery of functions. Till date a few literature support is there to substantiate this evidence. Methods: 22 patients between 2011 to 2015, 18 male and 4 female, attended with complete or retention type of cauda equina syndrome. Of the 8 men, 5 had acute discherniations, 2 had caries spine, 1 had trauma. Of the 4 women,3 had acute disc herniation,1 had caries spine. 4 attended 35- 39 days, 4 between 45- 45 days,4 between 45- 60 days. They were urgently decompressed within 72 hours of attendance. 4 were lost in follow- up within 1 year. Rest were followed up3- 5 years. Results: 3 patients improved by 14 to 28 days, their neurological status improved from ASIA A to ASIA D, 4 patients by 30 to 90 days from ASIA A to ASIA E. 1 male patient improved from ASIA A to ASIA C in 3 years. All the above neurological status maintained. 2 men and 2 women were lost to follow up within 1 year when their improvement were by only one grade in ASIA impairment scale. 7 out of 8 patients had excellent results. Conclusion: Though early intervention is the golden rule, in late presentations of complete cauda equine syndrome, thorough decompression improves the neurological status of the patient

Sexual dysfunction in epilepsy patients attending a tertiary care hospital

Introduction: Seizures and antiepileptic drugs both can contribute to sexual dysfunction. Seizures can modify sexual behavior by altering the release of hypothalamic or pituitary hormones, by disrupting the function of limbic cortex. Antiepileptic drugs can alter hormonal release and may have direct inhibitory effects. Though Epilepsy is a common disease in neurological practice, there are very few studies available regarding sexual dysfunction in epilepsy. Material and Methods: This cross sectional study was carried out on 100 patients of epilepsy with an age group between 25-50 years who presented as outpatient in the department of Neurology at M.S. Ramaiah Memorial Hospital, Bangalore, over two years. We also compared these cases with age matched normal people as a control. Pre-designed and pre-tested questionnaires like Arizona sexual experience scale, international index of erectile function questionnaire were used to collect data. Arizona sexual experience scale of >15 considered sexual dysfunction, Results: Out of 100 cases with epilepsy, 43 patients were male (43%), while 57 patients were female (57%). Out of 100 normal cases, 61 were male (61%), while 39 were female (39%). 38% of epilepsy patient had sexual disturbance. Polytherapy was associated with sexual dysfunction (p-0.016). Conclusion: Reduction of the frequency of epileptic seizures, and monotherapy is of great importance in improving the sexual health in epileptic patients. Keywords: Seizures, Epilepsy, Sexual dysfunction, Anti epileptic drugs

Chlorthalidone or Hydrochlorothiazide for Treatment of Hypertension

Chlorthalidone or Hydrochlorothiazide for Treatment of Hypertension

Sexual aggression in mammals

Abstract In non‐human mammals, sexual conflict should be particularly intense because males rarely provide parental care. An expected consequence of sexual conflict is male aggression towards mates. Considering how complex measurements and interpretations of behaviours such as sexual aggression and sexual coercion are, I preferred to define operationally, as ‘sexual disturbance’, any male behaviour towards females during the pericopulatory period that can be costly for females. The objectives in this review were as follows: 1) to estimate how widespread sexual disturbance is among mammals, 2) to analyse the types of female response to sexual disturbance, and 3) to characterise the costs of sexual disturbance to females. I conducted a systematic review by searching the literature in the Web of Knowledge database using the search tools available for 19 main journals, and I conducted a qualitative review via a taxon‐by‐taxon analysis. Sexual disturbance was frequent in four of the 32 mammalian orders: Primates, Artiodactyla, Carnivora, and Cetacea, which all include highly polygynous taxa. The most common expression of sexual conflict around copulation is seen in behaviours associated with female retention attempts that cause minor harm. Research suggests that the most common response of females to sexual disturbance comprises female grouping around a dominant male.

Evaluation of efficacy and adverse effects of paroxetine in the treatment of major depressive disorder patients.

Major depressive disorder is a serious and disabling disease in world; it is a most common chronic and recurrent disorder with fourth cause of loss in disability in the worldwide. Objectives: To evaluate the efficacy and adverse effects of Paroxetine in major depressive disorder patients. Study Design: Open Labeled study. Setting: Department of Psychiatry, Chandka Medical College Hospital Larkano. Period: Three months (August to October 2019). Material &amp; Methods: Total 40 patients of either sex were enrolled from OPD of Psychiatric department with age of 18 to 65 years. Follow-up visits were carried out fortnightly after making evaluation on symptoms at base line visit (day 0) continued till 90 days, and then results were compiled. The SPSS-16 version was used for the analysis of data. Results: Paroxetine is highly significant (p=0.001) to decrease the symptoms of depression during treatment of 90 days. Conclusion: In this study, Paroxetine is more effective drug to decrease the symptoms like, weight loss, sexual disturbance, insomnia and with less adverse effects in patients of major depressive disorder.