scholarly journals Tactics of treatment of patients with sexual dysfunctions and intermediate disorders

The article gives the world views on the main types of sexual disorders among the male contingent and their interrelation with the phases of sexual reaction. The interrelation of the development of sexual dysfunctions under the influence of significant stress or psychoemotional overload or in the absence of any psychoneurological disorders, among which the leading place occupy border disorder, is shown. The necessity of therapeutic correction of affective pathology in the complex therapy of sexual dysfunctions is substantiated. The basic mechanisms of complex treatment of sexual dysfunctions and psychopathological manifestations are shown. In order to work out a more effective therapeutic complex using the Questionnaire International Erectile Function Index (IEFI), calculation of the duration of sexual intercourse (the so-called Intravaginal latency interval (ILI) and the Hamilton Rating Scale for Depression (HDRS-17) were evaluated. 83 patients with sexual dysfunctions: 52 patients (1 group) with premature ejaculation (PE); 31 patients (2 groups) with erectile dysfunction (ED) (the presence of these sexual dysfunctions led to the development of anxiety-depressive and neurosis-like disorders, which was confirmed by the Hamilton Scales) and 45 patients (3 groups) with sexual dysfunctions that developed as a result of existing initial psychopathological or boundary disorders (BD). Each study group was divided into two subgroups (a and b), each of which used different therapies from each other. With the use of one or another therapeutic scheme, patients of each group received cognitive-behavioral psychotherapeutic correction, tadalafil, nootropic drugs (noofen or glycine) and antidepressants (fluoxetine or coaxiаl). The duration of the observation was 3 months. As a result of the study, improvement of the ejaculatory function (with an increase in the ILI score) was established, which significantly increased at each control examination. In the analysis of the dynamics of the overall indicator of the MIEF questionnaire after the therapy, improvement in sexual function was observed in all groups, but the best results were obtained in the ED group. The results of the HDRS questionnaire showed that after 3 months, patients in the PE group compared with the BD group were reliably less susceptible to depressive disorder, especially of a pronounced nature.

2021 ◽  
pp. 263183182110311
Author(s):  
Adarsh Tripathi ◽  
Dhirendra Kumar ◽  
Sujita Kumar Kar ◽  
PK Dalal ◽  
Anil Nischal

Background: Erectile dysfunction (ED) is one of the most common psychosexual disorders in clinical practice, and it results in significant distress, interpersonal impairments, poor quality of life, and marital disharmony. However, there is limited research on ED in India. Therefore, this study aimed to assess the sociodemographic and clinical profile of patients presenting with ED. Method: Cross-sectional evaluation of patients with ED presenting to the psychosexual outpatient department (OPD) of psychiatry department in a tertiary care hospital was done on structured clinical pro forma, Mini-International Neuropsychiatric Interview, International Index of Erectile Function-5, Arizona Sexual Experience, Hamilton rating scale for depression, and Hamilton rating scale for anxiety. Results: The sample included 102 patients. The mean age was 33.38 years. The majority of the patients were married (81.4%), Hindu (82.4%), residing in a rural area (60.8%), and belonging to a nuclear family (62.7%). The majority of the patients had a moderate level of ED (50%) followed by mild-to-moderate ED (26.5%) and severe ED (23.5%). Premature ejaculation (46.1%) and depression (28.4%) were the most common sexual and psychiatric comorbidities. Obesity was common (62.7%), and only a minority had other metabolic dysfunction, namely dyslipidemia (7.8%), diabetes (5.9%), and hypertension (4.9%). Tobacco dependence and alcohol dependence were present in 37.3% and 6.9% cases, respectively. Conclusion: Young adults with moderate-to-severe ED were present for treatment at a tertiary center. Comorbidities of other sexual disorders, psychiatric disorders, and substance use are commonly encountered in such patients. Promotion of early help-seeking should be encouraged. Clinicians should thoroughly assess even the young patients for other sexual, psychiatric, and medical comorbidities.


2021 ◽  
Author(s):  
Mina Kelleni

Premature ejaculation and erectile dysfunction are affecting millions of patients all over the world and the quest for novel and safe drugs to manage either or both diseases is considered of great importance. Topical use of the herbal extract berberine might provide potential cure through restoration of endothelial homeostasis that is disturbed in both diseases as well as numerous other mechanisms as described in this manuscript and the author is the inventor and one of the holders of an internationally registered copyright to use berberine topically for management of sexual disorders.


2020 ◽  
Vol 103 (10) ◽  
pp. 1028-1035

Background: Craniotomy causes acute and chronic pain. Uncontrolled postoperative pain may lead to adverse events. Perioperative scalp nerves block is not only effective in reducing intraoperative hemodynamic response, but it also reduces postoperative pain and postoperative analgesia requirement. Objective: To compare the benefits of adding dexmedetomidine to levobupivacaine in scalp nerves block before craniotomy for the duration of analgesia in supratentorial craniotomy. Materials and Methods: After approval by the Committee for Research, 50 supratentorial craniotomy patients were randomized into two groups. The control group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000, whereas the study group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000 plus dexmedetomidine 1 mcg/kg. The primary outcome was the time to first analgesic requirement postoperatively. The secondary outcomes included intraoperative fentanyl consumption, verbal numerical rating scale, tramadol consumption, and complications during the first 24 hours postoperatively. Results: Patients in the study group had significantly increase time to the first analgesic requirement in postoperative period and reduced intraoperative fentanyl consumption. The median time to first analgesic requirement was 555 (360 to 1,035) minutes in the study group versus 405 (300 to 520) minutes in the control group (p=0.023). Intraoperative fentanyl consumption 125 (75 to 175) mcg in the study group was significantly lower than 200 (150 to 250) mcg in the control group (p=0.02). The verbal numerical rating scale at 1, 4, 8, 12 and 24 hours postoperatively, tramadol consumption, and complications during the first 24 hours postoperatively were not statistically significant different. Conclusion: Preoperative scalp nerves block with 0.25% levobupivacaine with adrenaline (1:200,000) with dexmedetomidine 1 mcg/kg significantly increased the time to first analgesic requirement and reduced intraoperative fentanyl consumption compared to 0.25% levobupivacaine with adrenaline (1:200,000) without perioperative complications. Keywords: Scalp block, Dexmedetomidine, Post-craniotomy analgesia, Supratentorial tumor, Levobupivacaine


2020 ◽  
Vol 16 ◽  
Author(s):  
Asma Farooq Shah ◽  
Isha Chawla ◽  
Kirti Goel ◽  
Rakesh Gollen ◽  
Randhir Singh

: The prevalence of obesity around the globe is increasing at such an alarming rate that WHO consultation on obesity designated obesity as a major unattended public health problem worldwide. Obesity is associated with a greater risk of excessive fat related metabolic and endocrinal diseases associated with different set of illness and disabilities, including type 2 diabetes, cardiovascular diseases, kidney diseases, sleep apnea, arthritis, lung diseases and sexual disorders. Obesity is found to be associated with male and female sexual dysfunctions and several studies have indicated a positive correlation between obesity and sexual dysfunction among both males and females. The relationship between male obesity and sexual dysfunction has been widely discussed, whereas a very little emphasis is laid on relationship between obesity and female sexual dysfunctions. Sexual dysfunctions are common and affects 20-50% of obese women. Particularly, female sexual dysfunction is a multi-factorial problem, including organic and psychological aspects involved into it. These disorders not only affect physical health of women but to a greater extent mental health is also affected. Considering this point of view, present review is emphasized on the impact of obesity on female sexual dysfunctions.


2019 ◽  
Author(s):  
Pablo Rodrigo Guzman Cortez ◽  
Matias Marzocchi ◽  
Neus Freixa Fontanals ◽  
Mercedes Balcells-Olivero

BACKGROUND Computerized mental health interventions have shown evidence of their potential benefit for mental health outcomes in young users. All of the studied interventions available in the review and scientific literature can be classified as "serious games". Serious games are computerized interventions designed from the start with the objective of improving specific desired health outcomes. Moreover, there are reports of users experiencing subjective benefits in mental health after playing specific commercial games. These were games not intentionally made with a therapeutic objective in the design process. An example is the videogame "Journey", first released for the Playstation 3 console in 2012 which won "Game of the Year" in the 2013 D.I.C.E awards. The creator of the game describes the game as a short, 2-3-hour narrative experience in which the player goes through the "Hero's Journey" following a classic 3-part structure. There were more than 100 testimonials from players describing how the game helped them cope with psychological or personal issues. Some of them explicitly described recovering from depressive episodes through playing the game. OBJECTIVE To conduct a pilot test of the efficacy of the videogame Journey in reducing depressive symptoms in an acute impatient setting METHODS Depressive symptomatology was measured before and after the intervention using the Hamilton Rating Scale for Depression (HRSD) The intervention was conducted in an isolated room using a Playstation 3 console with the videogame "Journey" developed by Thatgamecompany. No internet access was allowed. The game was played over the course of 4 30-45 min sessions in a two week period. RESULTS The initial score in the Hamilton Rating Scale for Depression (HRSD) was 30, indicating a very severe depression. After the intervention the HRSD score was 10, showing a mild depression. CONCLUSIONS The Videogame Journey, a commercial game first available for the Playstation 3 console in 2012, was not created as a serious game with potential health benefits. Our pilot test is the first case report of a commercial game showing a potential effect in reducing depressive symptoms, which is consistent with the previous informal reports of users online.


1999 ◽  
Vol 11 (1) ◽  
pp. 34-37 ◽  
Author(s):  
I.P.A.M. Huijbrechts ◽  
P.M.J. Haffmans ◽  
K. Jonker ◽  
A. van Dijke ◽  
E. Hoencamp

SummaryAlthough the Hamilton Rating Scale for Depression (HRSD) is the most frequently used rating scale for quantifying depressive states, it has been criticized for its reliability and its usability in clinical practice. This criticism is less applying to the Montgomery-Asberg Depression Rating Scale (MADRS). Goal of the present study is to investigate the reliability and validity, and clinical relationship between the HRSD and the MADRS. For 60 out-patients with diagnosed depression (DSM IV296.2x, 296.3x, 300.40 and 311.00), the HRSD and MADRS were scored at baseline and 6 weeks later by an independent rater according to a structured interview. Also the Clinical Global Impression (CGI) was assessed by a psychiatrist. Satisfying agreement was found between the totalscores (r= .75, p>.000 en r=.92, p>.000 respectively, at baseline and 6 weeks later). Furthermore agreement was found between the items of both scales, and these agree with the clinical impression. The reliability of the MADRS is more stable than the reliability of the HRSD (α = .6367 and α =.8900 vs α = .2193 and α = .8362 at baseline and at endpoint respectively). Considering the ease of scoring both scales in one interview and the widely international use of the HRSD, scoring both the HRSD and the MADRS to measure the severity of a depression seems to be an acceptabel covenant.


1950 ◽  
Vol 4 (3) ◽  
pp. 545-546

The International Wool Study Group met at London from November 7 to 9, 1949. The meeting noted that world wool production had increased slightly since the war to a point where it was equal to prewar production. The group for the first time decided to release for publication its report on the world wool situation and reports on the wool situation in member countries, unless requested otherwise; On the basis of review it was decided that no immediate problems called for intergovernmental collaboration in world trade of wool; although it was recognized that the problem of surplus stocks which had led to the establishment of the group in 1946 had largely disappeared, it was felt that the group would prove a useful means for the improvement of wool statistics and a useful body to which world wool problems could be referred.


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