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Background: The lesbian, gay, bisexual, and transgender (LGBT) community faces unique stressors in the form of nondisclosure of their sexual orientation, relationship dissatisfaction, social isolation, and low self-esteem. Data regarding this community in India is scarce due to fear of discrimination and abuse. Aims: To describe the pattern of sexual orientation, relationships, social connectedness, and disclosure in men and to assess their self-esteem and its association with “coming out”. Method: This was a cross-sectional observational study of Indian men who use a gay dating website. Results: Majority of the 277 respondents were salaried, had higher education, unmarried, and belonged to Hindu religion. Seventy two per cent of the subjects expressed their orientation as either exclusively or predominantly homosexual and 18% as bisexual. Among those in relationship, an equal number reported being satisfied with the relationship (40%) and felt socially connected (53%). Seventy to 80% of them had a feeling of missing companionship and being left out. Sixty one per cent were not open about their orientation at all times. Eighty per cent of the subjects were not open at workplace and with family. The average age of coming out of the closet was 19.71 years (SD±6.67). The mean scores on the Rosenberg Self-Esteem Scale of the entire sample was 28.49 (SD±5.55). There was no association between age of coming out and self-esteem scores. Self-esteem scores were significantly lower in subjects who were in the closet and those who had negative coming out experiences. Conclusion: There is a need to address the sexual minority stress faced by this community due to social isolation and concealment which affects the self-esteem.

Background: The sexual minority status of the gay and bisexual community puts them into a unique vulnerability state for mental health problems. One of the factors associated with this stress is remaining in “closet” leading to a higher prevalence of depression. Aims: This study aimed to estimate the prevalence of depression in Indian men who have sex with men (MSM) and to assess the association of depression with disclosure, if any, in this community. Materials and Methods: This was a cross-sectional observational study of Indian men recruited through an advertisement on a dating website exclusive for gay men. Depression was assessed on self-reported scale of the Centre for Epidemiologic Studies Depression Scale-Revised (CESD-R). Results: Most of the men who took part in the study belonged to the age group of 25–35 years with mean age of the study sample being 30.31 years (standard deviation [SD] ±8.58). A majority of them were salaried, had higher education, and belonged to the Hindu religion. Most of the participants were either exclusively or predominantly homosexual (72%) followed by men with bisexual orientation (18%). On measures of disclosure/“outness,” out of 277 respondents, 171 (61.73%) were not open about their sexuality, 92 (33.21%) were sometimes open, while only 14 (5.05%) were always open about their sexual orientation in front of others. The average age of coming out of closet (n = 232) was 19.71 years (SD ± 6.67). The mean score on CESD-R scale was 25.65 (SD ± 16.38). Depression was present in 163 participants (58.84%) of the entire sample. The depression scores negatively correlated with age, with scores being higher in younger age group. Depression was not associated with the type of sexual orientation. Although the depression scores were higher in those who were in the closet, it was not statistically significant. Those who had negative experience of coming out of closet had significantly higher scores on CESD-R compared to those who had positive reaction on coming out. Conclusion: Depression is highly prevalent in Indian MSM.

Chronic kidney disease (CKD) is a significant health problem associated with high morbidity and mortality. Despite significant research into various pathways involved in the pathophysiology of CKD, the therapeutic options are limited in diabetes and hypertension induced CKD to blood pressure control, hyperglycemia management (in diabetic nephropathy) and reduction of proteinuria, mainly with renin-angiotensin blockade therapy. Recently, renal oxygenation in pathophysiology of CKD progression has received a lot of interest. Several advances have been made in our understanding of the determinants and regulators of renal oxygenation in normal and diseased kidneys. The goal of this review is to discuss the alterations in renal oxygenation (delivery, consumption and tissue oxygen tension) in pre-clinical and clinical studies in diabetic and hypertensive CKD along with the underlying mechanisms and potential therapeutic options.

This article outlines considerations for use of inhalation sedation (IS) in a primary care setting. It looks at indications, contraindications and case selection for use of IS in practice. The article also considers relevant rules, regulations and guidelines a practitioner should be aware of if practicing inhalation sedation. Some useful practical tips are included on setting up an inhalation sedation practice and being compliant with the Care Quality Commission (CQC) regulations. Standard requirements for staff and patient safety in practice setting are discussed, as are training, governance and CPD requirements for the dental team providing sedation in accordance with latest guidelines on conscious sedation. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is associated with impairments of sexual function and satisfaction. A review of available literature suggests that sexual dysfunction is common in depressed patients. Aim and objectives: This study was undertaken to assess prevalence of sexual dysfunction in patients with MDD, to evaluate relationship of MDD with sexual dysfunction, and to evaluate type of sexual dysfunction in these patients. Methods: Hundred consecutive drug naive patients of MDD according to DSM-IV-TR, presenting to psychiatry OPD of general teaching hospital, were evaluated. Sexual dysfunction was assessed by using Arizona Sexual Experience Scale. Female Sexual Functioning Index and Brief Sexual Function Inventory were used to identify type of sexual dysfunction in females and males respectively. Clinical Global Impression scale was used to assess overall severity of the illness. Data thus obtained was pooled and analysed using appropriate statistical tests. Results and conclusion: 77.78% of male patients and 74.55% of female patients with MDD had sexual dysfunction. In male patients, 48.89% had low sexual drive, 40% patients each had ejaculatory problem and problem with sexual life, while 37.78% had erectile dysfunction. In female patients, 54.54% had low lubrication and 52.73% had low orgasm. 49.09% of the patients each had low sexual drive, low arousal, and sexual pain disorder. Poor overall satisfaction with the sexual life was seen in 35% of male patients and 40% of female patients. Hence, this study emphasises the need for awareness and importance of enquiring about sexual dysfunction in depressed patients. [ABSTRACT FROM AUTHOR]

Unlabelled: Oral self-mutilation, although thought to be uncommon, is quite widespread. Practitioners should carefully consider self-mutilation as part of their differential diagnosis in unexplainable oral conditions. We report three paediatric cases of oral self-mutilation., Clinical Relevance: Deliberate self-mutilation, although practised in certain parts of the world, is relatively rare in western cultures. Although uncommon, Altom and DiAngelis believe oral self-mutilation is probably more widespread than is recognized. Self-mutilation of the oral soft and hard tissues can include gingival, mucosal and periodontal damage, glossectomy, auto extraction and the insertion of foreign bodies.