A 40 year male, resident from a tribal area near Mumbai, came to casualty with a green coloured plastic ring tightly encircling at the base of his penis. He gave history that, when he was sleeping under influence of tadi (local hooch) in his farm, few unknown people put his penis in a plastic bottle by force. He somehow managed to run away from there. He then himself managed to cut out the broad and thin portion of the bottle. But he could not remove the neck of bottle as it was hard to cut. Case was registered in MLC register & information was given to police for further action.

During the investigation of police the patient got frightened and confessed to that the act of inserting his penis into the bottle of sprite (cold drink) was done by himself for the sexual gratification.

Sexual offences are classified under the following headings: (I) Natural offences: Rape, Incest, and Adultery. (II) Unnatural offences: Sodomy, Tribadism, Bestiality, and Buccal Coitus. (III) Sexual Perversions: Sadism, Masochism, Necrophilia, Fetichism, Transvestism, Exhibitionism, Masturbation, Frotteurism, Undinism, and etc. (IV) Sex-linked offences: Stalking, Voyeurism, Sexual harassment, Trafficking, and Indecent assault. [1]

Sexual Perversions is defined as persistently induced sexual acts or fantasies in which complete satisfaction is sought and obtained without sexual intercourse. [2] Sexual perversion includes uranism, paraphilia, sadism, masochism, lust murder, necrophilia & etc. The perverted behavior is really a repulsively abnormal and frequently cruel form of tension release that by its nature tends to operate under compulsion. If not fulfilled they can cause clinically significant distress [DSM-V]. [3]

Diagnosis of all non-criminal paraphilias requires that they are present for at least six months and cause clinically important distress, or impair work, or cause problems with social or personal functioning.^[4] To differentiate between atypical sexual interest and a mental disorder, DSM-5 requires that, for diagnosis, people with such interests exhibit the following:

With the inventions of means of communication human race has advanced to many marks. One amongst these and most important is internet and other is smartphones. All dreams and fantasies are just a click away, though fictitious but can fulfill world of dreams with joy of own kind. Every invention comes with advantages and disadvantages, internet also shares the same. One of the most commonly worried and noticed disadvantage of net & other electronic means of communication is availability of pornography, anywhere anytime.

In June 2000, the Indian Parliament created the Information Technology (IT) Act to provide a legal framework to regulate internet use and commerce, including digital signatures, security, and hacking. The act criminalizes the publishing of obscene information electronically and grants police powers to search any premises without a warrant and arrest individuals in violation of the act. A 2008 amendment to the IT Act reinforced the government's power to block Internet sites and content and criminalized sending messages deemed defamatory or offensive.

The treatment of paraphilias and related disorders has been challenging for patients and clinicians. In the past, surgical castration was advocated as a therapy for men with pedophilia, a cruel punishment where the express willingness and consent of the patient is not objectively indicated. Psychotherapy, self-help groups, and pharmacotherapy (including anti-androgen hormone therapy sometimes referred to as "chemical castration") have all been used.

According to Thibaut et al’s evaluation of 40 years (1969-2009) of treatment research, use of psychotropic drugs showed very poor evidence of effective treatment for paraphilic sexual behaviors. The same was found for anti-androgens, also associated with many side effects including hot flushes, leg cramps, hair loss, bone mineral loss and cardio issues, with the benefit/risk ratio not favoring use of such drugs. [6]

Only gonadotropin-releasing hormone treatment showed high efficacy, working in a similar way to physical castration. It rapidly desensitizes gonadotropin-releasing hormone receptors, resulting in reduction of luteinizing hormone, which is responsible for the stimulation for release of testosterone in the testes. However, research into all treatments of paraphilia is blighted by small sample sizes, short duration of follow-up, open and retrospective studies, lack of controls and biases, and its associated co-morbidity with other disorders. Thus, the effectiveness of treatments for these paraphilias presented is inconclusive.

As part of prevention sex education at the basic primary level might contribute in helping the change necessary to up bring a healthy mind. Psychiatric counseling like behavior therapy whereas can help in managing non legal paraphilia cases.

The Indian government banned access to sites hosting pornography in November 2014. The ban was later lifted within a week due to heavy public pressure. On 1 August 2015, 857 pornographic sites were blocked under section 79 3(b) of Information Technology Act, 2000, to restrict access to pornographic content.

Conflict of Interest: None

Funding: None