Gynecomastia treatment should it be individualized? a prospective study

Gynecomastia is a benign enlargement of the male breast. Was to analyze a 3 year period of gynecomastia patients in Al Kindy Teaching Hospital and the surgical approach used and its outcome. A prospective study of patients consulting Al Kindy Teaching Hospital because of gynecomastia between October 2007and August 2010 was done. Data were analyzed for etiology, grade of gynecomastia, surgical technique, complications, and histological results. A total of 64 patients with 86 operations were included. Techniques included subcutaneous mastectomy alone, or subcutaneous mastectomy with wise pattern "inverted T incision". Atypical histological findings were found in 3.12% of the patients [papilloma, fibrolipoma]. Surgical revision among all patients was 7%. Body mass index higher than 25kg/m2 was found as significant risk factors for complications [p/0.043], and that higher grades of gynecomastia [grade IIb and III]had higher statistical incidence of complications p=0.01 The treatment of gynecomastia requires an individualized approach. Caution must be taken in high BMI and higher grades, which are associated with increased complication rates. Histological tissue diagnosis should be routinely performed in all true gynecomastia corrections, because histological results may reveal atypical cellular pathology

Cervical necrotizing fasciitis with thoracic and abdominal wall extension

A 54 year old diabetic male presented with extensive cervical cellulitis following history of a dental problem. This was followed by a very rapid development of necrosis, gangrene of the skin and deep fascia of the neck, anterior chest and abdominal wall. The patient died 50 hours following admission to Al-Kindy Teaching Hospital inspite of the aggressive triple antibiotic therapy and debridment, of system organ failure due to septicemia