When it comes to a man's physique, enlarged breasts can be quite embarrassing. This is a condition known as gynecomastia or men boobs or  enlarged breast in men and affects more men than you would imagine. It may affect one or both breasts. It can result in terrible embarrassment, teasing, and social trauma. Many will try to hide it with thick loose shirts, avoid bare chest activities like swimming, exercises etc and withdraw from public exposure.Though it does not pose a significant health risk, it can affect a man's psychological health and lower his self-confidence. The good news is that men suffering from this condition do not need to live with it. 

Male breast reduction surgery or gynecomastia surgery, aims at reconfiguring the contours of a man's chest by removing excess breast fat & if needed extra gland tissues. The only permanent solution to this condition is surgery. This is because fat tissues are not solely responsible for enlarged breasts. Often glandular tissue is present in excessive amounts as well. Patients need careful evaluation by Plastic Surgeon & sometimes if needed by endocrinologist to determine the source of their breast enlargement. 

Gynecomastia surgery is usually a daycare procedure. It is performed by Plastic Surgeons under local anesthesia with liposuction being the most preferred procedure. This procedure begins when the surgeon makes a small incision on each side of the chest. These incisions are usually placed along the natural contours of the body, around the edge of the areola or near the armpit so as to reduce the visibility of scars. Excess fat and glandular tissue are then sucked out of this incision. Simultaneously, the surgeon sculpts the other tissues in the chest to redefine chest contours. Patients are usually advised to wear a compression garment after the surgery to support the healing tissues and minimize swelling. 

Results of this procedure are visible almost immediately. Recovery from gynecomastia surgery is usually quick and many men find themselves back to their normal routine within a few days. However, vigorous exercising and heavy lifting should be avoided for a few weeks after the surgery. The patient may also experience slight soreness and minimal pain that can be relieved with over the counter pain killers. 

The results of this procedure are generally permanent if there are no hormonal abnormalities. It is important to maintain a healthy lifestyle and avoid drugs that influence your testosterone levels. Regular exercise can also help tone the chest muscles and maintain the achieved good shape of chest. It is really a very simple but rewarding surgery for the male & it definitely boosts his confidence, body image & self-respect.

Enlarged Breast In Men - Causes And Treatment 

Anal herpes and anal warts are sexually transmitted diseases. These both diseases affect the genitals. As these are sexually transmitted diseases, these are transmitted through sexual contact.

Anal Herpes:

It is an infection caused by herpes virus, which is caused by the sore or blisters formed around the anus. This infection is caused by the herpes simplex virus (HSV) type 1 or 2 viruses.
The symptoms of anal herpes include red bumps or white blisters, itching and pain around the anal area, development of ulcer at the site of blisters, a coating that covers the ulcers ruptures or is bleeding, any change in the bowel habit.
Treatment

Antiviral therapy is one of the primary treatment for anal herpes. The virus responsible mainly for herpes is herpes simplex virus type II. Antiviral medications are given to patients, these medicines fight the virus. The symptoms of herpes are reduced with this therapy.
Regular use of antiviral medication is referred to as suppressive therapy. As the name suggests, people on suppressive therapy, reduce the risk of passing the infection to their sexual partner.
In severe anal herpes, the doctor might give intravenous antiviral therapy to control the infection.However, the herpes virus cannot be cured as it is considered a lifelong infection. The virus stays in the nerve cells for lifelong and is inactive for long periods of time. It only outbreaks when it is triggered by an externalfactor such as illness, stress, or sun exposure.
Prevention
As anal herpes is transmitted through sexual contact, one can lower the risk of this disease. Safety measures can be used are:

Wear a condom or use barrier protection during every sexual intercourse, including anal or oral sex.
Reduce the number of sexual partners.
If one maintains monogamy, the risk is minimal for transmitting anal herpes.
One should abstain from sex altogether, if possible.
Anal Warts:
Anal warts are small warts that occur around the anus. Another name for anal wart is condyloma acuminate. In many cases, anal warts don t cause any pain or discomfort. But, they cause irritation when they grow in size and might be itchy and/or bleed. However, if there are no symptoms seen, people suffering from anal wart might not even know that they have warts. Anal warts might occur only at a spot or even spread to different parts of the genitals such as buttocks, anus, and inner thighs over a period of time.

Symptoms
The anal warts are small bumps initially, a size of the head of a pin, which is not even noticed. However, as they grow, they can develop to a size of a cauliflower-likean appearance, when several warts are clustered together to form a huge lump. These warts are peach colored and the color may vary from yellow, light brown, or pink and it might even blend with the skin color. Usually the anal warts are without any pain or discomfort, however, other rare occurring symptoms are itching, discharge from the anus, or bleeding. Anal warts in women might appear on vagina, vulva, or at the cervix, whereas in men it can develop on penis, scrotum, groin area, or thighs.

Treatment
Topical medication can be used to treat anal warts, such as imiquimod, podofilox, podophyllum, etc. Another treatment of anal wart that depends upon the location and severity of the condition:

Cryotherapy
Electrocautery
Laser treatments
Surgery can be recommended for larger warts that do not respond to medications.

Anal Herpes & Warts - Possible Ways They Can Be Treated!

Loosening of breasts is natural with age. However, small and drooping breasts at a young age can affect your overall appearance and even lower your self-esteem. Some ill habits and lack of knowledge on how to increase breast size and maintain firmness often are the primary causes of sagging breasts.

Fortunately, increasing one s breast size and getting a well-toned bust does not necessarily involve going under the knife. There are quite a few ways to reshape your breasts naturally - 

Olive Oil Massage -

Olive oil consists of antioxidants and fatty acids that can rectify the damage done by free radicals. Besides, olive oil massage improves your body and skin texture by making the breasts firm. All you need to do is take a few drops of the oil and gently rub it on and around the breasts. Make sure you are rubbing in an upward motion. Massage for 15 minutes until the area around your breasts generates heat. This increases the flow of blood and repairs the cells that are damaged. Follow the technique 4-5 times a week.

Cucumber with Egg Yolk Massage -

Cucumber has skin-toning properties, while egg yolks contain high levels of proteins and vitamins. Mixing these two ingredients, you can prepare a paste to apply on the breasts. Take an egg yolk, one cucumber and a tablespoon of cream. Make a paste using these, apply on your bust and massage gently. Leave it on for half an hour and then wash the area with cold water. Using the paste once a week will leave your breasts firmer and in an upright position.

Fenugreek Seeds -
The phytoestrogen present in fenugreek improves oestrogen levels, which further helps in cell division and promotes breast enlargement. Prepare a paste using fenugreek seed powder and massage the same on your breasts. After about 10 minutes, wash it off with cold water. You can also consume fenugreek seeds in the form of herbal supplements but only after discussing the same with your doctor. 

Shea Butter and Rhassoul Clay -

A rich source of vitamin E, Shea butter helps tighten the skin around your breasts to give them a firmer look. Similar to olive oil massage, Shea butter massage also prevents cell damage due to the free radicals. Apply Shea butter on your breasts and massage in a circular motion for about 15 minutes. Leave it on for another 10 minutes before rinsing with cold water. Rhassoul clay contains iron, silica, sodium, potassium, and calcium   all the vital minerals that help keep your skin tight. Dissolve the clay into the water and prepare a sticky paste. Cover your breasts with the paste and let dry completely. Gently wash it off with cold water later.

Why turn to expensive lotions and undergo surgery when you can get wonderful, firm breasts naturally? Follow these tips and see your body change for the better. Say goodbye to sagging breasts.

How To Increase Breast Size And Make Them Firm?

A chemical burn can occur owing to a number of substances, for instance, if the skin comes in contact with strong acids, bases, irritants, gasoline, paint thinner and drain cleaners then it react with your skin. Chemical burns are also termed as caustic burns. The symptoms usually depend on the intensity of a burn, which include redness, irritation, numbness, pain, the skin turning black and dead or even vision loss, if the chemicals come in contact with the eyes.


What are the Do s and Don ts?
Do away with those chemicals, which have caused the burn or wipe off the dry chemicals. It is safe to use towels or put on gloves for this work.
Remove jewelry or any contaminated clothing to avoid further burning and inflammation of the skin.
Rinse off the affected area immediately with cold water. 
Loosely wrap the area with sterile gauze or a bandage.
If required, you can even opt for pain relievers such as naproxen sodium, ibuprofen or acetaminophen.
Consider taking a tetanus injection, but at the same time, ensure that your booster is up-to-date.
Refrain from applying an antibiotic ointment over the burnt area or neutralizing it with an alkali or acid. This may aggravate the burn.


When should you seek an emergency care?
When the person exhibits sign of shock such as shallow breathing, pale complexion or is experiencing bouts of fainting.
When the chemical burn pierces through the upper layer of the skin, occupying an area of above 3 inches in diameter.
When the chemical burn has spread to the buttocks, groin, face, feet, hands, eyes or even the limb.


Chemical Burns - Do's and Don'ts You Must Follow

Stress and fatigue as well as hormonal issues and genetically inherited conditions may leave a mark on our faces, and the eyes in particular. We talk about getting under-eye puffiness, yet we fail to notice that some of us also experience the ill effects of another issue: eyes that look hollow. This issue is particularly evident on more thin faces. As a general rule, ladies who experience them say that they look tired even when they aren't. For some ladies, they start seeing hollows in the under eye area in their mid-30s. As they grow older, the procedure accelerates and gives them a tired and old appearance.

Causes: So what causes a hollow to happen? The fat cushions that line the drop and start to leave the area with an empty look. This creates a less than flattering look which also looks dark and unsightly. Some of the fixes for this problem are as follows:

Filler Fix: Hyaluronic corrosive is successful in filling the affected areas under the eyes, when the tissue is injected with it. The best choice is hyaluronic corrosive filler, for example, Restylane or Juv&eacute;derm Voluma, in combination with the surface medicines for the skin.

Lasting Fix: A lower eyelift or blepharoplasty surgery can expel any free skin under the eyes that gives a hollow look. The fat can be repositioned or added to smooth out depressed skin.

Product Fix: Applying cucumber cuts and items with vitamin C can also help. It can diminish the dark circles that occasionally come with eye hollows. If you find that you have dark circles as well, a solution of hydroquinone can help up under-eye shadows.

Utilize an eye cream with hyaluronic corrosive as one of the fixings.

Use hyaluronic corrosive alone on the influenced region, being exceptionally cautious not to get it in your eyes.

Some of the natural strategies are:

1. Rest: This is the genuine, essential and a viable home solution for hollow eyes. As said before, a depressed eye usually calls for more rest.

2. Almond Oil: Apply almond oil under the eyes a few times each day. Almond oil is rich in Vitamin E, a sustaining vitamin for glowing skin.

3. Raw Potato Juice: Raw potatoes are equally important to heal sore eyes and dark circles. Cut the potatoes and lay it on the affected spot for around 20 minutes.

4. Utilized tea packs: With rich cell reinforcements, utilizing tea packs advances blood flow. The sore and darker skin gets renewed.

5. Cucumber: Any eye based solution without cucumber is incomplete. Get some rest by setting cut cucumber on eyes and wake up with new, restored and sparkling eyes.

The Best Procedure for Doing Away With Under Eye Hollows

Hypothyroidism is a condition in which the thyroid gland is not producing the thyroid hormones adequately. This is a fairly common condition.

What is thyroid gland?

The thyroid gland is a small butterfly-shaped gland located just below Adam s apple. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs.

What are the hormones produced by thyroid gland and what do they do?

The thyroid hormones are of two types   T3 (Tri iodo thyronine) and T4 (Thyroxine). These hormones are mainly responsible for the body s metabolism - a process in which food is converted into energy in the cells. They influence growth and development and regulate various bodily functions which are mentioned below:

Heartbeat
Body temperature
Breathing
Body weight
Metabolism of fat
Menstrual cycles in females
Functioning of Nervous system
Digestion
Burning calories etc.
What is Hypothyroidism?

Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body s development to slow down and reduces metabolism rates.

What are the causes of Hypothyroidism?

Hypothyroidism can be caused by a number of factors:

Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.
Iodine deficiency in diet. For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.
Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc.   for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery   this is called Postpartum thyroiditis.
Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.
Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby s heel.
What are the different types of hypothyroidism?

One classification is based on whether the defect is with the thyroid gland or not:

Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
Secondary hypothyroidism: Here the problem is with the Pituitary gland or the Hypothalamus. This results in abnormal production of TSH or TRH, which indirectly leads to less production and secretion of thyroid hormones.
Another classification is based on the symptoms and levels of the thyroid hormones and TSH:

Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
Subclinical hypothyroidism: Here patient may or may not have symptoms. The T3/T4 levels are normal but TSH is high. In this situation the patient is at an increased risk of developing overt hypothyroidism in the future especially if he has Thyroid peroxidase antibodies on testing.
Who are at risk of developing Hypothyroidism?

Women have a higher risk of suffering from hypothyroidism than men.
Older people are at increased risk.
People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison s disease etc.
People with psychiatric conditions such as bipolar disorder
People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.
What are the symptoms of hypothyroidism?

Symptoms vary from person to person. They may also mimic other conditions and hence be difficult to diagnose. Symptoms may also develop very slowly over a span of moths-years. Some of the characteristic symptoms of this disease are:

Depression
Constipation
Hair loss
Dry hair
Dryness of the skin
Tiredness
Body pains
Fluid retention in the body
Irregular menstrual cycle
Increased sensitivity to cold
Reduced heart rate
Increase in size of the thyroid gland   called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
Weight gain
Carpal tunnel syndrome
Hoarse voice
Infertility
Loss of libido/sex drive
Confusion or memory problems especially in the elderly
What are the symptoms to look for in a baby if you suspect hypothyroidism?

Infants suffering from congenital hypothyroidism may show no symptoms or exhibit signs of excessive drowsiness, cold hands, cold feet, constipation, hoarse cry, poor growth or absent growth, poor appetite, bloating of abdomen, puffiness of face, swollen tongue, persistent jaundice.

How to diagnose hypothyroidism?

Blood tests:

TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
T4: A low level of thyroxine indicates hypothyroidism.
T3: these levels are generally not needed to diagnose hypothyroidism
Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
Ultrasound of the neck is done if the patient presents with a thyroid swelling.
What is the treatment of hypothyroidism?

Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30   45 minutes before breakfast. The treatment is continued for the rest of the patient s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective.

Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.

What are the side-effects of thyroxine medication?

There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains.

Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc.

There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc.

What are the complications of hypothyroidism?

If untreated hypothyroidism can lead to:

heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
obesity
infertility
joint pains
depression
A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma.
References:

2013 ETA Guideline: Management of Subclinical Hypothyroidism; European Thyroid Association (Nov 2013)
Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee; British Thyroid Association (2015)
The diagnosis and management of primary hypothyroidism; Royal College of Physicians and others (June 2011)
Suh S, Kim DK; Subclinical Hypothyroidism and Cardiovascular Disease. Endocrinology Metabolism (Seoul). 2015 Aug 4.
UK Guidelines for the Use of Thyroid Function Tests; British Thyroid Association (2006)
Gaitonde DY, Rowley KD, Sweeney LB; Hypothyroidism: an update. American Family Physician. 2012 Aug 1 86(3):244-51.
Bindra A, Braunstein GD; Thyroiditis. American Family Physician. 2006 May 15 73(10):1769-76.
Wilson GR, Curry RW Jr; Subclinical thyroid disease. American Family Physician. 2005 Oct 15 72(8):1517-24.
British National Formulary; NICE Evidence Services (UK access only)
Baumgartner C, Blum MR, Rodondi N; Subclinical hypothyroidism: summary of evidence in 2014. Swiss Medical Weekly. 2014 Dec 23 144:w14058. doi: 10.4414/smw.2014.14058. eCollection 2014.

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