Monthly Archives: December 2018

Does Ear Discharge Bother You?

Ear Infections

Ear discharge is defined as any fluid coming from the ear. It’s also called otorrhea. Earwax is a normal discharge made from oil, naturally produced in the ear.

But sometimes, blood or other fluids can enter the ear, such as through a ruptured eardrum. This is why ear discharge symptoms should never be ignored. They could be a sign of a treatable infection or a symptom of more serious trauma.


Ear discharge can be caused due to:-

1. Eardrum perforation – due to:-

  • Foreign object in the ear canal
  • Injury from a blow to the head, foreign object, very loud noises, or sudden pressure changes (such as in airplanes)
  • Inserting cotton-tipped swabs or other small objects into the ear
  • Middle ear infection

2. Fungal infection
3. Upper Respiratory Infection



  • White, yellowish, or grey discharge
  • Foul-smelling discharge
  • Painful at times
  • Decreased hearing
  • Swelling
  • Fever if due to infection


  • Ear drops: Commonly prescribed to reduce inflammation and swelling seen in cases of trauma and infections.
  • Antibiotics: Prescribed to prevent widespread infections.
  • Surgery: Treatment option for patients with a damaged eardrum due to trauma.


Are There Any Alternatives To Knee Replacement?

Knee Replacement

Knee replacement surgery involves surgeons replacing the damaged or diseased knee joint with a mechanical implant made of metal and plastic composites that act as a joint. Since this is an invasive procedure and requires a lengthy recovery period, this should be only considered after other less obtrusive treatments have been explored.

People between the ages of 45 and 60 who show signs of chronic knee pain, need not possibly regard knee replacement as a primary choice of treatment.

Non-surgical or surgical approach prior to knee replacement surgery includes:-

  • Weight loss and exercise

According to the John Hopkins Arthritis Centre, being just 10 pounds overweight can add up to 60 pounds of force on your knee with each step. One of the quickest, most effective ways to reduce knee pain is to lose weight. Exercise helps to achieve the goal to reduce weight and hence relieve you of knee pain.

  • Physical therapist

Doing exercises correctly is the basic regimen of the physicist to reduce the knee pain by strengthening the key muscles. Electrical stimulation, ultrasound therapy, or other procedures to increase blood flow to the skin are used.

  • Knee injections (hyaluronic acid)

Knee injections of hyaluronic acid lubricate the knee joint and help improve shock absorption. The procedure can reduce pain and improve knee mobility. However, this is typically offered to people after they have gone through steroid injections and physical therapy without success, or if they are allergic to certain painkillers.

  • Radiofrequency ablation

RFA is a quick procedure that uses radiofrequency energy to heat and alter nerves to create a nerve block.

  • Steroid Medication

Lidocaine or bupivacaine may help control your knee pain topically.
The steroids can be injected at the site of inflammation. They are used for relieving pain around the knee with immediate effects.

  • Arthroscopic surgery

A much less invasive technique that involves removal of bone fragments, pieces of a torn meniscus, or damaged cartilage, as well as repair of ligaments. People mostly go home the same day as their surgery. Within a week, you can resume your daily activities.

  •  Bone marrow aspirate conentrate

Concentrated BMA is high in stem cells that are capable of tissue regeneration and bone formation. It is a painless process that includes aspirating the needed bone marrow tissue, usually without any incision or stitches. The bone marrow aspirate is then injected into the knee, and can even be mixed with amniotic tissue for more powerful pain relief by healing.

  • Knee osteotomy

Knee osteotomy is usually used for younger patients with limited knee damage. This procedure aims to reduce the load around the damaged area of the knee.

If you are suffering from a knee pain and want to discover the various alternatives to knee replacement surgery, visit our eminent and proficient orthopedic surgeon, Dr. Ravinder Puri for better knowledge and treatment.

Feeling pain in the Chest? No, It’s not necessarily a Heart Attack!


Chest pain is broad term which can mean pain occurring in any region between the neck and upper abdomen.

Chest pain can differ from person to person based on:

  • Quality
  • Intensity
  • Duration
  • Location

Nature of pain explains a lot about the severity of the pain. Diagnosis becomes easier once the doctor gets the knowledge about the nature of pain.

A person might explain the pain as:

  • Sharp
  • Dull
  • Burning
  • A tight or squeezing
  • Stabbing

Depending on the location of pain, chest pain can be differentiated as:

  • Cardiac (pertaining to its origin in the heart)
  • Non- Cardiac (pain occurring elsewhere except from heart)

What could be the possible causes of Cardiac Chest Pain?

Chest pain because the heart is felt due to one of the following heart problems:
Coronary Artery Disease, or CAD. -A blockage in the heart blood vessels causing reduced blood flow and oxygen to the heart muscle. This may give rise to pain in the chest known as Angina. This chest pain is radiating in nature and may spread to arm, shoulder, jaw, or back. It may feel like a pressure or squeezing sensation. Chest pain or angina can be an early sign of a heart attack.

Myocardial infarction (heart attack) - The death of heart muscle cells due to complete obstruction in blood flow give rises to heart attack Myocarditis. Inflammation of myocardium or the heart muscle causes chest pain which is accompanied by fever, fatigue, fast heartbeat, and troubled breathing.

Pericarditis- An inflammation or infection of pericardium causes pain similar to that caused by angina.

Hypertrophic cardiomyopathy- The genetic disease in which the heart muscle abnormally thickens leading to interrupted blood flow and hence the chest pain.

Mitral valve prolapse- a condition in which a valve in the heart fails to close properly.
Coronary artery dissection- causes a sudden severe pain with a tearing sensation that goes up into the neck, back or abdomen.

Apart from the heart what are the other problems giving rise to Chest pain?


Gastrointestinal causes of chest pain

  •  Heartburn
  • Acid reflux
  • Gallstones
  • Swallowing problems related to disorders of the esophagus
  • inflammation of the pancreas or gallbladder

Lung-related causes of chest pain

  • Pneumonia
  • Bronchitis caused by virus
  • Pneumothorax
  • Pulmonary emboli
  • Bronchospam

Muscle- or bone-related causes of chest pain

  • Sore muscles from exertion
  • Chronic pain syndromes
  • Fractures causing pressure on a nerve
  • Costochondritis – inflammation of cartilage located in chest wall

Other causes
Psychological causes:

  •  Anxiety
  • Panic attacks

Shingles Caused by the varicella-zoster virus

How to Diagnose a Chest pain?
A doctor will diagnose the cause of chest pain by looking into the symptoms, pattern, and intensity of the pain. If at all it is a severe, non-explainable kind of chest pain visit the Cardiologist at Cheema Medical Complex, for it may be indicative of heart attack.

We at Cheema Medical Complex are well equipped with Diagnostic (ECG, ECHO, TMT, HOLTER monitors) as well as state of art therapeutic Cath Lab for proper diagnosis and treatment of cardiac chest pain.

Treatments for Heart-related causes of chest pain include:

  •  Medications, including Nitroglycerine
  • Clot-busting drugs, or blood thinners
  • Coronary angiography
  • Coronary angioplasty or CABG
  • Temporary and permanent Pacemakers

Treatments for other causes of chest pain include:

  • Lung re-inflation for a collapsed lung
  • Antacids for acid reflux and heartburn
  • Anti-anxiety medications for chest pain related to panic attacks

Heart Attack and Heart Failure- What is the difference?

heart attack

The heart pumps the blood and circulates it to the entire body. It carries the oxygen and nutrients to the tissue and the waste products from the tissue. In turn, blood gets the oxygen and nutrients via the coronary arteries to function continuously.

If the blood supply to the heart is deficient, the cardiac muscles suffer from hypoxia and ultimately die. Cardiac muscle cells are irreplaceable. Prior to the complete blockage of a coronary artery, most people with narrowed coronary arteries will experience a symptom known as angina. It is usually described as a discomfort in the chest and can radiate to the arms (usually left), neck, or jaw. Usually, this pain goes away with rest or after taking a medication to help improve blood flow to the heart muscle.

Most heart attacks develop in conjunction with coronary artery disease (CAD). In CAD, plaque gradually builds up in the coronary artery leading to a disease known as atherosclerosis. The combination of plaque formation along with a blood clot is the typical reason for blockage of the coronary artery causing the heart attack. Some of the contributing factors leading to heart attack due to blockage are obesity, high cholesterol, high blood pressure, smoking, diabetes, and sedentary lifestyle.
If the blood supply is cut off critically, the muscle dies to cause severe, unbearable pain. This is called myocardial infarction or heart attack. A heart attack usually occurs suddenly. Severe chest pain with sweating is seen in the myocardial infarction. The severity of the heart attack depends on how big a blood vessel was blocked, and therefore how much heart muscle died.

An extensive heart attack may cause heart failure.

Heart failure basically means ‘heart inefficiency’ to pump the required amount of blood each time it beats. It is a condition where the heart fails to pump out enough blood to the body causing ischemia of the body tissues.

A chronic progressive process from coronary disease or other diseases affects the heart muscle, making it weak. Common factors that can lead to heart failure are high blood pressure, alcohol, and problems with the heart valves.

Heart failure is not an acute process and is not painful. It does not lead to sudden death. The symptoms and signs of heart failure are gradual unlike those in a heart attack. The symptoms of heart failure include swelling of the tissues, difficulty in breathing, irregular pulse, difficult to sleep and fatigue.

When the electrical impulses cease and the heart stops to beat, it leads to cardiac arrest. A person with cardiac arrest dies due to fatal cardiac shock.


We at Cheema Medical Complex have a facility of catheterization laboratory or cath lab which is well-equipped for the effective diagnosis of the heart attack. Various diagnostic tests we recommend and perform on the patients suspected with heart attack are:

  • A series of electrocardiograms (ECGs) using Holter
  • Blood tests
  • Chest X-ray
  • Echocardiography
  • Nuclear imaging
  • Exercise tolerance (stress) test –TMT
  • Coronary angiography
  • Angioplasty

Some points to note:

  • Heart attack differs from heart failure.
  • Heart failure is a clinical diagnosis.
  • Heart attack is a medical emergency.
  • A heart attack may be a cause for heart failure
  • Severe chest pain is the feature of a heart attack.


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