Monthly Archives: April 2019

What is Epistaxis?


Epistaxis or nose bleeding is acute hemorrhage occurring in your nasal cavity. It is a noticeable medical condition when the blood drains out of your nostril.

Nosebleed rarely is the cause of death. Only 10% of cases have been reported to be fatal.
Based on the site of origin, you can classify it into anterior and posterior nose bleeding or epistaxis.

The anterior nose bleeding is the most common type. The posterior type of nose bleeding is less common and requires medical attention.

Usually, nose bleeds from one nostril. In case you suffer from heavy bleeding, you will notice bleeding from both nostrils. In rare cases, epistaxis can be accompanied by nausea or vomiting, when the blood drips down your stomach and comes out through the throat.

Though excessive bleeding is not a common finding, if at all your nose bleeds excessively, you might notice the following symptoms:

  • Dizziness
  • Fainting
  • Confusion
  • Loss of alertness
  • Light-headedness
  • Bleeding from teeth, gums, nostrils, etc.

Additional bleeding from other parts of the body such as bleeding gums when brushing teeth, blood in urine or bowel movements, or easy bruising is indicative of an inability of the blood to clot.

Epistaxis can happen if you are suffering from any of the following disorder, condition or disease:

  • Hemorrhage
  • Structural or anatomical deformities
  • Nasal sprays and prolonged usage of nasal steroids
  • Middle ear barotraumas due to the sudden change of pressure
  • Surgery such as functional endoscopic sinus surgery
  • Exposure to warm, dry air for prolonged periods of time
  • Allergic rhinitis
  • Deviated or perforated nasal septum
  • Cocaine use
  • Infectious disease (cold) or high blood pressure
  • Connective tissue disease
  • Leukemia
  • Certain drugs like aspirin, warfarin, isotretinoin, etc
  • Pregnancy (due to hypertension and hormonal changes)
  • Vascular disorders
  • Vitamin C and vitamin K deficiency

Your doctor will diagnose epistaxis by taking a thorough personal and family medical history. He/ she will look up your nose. The doctor will take a blood pressure reading to check if you have hypertension leading to epistaxis.

The doctor might perform a variety of other tests to help to diagnose potential underlying diseases, conditions or disorders, such as allergic rhinitis, skull fracture, or cocaine use. The various tests include drug testing, blood tests, allergy skin testing, and imaging tests, such as X-ray, CT scan, nuclear scans, and MRI.

Your doctor will pinch the nose shut or use a nose clip to hold it closed until the bleeding stops. Ice application may be advised. Treatment of epistaxis also involves diagnosing and treating the underlying disease, disorder or condition that is causing it.

If you notice epistaxis, visit CMC for proper diagnosis and treatment under the hands of experts.


Recovery Time for Total Laparoscopic Hysterectomy (TLH)

Laparoscopic Hysterectomy

Total laparoscopic hysterectomy is the process of removal of the uterus and cervix through four small (1/2’- 1’) abdominal incisions.

When is TLH recommended?

TLH is the choice of surgery to treat various conditions of the uterus, which may include:

  • Fibroids
  • Endometriosis
  • Infection in the ovaries or tubes
  • Pelvic pain
  • Overgrowth of tissue in the lining of the uterus
  • Abnormal vaginal bleeding

After proper preparation, the doctor will sedate you with anesthesia. Once you lose consciousness, the laparoscope is inserted into the abdomen and carbon dioxide gas is blown into the abdomen to inflate the belly wall away from the internal organs. Then your doctor will make 4 small incisions in your abdomen to remove the uterus, cervix, the ovaries, and tubes.

What can be the risk factors involved during the surgery?

Though your doctor will carry out the surgery with all precision, there can be still some chances of complications that may occur. They include:

  • Bleeding
  • Damage to the bladder or bowel
  • Conversion to an open surgery
  • Death

What can be the possible risks that can occur days to weeks after surgery?

  • Bowel obstruction
  • A blood clot in the legs or lungs
  • Hernia
  • Opening of the incision
  • Infection: Bladder or surgical site infection
  • Scar tissue

What is the recovery time for TLH?

The recovery period after a total hysterectomy is usually between six to eight weeks. It is normal to have a decreased energy level after surgery. During the first week at home, you should minimize any strenuous activity. Walking around the house and taking short walks outside can help you get back to your normal energy level more quickly.

Climbing stairs are permitted, but you may require some assistance when you first return home. For 4-6 weeks after your surgery, you should not lift anything heavier. You may begin normal physical activity within hours of surgery. No sexual activity for 8 weeks after surgery is recommended.

Talk to our gynecologist at CMC, Dr. Navdeep Kaur for accurate treatment involving TLH.

How to Manage Time in a Heart Attack?

Heart Attack

A heart attack is an emergency condition. It needs your immediate attention. An extensive heart attack may cause heart failure. Timely preserve your heart muscle by preventing further blood clots from forming in your coronary arteries. With appropriate medical therapy, help the cardiologist maintain your cardiovascular system.

Prevent any long-term complications from the heart attack by well-timed treatment.
Surviving a heart attack requires an ongoing effort on your part, and on the part of your doctor.

The immediate priorities while managing Heart Attack includes:

  • Accurate diagnosis of the heart attack
  • Stability of your vital signs (pulse and blood pressure)
  • Preparation to deal with life-threatening conditions

Your doctor would open up the blocked vessel to restore blood flow to your heart muscle. Other than that the cardiologist would use all the possible measures to treat acute heart attack well in time.

Also Read: Warning Signs of Heart Attack

Our cardiologist, Dr. Ruchir Rastogi, at CMC is well versed in his expertise. You will be surely impressed by his time management. You would not be disappointed once you get treatment in his fine hands.

Exercise During Pregnancy

Exercise During Pregnancy

Physical exercise improves your overall health and wellness. Without any doubt, you should continue exercising even if you’re pregnant. Overall exercise during is considered safe.

Especially if you’ve been already exercising, it is totally normal to continue the same as long as you feel no discomfort. There are certain exercises that specifically help you build stamina for labor and delivery.
However, if you have never exercised regularly before, you can safely begin exercising during pregnancy after consulting your health care professional.

How much exercise is enough?

Unless you have a medical or pregnancy complication, 30 minutes of moderate exercise per day on most if not all days of the week is enough for you if you are pregnant. Exercising for 20 minutes just 3-4 days a week is fine as well.

What are the benefits of exercise during pregnancy?

Regular exercise can help:

  • Keep your mind and body healthy.
  • Gain the right amount of weight during pregnancy
  • Fight constipation, back pain and swelling in your legs, ankles, and feet
  • Manage stress and sleep better.
  • Reduce your risk of pregnancy complications, like gestational diabetes and preeclampsia.
  • Reduce your risk of having a cesarean birth (also called c-section).
  • Gets your body ready for labor and birth

When should you stop exercising?

Though exercising is safe during pregnancy, but if you notice any of the following symptoms, you should immediately abstain from the activity and consult your doctor:

  • Bleeding from the vagina or fluid leaking from the vagina
  • Chest pain, fast heartbeat or trouble breathing
  • Feeling dizzy or faint
  • Headache
  • Muscle weakness, trouble walking or pain or swelling in your lower legs.
  • Regular, painful contractions.
  • Your baby stops moving. This may be a symptom of stillbirth

Guidelines to follow when you exercise during pregnancy:

  • Wear loose-fitting, comfortable clothes and shoes as well as a good support bra
  • Exercise on a flat, level surface to prevent injury.
  • Consume enough calories to meet the needs of your pregnancy.
  • Eat your meals at least one hour before exercising.
  • Drink water before, during, and after your workout.
  • After doing floor exercises, get up slowly and gradually to prevent dizziness.
  • Avoid exercise to the point of exhaustion.

What exercises are safe to do?

These activities usually are safe during pregnancy:

  • Walking
  • Swimming and water workouts to relieve lower back pain.
  • Prenatal yoga and Pilates classes especially for pregnant women.
  • Low-impact aerobics classes including walking, riding a stationary
  • Strength training to build muscle and make your bones strong.

What kinds of activities aren’t safe during pregnancy?

They include:

  • Holding your breath during any activity.
  • Activities where falling is likely (such as skiing and horseback riding).
  • Contact sports such as softball, football, basketball, and volleyball.
  • Any exercise that may cause even mild abdominal trauma such as activities that include jarring motions or rapid changes in direction.
  • Activities that require extensive jumping, hopping, skipping, bouncing, or running.
  • Deep knee bends, full sit-ups, double leg raises, and straight-leg toe touches.
  • Bouncing while stretching.
  • Waist-twisting movements while standing.
  • Heavy exercise spurts followed by long periods of no activity.
  • Exercise in hot, humid weather.

What are the body changes that affect exercise during pregnancy?

You may notice the following changes:-

  • Loss of Balance
  • Slightly higher body temperature
  • Breathing- As your baby develops and your body changes, you need more oxygen. Your growing belly puts pressure on your diaphragm, a muscle that helps you breathe. You may even find yourself feeling short of breath at times.
  • You may have less energy.
  • Your heart works harder and beats faster during pregnancy to get oxygen to your baby.
  • Try to avoid any movements that may strain or hurt your joints.

You can visit CMC, Mohali to seek the best knowledge about exercise during pregnancy.

What is IVF(Vitro Fertilization)?

vitro fertilization

IVF or in vitro fertilization is a fertility treatment wherein eggs and sperm are made to fertilize outside the body in a laboratory, post which the embryo or embryos placed or implanted in the uterus.

IVF is a type of ART or assisted reproductive technology.

When is IVF done?

Your doctor will recommend you to have IVF if you face any of the following problems:

  • Endometriosis
  • Low sperm counts
  • Problems with the uterus or fallopian tubes
  • Problems with ovulation
  • Antibody problems that harm sperm or eggs
  • The inability of sperm to penetrate or survive in the cervical mucus
  • An unexplained fertility problem

How does IVF work?

IVF is a lab procedure and takes several months for its completion. The first step involves your doctor prescribing some medications that would help in maturation of your eggs, making them ready for fertilization. Your ovaries will be examined with the help of an ultrasound. To keep the hormone levels under check, your doctor will perform blood tests. Once the ovulation is induced, the doctor will perform a minor surgery called egg retrieval to remove the eggs from your body.
The eggs that are taken out of your body are then mixed with your partner’s sperm. This is known as insemination and is carried out in a lab, to help the sperm fertilize the eggs.

The next step involves the transfer of the fertilized egg or embryo into your uterus. The doctor will insert the embryo directly into your uterus through the tube via your cervix, which is painful in rare cases.

For the survival of the embryo in your uterus, you may be given shots of progesterone for the first 8-10 weeks. Implantation of the embryo occurs usually after 6-10 days of egg retrieval. Pregnancy takes place only if any of the embryos attach to the lining of your uterus.

What are the possible side effects of IVF?

  • Bloating
  • Cramping
  • Tenderness in breasts
  • Mood swings
  • Headaches
  • Bruising from shots

Allergic reaction to medicines

  • Bleeding
  • Infection

What are the various risks involved with IVF?

  • Multiple pregnancies
  • Ectopic pregnancy wherein the embryo implants anywhere other than the uterus
  • Can cause emotional and financial stress

The success rate of IVF involves many factors like the age of the woman, cause of infertility, years of infertility, type of embryo transfer, quality of the sperm and whether self-eggs or donor eggs were used.

  • The success rate is higher when frozen embryos are used as opposed to fresh embryos.
  • Success is higher in younger women.
  • Donor eggs likewise come from a younger donor who is medically fit and hence tends to give better success rates.
  • Better the sperm quality better the success rate.

Visit CMC for any knowledge regarding IVF as we are well equipped with the best facilities as well as the best gynecologist in tricity.

What is Intrauterine Insemination (IUI)?

Intrauterine insemination

IUI or Intrauterine insemination is a process in which the healthy sperm sample is put into the uterus directly around the time of ovulation.
It is carried out as an alternative to natural fertility or as an infertility treatment. It is an artificial way of bringing together sperm and egg to fertilize. It is also known as artificial insemination or donor or alternative insemination.

When is IUI done?

Intrauterine insemination is used most often in couples who have:

  • For women who need to use donor sperm to get pregnant
  • Unexplained infertility
  • Endometriosis-related infertility
  • Mild male factor infertility- below-average sperm concentration, weak movement (motility) of sperm, or abnormalities in sperm size and shape.
  • Ejaculation dysfunction
  • Too thick cervical mucus interfering with the sperm’s journey.
  • Semen allergy. Rarely, a woman could have an allergy to proteins in her partner’s semen.

How does IUI work?

The IUI procedure is performed around the time you are ovulating for which your doctor will monitor your cycle closely. For IUI, your doctor will do sperm washing which is a laboratory technique for separating sperm cells from other cells and fluid, and the separating motile sperm from non-motile sperm, to use in IUI or IVF.

The technique helps to maximize healthy sperms. Then the sample is loaded and injected in the uterus of the female body. Various ovulation-stimulating medications may be used for the best results.

1-2 days post-surge of the Luteinizing Hormone (LH) is the right time to carry out the procedure as it indicates the beginning of ovulation. Pregnancy happens if sperm fertilizes an egg and the fertilized egg implants in the lining of the uterus.

Is IUI Painful?

An IUI is not painful at all. The discomfort experienced may be due to the ovulation process and feels more like cramps or slight pain in the lower abdomen.

What about Post Procedure?

  • About a week post the procedure, the doctor will prescribe lab tests to check hormone levels (progesterone, estrogen, hCG)
  • After a couple of weeks post IUI, to check pregnancy, the doctor may advise performing a urine pregnancy test or a blood test.

What are the risks of IUI?

  • There may be spotting or a small amount of vaginal bleeding caused by placing catheter inside the uterus.
  • There is a small chance of infection post IUI.
  • In case the gonadotrophin levels are high, there are chances of conceiving multiples (twins, triplets)

What is the success of IUI?

The chances of getting pregnant are 10%-20% with a single IUI cycle but can increase to as high as 80% with 3 to 6 cycles of IUI. However, the success rate of IUI depends on several factors like the age of the woman, the semen sample of man and medical condition.
Visit CMC for consultation and right options if you are facing problem to conceive. We have the best gynecologist in Mohali to guide you with your timely treatment.

Fractures in Elderly Patients- What are Geriatric Fractures?

Geriatric Fractures

Old people are more prone to fractures and injuries. A slight injury in young people may cause a fracture in the elderly. The main reason owing to this is that the bones lose their mineral content (osteoporosis) and become weak with age.

Causes of fracture in elderly patients may include:

  • Falls
  • Trauma
  • A direct blow to the body
  • Pressure on bones causing stress fractures
  • Bone cancer

Types of Fractures in the Elderly

Certain fractures are typical of old age. Most common fractures in the elderly include:

  • Fracture neck of femur
  • Fracture of the intertrochanteric region in the femur
  • Fracture of distal end of the radius
  • Osteoporotic compression fractures of the spine (fracture of back)
  • Fractures of the upper end of a humerus

Symptoms of a fracture

Symptoms of a broken or fractured bone may include:

  • Swelling
  • Sudden pain
  • Trouble using or moving the injured area or nearby joints
  • Deformity
  • Redness
  • Bruising

How to diagnose fractures in elderly patients?

After taking a complete history, your orthopaedician will carry out the following tests:

  • X-ray
  • Magnetic resonance imaging (MRI):
  • Computed tomography scan (also called a CT or CAT scan) to show detailed images of any part of the body, including the bones, muscles, fat, and organs.

What is the possible treatment of geriatric fractures?

Depending on the location, type and extent of the fracture, your orthopaedician will rule out the best possible treatment, which may include:

  • Splint or cast- to immobilize the injured area to keep the bone in alignment and protect the injured area from motion while the bone heals.
  • Medication: to control pain.
  • Traction: to stretch the muscles and tendons around the broken bone to help the bone ends to align and heal.
  • Surgery: to restore the broken bones back into place by either internal fixation (metal rods or pins located inside the bone) or external fixation devices (metal rods or pins located outside of the body) to hold the bone fragments in place while they heal.

How can you prevent fractures in the elderly?

  • Diet: Ensure sufficient calcium intake through supplements
  • Exposure to sunlight: To provide sufficient vitamin D
  • Weight-bearing exercises
  • Balance training: To prevent any injury from fall due to imbalance
  • Regular checkups: Visit our proficient orthopaedician, Dr.Ravinder Puri at CMC to get the best treatment for fractures in the elderly.

What is Thyroid Swelling?

Thyroid Swelling

When thyroid gland located in your neck becomes inflamed and increases in size, it is known as thyroid swelling.
It is also known as a goiter or thyroiditis.

Many causes of thyroid swelling include:

  • Diet

Lack of iodine in your diet may cause goiter or your thyroid gland to swell. This is because thyroid gland requires iodine to make hormones and iodine deficiency can result in its overworking and swelling.
In this case, increasing the iodine intake in a diet is generally the only treatment required.

  • Pregnancy

Women who are pregnant will, on rare occasions, notice mild thyroid swelling. During pregnancy, the body produces a hormone called human chorionic gonadotropin (hCG). The hormone can cause irritation in the thyroid gland, producing a small to moderate sized painless goiter. Often there is no treatment necessary and the thyroid gland typically returns to its normal size shortly after childbirth.

  • Certain Medicines

Adjusting medicine dosages or replacing them might help.
On rare occasions, a goiter may be present with a more serious underlying condition.

  • Swelling

swelling caused by a lump on the thyroid gland is often a benign tumor or cyst but, in rare cases, it can be a cancerous tumor. Your physician will recommend a biopsy to determine the cause of the nodule and then treat it accordingly.

  • Grave’s disease

Thyroid swelling caused due to overproduction of thyroid hormones. If the swelling is accompanied by other symptoms, such as weight loss and insomnia, your doctor will often test for increased hormones in the blood. If hormones levels are high, a radioactive iodine uptake test is then necessary.


What is a possible treatment for thyroid swelling?

Treatment for thyroid swelling is not needed unless goiter causes difficulty in breathing or swallowing. Increased coughing or hoarseness may require intervention.

  • Medications

Aspirin and corticosteroid drugs treat just the swelling without addressing the cause.
Levothyroxine decreases the production of certain thyroid hormones and can shrink the growth.

  • Surgical intervention

It can be more invasive but can be directed at a specific area of the gland.

  • Radioactive iodine treatment

Ingestion of a capsule containing iodine mixed with radioactive chemicals to cause part of the gland to be destroyed.


Both surgery and radioactive iodine treatment:

  • Reduce the size of the thyroid swelling by removing part or all of the thyroid gland.
  • Require you to take hormone replacement medications indefinitely.

We at CMC provide you with all the facilities as well as specialists for the best treatment. Consult our ENT specialist if you notice swelling in your neck.

Warning Signs of Genital Cancers


Genital cancer is cancer affecting the male and female genitals. The female genital system consists of organs such as the ovaries, fallopian tubes, uterus, cervix, vagina, and vulva. The male genital system consists mainly of the penis, scrotum, urethra and their encompassed structures.

Various genital cancers may include:

In males:

  • Testicular cancer
  • Penile cancer
  • Prostate cancer

In Females:

  • Cervical cancer
  • Ovarian cancer
  • Endometrial or Uterine cancer

A warning sign indicates a serious condition that needs your special attention. You may suffer from certain signs and symptoms that don’t always mean that cancer is present. But they are just warning signs which suspect that you might have cancer. As soon as you feel these signs and symptoms, you should go and visit your doctor for timely diagnosis and treatment:

In the case of cancer, men may face the following changes:-


  • An area of skin becoming thicker
  • Changes in the skin color
  • A lump
  • An ulcer (sore) that might bleed
  • A reddish, velvety rash
  • Small, crusty bumps
  • Flat, bluish-brown growths
  • Smelly discharge (fluid) or bleeding
  • Swollen lymph nodes


  •  Pain
  •  Discomfort
  •  Lump, or swelling in the testes
  • The ache in the lower abdomen (belly)
  • Change in shape of testicles
  • Fluid in scrotum
  • Heaviness of scrotum


  • blood in urine
  • Weak flow of urine,
  •  pain in the back, hips, or pelvis (lower belly between the hips)
  •  Urge for frequent urination.

Females may face following warning signs:

vulvar cancer


  • Light bleeding or blood spots between menstrual periods.
  • Vaginal discharge changes: watery, foul-smelling or more discharge than usual.
  • Pain or discomfort during sexual intercourse.
  • Bleeding during or after sex, or after a pelvic exam.
  • Increased or extended menstrual bleeding.
  • Pelvic or unexplained back pain.
  • Postmenopausal bleeding.


  • Abdominal Bloating, Fullness, Pressure
  • Pelvic Pain or discomfort
  • Increased frequency of urination
  • Loss of appetite or feeling full quickly after eating
  • Persistent gas or Indigestion
  • Constipation
  • Lower back pain
  • Increase in the size of  your abdomen
  • Fatigue
  • Pain during sexual activity


  • Abnormal vaginal bleeding
  • Foul smelling discharge
  • Sudden weight loss
  • Difficulty in passing urine
  • Pain in the pelvic region

Visit CMC for timely detection and diagnosis of the genital cancers. We are equipped with well-read specialists and facilities to provide you with the best treatment.

What is Hoarseness- its Causes and Treatment?


An abnormal change in pitch and volume of the voice is known as hoarseness. It may range from deep, harsh voice to raspy, breathy or strained voice.
Hoarseness is a symptom and not a disease. It is indicative of an underlying disorder or condition.

The reason for the hoarseness is an injury or irritation of vocal cords located in your voice box or larynx.

A most common cause of hoarseness is laryngitis.

Other causes of hoarseness include:

  • Benign vocal cord nodules, cysts or polyps
  • common cold or upper respiratory infection
  • gastroesophageal reflux (GERD)
  • allergies
  • Inhalation of respiratory tract irritants
  • smoking
  • Thyroid problems
  • Neurological conditions (such as Parkinson’s disease and strokes)
  • Cancer of the larynx

To diagnose your hoarseness, your ENT specialist or otolaryngologist will take a thorough medical history. He/ she will examine your voice box and surrounding tissue using a laryngoscope. Evaluation of voice quality is made.

  • A breathy voice may be suggestive of poor vocal cord function, caused by a benign tumor, polyp or larynx cancer.
  • A raspy voice may be indicative of vocal cord thickening due to swelling, inflammation from infection, a chemical irritant, voice abuse or paralysis of the vocal cords.
  • A high, shaky voice or a soft voice may be suggestive of trouble getting enough breathing force or air.

Your doctor will perform some Lab tests, such as a biopsy, x-rays, or thyroid function depending on the findings.

Depending on the underlying cause, your specialist will recommend the following treatment:

  • Cough suppressants and humidified air for acute laryngitis caused by an upper respiratory tract infection
  • Voice rest is recommended in order to avoid further irritation or injury to the vocal cords.
  • Cessation of smoke in individuals that smoke.
  • Medications for gastroesophageal reflux (GERD) or allergies.
  • Surgery may be advised for benign nodules or polyps, trauma to the larynx/vocal cords and for cancer of the larynx.

Consult our otolaryngologist, Dr. Mohit Bhutani, at CMC for proper diagnosis and treatment of voice hoarseness.

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