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Delayed diaphragmatic rupture is usually seen after blunt trauma. The diagnosis is often missed since the symptoms are often nonspecific.The radiograph findings are also nonspecific, and high index of suspicion is necessary for diagnosis. We report a patient who presented to us 7 years after blunt trauma with delayed diaphragmatic rupture and was successfully diagnosed and treated surgically.

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Hereditary angioedema is a rare life-threatening disease. Undiagnosed angioedema is associated with high mortality. Diagnosis is often delayed due to lack of clinical suspicion. We report two cases of patients (mother and son) with angioedema who had been wrongly diagnosed as nephrotic syndrome and hypothyroidism. These case reports highlight the need for a high index of suspicion to diagnose a potentially life-threatening disease which can lead to timely treatment, preventing morbidity and mortality.

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Otitis media is a spectrum of diseases associated with middle ear infection. Acute otitis media is one of the most common acute infections in childhood, with a peak incidence in the second half of infancy. A diagnosis of acute otitis media is often challenging and requires three criteria to be met - acute onset of symptoms, signs of middle ear inflammation, and effusion. Otitis media with effusion is the presence of middle ear effusion without signs or symptoms of ear inflammation such as pain and fever as a result of impaired middle ear ventilation. Features of middle ear effusion in the absence of features of inflammation helps to make the diagnosis of otitis media with effusion. Most cases are self-resolving with 75%–90% showing complete resolution within 3 months.

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Heat-related illnesses are part of a continuum comprising heat cramps, heat exhaustion, heat syncope and heat stroke, and are associated with significant morbidity and mortality, especially in a tropical country like India. Heat stroke, which is the most severe, is caused by failure of thermoregulation with elevation of core temperature to 40°C (104°F) or more, associated with central nervous system dysfunction. The two important principles in management of heat stroke are lowering of core temperature immediately to 38.9°C and supporting organ systems injured by heat, hypotension, inflammation and coagulopathy. It is important to initiate cooling as fast as possible and keep the individual adequately hydrated to prevent complications.

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Dr. Ian R McWhinney is well known to most family doctors as the father of academic family medicine (FM). He outlined the philosophical basis, principles, and knowledge of this clinical discipline. He started the very first academic department of FM located at the University of Western Ontario in 1968. He was instrumental in transforming FM worldwide by his visionary writings and research. In collaboration with a group of gifted colleagues, he advanced this discipline from an unknown subject into an academic one with a distinct clinical method and undergraduate and graduate courses. He was renowned for this great empathy, patient-centeredness, and inspired teaching.

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