No abstract

Flood syndrome refers to the exsanguination of ascitic fluid following the spontaneous rupture of an umbilical hernia, and is a rare complication of liver cirrhosis with ascites. In this case report, we describe a 67-year-old patient with Flood syndrome who was initially managed conservatively in a community hospital run by primary care physicians, prior to transfer to a tertiary hospital for specialist surgical review and management. We also performed a literature review of the current treatment modalities to manage this condition.

This is a case report of a 7-year-old boy who presented with lower limb pain. He was initially presumed to have growing pains but was subsequently diagnosed with acute lymphoblastic leukaemia (ALL). This case highlights the important clinical presentations and differential diagnoses of ALL that a family physician should be cognizant about to avoid misdiagnosis. It also demonstrates the importance of understanding the patient and family's perspectives when evaluating a child with lower limb pain. This enables us to anticipate and meet their needs.

This is a case study of a 22-year-old National Serviceman presenting with the main complaint of insomnia. This case demonstrates possible gaps in the integration of care between public and National Service healthcare. We illustrate a pathway which primary physicians may use to improve communication with National Service healthcare.

Dementia is an increasing problem in Singapore’s ageing population with the most common being Alzheimer’s disease, vascular dementia, and mixed dementia. Creutzfeldt-Jakob Disease (CJD) is a fatal neurodegenerative condition that causes rapidly progressive dementia. It is a rare human transmissible prion disease with limited literature in Southeast Asia. In this article, we report 2 patients diagnosed with CJD who presented to primary care with rapidly progressive dementia, behavioral changes, and rapid functional decline. Deterioration of their clinical condition was relentless, and treatment remained palliative and supportive. It is important for family physicians to be cognisant of the clinical manifestations of CJD. We will outline the role of family physicians in the management of patients with CJD in different healthcare settings – general practice, tertiary hospital, community hospital and hospice home care.