Editors
Khan Abul Kalam Azad
MBBS FCPS MD FACP
Professor, Department of Medicine Principal, Dhaka Medical College, Dhaka Dean, Faculty of Medicine and Postgraduate Medical Science and Research University of Dhaka, Dhaka, Bangladesh
Ahmedul Kabir
MBBS FCPS FACP FRCP
Professor Department of Medicine Dhaka Medical College Dhaka, Bangladesh
Mohammad Robed Amin
MBBS FCPS FACP FRCP
Associate Professor Department of Medicine Dhaka Medical College Dhaka, Bangladesh
Co-Editors
Madhabi Karmaker
MBBS FCPS
Indoor Medical Officer Department of Medicine Dhaka Medical College Hospital Dhaka, Bangladesh
Chowdhury Tamanna Tabassum
MBBS
Postgraduate Trainee Department of Medicine Dhaka Medical College Hospital Dhaka, Bangladesh
Noshin Tabassum
MBBS
Postgraduate Trainee Department of Medicine Dhaka Medical College Hospital Dhaka, Bangladesh
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101 Interesting Cases in Clinical Medicine
First Edition: 2020
9789389129632
Printed at
_FM_5Dedicated to
All the patients of Department of Medicine,
Dhaka Medical College Hospital, for their outstanding
contribution in our clinical preparedness;
who amidst their tremendous sufferings,
showed excellent magnitude of cooperation that paved a great
way to gather more and more clinical knowledge
_FM_7Contributors
- Sabbiha Nadia Majumder MBBS MRCP FCPS
- Registrar
- Department of Medicine
- Green Life Medical College and Hospital
- Dhaka, Bangladesh
- Madhabi Karmaker MBBS FCPS
- Indoor Medical Officer
- Department of Medicine
- Dhaka Medical College Hospital
- Dhaka, Bangladesh
- Shegufta Mishket Mukerrama MBBS
- Postgraduate Trainee
- Department of Medicine
- Dhaka Medical College Hospital
- Dhaka, Bangladesh
- Chowdhury Tamanna Tabassum MBBS
- Postgraduate Trainee
- Department of Medicine
- Dhaka Medical College Hospital
- Dhaka, Bangladesh
- Mousumi Sanyal MBBS MRCP FCPS
- Consultant
- Department of Medicine
- Better Life Hospital
- Dhaka, Bangladesh
- Noshin Tabassum MBBS
- Postgraduate Trainee
- Department of Medicine
- Dhaka Medical College Hospital
- Dhaka, Bangladesh
- Mohammad Sayem MBBS FCPS MRCP
- Consultant
- Department of Internal Medicine
- AMZ Hospital
- Dhaka, Bangladesh
- Farnaz Nobi Rima MBBS
- Postgraduate Trainee
- Department of Medicine
- Dhaka Medical College Hospital
- Dhaka, Bangladesh
- Nawsabah Noor MBBS ECFMG Certified (USA)
- Postgraduate Trainee
- Department of Medicine
- Dhaka Medical College Hospital
- Dhaka, Bangladesh
- Proma Halder MBBS
- Postgraduate Trainee
- Department of Medicine
- Dhaka Medical College Hospital
Vice-Chancellor
Bangabandhu Sheikh Mujib Medical University
Shahbag, Dhaka
Foreword
I feel honored and privileged to have the opportunity to write a few words about ‘101 Interesting Cases in Clinical Medicine’ by Department of Medicine, Dhaka Medical College of Bangladesh.
Internal medicine is a subject of inquisitiveness and search for the hidden. Sometimes common diseases present in an uncommon way while atypical diseases present in the common way, which requires sound understanding of the whole scenario and critical analysis to finally discover the cases as interesting or rare disease. This book unfolds 101 interesting cases in an amazing way with a sequential exploration of newer dimensions of thinking as one would go through the pages ahead.
This book seems to be very exciting and challenging to readers as they will go through case-by-case exploring the answers of all questions in mind in a fascinating way. I believe these explanations will surely shed light on the important basics of unsolved problems and will lay the foundation of academic case analysis.
At this point I must appreciate the dedication, enormous effort and enthusiasm of the team who worked behind it. I have already seen various publications and reputed works of Department of Medicine of our renowned institution Dhaka Medical College, which is our pride and the editorial board should get a full credential due to their talent, hard work, sincere endeavor, patience, analyzing expertise and their achievements despite all constraints. I believe it is more than a book and surely this amazing work will be beneficial to the medical book lovers and they would feel comfort in going through the pages.
I hope this invaluable work will reach to the widest possible readers, including medical students, postgraduate trainees, and physicians of all stages. I must thank the authors and the team and contributors for producing such a masterwork.
Professor Kanak Kanti Barua
MBBS FCPS (Surgery) MS (Neurosurgery) PhD FICS
Professor and Chairman, Department of Neurosurgery
Vice-Chancellor
Bangabandhu Sheikh Mujib Medical University
Principal
DHAKA MEDICAL COLLEGE
Dhaka, Bangladesh
Preface
“What the mind does not know, the eyes cannot see”. The eyes can only perceive the signs hidden in plain sight when the knowledge is already stored in the mind. For a clinician to see beyond what the ordinary eyes see, both in-depth knowledge and clinical skills are required.
Dhaka Medical College Hospital, Dhaka, Bangladesh, being the country's largest tertiary care hospital is playing its gracious role both in patient care and also in academic activities. While dealing with patients, we came across a significant number of rare diseases as well as common diseases with uncommon presentations. It is worth mentioning that, each of the 101 cases presented here posed much difficulty on their initial presentation-so that in each case, reaching the final diagnosis was not a very straight-forward task. The term ‘interesting’ focuses on the intriguing presenting features, and the fascinating journey towards diagnosis. Having utmost respect to all our patients, we never had an intention to present any of the debilitating features of patients as interesting. Later the thought of dispersing this hard-acquired knowledge and experience inspired us to take on the endeavor of writing this book.
Many excellent medical textbooks are already available for theoretical knowledge, but this book focuses on improving decision-making capability by guiding the critical thinking process and application of theories.
Problem-based learning is the best way to learn medicine. Every case in the book has some practical problem-related questions for the reader's self-evaluation, followed by correct answers, and discussion on relevant topics and management.
We hope physicians will go through the book and practice the lessons in an enthralling way. We would like to invite suggestions, queries, comments, and constructive criticism from the esteemed readers of this book through email to bsmag.dmch@gmail.com, for further improvement in future editions.
Khan Abul Kalam Azad
Professor of Medicine, Dhaka Medical College
Dean, Faculty of Medicine and
Postgraduate Medical Science and Research
University of Dhaka
_FM_13Acknowledgments
We want to express our humble respect and sincere gratitude to all the teachers of the Department of Medicine of Dhaka Medical College, Dhaka, Bangladesh, for their encouragement and valuable suggestions while writing this book. We are also indebted to all the teachers working in Medicine and allied departments of all the government and private medical colleges of Bangladesh for their continuous support and interest for this book.
Our special thanks and gratefulness to all the patients who allowed us to examine them and had given their consent for publishing their photographs, data and other personal information in the book; and to all the doctors who took the responsibility of managing and presenting the cases in weekly grand round.
We are thankful to Professor HAM Nazmul Ahasan and Professor Mohammad Mujibur Rahman for their consent to publish some case reports in the book. We also choose this moment to acknowledge the contribution of Professor Titu Miah, Professor MA Kashem, Associate Professor Mohammad Rafiqul Islam, and Associate Professor Sarmistha Biswas in some specific cases.
Lastly, we are deeply indebted to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy) and Ms Nedup Denka Bhutia (Development Editor) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India for their endeavor and relentless help which made the book possible to come into the light.