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New cases in Pous 2064, HIV = 175, AIDS = 26, Death = 2. HIV rate is very high in Housewives than sex workers in Nepal ! ! ! HIV status in Nepal till 2005: Total Adult=70000, Adult Prevalence (15-49)=0.55%, Number of Women (15-49) LWHA=15,310 (22%), HIV Prevalence rate in IDUs=32.7%, HIV prevalence rate in sex worker=3.8%, HIV prevalence rate in client of SW=2.1%. The latest U.N. report shows that 65 million people have been infected with HIV since it was first identified 25 years ago. Twenty five million people have died of AIDS.

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Reload this Page A patient with MI
Clinical Vignette A clinical vignette is a concise presentation of an interesting or challenging patient encounter that stimulated an interesting learning issue.

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A patient with MI - 16-07-2006, 06:36 PM
A 58 yr old man with myocardial infarction in RCA (rt.coronary art.) region. Heavy smoker and H/O DM and HTN. Prev not taking medications. EKG shows ST elevation in the inferior leads. Thrombolytic was given, Nitro drip, metoprolol, anticoagulants were started. After 2 hours BP was 80/60mmHg, HR was 32 bpm. What is the next appropriate mgmt:
1. Stop metoprolol
2. Atropin inj
3. Dobutamine iv
4. iv fluids
5. Temp pacemaker

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Re: A patient with MI - 16-07-2006, 06:56 PM
I would go for IV fluids, because the patient has developed RV infarction and RV infarction is a low out put failure so we have to give titrated fluids.

I Love Clinical Vignette a concise presentation of an interesting & challenging patient encounter that stimulates an inquisitive learning session.
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