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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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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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Mvp - 12-09-2006, 07:35 AM

Which of the following statements about mitral valve prolapse is true?

1. Patients with mitral valve prolapse depicted on echocardiogram but who have no leaflet redundancy or regurgitation are more likely to have panic disorder than patients who have mitral valve prolapse with regurgitation
2. Patients with mitral valve prolapse and mitral regurgitation are at increased risk for panic disorder
3. There is no association between mitral valve prolapse and panic disorder
4. Surgery to correct a mitral valve with prolapse will also resolve panic disorder
5. Mitral valve prolapse is always considered a risk factor for panic disorder regardless of its severity or clinical significance
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Re: Mvp - 13-09-2006, 09:19 AM

The correct answer is (1)
No explanation coz no one has answered and it seems tough as well
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Re: Mvp - 14-09-2006, 10:01 AM

mvp and panic disorders r related.. all of us know.. what's the basis??? u seem to know .. pls be kind enough to share ur knowledge with us.
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Re: Mvp - 14-09-2006, 10:20 PM

how to define panic disorder?
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Re: Mvp - 15-09-2006, 02:23 AM

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Originally Posted by Vishal View Post
how to define panic disorder?
Panic disorder is a type of anxiety disorder. Patient has fear of sudden attack of stroke, or MI like this. I don't know the exact definition but literatures have defined it as a type of anxiety disorder characterized by at least 3 panic attacks within a 3 week period OR 1 panic attack followed by fear of subsequent panic attacks for at least 1 month. (Note it--3 for 3 and 1 for 1 )

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mvp and panic disorders r related.. all of us know.. what's the basis??? u seem to know .. pls be kind enough to share ur knowledge with us.
Individuals with MVP seem to be at higher risk to develop panic disorder than the general population; however, not all individuals with MVP will develop panic disorder. It is probably the most frequently reported psychiatric syndrome associated with MVP. But the exact mechanism is also not clear. MVP and panic disorder have similar symptoms-chest pain, SOB, effort intolerance, but there is lack of proven cause-and-effect relationship betn MVP and panic disorder. Some has suggested serotonin imbalances-- which play a large part in the symptoms a/w MVP. Interestingly some Japanese docs demonstrated that 66% panic disorder pts had MVP in one study. Reassure the pt that this is neither MI nor u gonna get stroke--this is the best way to manage this condition. Although some suggested beta-blockers, antidepressants, and benzodiazepines are probably the most effective but we have not seen this type of case in our dept..thats why no idea.
DrDevil I don't know more than this ... looking for ur comment and more info
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Re: Mvp - 15-09-2006, 07:41 AM

oh great Hero !!! u r really genius i mean it. ur explanations r so smooth and cool...thanks a lot
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