Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare and fatal spongiform encephalopathy characterized by rapidly progressive dementia and myoclonus. The rarity of this disease and varied initial symptoms make the early diagnosis fairly challenging. Here, we present a case initially admitted for confusion and bizarre behaviors. She had acute deterioration of mental status, akinetic mutism, and myoclonus jerks four weeks later. Cerebrospinal fluid (CSF) analysis was positive for protein 14-3-3. Brain magnetic resonance imaging (MRI) showed hyperintensities in the bilateral cortex, basal ganglia, and thalami in diffusion-weighted imaging (DWI). Electroencephalogram (EEG) showed bihemispheric periodic lateralizing epileptiform discharges. The probable diagnosis of sCJD was reached based on the clinical features, characteristic findings in her MRI, the EEG, and a positive 14-3-3 CSF assay. The literature was also reviewed for early diagnosis of sCJD.
Maternal education is significantly related to early childhood morbidity and mortality. In Bangladesh, most mothers do not have a correct knowledge on exclusive breastfeeding and the appropriate time for introduction of weaning foods; and only 3% of them know how to prepare proper weaning foods 1 . Another study conducted in the rural population reported that according to Gomez classification, 96% of children had varying degrees of protein energy malnutrition (PEM) (28.4% mild, 58.2% moderate and 9.2% severe) 2 . Timely weaning, education and promotion of essential vaccination may reduce childhood malnutrition, especially severe PEM. It has also been reported that the prevalence of breastfeeding in Bangladesh is one of the highest in the world where diarrheal diseases are hyper-endemic and issues of breastfeeding in several diarrheal diseases have been well documented 3 . We undertook this study to determine knowledge, attitude and feeding behavior of the mothers in a rural community. This cross sectional study was conducted in Sreepur Thana. Four villages were purposively selected. All women having children below 5 years were interviewed face to face. Structured questionnaire was used. Each participant was informed about the objectives of the interviewing. After taking her consent the interview session was started. The interviewing included socio-demographic information like housing, sanitation, education, water-supply and family-income. As regards feeding practices, each mother was interviewed for information related to nutrition during pregnancy and lactation. The questionnaire also included information about breast feeding like colostrum, exclusive breastfeeding, weaning and feeding during diarrhea and fever. The collected information were entered into computer using SPSS 11.5 version. The prevalence rates of feeding and weaning practices were expressed in percentages. Chi-sq was used to determine association of feeding practices with education and social class.A total of 500 families were visited in four villages. Of these families, 409 (81.1%) women were selected. Of the 91 non-participants, 85 women had no children below 5 years and only 6 women refused to participate. The mean age of the participants was 25 years (16-45y). The average family size was 4 (4-11) and the average monthly expenditure was 3751 (500-15000) taka. About 25% were illiterate and 95% were housewives. Most of the families had access to tube well water for drinking and domestic purposes. Of them, 94% had living rooms with corrugated tin sheet.The study revealed that 68% of mothers took extra food during pregnancy, 80% took extra food during lactation, 54% mothers gave exclusive breast feeding for 6 months. More than one third (36%) mothers started weaning at 6 th month and only 62% mothers chose khichuri made of rice and pulse as supplementary food. About twothirds used to provide balanced diet to their children; 70% used to serve normal diet during fever, 71% during diarrhea and 88% during recovery from illness. The prevalence of taki...
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