Exploring a community's understanding of HIV vaccine-induced seropositivity in a South African research setting

Background. The high HIV prevalence and incidence in South Africa makes it suitable for recruitment of participants for large-scale HIV preventive vaccine trials. However, fear of vaccine-induced seropositivity (VISP) may be a barrier for community acceptability of the trial, for volunteers to participate in HIV preventive vaccine trials and for uptake of an efficacious vaccine. Prior to 2015, when the first phase 1 safety HIV vaccine trial was undertaken at Setshaba Research Centre, Soshanguve, the local community stakeholders and healthcare workers were naive about HIV vaccine research and HIV preventive vaccines. Objective. To explore knowledge and perceptions regarding VISP among community stakeholders and healthcare workers in peri-urban Soshanguve, Tshwane.Methods. Using a quantitative-qualitative mixed-methods study design, surveys (n=50) and in-depth interviews (n=18) were conducted during July - August 2015. Participants included community stakeholders, community advisory board members and healthcare workers, who were >18 years old and had attended community educational workshops during September 2014 - May 2015. Audio recordings of interviews were transcribed verbatim and coded using content thematic analysis. Data were further analysed by sex, age and educational level.Results. Of a maximum score of 2 on knowledge on VISP, the 50 survey participants (mean age 33.78 years; 45 females) obtained an average of 0.88 (44%). Of 17 in-depth interviewees (one interview could not be transcribed; mean age 30.9 years; 12 females), 8 (47%) displayed some knowledge about VISP, of whom only 5 defined VISP correctly. Women were more knowledgeable about VISP than men; 5 of 12 women (42%) came close to defining VISP correctly, while none of the 5 men did so. The main fear of trial participation expressed by most participants (n=6) was testing HIV-positive as a result of the vaccine. While some participants believed that the community's perceptions of VISP would negatively affect HIV vaccine trial support and recruitment efforts, others noted that if trial participants understand the concept of VISP and are part of support groups, then they would have the information to combat negative attitudes within their community. Conclusion. Most participants had an inaccurate and incomplete understanding of VISP. Many feared testing HIV-positive at clinics; therefore, education on improving a basic understanding of how vaccines work and why VISP occurs is essential. In addition, assessing participant understanding of HIV testing, transmission and VISP is critical for recruitment of participants into HIV vaccine trials and may improve acceptability of an HIV preventive vaccine

Prevalence And Predicting Risk Factors Of Overweight And Obesity Among Primary School Pupils In Ramadi, Iraq

@#Childhood obesity is increasing at a dramatic rate that it can be considered a pandemic. The aim of this study is to address the prevalence of obesity among primary pupils in Ramadi City and to determine different risk factors associated with obesity among these children. A cross-sectional study was carried out and random selections of three primary schools were taken at the center of Ramadi City. A total of 512 pupils were included in this study (232 male and 280 female) to include all eligible children age 6 to 12 years. The study period was during the study year 2018-2019. Anthropometric measurements of height and body weight were carried out using standardized methods.The prevalence of overweight was 15.4% (85-97th percentile) and obese (=≥ 97th percentile) was 13.3%. The Mean BMI percentile of pupils was 17.8±3.9, range (11.3-37.5). Risk factors highly associated with overweight and obesity (P>0.05) were gender, increased age, mother education, taking breakfast and fruits, sitting in front of the TV. While daily vegetable intake and type of feeding at first 6 months after delivery were not found to be significantly associated with overweight and obesity in our study.The prevalence of overweight and obesity primary school children in this study are at an alarming level and the disease trends are growing in this country. Preventive pupils' health action is required for this age group.

Dexmedetomidine during suprazygomatic maxillary nerve block for pediatric cleft palate repair, randomized double-blind controlled study

Background@#For children with cleft palates, surgeries at a young age are necessary to reduce feeding or phonation difficulties and reduce complications, especially respiratory tract infections and frequent sinusitis. We hypothesized that dexmedetomidine might prolong the postoperative analgesic duration when added to bupivacaine during nerve blocks. @*Methods@#Eighty patients of 1-5 years old were arbitrarily assigned to two equal groups (forty patients each) to receive bilateral suprazygomatic maxillary nerve blocks. Group A received bilateral 0.2 mL/kg bupivacaine (0.125%; maximum volume 4 mL/side). Group B received bilateral 0.2 mL/kg bupivacaine (0.125%) + 0.5 µg/kg dexmedetomidine (maximum volume 4 mL/side). @*Results@#The modified children’s hospital of Eastern Ontario pain scale score was significantly lower in group B children after 8 hours of follow-up postoperatively (P < 0.001). Mean values of heart rate and blood pressure were significantly different between the groups, with lower mean values in group B (P < 0.001). Median time to the first analgesic demand in group A children was 10 hours (range 8-12 hr), and no patients needed analgesia in group B. The sedation score assessment was higher in children given dexmedetomidine (P = 0.03) during the first postoperative 30 minutes. Better parent satisfaction scores (5-point Likert scale) were recorded in group B and without serious adverse effects. @*Conclusions@#Addition of dexmedetomidine 0.5 μg/kg to bupivacaine 0.125% has accentuated the analgesic efficacy of bilateral suprazygomatic maxillary nerve block in children undergoing primary cleft palate repair with less postoperative supplemental analgesia or untoward effects.

Efficacy of olibanum and propolis medicinal extracts versus metronidazole in Giardia lamblia experimentally infected mice

Giardiasis is a common intestinal infection, recently included by the World Health Organization in the 'Neglected Diseases Initiative'. Despite the efficacy of nitroimidazoles; the main antigiardial chemotherapeutics, adverse effects and resistance enforced developing non-chemical alternatives. The present study aimed to assess the therapeutic efficacy of ethanol extract of olibanum (OL), propolis (PR), and their combination versus metronidazole (MTZ) against G. lamblia infection. Sixty Swiss male albino mice were randomly divided into 6 groups; 10 mice each,: Group I: normal control (non-treated; non-infected). Group II: infected with G. lamblia cysts, non-treated. On the 6th day postinfection (dPI), the remaining 4 infected groups were treated orally with: Group III: (OL). Group IV: (PR). Group V: combination of (OL+PR). Group VI: (MTZ). These mice were subjected to direct parasitological diagnosis of Giardia trophozoite in intestinal exudate, immunochromatographic test for antigen detection and histopathological studies. After 7 days therapy, complete clearance of Giardia trophozoites were in the combination of (OL+PR) and MTZ groups therapy. Lower percentages of reduction (91%) & (83%) were recorded in PR and OL-treated groups, respectively. Histopathological examination showed marked healing of intestinal mucosa using non-chemical combination and different degrees of dysplasia using MTZ, while partial healing was observed using olibanum and propolis separately. Olibanum, propolis and their combination were proved to enhance the clearance of Giardia trophozoites; with progressive improvement of the histopathological changes of jejunal mucosa, making good non-chemical alternative antigiardial therapeutics sidestepping the obstacles of metronidazole like dysplasia and teratogenicity

Vesicles stage of camel brain development / Etapas del desarrollo de las vesículas cerebrales del camello

A successive embryonic developmental study was conducted on the brain of twenty eight embryos and fetuses of one humped camel (Camelus Dromedarius), whose crown vertebral rump lengths (CVRL) ranged from 9 to 80 mm, collected from the El-Basateen (Cairo) and Belbees (ElSharqya) Slaughterhouse. The current investigation revealed that camel brain was found to consist of fore, mid and hind brains. The fore brain is divided into telencephalon and diencephalon while the rhombencephalon divided into metencephalon and myelencephalon. Flexures appeared between the vesicles are cervical flexure between the rhomencephalon and the spinal cord, cephalic flexure in the mesencephalon and pontine flexure between the metencephalon, and the myelencephalon of the hind brain (rhombencephalon). The cavity of the rhombencephalon is the fourth ventricle, while that of the diencephalon is the third ventricle, and those of the telencephalon are the lateral ventricles but that of mid brain is the cerebral aqueduct. myelencephalon becomes medulla oblongata and metencephalon developed to pons and cerebellum while mesencephalon gives rise to the cerebral crura and anterior and a posterior colliculus. Diencephalon gives the thalamus, hypothalamus, mamillary body, infundibulum and pineal body while telencephalon becomes the cerebral hemispheres and corpus striatum.

Se llevó a cabo un estudio del desarrollo embrionario cerebral de veintiocho embriones y fetos de camello jorobado (Camelus dromedarius). Las muestras fueron recolectadas en los mataderos de El-Basateen (El Cairo) y Belbees (ElSharqya). La investigación reveló que el cerebro de camello posee un cerebro anterior, medio y posterior. El cerebro anterior se divide en telencéfalo y diencéfalo, mientras que el rombencéfalo se divide en metencéfalo y mielencéfalo. Las flexiones encontradas entre las vesículas son la flexión cervical entre el rombencéfalo y la médula espinal; la flexión cefálica en el mesencéfalo; y la flexión pontina entre el metencéfalo y el mielencéfalo del cerebro posterior (rombencéfalo). La cavidad del rombencéfalo conforma el cuarto ventrículo, la del diencéfalo forma el tercer ventrículo, y las del telencéfalo a los ventrículos laterales. En el cerebro medio, la cavidad corresponde al acueducto cerebral. El mielencéfalo se convierte en médula oblonga y el metencéfalo deriva en puente y cerebelo, mientras que el mesencéfalo da lugar a la crura cerebral y a los colículos anterior y posterior. El diencéfalo origina el tálamo, el hipotálamo, el cuerpo mamilar, el infundíbulo y la hipófisis, mientras que del telencéfalo se originan los hemisferios cerebrales y el cuerpo estriado.

Prevalence and pattern of social media use and its effect on social health among Fayoum university students

Background: Social media social media are caused a revolution in the last century. Almost everyone has access to social media with different ways. Many students use Social media for contact with each other, following updating news, and help them in their study. The study aimed to estimate the prevalence, pattern of Social media and its effects on social health of Fayoum university students.Methods: This is a cross-sectional descriptive study involving 633 students at Fayoum university.Results: As regards social media use, the majority of the student (94.2%) was using at least one type of SM. More than half of them (55.5%) visit (3-5) SM sites. About one third of the students (30.9%) stated that they spend (3-4) hours daily. Regarding effect of social media, one third of the students (30.2%) thought that SM sites decrease friendship level, (73.0%) limit sport time, and has a negative effect on the learning process (62.4%). The motivations for using social media were the search for news (38.1%) and making friendship (31.2%). Multiple logistic regression for factors associated with using social media revealed that age more than 20 years and male gender were significantly associated with using social media (p=0.003 and 0.016, respectively).Conclusions: The majority of students use Social media for different reasons. Social media reduced social interrelations of the students may set down their study. So, increase awareness about the hazards of social media among students including their physical and psychosocial health. Highlighted the balanced use of social media for proper improving the learning process through prompt uses of information and communication.

Superficial and Deep Skin Preparation with Povidone-Iodine for Ventriculoperitoneal Shunt Surgery : A Technical Note

OBJECTIVE: Ventriculoperitoneal (VP) shunt surgery is a common and effective treatment for hydrocephalus and cerebrospinal fluid disorders. Infection remains a major cause of morbidity and mortality after a VP shunt. There is evidence that a deep skin flora microbiome may have a role to play in post-operative infections. In this technical note, we present a skin preparation technique that addresses the issue of the skin flora beyond the initial incision. METHODS: The patient is initially prepped, as standard, with. a single layer of 2% CHG+70% isopropyl alcohol. The novel stage is the ‘double incision’ whereby an initial superficial incision receives a further application of povidone-iodine prior to completing the full depth incision. RESULTS: Of the 84 shunts inserted using the double-incision method (September 2015 to September 2016), only one developed a shunt infection. CONCLUSION: The double incision approach to skin preparation is a unique operative stage in VP shunt surgery that may have a role to play in reducing acute shunt infection.

Superficial and Deep Skin Preparation with Povidone-Iodine for Ventriculoperitoneal Shunt Surgery : A Technical Note

OBJECTIVE: Ventriculoperitoneal (VP) shunt surgery is a common and effective treatment for hydrocephalus and cerebrospinal fluid disorders. Infection remains a major cause of morbidity and mortality after a VP shunt. There is evidence that a deep skin flora microbiome may have a role to play in post-operative infections. In this technical note, we present a skin preparation technique that addresses the issue of the skin flora beyond the initial incision.METHODS: The patient is initially prepped, as standard, with. a single layer of 2% CHG+70% isopropyl alcohol. The novel stage is the ‘double incision’ whereby an initial superficial incision receives a further application of povidone-iodine prior to completing the full depth incision.RESULTS: Of the 84 shunts inserted using the double-incision method (September 2015 to September 2016), only one developed a shunt infection.CONCLUSION: The double incision approach to skin preparation is a unique operative stage in VP shunt surgery that may have a role to play in reducing acute shunt infection.

Risk factors for Ventriculoperitoneal shunting in children with posterior fossa tumor

Objectives: To investigate the Predictors of the need of post-operative VP- shunting, in pediatric patients who underwent primary surgical resection for posterior fossa tumors, without pre-operative VP-shunt, were investigated

Methods: All the 52 pediatric patients who presented to King Hussein Cancer Center in the last 12 years with a diagnosis of posterior fossa tumor, and who did not have a VP shunt inserted prior to undergoing their primary surgical resection in our institution, were included in the study. Patients were divided retrospectively into those who ended up with VP-shunt insertion and those who did not need a VP-shunt insertion, and then factors such as age, sex, duration of pre-operative symptoms, size of primary tumor, presence of preoperative spinal metastasis, extent of surgical resection, post-operative ICP readings, presence of post-operative spinal metastasis and the development postoperative infection and leak were investigated and compared between the two groups

Results: 24 patients needed a VP- shunt to be inserted in the post-operative period. The extent of tumor excision and age below 3 years were the only significant predictors of post-operative need for VP-shunt insertion among the factors that were included in this study

Conclusion: age of the patient less than 3 years was a significant factor in the need for shunt placement. The average age of the patients who needed a VP- shunt in our set of patients is 6.2 years compared to 7.3 years in patients who did not need a VP- shunt, The extent of tumor excision was also important factor in predicting the need for post-operative shunt insertion. Other factors were not significant in this study even infection which increases the basal adhesion

Parasitological studies on some intestinal parasites in primary school children in Aswan Governorate, Egypt

This cross sectional study in Aswan Governorate determined the prevalence of intestinal parasites and to identify the risk factors for infection in primary school children in this geographical area. The results would facilitate evaluation of the endemic level of different intestinal parasites and the determination of whether widespread or focal measures of parasite control are required. After obtaining official permission from the school administration, information and consent forms were given to the parents of all the schoolchildren. They were three-hundreds children aged between 6-12 year were enrolled; a detailed questionnaire, complete clinical assessment complete as well as stool analysis was done The study showed that the over-all infection was 31%, single parasitic infection was 26% and mixed one was 5%.The commonest helminthic infection was E. vermicularis 6.6% followed by H. nana 3% Ascaris lumbricoides 1%, The commonest protozoa infection was E. histolytica 8.3% followed by Giardia lamblia 3.7% and Cryptosporidium parvum 1.7%. Mixed infection was E. vermicularis plus E. histolytica [23.4%], E vermicularis plus G. lamblia [17.6%], E. vermicularis plus C. parvum [11.8%], E. histolytica plus H. nana [11.85%], A. lumbricoides plus E. histolytica [17.6%] and G. lamblia plus E. histolytica. in [11.8%]. Parasitic infection was more prevalent in boys [53.8%] than girls [46.2%] and more prevalent in rural children [39.73%] than urban ones [20.13%] among age ranged from to 12 years [8.97+/-1.72]

Finding Wolbachia in Filarial larvae and Culicidae Mosquitoes in Upper Egypt Governorate

Wolbachia is an obligatory intracellular endosymbiotic bacterium, present in over 20% of all insects altering insect reproductive capabilities and in a wide range of filarial worms which is essential for worm survival and reproduction. In Egypt, no available data were found about Wolbachia searching for it in either mosquitoes or filarial worms. Thus, we aimed to identify the possible concurrent presence of Wolbachia within different mosquitoes and filarial parasites, in Assiut Governorate, Egypt using multiplex PCR. Initially, 6 pools were detected positive for Wolbachia by single PCR. The simultaneous detection of Wolbachia and filarial parasites (Wuchereria bancrofti, Dirofilaria immitis, and Dirofilaria repens) by multiplex PCR was spotted in 5 out of 6 pools, with an overall estimated rate of infection (ERI) of 0.24%. Unexpectedly, the highest ERI (0.53%) was for Anopheles pharoensis with related Wolbachia and W. bancrofti, followed by Aedes (0.42%) and Culex (0.26%). We also observed that Wolbachia altered Culex spp. as a primary vector for W. bancrofti to be replaced by Anopheles sp. Wolbachia within filaria-infected mosquitoes in our locality gives a hope to use bacteria as a new control trend simultaneously targeting the vector and filarial parasites.

In-Hospital Outcome of Compromised Small Side Branch after Percutaneous Coronary Intervention.

Background: Side branch occlusion is a well known complication of percutaneous coronary intervention. Although occlusion of small side branches is well tolerated, occlusion of larger side branches may cause more serious complications. After PCI the incidence of complications in patients with compromised side branches smaller than 2 mm is small. Compromising side branches larger than 2 mm can be accompanied by clinical outcomes as non Q-wave MI. This study was undertaken to assess the in-hospital outcomes of compromised small (<2mm) side branch after percutaneous coronary intervention. Methods: This cross sectional analytical study was carried out in the department of cardiology, National Institute of Cardiovascular Diseases, Dhaka during the period of September 2011 to June 2012. A total of 100 consecutive patients with coronary artery disease who underwent elective PCI were included in the study. Study patients were divided into two groups on the basis of presence of compromised small (< 2 mm) side branch. In Group- I, small (< 2 mm) side branch were compromised after PCI and in Group- II, side branches were patent after PCI, with 50 patients in each group. In-hospital outcome were evaluated in both groups. Result: There were no significant differences of the baseline clinical demographics between two groups. Post PCI angina was higher in group I than group II (10.0% vs. 9.0%). Non ST elevation myocardial infarction and significant arrhythmia was identical in both groups (2.0% vs. 2.0%) but hypotension was more in group II than group I (4.0% vs. 2.0%). The findings were statistically insignificant between the study groups. There was no mortality, emergency CABG within 24 hours, ST elevation myocardial infarction, cardiogenic shock or acute left ventricular failure during their hospital course in either group. Conclusion: The present study concluded that compromised small (<2mm) side branch after percutaneous coronary intervention was not associated with adverse in-hospital outcome.

Bone Mineral Density of Children with Cerebral Palsy in the Age Group 7 to 14 Years

Cerebral palsy children have increased tendency to develop fractures later in life, for which low bone mineral density might be one of the factors. The aim of this study was to evaluate the bone mineral density in children with cerebral palsy and factors affecting it. A total of 82 diagnosed children with cerebral palsy were sampled by non-probability purposive sampling from the outpatient department of Armed Forces Institute of Rehabilitation Medicine. Bone mineral density (BMD), z-score was measured at lumbar spine with Dual Energy X Ray Absorptiometry (DEXA) at L1- L4 lumbar vertebra. Analysis was done using SPSS (Version 20). Statistical comparisons were made using independent sample t-test. Of the 82 children 37 (45.1%) were males and 45 (54.9%) females. The mean age for all the children was 5.6 + 2.34 years and mean BMDz- score was -2.12 + 0.67. There were statistically significant differences in BMDz score with respect to age groups, pattern of involvement and ambulation status (p0.05). The BMDz-scores were lower, especially in the quadriplegic and non-ambulant children. BMD if identified early and managed timely can prevent future fragility fracture risk and avoid delay in rehabilitation process.

Urinary bladder stone complicating ventriculovesical shunt

The standard treatment for hydrocephalus is either a ventriculoperitoneal or a ventriculo-atrial shunt. However, these conventional shunts may be associated with considerable complications and high revision rates which make these familiar shunts inappropriate for a certain subset of patients. A rare complication is reported associated with an unusual procedure in a 42-year-old woman who had had a ventriculovesical shunt for four years. She presented with recurrent urinary tract infections, haematuria and urge incontinence, and was discovered to have a large vesical stone over the vesical end of the shunt. She was treated with open suprapubic cystolithotomy and the redirection of the shunt to the peritoneal cavity. The patient was followed up for 12 months postoperatively and remained free of any urinary tract symptoms

Detection of filarial parasites and Wolbachia endosymbiotic bacteria in mosquitoes by PCR

Wuchereria Bancroft; the principal etiologic agent of lymphatic filariasis is mosquito dependant in the biological transmission. Dirofilariasis is essentially a disease of canines which can also be trans-mitted to humans by culicine mosquitoes. Wolbachia are Rickettsia-like, obligatory intracellular bacteria that infect the reproductive and somatic tissues of some arthropods and nematodes. Our study aimed to identify the possible association between filarial parasites and Wolbachia by single and multiplex PCR. 1600 female mosquitoes collected from: four localities in Assiut Governorate, Egypt were microscopically identified and divided into 64 mosquito pools according to their genera and collection site. Single PCR was firstly conducted on mosquitoes followed by multiplex PCR for simultaneous detection of the three filarial parasites [Wucheraria bancrofti, Dirofilaria immitis, and Dirofilaria repens] and Wolbachia in mosquitoes. The results indicated that: Out of 64 mosquito pools, 8 pools were positive for Wuchererio bancrofti with estimated rate of infection [ERI 0.53%], 3 for each of Dirofilaria immitis and Dirofilaria repens [ERI 0.19%] and 6 pools were positive for Wolbachia [ERI 0.39%], five of them with filarial parasites [W. Bancrofti, D. immitis and D repens] [83.3%], with a significant P. value [< 0.05]. We concluded that there was a strong association between the presence of Wolbachia and filarial parasites that should be considered during the treatment of patients with filarial diseases by the use of specific anti-Wolbachia antibiotic in addition to the usual anti-filarial drugs

The Metabolic Syndrome: Comparison of Newly Proposed IDF, Modified ATP III and WHO Criteria and their Agreements.

Background: Metabolic syndrome (MS) results from clustering of cardiovascular risk factors occurring in association with insulin resistance and obesity. With the increasing prevalence of obesity worldwide, MS is of keen interest in research. The disorder is defined in various ways, but one consolidated definition is needed to make studies comparable worldwide. The study was to determine the risk factors of metabolic syndrome in Bangladesh and comparison of newly proposed definition of International Diabetes Federation (IDF), modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and the World Health Organization (WHO) criteria and their agreements. Materials and Methods: This was a cross sectional hospital based study. We randomly selected 229 participants. After obtaining informed written consent data collectors collected data by interview, clinical examination, anthropometric measurement and investigations. We calculated independent sample t-test means between to distinguish which risk factors were present in participants with and without MS, using SPSS v17. Results: The percentage of risk factors of MS among subjects according to different criteria was 72% of Modified ATP-III, 69% of IDF and 39% of WHO definition .In Modified NCEP ATP III when did independent sample t-test mean of BMI, waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose, high density lipoprotein and triglyceride were present statistically significant difference between without MS and with MS (p<0.05). According to WHO criteria BMI, waist circumference, fasting blood glucose were statistically significant (p<0.05) and similarly fasting blood glucose & triglyceride were statistically significant difference between without MS and with MS (p<0.05) according to IDF criteria.ATP III and WHO criteria showed good agreement (k 0.56) compared to ATP III with IDF (k 0.31) and WHO with IDF (k 0.11) criteria. Conclusion: Metabolic syndrome is highly prevalent in Bangladesh. We detected the highest proportion of participants with MS using the ATP III definition, which emphasizes the predominant focus on the modified waist circumference for Asian participants. However, MS prevalence following WHO criteria in those with impaired glucose regulation is comparable with ATP III definition. Follow up study needed to examine the significance of MS following all definitions for the assessment of risk for diabetes and or cardiovascular disease.

Homocystiene profile in elderly

Homocysteine [Hcy] is a sulfurated amino acid an elevated homocysteine level is a marker for a pathogenic process as well as a cause of pathology. It is across sectional study conducted on 91 elderly participants 60 years and older selected from geriatric outpatient clinic and geriatric inpatient departmentthey underwent comprehensive geriatric assessment, and homocysteine [Hcy] level in blood by Enzyme Immunoassay [EIA]. homocysteine not significantly related to age, sex and functional status. Also mean Hcy level is 15.4 micromol/liter. Further studies to evaluate Hcy level in elderly with different ages are recommended

A case of battered wife.

The use of corrective force against the wife is still rife in all cultures and even socially acceptable in some culture. Domestic violence is still common in our society. We report a case of 20 years old woman who admitted into OCC of DMCH through emergency department owing to be assaulted by her husband. This case is exceptional one because the injuries inflicted upon her were over the middle of the forehead and clean cut in nature, though non fatal. Awareness and education is needed to stop this social stigma.