Extension Casting For Both-Bone Forearm Fractures In Children.

Paediatric forearm fractures are commonly treated with closed reduction and cast immobilization. Determining the best way to cast these fractures during the initial presentation may prevent the need for re-manipulation . An analysis of casting technique for all patients under eighteen years of age treated with closed reduction and cast immobilization for both-bone fractures of the forearm at a regional tertiary referral hospital over 7 years was undertaken. One-hundred and eighty-nine consecutive patients with 207 fractures were reviewed. No significant association was found between casting technique and failure rates (p=0.124). However, if manipulation and plaster was performed by a trainee, failure rates were significantly reduced when extension casting was utilized (p=0.029). Closed reduction and cast immobilization with the elbow in an extended position is an effective treatment option for both-bone forearm fractures in a paediatric population and is a safer option when performed by more junior staff-members.

Inkwari: an emerging high-risk place potentiating hiv spread among young adults in a hyper-endemic South African setting.

Young adults in South Africa are at the epicenter of the HIV epidemic. The prevalence of HIV among young people in the province of KwaZulu-Natal (KZN) is particularly high. This study characterizes inkwari (Zulu word for raves or weekend-long parties) in eThekwini District, KZN and explored how these place-based dynamics shape the risk environment for the young adult attendees. In 2011, 13 qualitative interviews were conducted with men and women between 18 and 30 years-old who reported unprotected sex with at least one casual partner in the prior 3 months and attended an inkwari in the same time period. Interviews were analyzed using qualitative content analysis. Nine key informant interviews helped to triangulate these data. Five women and eight men were interviewed and the mean age was 25 years (SD 3.24). Ten reported meeting a sexual partner at an inkwari. Inkwari were characterized as sexualized settings with limited adult supervision. Participants attended inkwari to socialize with peers, use drugs and alcohol, and meet sexual partners. Sexual and physical violence also occurred at inkwari. Given the convergence of social, sexual, and substance-using networks at inkwari, further inquiry is needed to determine how this place may potentiate HIV transmission risk in an endemic setting.