Are Gap and Cast Indices Predictors of Efficacy of Reduction in Fractures of Both Bones of the Leg? A Cohort Study

@#Introduction: Non-operative management has successfully been practised for long in diaphyseal fractures of both bones of the leg. This study attempts to establish an acceptability criteria for plaster cast in order to predict future loss of reduction and its adequacy. Materials and Methods: A total of forty subjects were included as per inclusion-exclusion criteria. Gap and cast indices were calculated in the immediate post reduction phase and at third week follow-up visit. Results: The mean values of gap and cast indices in the immediate post-reduction phase were 0.35±0.220 and 0.99±0.08 respectively and at the third week follow-up the mean value for both the parameters in those without loss of reduction were 1.11±0.50 and 1.03±0.09 respectively and in those with loss of reduction were 0.84±0.44 and 1.01±0.06 respectively. Conclusion: Gap and cast indices are not informative in assessing adequacy of reduction in diaphyseal fractures of both bones of the leg.

Suppression of Eis and expression of Wag31 and GroES in Mycobacterium tuberculosis cytosol under anaerobic culture conditions.

A major impediment in chemotherapy of Tuberculosis (TB) is the persistence of M. tuberculosis in a latent or dormant state, possibly perpetuated by paucity of oxygen within the lung granuloma. Proteome analysis of the anaerobically persisting microbe could therefore provide novel targets for drugs against latent TB infection (LTBI). An Indian clinical isolate of M. tuberculosis was cultured under aerobic and anaerobic conditions following Wayne’s hypoxia model and its cytosolic proteins were resolved by two-dimensional gel electrophoresis (2DE). Peptide mass fingerprinting of 32 differentially expressed spots using MALDI TOF-TOF MS-MS resulted in identification of 23 proteins. Under the anaerobic culture conditions, expression of 12 of these proteins was highly suppressed (>2 fold reduction in spot volumes), with 4 of them (GrpE, CanB, MoxR1 and Eis) appearing as completely suppressed since corresponding spots were not detectable in the anaerobic sample. On the other hand, 4 proteins were highly expressed, with two of them (Wag31 and GroES) being uniquely expressed under anaerobic conditions. Suppression of Eis could make the anaerobically persisting bacilli susceptible to the aminoglycoside antibiotics which are known to be acetylated and inactivated by Eis. Although all 4 over-expressed proteins can be considered as putative drug targets for LTBI, Wag31 appears particularly interesting in view of its role in the cell wall biogenesis.