Colorectal hypersensitivity and sensitization of both mechanosensitive and mechanically insensitive afferents develop after intracolonic instillation of 2,4,6-trinitrobenzenesulfonic acid (TNBS) in the mouse, a model of post-infectious irritable bowel syndrome. In mice in which ~80% of extrinsic colorectal afferents were labeled genetically using the promotor for vesicular glutamate transporter type 2 (VGLUT2), we systematically quantified the morphology of VGLUT2-positive axons in mouse colorectum 7-28 days following intracolonic TNBS treatment. After removal, the colorectum was distended (20 mmHg), fixed with paraformaldehyde, and optically cleared to image VGLUT2-positive axons throughout the colorectal wall thickness. We conducted vector path tracing of individual axons to allow systematic quantification of nerve fiber density and shape. Abundant VGLUT2-positive nerve fibers were present in most layers of the colorectum, except the serosal and longitudinal muscular layers. A small percentage of VGLUT2-positive myenteric plexus neurons was also detected. Intracolonic TNBS treatment significantly reduced the number of VGLUT2-positive nerve fibers in submucosal, myenteric plexus, and mucosal layers at day 7 post TNBS, which mostly recovered by day 28. We also found that almost all fibers in the submucosa were meandering and curvy, with ~10% showing pronounced curviness (quantified by the linearity index). TNBS treatment resulted in a significant reduction of the proportions of pronounced curvy fibers in the rectal region at 28 days post TNBS. Altogether, the present morphological study reveals profound changes in the distribution of VGLUT2-positive fibers in mouse colorectum undergoing TNBS-induced colitis, and draw attention to curvy fibers in the submucosa with potential roles in visceral nociception.

In this paper, we analyze the impact of COVID-19 in India and the nation's shortcomings in responding appropriately to the pandemic. We discuss how international vaccine inequities, rooted in neocolonialism, and the WHO's broad recommendation of Global North pandemic responses (i.e., lockdowns, nonspecific social distancing) blunted the effectiveness of India's COVID-19 response and instead heightened classism, economic turmoil, and unnecessary infection and death from the virus.

Context: A total of 20% of Chronic Obstructive Pulmonary Disease(COPD) patients are non-smokers due to preventable causes, such as biomass fuel exposure, post tuberculous sequelae, occupational exposure, air pollution, persistent chronic asthma, and genetic predisposition. Aims: To compare smokers and non-smokers with COPD. Settings and Design: An observational study was conducted at a tertiary care hospital on 60 patients diagnosed with COPD, (GOLD criteria), who were divided into smoker and non-smoker groups. Subjects and Methods: Demographic data, clinical profile, smoking history, and radiological data were collected and compared. Exclusion criteria were individuals having active pulmonary tuberculosis and reversible air flow limitations. Statistical Analysis Used: Using STATA 14.2, quantitative and qualitative data were presented using descriptive statistics. Results: A total of 100% of smokers were male, whereas 70% of non-smokers were female. Compared to non-smokers (16.67%), smokers (26.6%) presented with higher grade of dyspnea. A statistically significant difference was seen with more smokers diagnosed as severe (40%) and very severe (30%) COPD compared to non-smokers with mild (16.67%) and moderate (46.67%) COPD ( P < 0.012), Post bronchodilator FEV 1 among smokers (42.63) compared to non-smokers (56.63) ( P < 0.01) and decrease in FEV 1 as the grade of dyspnea increased ( P < 0.002). Compared to 36.67% in non-smokers, 70% smokers showed emphysematous x-rays. Conclusions: In our study we found majority of non-smokers to be female, and smokers had a higher grade of dyspnea, more severe COPD, lower post bronchodilator FEV 1 , and more emphysematous changes on x-rays.

Paraquat (1,1′-dimethyl-4, 4′-dipyridylium) is a broad-spectrum liquid herbicide associated with both accidental and intentional ingestion leading to severe and often fatal toxicity. 1 Paraquat is actively taken up against a concentration gradient into lung tissue leading to pneumonitis and lung fibrosis. Paraquat also causes renal and liver injury. 2 There are few case publications of paraquat poisoning and only few of them have reported that renal failure has ensued before acute respiratory distress syndrome (ARDS). Our patient presented with above lethal dose intake of paraquat containing substance and we did gastric lavage followed by charcoal hemoperfusion and hemodialysis but patient could not be saved despite optimum efforts suggesting the high fatality of this kind of poisoning. How to cite this article Sharma DS, Prajapati AM, Shah DM. Review of a Case of Paraquat Poisoning in a Tertiary Care Rural-based ICU. Indian J Crit Care Med 2019;23(6):284–286. Key Messages Acute renal injury with hypoperfusion state due to toxicity at cellular level, redox cycling and intracellular reactive oxidative stress generation may also cause death in early stages in paraquat poisoning despite optimal management.