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Local anesthetic gel application was done for oral ulcers [Figure 1], which she had developed two days following consumption and she also received oral folic acid, riboflavin and Vitamin E supplements. The second session of hemoperfusion was carried out after a period of 48 hours. She developed non-oliguric renal failure during her hospital stay, which improved slowly over a period of one week. Her oral ulcers also improved with treatment. She was discharged after 10 days of hospital stay on prednisolone 40 mg/day. The chest X-ray at discharge showed no abnormality. Prednisolone Laccase was continued at a dose of 40 mg for 1 month following which it was tapered over a period of 6 weeks and stopped. Follow-up assessment after 7 months revealed stable vitals, spO2 of 96% with normal systemic examination. Chest X-ray was normal. High resolution computed tomography (HRCT) scan of the thorax showed only few fibrotic bands in lower lobes of both lungs with ground glass appearance in the surrounding areas. The middle lobe of right lung showed fibrotic bands with minimal traction bronchiectasis [Figure 2]. Figure 1 Oral ulcers Figure 2 HRCT thorax showing few fibrotic bands, ground glass appearance and traction bronchiectasis Paraquat, a herbicide is chemically a dipyridyl compound. It can produce local and systemic toxicity. The mortality in acute Paraquat poisoning is highly correlated with the plasma and urine Paraquat levels. Mortality in acute stage results from multi-organ dysfunction while in sub-acute stage, it results from lung learn more fibrosis. The levels of Paraquat following ingestion peak in plasma around 1�C2 hours, in the lung cells by 4�C5 hours and 90% of Paraquat is cleared from plasma by 5�C6 hours.[2,3] Hsu et al. studied the role of early hemoperfusion ( 81% (hemoperfusion SLx-2119 datasheet in patients treated with repeated pulse therapy with methyl prednisolone and cyclophosphamide. Pulse therapy with these drugs causes immunosuppression, which may prevent ongoing inflammatory injury to the tissues. A study has found them to be effective in preventing pulmonary fibrosis.[5] Our case clearly demonstrates the importance of early initiation of hemoperfusion and immunosuppression in a case of Paraquat poisoning. Thus the initial 4 hours might be the ��golden hour�� to initiate hemoperfusion in a case of Paraquat poisoning.""Earlier reported cases of olanzapine-induced myoclonus were elderly and had comorbid neurodegenerative and physical disorders.[3,4] Ours is the first case of olanzapine-induced myoclonus in an adolescent patient with schizophrenia.