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Acute methanol poisoning produces severe metabolic acidosis, increased anion and osmolal gaps. These metabolic disturbances are due to accumulation of formic acid with has serious neurological sequelae. If renal functions starts deteriorating that is associated with increased mortality. Early diagnosis and treatment can reduce morbidity and mortality. Treatment include infusion of sodium bicarbonate and administration of ethanol orally or parentally to inhibit the production of formic acid from methanol. Hemodialysis is helpful in removal of methanol and its breakdown products from circulation and also in correcting acidosis. We report the case of a boy admitted to the emergency room with a history of acute illness, characterized by nausea, vomiting, blurred vision, and shortness of breath. Arterial blood gases showed severe metabolic acidosis with high anion gap. He had ingested large quantity of alcohol containing methanol. The patient was managed with hemodialysis and strong intravenous hydration. He improved well and made a full recovery. [ABSTRACT FROM AUTHOR]

Background: Stroke is a leading cause of disability and the second principal cause of death in the world. The aim of this study was to analyze different characteristics in stroke patients in Medical Unit 1 of Lahore General Hospital, which is biggest referral hospital for Neurology patients in Punjab, to identify the risk factors and help in targeting prevention in our patients. Study Design: Descriptive study. Setting: Lahore General Hospital, Lahore. Period: January 2016, including data from January to November 2015. Methods: The demographic data, clinical manifestations, risk factors, side of weakness, cranial nerves involved, neurological weakness and Glasgow Coma Scale, duration of stay in hospital and outcome were included in the data. For the comparison between categorical variables Chi-square test was used. For other variables, t-test was used. Results: A total of 235 patients with stroke, age 20 to 105 (mean ±SD= 58±14.6) were included. 127 (54%) had Ischemic stroke (IS) and 100 (42.6%) had hemorrhagic stroke (HS). 127 (54%) were men and 108 (46%) were women. 17.9% of the patients with IS and 21.7% of the patients with HS died (OR 0.65 95% CI 0.48-0.89). Hypertension, diabetes and dyslipidemia were the most common risk factors. Conclusion: Burden of stroke is high in Pakistan. Mean age of patients with stroke is less. Hypertension, diabetes, dyslipidemia and smoking are highly prevalent and hypertension is the most common. Ischemic strokes are more common, mortality of intra-cerebral hemorrhage is higher. [ABSTRACT FROM AUTHOR]