Minimally invasive parathyroidectomy for regional hospitals.

However, we disagree with Dr Lee that the toxicity should be attributed solely to rectal paracetamol. Firstly, the pharmacokinetics of rectal paracetamol have been extensively studied, and it has been suggested that even a rectal regimen of 25 mg/kg every 6 hours for a mean of 2 to 3 days did not result in supratherapeutic concentration. Secondly, because oral and rectal paracetamol are metabolised through the same mechanism, we do not agree that toxicity from rectal paracetamol would contribute differently to the hepatotoxicity of the patient described in our report. Nevertheless, this scenario highlights the risk of concomitant use of both oral and rectal paracetamol resulting in overdose of the drug.