METHODS: Retrospective case review of children <6 years-old with liquid paracetamol overdoses referred to a regional poisons information centre January 2017 to August 2022. We extracted data on the exposure and management from the poisons information centre and hospital medical records. We identified additional cases with two paracetamol concentrations obtained from September 2022 to June 2024.

RESULTS: Of 437 paediatric poisonings, 271 were eligible for inclusion. The median age was 24 months, the median time to presentation was 120 min, and paracetamol was the sole ingestant in 92% of cases. Blood testing was recommended in 131 patients (48.3%), occurring at 2 h post-ingestion in 62 patients (47.3%). Testing at a later time was mostly due to delayed presentation, including to hospitals unable to measure paracetamol concentrations. Eighteen patients (16.7%) had repeat blood testing, and five additional cases were identified in the subsequent period. Overall, the concentration decreased in 19 patients (83%), but in three patients it increased, from 73 mg/L to 81 mg/L (0.49-0.54 mmol/L), from 154 mg/L to 179 mg/L (1.03-1.19 mmol/L), and from 56 mg/L to 115 mg/L (0.37-0.77 mmol/L). Symptomatic patients were more likely to receive a second blood test or acetylcysteine while awaiting investigations. Of 19 patients administered acetylcysteine, it was discontinued in five due to low paracetamol serum concentrations. All patients recovered.

DISCUSSION: Guidelines were followed in >90% of patients and this testing regimen shortened length of stay. Based on these data, Australian treatment guidelines now recommend repeat testing for 2 h paracetamol serum concentrations >100 mg/L (0.67 mmol/L).

SETTING: All glyphosate-related data of the Malaysia National Poison Centre from 2006 to 2023.

PARTICIPANTS: Telephone inquiries of incidents involving glyphosate made by healthcare professionals across Malaysia. Information received was recorded according to WHO guidelines.

OUTCOMES: The outcome is to provide an overview of national glyphosate poisoning epidemiology, including identifying risk factors and high-risk groups to strategise appropriate measures.

RESULTS: A total of 4548 glyphosate poisoning cases were reported, with males comprising 67.3% of cases. The most affected age groups were 21-30 years (25.5%) and 31-40 years (23.5%). Ingestion was the primary exposure route (93.0%). Intentional poisonings, mainly suicides, accounted for 68.4% (n=3078) of cases. Among the 1420 unintentional cases, 78.2% resulted from ingestion exposures. The incidence rate declined from 1.17 per 100 000 in 2011 to 0.61 in 2023. Significant associations were found between intentional ingestion and sociodemographic factors. From 2013 to 2023, 73.7% of cases were minor, 11.5% moderate, 0.8% severe and 0.1% fatal.