P117 Surgical management of Ureteropelvic Junction Obstruction (UPJO) in Neonates amid COVID-19 pandemic; Review of Literature and a Cohort Study in Iran

Introduction The current study presents a systematic review of literature on surgical management of ureteropelvic junction obstruction (UPJO) alongside an ongoing cohort study of neonates presenting with high grades of hydronephrosis due to UPJO requiring urgent treatment in a developing country amid the COVID-19 pandemic. The aim of this study is to investigate the efficacy and cost effectiveness of laparoscopic-assisted pyeloplasty. Methods Patients’ demographics, clinical presentations and treatment outcomes are recorded. The cohort is classified into 3 groups based on type of surgical treatment offered including open, laparoscopic and laparoscopic-assisted pyeloplasty. All patients admitted with grade 3-4 hydronephrosis due to UPJO are included. Patients with UPJO as part of a complex multisystemic syndrome are excluded. Literature review was conducted from 2000/1/1 to 2020/1/1 to include all original research papers on surgical management of UPJO. The age group was limited to neonates (under 1 year-old). Results 32 articles were included in the review. 20 papers (62.5%) recommended open pyeloplasty, 10 papers (31.3%) recommended laparoscopic pyeloplasty and 2 papers (6.25%) recommended laparoscopic-assisted pyeloplasty. The cohort study is currently recruiting patients treated by the 3 surgical approaches. Conclusion The majority of studies are focusing on open pyeloplasty. However, as more surgeons are going through the learning curve of laparoscopic pyeloplasty, the trend is towards more laparoscopic management in the future. It is important to discover the advantages of laparoscopic-assisted approach as a new technique to improve the outcome and shorten the hospital stay amid the COVID-19 pandemic

Demographic and clinical features of patients suffering acute intoxication with an emphasis on cardiovascular complications; an observational case series

Introduction: Acute intoxication is an ongoing health issue worldwide and one of the most prevalent causes of hospital admission. Investigation of the features of acute intoxication occurrence allows for effectively planning preventive measures and required health resources. Objectives: The current study investigated acute intoxication’s demographic and clinical characteristics in an Iranian province. Patients and Methods: An observational case-series study was designed to investigate patients suffering from acute intoxication and admitted to two referral tertiary teaching hospitals over six months. Demographic data, vital parameters comprising neurologic, respiratory, and hemodynamic status, clinical symptoms, and blood analysis data were prospectively recorded. Data analysis was conducted using SPSS version 21 software. Results: In total, 447 patients were included in the study (3.5% of all emergency admission). The mean age of patients was 33 ± 16 (4-88) years, and 190 (42.6%) patients were female. Seventy percent of patients were under 40 years. The male patients were significantly older than the female ones (P = 0.001). Hospital mortality was 2.7%. Circulatory shock and respiratory apnea occurred separately in 13 (2.9%) patients, and alteration in consciousness affected 30%. Reduced arterial blood saturation and visual acuity were observed in 14% and 3.6% of the patients. A cumulative prevalence of electrocardiogram anomalies of 38% was also observed. The most prevalent electrolyte disorder was hypocalcemia (12%), followed by hypokalemia (10%); 17 % of patients were affected by severe blood acidosis. Conclusion: Acute intoxication is a medical emergency with a high risk of death. A multi-organ-based diagnosis and therapeutic approach should be implemented to manage the potentially lethal complications as soon as possible. Effective preventive planning for reducing acute intoxication should be performed concerning the socioeconomic status of the targeted population