Initiation of pharmacist–psychiatrist collaborative patient education in ambulatory care settings of a tertiary care teaching hospital in south India

The aim of this study is to initiate the pharmacist–psychiatrist collaborative patient education in ambulatory caresettings. A prospective cohort study was conducted in psychiatry out-patient department of a tertiary care teachinghospital over a period of 6 months. All the eligible patients were enrolled, and the necessary information was collected.The collected data were analyzed for medication adherence by using medication adherence rating scale and healthrelated quality of life by using the World Health Organization Quality of Life questionnaire. Student t-test was usedto analyze the results at p-value <0.05. A total of 210 patients were analyzed and followed for a period of 6 months.When compared to the baseline values, a significant improvement in medication adherence and quality of life witheach follow-up at p-value <0.05 was observed. The study results have evidently proven that pharmacist–psychiatristcollaborative approach could significantly improve patient education and related clinical outcomes.

Effect of utilization of veno-venous bypass vs. cardiopulmonary bypass on complications for high level inferior vena cava tumor thrombectomy and concomitant radical nephrectomy

ABSTRACT Purpose: To determine if patients with renal cell carcinoma (RCC) with levels III and IV tumor thrombi are receive any reduction in complication rate utilizing veno-venous bypass (VVB) over cardiopulmonary bypass (CPB) for high level (III/IV) inferior vena cava (IVC) tumor thrombectomy and concomitant radical nephrectomy. Materials and Methods: From May 1990 to August 2011, we reviewed 21 patients that had been treated for RCC with radical nephrectomy and concomitant IVC thrombectomy employing either CPB (n =16) or VVB (n=5). We retrospectively reviewed our study population for complication rates and perioperative characteristics. Results: Our results are reported using the validated Dindo-Clavien Classification system comparing the VVB and CPB cohorts. No significant difference was noted in minor complication rate (60.0% versus 68.7%, P=1.0), major complication rate (40.0% versus 31.3%, P=1.0), or overall complication rate (60.0% versus 62.5%, P=1.0) comparing VVB versus CPB. We also demonstrated a trend towards decreased time on bypass (P=0.09) in the VVB cohort. Conclusion: The use of VVB over CPB provides no decrease in minor, major, or overall complication rate. The use of VVB however, can be employed on an individualized basis with final decision on vascular bypass selection left to the discretion of the surgeon based on specifics of the individual case.