Pseudohyperkalemia in Serum and Plasma: The Phenomena and Its Clinical Implications

Hyperkalemia is a life threatening electrolyte derangement that must be recognized and treated quickly. Pseudohyperkalemia is defined as a difference between serum and plasma potassium concentration of more than 0.4 meq/L with serum values on the higher side when both the samples are obtained at the same time, remain at room temperature and are tested within 1 h of sample collection. Given the implication of basing medical decisions on falsely elevated potassium levels, timely identification of the entity of pseudohyperkalemia and differentiating it from true hyperkalemia becomes utmost important. Here we present a case report of a 36 year old female admitted with a provisional diagnosis of pyrexia of unknown origin with hepatosplenomegaly and anaemia under evaluation. During hospital stay her potassium levels in whole blood, serum and plasma reportedly differed significantly. An abnormal WBC count beyond assay range was reported and during subsequent investigations this lead to a peripheral smear being advised and diagnosis revealed chronic lymphoblastic leukaemia with blast crisis and 86% blast cells. In patients with leukocytosis and thrombocytosis, pseudohyperkalemia may exist in the absence of electrocardiogram changes or other clinical manifestations of true hyperkalemia thus leading to reevaluation of potassium values in serum, plasma and whole blood to arrive at the true picture.     

Comparison Between Serum hsCRP and LDL Cholesterol for Search of a Better Predictor for Ischemic Heart Disease

Acute myocardial Infarction is one of the major causes of morbidity & mortality in world and atherosclerosis is the major cause of ischemic heart disease. In order to determine the better clinical marker of atherosclerosis, we estimated serum low-density lipoprotein (LDL-C) and high sensitivity C-reactive protein (hsCRP). Hundred patients of myocardial infarction and 100 controls irrespective of age and sex were studied for these parameters over a period of 2 years. The statistical analysis showed that the serum hsCRP was significantly raised in myocardial infarction cases than controls (P < 0.01) but LDL-C was not (P > 0.05). We conclude that the serum hsCRP has better predictive value for risk of atherosclerosis.     

Human capital and hierarchy

This paper investigates the relationship between schooling, experience, hierarchy and earnings, using sample data drawn from one of the largest companies in the Indian private sector. A recursive path approach is posited and an analysis of the results indicates that hierarchic status acts as an intervening variable to channel the transmission effect of schooling and experience onto earnings. After controlling for differences in schooling, hierarchic status is shown to rise monotonically, albeit by diminishing increments, with experience, thereby offering support for the marginal productivity theory. In the process, the weak version of the screening hypothesis is also borne out.