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.     

Making e-government work: Adopting the network approach

Much of what was promised has not been delivered by e-government. This necessitates a better understanding of the critical factors necessary for making e-government work. While a number of factors are known to cause e-government failure, this knowledge has not translated into greater success in e-government implementation. This suggests that other, more deep-rooted issues may have remained unaddressed. The nature of modern governance implies that e-government should be looked upon as a network. Application of network concepts like the politics of partner selection, achievement of network goals, institutionalisation processes, network structuring and incentive design can make e-government projects more realistic. We analyse three projects in India based on these issues and argue how a network approach could lead to success of such initiatives. In addition, we show that adoption of a process focus can help in identifying the appropriate partners and facilitate other network processes.     

Using electronic portfolios to promote reflective thinking in language teacher education

This study aimed at investigating the role of electronic portfolios in fostering pre‐service teachers’ reflective thinking. The research was conducted with pre‐service English language teachers enrolled in a practicum course in an undergraduate teacher education programme in Turkey. The data were collected through e‐portfolios and interviews. The findings revealed that e‐portfolios gave participants a sense of ownership, fostered reflecting thinking, supported collaboration and allowed them to make connections between theory and practice. With the on‐going nature of the e‐portfolio, participants had the chance of developing and reviewing their portfolio artefacts whenever and wherever they wanted. Therefore, electronic portfolios allowed teacher candidates to reflect more on their own work and thus engage in on‐going professional development.     

Effect of surface acoustic waves on the viability, proliferation and differentiation of primary osteoblast-like cells

Surface acoustic waves (SAWs) have been used as a rapid and efficient technique for driving microparticles into a three-dimensional scaffold matrix, raising the possibility that SAW may be effective in seeding live cells into scaffolds, that is, if the cells were able to survive the infusion process. Primary osteoblast-like cells were used to specifically address this issue: To investigate the effects of SAW on the cells’ viability, proliferation, and differentiation. Fluorescence-labeled osteoblast-like cells were seeded into polycaprolactone scaffolds using the SAW method with a static method as a control. The cell distribution in the scaffold was assessed through image analysis. The cells were far more uniformly driven into the scaffold with the SAW method compared to the control, and the seeding process with SAW was also significantly faster: Cells were delivered into the scaffold in seconds compared to the hour-long process of static seeding. Over 80% of the osteoblast-like cells were found to be viable after being treated with SAW at 20 MHz for 10–30 s with an applied power of 380 mW over a wide range of cell suspension volumes (10–100 μℓ) and cell densities (1000–8000 cells∕μℓ). After determining the optimal cell seeding parameters, we further found that the treated cells offered the same functionality as untreated cells. Taken together, these results show that the SAW method has significant potential as a practical scaffold cell seeding method for tissue and orthopedic engineering.