CASE STUDY BASICS;In most countries cooperation does not go far beyond the signing of treaties and protocols. The objectives of the treaties are not integrated in national development plans or in the sectoral programmes of appropriate substantive ministries. The officials and ministers who participate at intergovernmental meetings on the implementation of the treaties of cooperation generally come to the meetings without the mandate of their cabinet colleagues and, on returning to their respective capitals, they do not brief their cabinet colleagues on the proceedings and decisions taken at the meetings. Moreover, the governments do not send officials to the meetings who have the appropriate expertise on the issues to be discussed. Another inhibiting factor is lack of grass root support at the national level, due to the manner in which the cooperation arrangement are launched. In many countries the idea of forming or joining an economic corporation arrangement sprang less from the wishes of the people in response to their felt needs than from the leadership; and sometimes the idea may be instigated by a donor country which may be a previous colonial power or is the main provider of aid and technical assistance. The donor country/countries would, of course, give priority to their interests. The economic dependency status of many African countries is another factor that works against the viability and strength of sub-regional economic cooperation groupings in Africa. Many African countries still depend excessively on supplies and manufactured products originating from developed countries, even where comparable products are available within a sub-regional preferential arrangement.

questions

Question 10 Is the mean corpuscular volume (MCV) useful? What is the RDW and when is it used?

Question 11 What is the significance of renal disease with respect to anaemia, if any?

Question 12 Can anaemia be a differentiating point between muscle wasting and cachexia owing to another systemic disorder?

Question 13 Anaemia of chronic disease does not respond to iron therapy, but there are trials studying the use of iron and erythropoietin (EPO). Could you tell me where to find more detailed information about these trials, and whether there have since been any further developments?

Question 14 Is the deoxyuridine test helpful?

Question 15 The Schilling test is very rarely performed. Why is this?

Question 16 There is no extramedullary haematopoiesis in aplastic anaemia, why?

Question 17 Why is the anaemia in aplastic anaemia, macrocytic?

Question 18 Is vitamin B12 absorbed passively from the jejunum?

Question 19 What role does 'R' binder play in the absorption of vitamin B12?

Question 20 In pernicious anaemia, investigation of the serum shows an elevated level of gastrin. Why is it so