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Prepare multiple small vials instead of one large container

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Serum B12, and potentially methylmalonic acid (MMA) and homocysteine, give your clinician the data to determine whether B12 is a contributing factor or whether the mood symptoms are being driven by something else entirely

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A paradoxical reaction should be suspected if the symptoms were worse after the antibiotic therapy based on susceptibility testing results and proper surgical interventions, especially if patients had taken corticosteroids before being admitted