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Prescription and administration: Once B12 deficiency is confirmed, GPs prescribe hydroxocobalamin injections according to standardised protocols: Standard loading regimen: 1mg intramuscularly three times weekly for two weeks Neurological involvement: 1mg intramuscularly on alternate days until no further improvement Maintenance therapy: 1mg every three months for life in pernicious anaemia or malabsorption conditions (or every two months if there was neurological involvement) Injections are typically administered by practice nurses at GP surgeries

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The complete and simultaneous obstruction of the mesenteric vein and artery was instant and thereby provides no time for adequate spontaneous adaptation unless an essential therapy is active

Acute Med

Apply a cold pack or ice for 15-20 minutes to alleviate pain and bee sting pain relief