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Description

The methodological quality of the included studies, as assessed through the Jadad and NewcastleOttawa scales, varied from moderate to high, while the GRADE assessment indicated moderate certainty of evidence for serum vitamin B12 increase and low certainty for homocysteine reduction

Do not administer repeated injections of epinephrine at the same site, as the resulting vasoconstriction may cause tissue necrosis

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Secondly, the retrospective data collection constituted a risk of bias due to the possible difference of data reliability between patients with and without cancer