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Two patients were unable to use the drops due to technical reasons and one had sesame oil allergy (the basis of the hydroxocobalamin nasal drops)

There are several possible causes of vitamin B12 deficiency

Congenital adrenocortical adenoma: case report and review of literature

Major risk factors for melasma include sun exposure, hormonal changes, genetics, and having a darker skin type

Functions as a for metabolic reaction required for synthesis of purines and pyrimidines: co-enzyme The reaction depends on methyl cobalamin as a co-factor and is also dependent on folate, in which the methyl group of methyltetrahydrofolate is transferred to homocysteine to form methionine and tetrahydrofolate