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Needle innovations, including the use of a shorter 8 mm needle, offer drugs, to enable the delivery of larger, more viscous drugs, without compromising end-user experience.16 IM RISK, INJECTION-RELATED ANXIETY & PAIN PERCEPTION Standard needles for chronic disease treatment and parenteral administration are historically 12.7 mm (half an inch) long

Most involve a relatively small number of subjects, and few of the research teams seem to have actually published papers describing their methods and data

and patients with pernicious anemia who have optic neuropathy COBALAMIN (Vitamin B12) Deficiency Causes Vegetarians (dietary deficiency) Older adults: atrophic gastritis affects 10% 30% and leads to decrease in hydrochloric acid secretion in the stomach and decreased absorption of Vitamin B12 The liver can store up to six years worth of Vitamin B12 so deficiencies are rare Effects of deficiency Megaloblastic anaemia (pernicious anaemia) Progressive demyelination of nerve cells Elevation in levels of circulating homocysteine that leads to production of defective collagen and elastin with a negative impact on arteries, bone and skin Deep vein thrombosis is associated with homocysteinemia that causes the activation of the intrinsic coagulation cascade Symptoms include fatigue, weakness, constipation, loss of appetite and weight loss Numbness, tingling of the feet imbalance, depression, confusion, dementia, poor memory and glossitis

Because of lack of renal clearance, serum values rose to more than a hundredfold from 422 pmol/L on average to 54 000 pmol/L, with 67 000 pmol/L as highest value, without side-effects