We all see the articles about what it takes to run a successful practice: slick marketing, conflict management, Web pages, team training, appropriate compensation packages, etc. The list is endless. Yet these topics are but condiments on a great hamburger. The substance of the hamburger is the patty. The substance of clinical medicine is a patient's assessment, diagnosis, treatment and plan. Do that well, and you will succeed. Do that poorly, and you must rely on the condiments for success.
Conversely, its absence causes a needlessly high risk of disease and death. For children, lack of vitamin A causes severe visual impairment and blindness, and significantly increases the risk of severe illness, and even death, from such common childhood infections as diarrhoeal disease and measles.
The main causes of vitamin B12 deficiency include vitamin B12 malabsorption from food, pernicious anemia, postsurgical malabsorption, and dietary deficiency [ 12 ]. However, in many cases, the cause of vitamin B12 deficiency is unknown.itamin B12 Deficiency. Vitamin B12 deficiency is characterized by megaloblastic anemia, fatigue, weakness, constipation, loss of appetite, and weight loss [ 1, 3, 27 ]. Neurological changes, such as numbness and tingling in the hands and feet, can also occur [ 5, 28 ].