Empirical Treatment in Clinically Diagnosed Cases of Vitamin B12 Deficiency

摘要

Background: Vitamin B12 deficiency may present with fatigue, weakness, numbness, decreased memory, irritability, confusion and depression, although initial symptoms might often be vague. Even though the human body can store vitamin B12 to last for up to five years, its deficiency is not very uncommon. The diagnosis is frequently made on the basis of a costly tests like low serum vitamin B12 level or megaloblastic bone marrow or both. This study was aimed to measure the effect of Empirical treatment in clinically diagnosed cases of Vitamin B12 deficiency. Methodology: Current study was a prospective study, done in a private hospital. All patients attending OPD during July 2015 to December 2015 forms the study population. All patients full filling inclusion criteria and willing to give informed written consent were treated with 2ml Intramuscular injection of Vit B 12 1000mcg thrice a week for total ten injections. Follow up of patients were done on weekly basis for first month, then every two weekly for next two month and then monthly basis for next three months. After this period, symptoms were reassessed and recorded. Results: Total 90 clinically suspected patients of Vitamin B12 deficiency were willing to participate in the study. Out of total 90 patients, 39 (43.33%) patients were male and 51 (56.67%) patients were female. Out of total 90 patients, maximum number of patients i.e 31 (34.44%) were from age group of 41 to 50 years. All symptoms were significantly improved after completion of standard course of Vit B12. In out of total 90 patients having complain of generalized weakness, improvement was observed in 83 (92.22%) patients. Out of total 88 patients having complain of myalgia and 84 patients having complain of paresthesia, improvement was recorded in 76 (86.36%) and 73 (86.9%) patients respectively. Conclusion: We conclude and recommend from the study that diagnosis based on clinical assessment is reliable. Thus, in resource poor country like India diagnosis should be advocated on symptoms of Vit B12 deficiency and empirical treatment should be suggested.