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Step 5: Pinch a small fold of skin at the injection site and insert the needle at a 45-degree angle

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The most abundant genus was Ileibacterium , a relatively novel genus of the Firmicutes phylum 48

The following criteria were considered: Full economic evaluations: cost-utility analysis, cost-effectiveness analysis, cost-benefit analysis Economic evaluations reporting incremental cost-effectiveness ratios (i.e., cost per quality-adjusted life year/life years gained or cost per event avoided) Studies in patients with confirmed vitamin B12 deficiency Studies in English Abstracts were reviewed by a single reviewer and, for those studies meeting the eligibility criteria, full-text articles were obtained