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On examination, he was conscious and oriented with stable vitals

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Symptoms of pernicious anemia include: Excessive weakness, Pale skin, Diarrhea, Weight loss, Fever, Numbness or tingling sensation in the hands and feet, Imbalance, Confusion, Memory loss, and Mood swings

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For maintenance-level treatments at 0.25 mm, a dermaroller works fine and costs a fraction of the price