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Conditions include alcoholic liver disease, viral hepatitis, cirrhosis, and primary or metastatic liver cancer Renal dysfunction : Impaired kidney function reduces B12 elimination, causing accumulation even with normal intake Haematological conditions : Myeloproliferative neoplasms, chronic myeloid leukaemia, polycythaemia vera, and hypereosinophilic syndrome increase transcobalamin production, elevating total serum B12 Laboratory interference : Macro-B12 (immunoglobulin-bound B12) and assay interference can cause spuriously elevated results without true excess In clinical practice, unexplained hypercobalaminaemia should prompt investigation for underlying disease, particularly in patients without obvious supplementation history

The disease resulted from exposure to aflatoxins produced by the fungus Outbreaks of aflatoxicosis sadly do occur

Carcinogens whether chemical, dietary, or environmental shift the terrain toward inflammation, oxidative stress, hormonal imbalance, and immune dysfunction

We evaluated the predictive performance of URS, comparing it with Paris-II criteria