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The accompanying changes of sensation or other nerve functions that occur with tetany may not be apparent because the cramping pain is masking or distracting from it

Some bacteria that produce thiaminases are usually present in the the rumen but overgrowth is the issue

If it needs help, gently swirl or roll the vial

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To ensure full contraceptive protection, it is essential to use an additional barrier method of contraception, such as condoms, or switch to a non-oral contraceptive method like an intrauterine device (coil) during this time