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This results in B12 malabsorption, deficiency, and megaloblastic (abnormally large and dysfunctional) RBCs in many cases

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Resistance to cornerstone drugs like isoniazid and rifampicin reduces the efficacy of standard regimens and necessitates second-line agents that often fail to achieve adequate ocular levels and carry systemic toxicities, including nephrotoxicity, hepatotoxicity, and hematologic complications (Prasad et al., 2021)

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