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The reported adverse reactions following parenteral administration of vitamin B12 include: Generalized: Anaphylaxis and death Cardiovascular: Pulmonary edema and congestive cardiac/heart failure during early treatment

Oxidative modification experiments have demonstrated that the epoxide moiety disrupts the planar rigidity and electron density distribution of the steroid nucleus, thereby affecting its binding affinity to viral transcriptional regulatory elements (Wang et al., 2012a)