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Including clinically diagnosed cases alongside genetically confirmed patients enhances the real-world representativeness of this review but introduces diagnostic heterogeneity and potential misclassification, which may limit the generalizability of treatment-related conclusions, particularly regarding the efficacy of oral vitamin B12 therapy

Ans: Side effects are infrequent when given properly by a trained clinician

CD38 expression in chronic lymphocytic leukemia CD38 is also involved in chronic lymphocytic leukemia (CLL), a malignancy characterized by the accumulation of malignant mature lymphocytes in the peripheral blood, bone marrow and lymphoid tissues [27]

Therefore, there is a significant need to investigate the efficacy of complementary and alternative therapies and their tolerability in children with ASD while also identifying those that respond to these interventions

The active group showed improvement in these markers over the treatment period