SIR, I am your student and now medical Superintendent and seeking MD community medicine ,I need your help for my health I had severe burning aching pain in fingers both hands n toes on n off since 4 yrs C/o severe pain in foot , sole during walking and on rest too since 1year C/o muscular ,weakness ,easy fatigue ..low backache since 3 month On exam TPR normal , ECG low voltage Thyroid function normal, xray chest normal , Ct chest normal , Pre n para tracheal lymph node ,CBC normal with HB 15 , P s megaloblastic anemia Ectrolytes normal , alkaline phosphatase raises 900, Crp, ncv study ,creatinine normal , ana negative, ESR normal Vit b12 , Vit d severe deficiency Started vitcofol c injection n Vit d sachets since one month now Vit levels normal But muscular and joint pain , fatigue is still there foot n sole pain significantly reduced No cough breathlessness but painful paratracheal lymph node on off . Plz guide n help