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Ultimately, the total calories consumed and burned appear to be the most important factors for weight loss

These improvements hold even when patients make modest dietary mistakes, suggesting the medication's glucose regulation is robust enough to handle occasional sugar intake without derailing overall metabolic progress

Fourth, following the improved results of PHES in both groups without significant change in serum ammonia levels, we could not exclude the possibility of learning effects that patients could have achieved during the repeated examinations throughout the study period.In conclusion, 24 weeks of L-carnitine supplementation was safe but was not effective in improving the quality of life among patients with covert HE