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That works at first, but as titration schedules, missed doses, injection-site changes, and notes about side effects pile up, the process becomes messy: missed steps slow down tolerance, inconsistent injection sites can cause irritation, and symptom patterns get lost in notes or memory

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According to the ESPEN guidelines, while case reports have linked zinc deficiency to hepatic encephalopathy, randomized controlled trials have shown no therapeutic effect of oral zinc supplementation on hepatic encephalopathy [51, 52]

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