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The random-effects model (DerSimonian-Laird method) was applied across studies

But heres the quiet detail most people miss: In certain patients, this combination can contribute to high anion gap metabolic acidosis (5-oxoproline accumulation), especially where there are risk factors like sepsis, malnutrition, renal impairment, chronic alcohol use, or prolonged high-dose paracetamol

Specimens should be obtained at the time of spontaneous presentation and before treatment whenever possible

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