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Nevertheless, despite its popularity, this combination is not based on any independent scientific study

Fungal infections like oral thrush Bacterial infections such as impetigo Inflammatory conditions like cheilitis These conditions can cause discomfort and change lip appearance, including making them look pale or white

For example, in a recent cross-sectional surveillance study conducted in 43 paediatric patients taking VPA [48], only two were found to have carnitine levels below the normal limit, suggesting that routine carnitine level checking is not justified

May 2012;44:600604