Australia: Mc-Graw-Hill Australia; 2003. pp. 152–182. Westman EC. Is dietary carbohydrate essential for human nutrition? Am J Clin Nutr. 2002;75:951–954. [ PubMed ] Feinman RD, Makowske M. Metabolic syndrome and low-carbohydrate ketogenic diets in the medical school biochemistry curriculum. Metab Synd Relat Disord. 2003;1:189–197. doi: _link_/154041903322716660. [ PubMed ] [ Cross Ref ] Veech RL, Chance B, Kashiwaya Y, et al.
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Pseudohypertrophy is rare. There is rarely cardiac involvement and mental function is normal. A variant of FSHMD the early onset and rapidly progressive form called Coats disease associated with of high-frequency sensorineural hearing loss, retinal telangiectasias and detachment. In FSHMD, CK levels are either normal or increased (up to 5x baseline). Progression is usually slow and about 20% will become wheelchair bound.
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Intentional Vomiting If one is overcome by the urge to vomit, and vomits unintentionally, then he should continue to fast. If someone chooses to vomit, for any reason, then his fast will become invalid. Intentional Sexual Intercourse If one has sexual intercourse while fasting, then he must perform kaffaarah, expiation of the sin. (Fasting continuously for sixty days or if unable then one should feed sixty poor people).
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 Serious weight loss may reduce quality of life, impair treatment effectiveness or recovery, worsen disease processes and be a risk factor for high mortality rates.   Malnutrition can affect every function of the human body, from the cells to the most complex body functions, including:  immune response; muscle strength (including respiratory muscles); renal capacity and depletion leading to water and electrolyte disturbances; thermoregulation; and menstruation.