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Local envenomation findings Most patients in both groups presented with progressive edema, accounting for 93.3% of patients in the ASV group and 73.3% in the ASV + NAC group, with no statistically significant difference between groups ( = 2.36, p = 0.31)

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This establishes a reference point for tracking changes and helps identify patients who may need adjustment of existing antihypertensive medications as weight loss occurs

Additionally, processes involving kappa kinase (IKK-), c-Jun N-terminal kinase (JNK-1), protein kinase C (PKC), and mammalian target of rapamycin (mTOR)-driven serine modification of IRS1 also contribute to insulin resistance, further intensified by free fatty acids, lipotoxicity, oxidative stress, and inflammation (Stergios et al., 2009)