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Tirzepatide works through two metabolic pathways (GLP-1 and GIP), which may enhance appetite regulation and metabolic response

Since ACh was reported to be the main neurotransmitter involved in learning and memory, it was assessed through the measurement of the AChE activity

Accurate low-dose measurement matters because the titration phase is specifically designed to minimize side effects like fatigue , nausea, and gastrointestinal discomfort that are more likely when starting doses are too high

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Governance A designated peri-operative lead convenes quarterly meetings with IVF, endocrinology, and quality teams to update the protocol against emerging ASA- or multi-society statements