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Many therapies now considered foundational in perioperative medicine were initially adopted based on mechanistic plausibility and early observational signals before high-quality surgical outcome trials were performed

Keywords: N-acetylcysteine, obesity, hepatic steatosis, insulin resistance, inflammation INTRODUCTION N-acetylcysteine (NAC, C 5 H 9 NO 3 S) is a thiol compound that stimulates glutathione-S-transferase activity and promotes detoxification by providing sulfhydryl groups and acting as a scavenger of free radicals through direct interaction with reactive oxygen species (1, 2)

A double-blind, placebo-controlled trial in 90 HIV-positive patients with symptomatic distal symmetrical polyneuropathy found no benefit of intramuscular injection with 1 g/day of ALCAR for two weeks in the intention-to-treat analysis, but there was some pain relief in the group of 66 patients who completed the trial (84)

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Tirzepatide can sometimes cause a loss of thirst or mild nausea, leading to dehydration