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Mechanisms include increased growth factor expression (VEGF, FGF, EGF), enhanced fibroblast migration and proliferation, improved collagen organization, and accelerated revascularization

However, first rule out other causes of increased nausea, such as recent dose escalation, dietary changes, or dehydration, before attributing the change to levocarnitine

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Risk of recurrence and other complication is least with microscopic surgery.

Metformin is also often considered a reassuring oral agent, but GLP-1 RAs are not recommended to be continued during pregnancy