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For minor procedures performed under local anaesthesia alone such as dental work, skin biopsies, joint injections, or minor dermatological surgerythe risk of aspiration is generally minimal because the patient remains fully conscious and maintains protective airway reflexes

3.4.1 Oxidative stress-endocrine axis integration ROS accumulation triggers activation of stress-activated protein kinases (JNK/p38 pathway), which subsequently inhibits AR transcriptional activity, creating a cascade that disrupts testosterone synthesis (52)

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