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The HPA axis ties it together, and when chronic stress keeps it activated, cortisol ends up high at night and low in the morning, producing anxiety alongside fatigue

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The form documents that a patient understands the treatment, acknowledges potential side effects (including serious adverse reactions like anaphylactic shock), and consents voluntarily to proceed

This is because, upon heating, the compact native form of BSA becomes more flexible and reactive, exposing the Tyr and Trp residues from the hydrophobic core of BSA molecule to a more polar solvent environment 64,65

The Cochrane review also underscored the need to include a measurement of the quality of life as an outcome, and patient preference at the time of prescribing treatment