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Although often underreported by patients, trauma stands as the leading cause, and its progression with nail plate growth serves as the key diagnostic evidence

Several studies have explored the effects of polymorphisms in the genes encoding glutathione S-transferase (GST), an enzyme responsible for conjugation of GSH to xenobiotics, on air pollution exposure [41]

However, this trend did not reach statistical significance ( p = 0.5400) (Table 4)

Initially, the body compensates for this by enhancing insulin secretion leading to abnormally high concentrations of insulin in the blood, a condition called hyperinsulinemia