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A reduction in Na + /K + -ATPase activity directly results in membrane depolarization, which not only impairs the efficiency of action potential generation and propagationpotentially constituting a direct electrophysiological factor for myasthenia at restbut also brings the membrane potential closer to threshold, thereby inducing muscle hyperexcitability (manifested as fasciculations and painful spasms)

Sodium thiosulfate decreases ROS by readily donating electrons to the radical ROS species, inactivating them and rendering them harmless [176]