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Participants were instructed to keep the specimens at home in the refrigerator before transporting them to our institute in a cooling bag

Narrative flow of study selection A total of 612 records were identified through database searching (PubMed = 205, Scopus = 188, Web of Science = 172, Google Scholar = 47)

Alternative Routes of Administration & the First-Pass Effect There are several reasons for different routes of administration used in clinical medicine ( Table 33 )for convenience (eg, oral), to maximize concentration at the site of action and minimize it elsewhere (eg, topical), to prolong the duration of drug absorption (eg, transdermal), or to avoid the first-pass effect (sublingual or rectal)