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Normality of the distribution was evaluated using Shapiro-Wilk test and as several variables were not normally distributed, non-parametric tests were used for statistical analyses

**Key Adverse Drug Reactions (ADRs):** Acute pancreatitis Diabetic retinopathy complications Hypoglycemia Acute kidney injury Severe gastrointestinal reactions Hypersensitivity reactions Gallbladder disease **Why reporting matters?** Timely reporting of adverse events strengthens pharmacovigilance systems, improves patient safety, and supports evidence-based clinical decisions

J Cereb Blood Flow Metab 17:229232 Nawashiro H, Tasaki K, Ruetzler CA, Hallenbeck JM (1997b) TNF-alpha pretreatment induces protective effects against focal cerebral ischemia in mice