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None of the authors have any financial or non-financial conflicts of interest that could have influenced the work reported in this manuscript.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The original study protocol was approved by the Institutional Ethics Committee of the Faculty of Medicine, Al-Azhar University. All procedures were conducted in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments. Written informed consent was obtained from all individual participants included in the original study. Participants were informed that their anonymized data might be used for future related analyses, and all provided explicit consent for this purpose. 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