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BS assisted\u00a0AA with patient verification during data collection.\u00a0DB, SS and RS contributed\u00a0to data analysis and were involved in all stages of manuscript\u00a0preparation, from writing, and\u00a0critical review of the manuscript. All authors read and approved the final version\u00a0of the manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Author contribution"}},{"value":"The data that support the findings of this study are available from the first author upon reasonable request and with permission but restrictions may apply regarding participants\u2019 confidential information.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"The authors have no competing interests to declare that are relevant to the content of this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval (Approval No. 13\/25) for this study was obtained from the Institutional Review Committee of Kathmandu University School of Medical Sciences (KUSMS) on 3 February, 2025, and the study was conducted in accordance with the principles outlined in the Declaration of Helsinki (1975), as revised in 2024 [\n                      \n                      ]. Confidentiality of patient information was strictly maintained, and all data were handled with full respect for participants\u2019 privacy. Data collection commenced only after the study protocol received formal approval from the KUSMS IRC.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Eligible participants were given a thorough explanation of the Participant Information Sheet, and written informed consent was obtained. Participants were informed of their right to withdraw at any time without any consequences and participation was completely voluntary.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Not applicable.","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Code availability"}}]}}