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No pharmaceutical, medical device, or industry funding was received for this study. None of the authors have any patent, stock ownership, or consultancy relationships that could be perceived as constituting a conflict of interest.","order":1,"name":"Ethics","label":"<b>Competing Interests<\/b>","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki (2013 revision) and followed Good Clinical Practice guidelines. Ethical approval was obtained from the Institutional Review Board of Lady Reading Hospital, Peshawar, Pakistan (Reference No: LRH\/IRB\/2024-127, dated: 20 September 2024) and the Research. Written informed consent was obtained from all individual participants included in the study. For non-literate participants, the consent form was read aloud and explained in the local language (Pashto\/Urdu), and left thumb impressions were accepted in lieu of signatures in the presence of an impartial witness. Participants were assured of their right to withdraw from the study at any time without any consequences for their ongoing medical care. All collected data were anonymized using unique study identification numbers, and patient confidentiality was maintained throughout the research process.","order":2,"name":"Ethics","label":"<b>Ethics Approval and Consent to Participate<\/b>","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. This manuscript does not contain any individual person\u2019s data in the form of images, videos, or detailed case histories requiring explicit consent for publication.","order":3,"name":"Ethics","label":"<b>Consent for Publication<\/b>","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"LLM like ChatGPT was used from spelling, language, and grammar corrections.","order":4,"name":"Ethics","label":"Large Language Model Declaration","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"31544"}}