{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T20:05:24Z","timestamp":1785528324163,"version":"3.56.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"DOI":"10.1186\/s12893-026-03822-2","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T23:47:46Z","timestamp":1785368866000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Endovenous laser ablation versus ligation plus stripping or sclerotherapy for primary lower limb varicose veins: a multicentric three-arm propensity score matched analysis"],"prefix":"10.1186","volume":"26","author":[{"given":"Walied","family":"Khereba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almetwaly","family":"Ragab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Moeen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Ahmed","family":"Agena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsayed","family":"Hadhoud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reda Othman","family":"Abbas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Atef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maisa A. Abdel","family":"Wahab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameh E.","family":"Elimam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Khairy","family":"Sakr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimaa M.","family":"Elhalafawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Ibrahim","family":"Badran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed T.M.","family":"Radwan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsayed Mohamed Abd","family":"El-Hamid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr Bakr Mahmoud","family":"Elashry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Emad","family":"Eldin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"issue":"3","key":"3822_CR1","doi-asserted-by":"publisher","first-page":"1560","DOI":"10.3390\/ijms25031560","volume":"25","author":"L Gwozdzinski","year":"2024","unstructured":"Gwozdzinski L, Pieniazek A, Gwozdzinski K. Factors Influencing Venous Remodeling in the Development of Varicose Veins of the Lower Limbs. Int J Mol Sci. 2024;25(3):1560. https:\/\/doi.org\/10.3390\/ijms25031560.","journal-title":"Int J Mol Sci"},{"issue":"4","key":"3822_CR2","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1016\/j.jtv.2024.09.012","volume":"33","author":"Y Wang","year":"2024","unstructured":"Wang Y, Li R, Bai L, Zou Z, Zheng C, Peng F, Wang S, Yang Y. A study of social isolation in patients with varicose veins of the lower extremities: A scoping review. J Tissue Viability. 2024;33(4):930\u20137. https:\/\/doi.org\/10.1016\/j.jtv.2024.09.012.","journal-title":"J Tissue Viability"},{"issue":"5","key":"3822_CR3","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1080\/07315724.2021.1909510","volume":"41","author":"M Gawas","year":"2022","unstructured":"Gawas M, Bains A, Janghu S, Kamat P, Chawla P. A Comprehensive Review on Varicose Veins: Preventive Measures and Different Treatments. J Am Nutr Assoc. 2022;41(5):499\u2013510. https:\/\/doi.org\/10.1080\/07315724.2021.1909510.","journal-title":"J Am Nutr Assoc"},{"issue":"18","key":"3822_CR4","doi-asserted-by":"publisher","first-page":"5946","DOI":"10.12998\/wjcc.v10.i18.5946","volume":"10","author":"RD Gao","year":"2022","unstructured":"Gao RD, Qian SY, Wang HH, Liu YS, Ren SY. Strategies and challenges in treatment of varicose veins and venous insufficiency. World J Clin Cases. 2022;10(18):5946\u201356. https:\/\/doi.org\/10.12998\/wjcc.v10.i18.5946.","journal-title":"World J Clin Cases"},{"issue":"1","key":"3822_CR5","doi-asserted-by":"publisher","first-page":"5","DOI":"10.17219\/acem\/31880","volume":"24","author":"M Chwa\u0142a","year":"2015","unstructured":"Chwa\u0142a M, Szczeklik W, Szczeklik M, Aleksiejew-Kleszczy\u0144ski T, Jagielska-Chwa\u0142a M. Varicose veins of lower extremities, hemodynamics and treatment methods. Adv Clin Exp Med. 2015;24(1):5\u201314. https:\/\/doi.org\/10.17219\/acem\/31880.","journal-title":"Adv Clin Exp Med"},{"issue":"7","key":"3822_CR6","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1177\/0268355517720307","volume":"33","author":"C Argyriou","year":"2018","unstructured":"Argyriou C, Papasideris C, Antoniou GA, Georgakarakos E, Papanas N, Lazarides MK, Georgiadis GS. The effectiveness of various interventions versus standard stripping in patients with varicose veins in terms of quality of life. Phlebology. 2018;33(7):439\u201350. https:\/\/doi.org\/10.1177\/0268355517720307.","journal-title":"Phlebology"},{"issue":"5","key":"3822_CR7","doi-asserted-by":"publisher","first-page":"101842","DOI":"10.1016\/j.jvsv.2024.101842","volume":"12","author":"W Jiang","year":"2024","unstructured":"Jiang W, Liang Y, Long Z, Hu M, Yang H, Qin X. Endovenous radiofrequency ablation vs laser ablation in patients with lower extremity varicose veins: A meta-analysis. J Vasc Surg Venous Lymphat Disord. 2024;12(5):101842. https:\/\/doi.org\/10.1016\/j.jvsv.2024.101842.","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"issue":"10","key":"3822_CR8","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1177\/02683555241263224","volume":"39","author":"F Duarte","year":"2024","unstructured":"Duarte F, de Souza DM, Regueira Filho A, Bazzanella LJ, Del Castanhel F, de Oliveira Filho GR. Treatment of varicose great saphenous vein with endovenous laser alone or combined with eco-guided foam sclerotherapy: A randomized controlled trial. Phlebology. 2024;39(10):660\u20138. https:\/\/doi.org\/10.1177\/02683555241263224.","journal-title":"Phlebology"},{"issue":"4","key":"3822_CR9","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1016\/s0002-9610(05)80155-2","volume":"168","author":"PH Rutgers","year":"1994","unstructured":"Rutgers PH, Kitslaar PJ. Randomized trial of stripping versus high ligation combined with sclerotherapy in the treatment of the incompetent greater saphenous vein. Am J Surg. 1994;168(4):311\u20135. https:\/\/doi.org\/10.1016\/s0002-9610(05)80155-2.","journal-title":"Am J Surg"},{"issue":"7","key":"3822_CR10","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1007\/BF02484620","volume":"28","author":"M Ishikawa","year":"1998","unstructured":"Ishikawa M, Morimoto N, Sasajima T, Kubo Y, Nozaka T. Treatment of primary varicose veins: an assessment of the combination of high saphenous ligation and sclerotherapy. Surg Today. 1998;28(7):732\u20135. https:\/\/doi.org\/10.1007\/BF02484620.","journal-title":"Surg Today"},{"issue":"1","key":"3822_CR11","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.ejvs.2005.08.024","volume":"31","author":"DG Bountouroglou","year":"2006","unstructured":"Bountouroglou DG, Azzam M, Kakkos SK, Pathmarajah M, Young P, Geroulakos G. Ultrasound-guided foam sclerotherapy combined with sapheno-femoral ligation compared to surgical treatment of varicose veins: early results of a randomised controlled trial. Eur J Vasc Endovasc Surg. 2006;31(1):93\u2013100. https:\/\/doi.org\/10.1016\/j.ejvs.2005.08.024.","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"4","key":"3822_CR12","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1177\/02683555221077742","volume":"37","author":"T Pihlaja","year":"2022","unstructured":"Pihlaja T, Mella M, Ohtonen P, Romsi P, Pokela M. Recovery and patient satisfaction following radiofrequency ablation and concomitant foam sclerotherapy of varicose veins with and without compression: A randomized controlled non-inferiority trial. Phlebology. 2022;37(4):303\u201311. https:\/\/doi.org\/10.1177\/02683555221077742.","journal-title":"Phlebology"},{"issue":"1","key":"3822_CR13","doi-asserted-by":"publisher","first-page":"100538","DOI":"10.1016\/j.jscai.2022.100538","volume":"2","author":"RR Attaran","year":"2022","unstructured":"Attaran RR, Carr JG. Chronic Venous Disease of the Lower Extremities: A State-of-the Art Review. J Soc Cardiovasc Angiogr Interv. 2022;2(1):100538. https:\/\/doi.org\/10.1016\/j.jscai.2022.100538.","journal-title":"J Soc Cardiovasc Angiogr Interv"},{"issue":"6","key":"3822_CR14","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.1016\/j.jvs.2004.09.027","volume":"40","author":"B Ekl\u00f6f","year":"2004","unstructured":"Ekl\u00f6f B, Rutherford RB, Bergan JJ, Carpentier PH, Gloviczki P, Kistner RL, Meissner MH, Moneta GL, Myers K, Padberg FT, Perrin M, Ruckley CV, Smith PC, Wakefield TW, American Venous Forum International Ad Hoc Committee for Revision of the CEAP Classification. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg. 2004;40(6):1248\u201352. https:\/\/doi.org\/10.1016\/j.jvs.2004.09.027.","journal-title":"J Vasc Surg"},{"issue":"2","key":"3822_CR15","doi-asserted-by":"publisher","first-page":"107","DOI":"10.4174\/jkss.2013.84.2.107","volume":"84","author":"JH Choi","year":"2013","unstructured":"Choi JH, Park HC, Joh JH. The occlusion rate and patterns of saphenous vein after radiofrequency ablation. J Korean Surg Soc. 2013;84(2):107\u201313. https:\/\/doi.org\/10.4174\/jkss.2013.84.2.107.","journal-title":"J Korean Surg Soc"},{"issue":"Suppl 1","key":"3822_CR16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00105-022-04977-8","volume":"73","author":"F Pannier","year":"2022","unstructured":"Pannier F, Noppeney T, Alm J, Breu FX, Bruning G, Flessenk\u00e4mper I, Gerlach H, Hartmann K, Kahle B, Kluess H, Mendoza E, M\u00fchlberger D, Mumme A, N\u00fcllen H, Rass K, Reich-Schupke S, Stenger D, St\u00fccker M, Schmedt CG, Schwarz T, Tesmann J, Te\u00dfarek J, Werth S, Valesky E. S2k guidelines: diagnosis and treatment of varicose veins. Hautarzt. 2022;73(Suppl 1):1\u201344. https:\/\/doi.org\/10.1007\/s00105-022-04977-8.","journal-title":"Hautarzt"},{"key":"3822_CR17","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1016\/j.avsg.2025.07.025","volume":"120","author":"C Geng","year":"2025","unstructured":"Geng C, Xie Y, Zhang L, Lin Y, Zhang J, Xie Y, Zeng W. Comparison of Radiofrequency Ablation and High Ligation Stripping for Varicose Veins: A Retrospective Analysis. Ann Vasc Surg. 2025;120:392\u20139. https:\/\/doi.org\/10.1016\/j.avsg.2025.07.025.","journal-title":"Ann Vasc Surg"},{"issue":"4","key":"3822_CR18","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1016\/j.jvir.2021.12.027","volume":"33","author":"J Kong","year":"2022","unstructured":"Kong J, Liu Z, Fu G, Li Y, Chen G, Lou W, Zhao B, Gong M, Lu Z, Zhou Y, Chen L, Su H, Gu J, He X. Outcomes of Fluoroscopy-Guided Percutaneous High Ligation of the Great Saphenous Vein Combined With Foam Sclerotherapy for Symptomatic Great Saphenous Veins. J Vasc Interv Radiol. 2022;33(4):445\u201350. https:\/\/doi.org\/10.1016\/j.jvir.2021.12.027.","journal-title":"J Vasc Interv Radiol"},{"issue":"23","key":"3822_CR19","doi-asserted-by":"publisher","first-page":"7148","DOI":"10.3390\/jcm13237148","volume":"13","author":"J Jun","year":"2024","unstructured":"Jun J, Yoon M, Jung H, Jun H. Feasibility and Safety of Flush Endovenous Thermal Ablation of the Great Saphenous Vein with Consecutive Foam Sclerotherapy of Saphenofemoral Junction Tributaries: A Single-Center Experience. J Clin Med. 2024;13(23):7148. https:\/\/doi.org\/10.3390\/jcm13237148.","journal-title":"J Clin Med"},{"issue":"3","key":"3822_CR20","doi-asserted-by":"publisher","first-page":"102198","DOI":"10.1016\/j.jvsv.2025.102198","volume":"13","author":"ACC Bacelar","year":"2025","unstructured":"Bacelar ACC, Netto EM, Barreto N, Neves R, Heine C, Botelho P, Almeida CS, Ramalho E, Aras R. Promising results of ultrasound guided foam sclerotherapy for treating chronic venous ulcers. J Vasc Surg Venous Lymphat Disord. 2025;13(3):102198. https:\/\/doi.org\/10.1016\/j.jvsv.2025.102198.","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"issue":"7","key":"3822_CR21","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1177\/02683555241309808","volume":"40","author":"T Cartee","year":"2025","unstructured":"Cartee T, Friedmann DP, Blebea J, Daugherty S, Vayuvegula S, Mishra V. Ultrasound-guided foam sclerotherapy using physician-compounded foam: Position statement from the American vein and lymphatic society. Phlebology. 2025;40(7):466\u201372. https:\/\/doi.org\/10.1177\/02683555241309808.","journal-title":"Phlebology"},{"issue":"1","key":"3822_CR22","doi-asserted-by":"publisher","first-page":"24","DOI":"10.3400\/avd.oa.24-00130","volume":"18","author":"T Kawahira","year":"2025","unstructured":"Kawahira T, Miyashita F, Hitomi E, Enomoto M, Kondo Y, Morimoto M, Minamidate N, Takashima N, Suzuki T. Short and Mid-term Outcome of Radiofrequency Ablation without Concomitant Phlebectomy\/Sclerotherapy for Tributary Varicose Veins. Ann Vasc Dis. 2025;18(1):24\u201300130. https:\/\/doi.org\/10.3400\/avd.oa.24-00130.","journal-title":"Ann Vasc Dis"},{"issue":"3","key":"3822_CR23","doi-asserted-by":"publisher","first-page":"281","DOI":"10.23736\/S0392-9590.17.03827-5","volume":"36","author":"M Lawaetz","year":"2017","unstructured":"Lawaetz M, Serup J, Lawaetz B, Bjoern L, Blemings A, Eklof B, Rasmussen L. Comparison of endovenous ablation techniques, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Extended 5-year follow-up of a RCT. Int Angiol. 2017;36(3):281\u20138. https:\/\/doi.org\/10.23736\/S0392-9590.17.03827-5.","journal-title":"Int Angiol"},{"issue":"4","key":"3822_CR24","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1097\/DSS.0000000000001022","volume":"43","author":"F Ran","year":"2017","unstructured":"Ran F, Shi Y, Qiao T, Shang T, Liu Z, Liu CJ. Comparison of Foam Sclerotherapy Alone or Combined With Stripping of the Great Saphenous Vein for Treating Varicose Veins. Dermatol Surg. 2017;43(4):541\u20137. https:\/\/doi.org\/10.1097\/DSS.0000000000001022.","journal-title":"Dermatol Surg"},{"issue":"2","key":"3822_CR25","doi-asserted-by":"publisher","first-page":"83","DOI":"10.23736\/S0392-9590.25.05223-X","volume":"44","author":"JM Vieira","year":"2025","unstructured":"Vieira JM, Porto CL, Hara WY, Oliveira BF, Bouskela E. Use of microcirculatory parameters to evaluate foam sclerotherapy treatment of superficial chronic venous disease, associated or not with venotonic drug: randomized, double-blind trial. Int Angiol. 2025;44(2):83\u201393. https:\/\/doi.org\/10.23736\/S0392-9590.25.05223-X.","journal-title":"Int Angiol"},{"issue":"2","key":"3822_CR26","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1177\/0268355512473911","volume":"29","author":"Y Pan","year":"2014","unstructured":"Pan Y, Zhao J, Mei J, Shao M, Zhang J. Comparison of endovenous laser ablation and high ligation and stripping for varicose vein treatment: a meta-analysis. Phlebology. 2014;29(2):109\u201319. https:\/\/doi.org\/10.1177\/0268355512473911.","journal-title":"Phlebology"},{"issue":"1","key":"3822_CR27","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1258\/phleb.2011.011147","volume":"28","author":"I Flessenk\u00e4mper","year":"2013","unstructured":"Flessenk\u00e4mper I, Hartmann M, Stenger D, Roll S. Endovenous laser ablation with and without high ligation compared with high ligation and stripping in the treatment of great saphenous varicose veins: initial results of a multicentre randomized controlled trial. Phlebology. 2013;28(1):16\u201323. https:\/\/doi.org\/10.1258\/phleb.2011.011147.","journal-title":"Phlebology"},{"issue":"4","key":"3822_CR28","doi-asserted-by":"publisher","first-page":"514","DOI":"10.3400\/avd.oa.18-00169","volume":"12","author":"M Nakashima","year":"2019","unstructured":"Nakashima M, Kobayashi M. Endovenous Laser Ablation Combined with Stripping Technique for Large Saphenous Varicose Veins: The Selection of Operation Technique. Ann Vasc Dis. 2019;12(4):514\u20138. https:\/\/doi.org\/10.3400\/avd.oa.18-00169.","journal-title":"Ann Vasc Dis"},{"issue":"2","key":"3822_CR29","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.avsg.2019.04.008","volume":"62","author":"NK Itoga","year":"2020","unstructured":"Itoga NK, Rothenberg KA, Deslarzes-Dubuis C, George EL, Chandra V, Harris EJ. Incidence and Risk Factors for Deep Vein Thrombosis after Radiofrequency and Laser Ablation of the Lower Extremity Veins. Ann Vasc Surg. 2020;62(2):45\u2013e50. https:\/\/doi.org\/10.1016\/j.avsg.2019.04.008.","journal-title":"Ann Vasc Surg"},{"issue":"1","key":"3822_CR30","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.jvsv.2022.06.006","volume":"11","author":"LB Suarez","year":"2023","unstructured":"Suarez LB, Alnahhal KI, Salehi PA, King EG, O\u2019Donnell TF Jr, Iafrati MD. A systematic review of routine post operative screening duplex ultrasound after thermal and non-thermal endovenous ablation. J Vasc Surg Venous Lymphat Disord. 2023;11(1):193\u2013e2006. https:\/\/doi.org\/10.1016\/j.jvsv.2022.06.006.","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"issue":"6","key":"3822_CR31","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1016\/j.thromres.2015.03.008","volume":"135","author":"K Chen","year":"2015","unstructured":"Chen K, Yu GF, Huang JY, Huang LD, Su X, Ni HZ, Pan LM, Zheng XT. Incidence and risk factors of early deep venous thrombosis after varicose vein surgery with routine use of a tourniquet. Thromb Res. 2015;135(6):1052\u20136. https:\/\/doi.org\/10.1016\/j.thromres.2015.03.008.","journal-title":"Thromb Res"},{"issue":"2","key":"3822_CR32","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1177\/1358863X14564592","volume":"20","author":"H Wang","year":"2015","unstructured":"Wang H, Sun Z, Jiang W, Zhang Y, Li X, Wu Y. Postoperative prophylaxis of venous thromboembolism (VTE) in patients undergoing high ligation and stripping of the great saphenous vein (GSV). Vasc Med. 2015;20(2):117\u201321. https:\/\/doi.org\/10.1177\/1358863X14564592.","journal-title":"Vasc Med"}],"container-title":["BMC Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12893-026-03822-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-026-03822-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-026-03822-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:20:30Z","timestamp":1785522030000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12893-026-03822-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,30]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3822"],"URL":"https:\/\/doi.org\/10.1186\/s12893-026-03822-2","relation":{},"ISSN":["1471-2482"],"issn-type":[{"value":"1471-2482","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,30]]},"assertion":[{"value":"16 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Protocol of the present study was approved by the ethical committee of Al-Azhar University Faculty of Medicine. All participants provided informed consent in accordance with the Helsinki Declaration on clinical research involving human subjects.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"505"}}