{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T18:41:47Z","timestamp":1788633707132,"version":"build-2803163510"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"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 Oral Health"],"DOI":"10.1186\/s12903-024-05017-8","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T10:41:14Z","timestamp":1740134474000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The impact of psychological stress on salivary cortisol levels in periodontitis patients: a case-control study"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6985-4133","authenticated-orcid":false,"given":"Mozaffer Rahim","family":"Hingorjo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Owais","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad uddin","family":"Siddiqui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shazia","family":"Nazar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumna Shaheen","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,21]]},"reference":[{"issue":"Suppl 18","key":"5017_CR1","doi-asserted-by":"publisher","first-page":"S94","DOI":"10.1111\/jcpe.12677","volume":"44","author":"JE Frencken","year":"2017","unstructured":"Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T. Global epidemiology of dental caries and severe periodontitis - a comprehensive review. J Clin Periodontol. 2017;44(Suppl 18):S94\u2013105. https:\/\/doi.org\/10.1111\/jcpe.12677. Article PubMed Google Scholar.","journal-title":"J Clin Periodontol"},{"issue":"3","key":"5017_CR2","first-page":"970","volume":"19","author":"T Bibi","year":"2023","unstructured":"Bibi T, Arshad Hassan DR, Kumar C, Naz A, Tanwir F, Qadir F, Mazhar S. Prevalence of periodontitis based on ethnic disparity in Karachi, Pakistan. J Xi\u2019an Shiyou Univ. Nat Sci Ed. 2023;19(3):970\u201387. Research Gate Google Scholar.","journal-title":"Nat Sci Ed"},{"key":"5017_CR3","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1007\/s11883-020-00878-0","volume":"22","author":"S Naderi","year":"2020","unstructured":"Naderi S, Merchant AT. The Association between Periodontitis and Cardiovascular Disease: an update. Curr Atheroscler Rep. 2020;22:52. https:\/\/doi.org\/10.1007\/s11883-020-00878-0. Article PubMed Google Scholar.","journal-title":"Curr Atheroscler Rep"},{"key":"5017_CR4","doi-asserted-by":"crossref","unstructured":"Isola G, Pesce P, Polizzi A, Lo Giudice A, Cicci\u00f9 M, Scannapieco FA. Effects of minimally invasive non-surgical therapy on C-reactive protein, lipoprotein-associated phospholipase A2, and clinical outcomes in periodontitis patients: A 1-year randomized, controlled clinical trial. J Periodontol. 2024 May 2. doi: 10.1002\/JPER.23-0518. Epub ahead of print. PMID: 38696664. Article PubMed Google Scholar.","DOI":"10.1002\/JPER.23-0518"},{"key":"5017_CR5","doi-asserted-by":"publisher","first-page":"460","DOI":"10.2174\/1874210601711010460","volume":"11","author":"G Matarese","year":"2017","unstructured":"Matarese G, Ramaglia L, Fiorillo L, Cervino G, Lauritano F, Isola G. Implantology and Periodontal Disease: the panacea to Problem solving? Open Dent J. 2017;11:460\u20135. doi: 10.2174\/1874210601711010460. PMID: 28979575; PMCID: PMC5611775. Article PubMed PubMed Central Google Scholar.","journal-title":"Open Dent J"},{"issue":"1","key":"5017_CR6","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1111\/prd.12430","volume":"89","author":"G Hajishengallis","year":"2022","unstructured":"Hajishengallis G. Interconnection of periodontal disease and comorbidities: evidence, mechanisms, and implications. Periodontol 2000. 2022;89(1):9\u201318. https:\/\/doi.org\/10.1111\/prd.12430. Article PubMed PubMed Central Google Scholar.","journal-title":"Periodontol 2000"},{"issue":"Suppl 2","key":"5017_CR7","doi-asserted-by":"publisher","first-page":"S438","DOI":"10.1016\/j.gaceta.2021.10.071","volume":"35","author":"RW Gayatri","year":"2021","unstructured":"Gayatri RW, Tama TD, Alma LR, Yun LW, Savira L, Kuroidah A. Behavioral risk factors and periodontal disease in Malang. Indonesia Gac Sanit. 2021;35(Suppl 2):S438\u201340. https:\/\/doi.org\/10.1016\/j.gaceta.2021.10.071. Article PubMed Google Scholar.","journal-title":"Indonesia Gac Sanit"},{"key":"5017_CR8","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.17179\/excli2017-480","volume":"16","author":"H Yaribeygi","year":"2017","unstructured":"Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: a review. EXCLI J. 2017;16:1057\u201372. https:\/\/doi.org\/10.17179\/excli2017-480. Article PubMed PubMed Central Google Scholar.","journal-title":"EXCLI J"},{"issue":"9","key":"5017_CR9","doi-asserted-by":"publisher","first-page":"1933","DOI":"10.1016\/j.immuni.2021.08.023","volume":"54","author":"H Haykin","year":"2021","unstructured":"Haykin H, Rolls A. The neuroimmune response during stress: a physiological perspective. Immunity. 2021;54(9):1933\u201347. https:\/\/doi.org\/10.1016\/j.immuni.2021.08.023. Article PubMed PubMed Central Google Scholar.","journal-title":"Immunity"},{"key":"5017_CR10","doi-asserted-by":"publisher","unstructured":"Macr\u00ec M, D\u2019Albis G, D\u2019Albis V, Antonacci A, Abbinante A, Stefanelli R, Pegreffi F, Festa F. Periodontal Health and Its Relationship with Psychological Stress: A Cross-Sectional Study. J Clin Med. 2024;13(10):2942. https:\/\/doi.org\/10.3390\/jcm13102942. Article Research Gate Google Scholar.","DOI":"10.3390\/jcm13102942"},{"issue":"9","key":"5017_CR11","doi-asserted-by":"publisher","first-page":"e015697","DOI":"10.1161\/JAHA.119.015697","volume":"9","author":"JL Greaney","year":"2020","unstructured":"Greaney JL, Surachman A, Saunders EF, Alexander LM, Almeida DM. Greater daily psychosocial stress exposure is associated with increased norepinephrine-induced vasoconstriction in young adults. J Am Heart Assoc. 2020;9(9):e015697. Article PubMed PubMed Central Google Scholar.","journal-title":"J Am Heart Assoc"},{"issue":"1","key":"5017_CR12","doi-asserted-by":"publisher","first-page":"8","DOI":"10.3390\/healthcare11101516","volume":"96","author":"P Kazakou","year":"2023","unstructured":"Kazakou P, Nicolaides NC, Chrousos GP. Basic concepts and hormonal regulators of the stress system. Horm Res Paediatr. 2023;96(1):8\u201316. https:\/\/doi.org\/10.3390\/healthcare11101516. Article PubMed Google Scholar.","journal-title":"Horm Res Paediatr"},{"key":"5017_CR13","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.clinbiochem.2023.01.005","volume":"114","author":"A Vage","year":"2023","unstructured":"Vage A, McCarron E, Hamilton PK. Biological testing during acute psychological stress: a hindrance or an opportunity? Clin Biochem. 2023;114:11\u20137. https:\/\/doi.org\/10.1016\/j.clinbiochem.2023.01.005. Article PubMed Research Gate Google Scholar.","journal-title":"Clin Biochem"},{"key":"5017_CR14","doi-asserted-by":"publisher","unstructured":"L\u00f3pez-Jornet P, Hynninen JN, Parra-Perez F, Peres-Rubio C, Pons-Fuster E, Tvarijonaviciute A. The Role of Salivary Biomarkers in Monitoring Oral Health in Patients with Implants and Periodontitis. Appl Sci. 2024;14(2):927. https:\/\/doi.org\/10.3390\/app14020927. Article Research Gate Google Scholar.","DOI":"10.3390\/app14020927"},{"issue":"Suppl 2","key":"5017_CR15","doi-asserted-by":"publisher","first-page":"S299","DOI":"10.4103\/ccd.ccd_289_18","volume":"9","author":"VT Obulareddy","year":"2018","unstructured":"Obulareddy VT, Chava VK, Nagarakanti S. Association of Stress, salivary cortisol, and chronic periodontitis: a clinico-biochemical study. Contemp Clin Dent. 2018;9(Suppl 2):S299\u2013304. https:\/\/doi.org\/10.4103\/ccd.ccd_289_18. Article PubMed PubMed Central Google Scholar.","journal-title":"Contemp Clin Dent"},{"issue":"S1","key":"5017_CR16","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1002\/JPER.17-0721","volume":"89","author":"PN Papapanou","year":"2018","unstructured":"Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, et al. Periodontitis: Consensus report of workgroup 2 of the 2017 World workshop on the classification of Periodontal and Peri-implant diseases and conditions. J Periodontol. 2018;89(S1):73\u201382. Article PubMed Google Scholar.","journal-title":"J Periodontol"},{"issue":"1","key":"5017_CR17","doi-asserted-by":"publisher","first-page":"166","DOI":"10.15517\/ijds.2022.52533","volume":"25","author":"G Ayan","year":"2023","unstructured":"Ayan G, Dayi B. Evaluation of plaque index, gingival index and oral health-related quality of life in obese patients. Odovtos-International J Dent Sci. 2023;25(1):166\u201378. https:\/\/doi.org\/10.15517\/ijds.2022.52533. Article Google Scholar.","journal-title":"Odovtos-International J Dent Sci"},{"key":"5017_CR18","doi-asserted-by":"publisher","unstructured":"Greene JC, Vermillion JR. The oral hygiene index: a method for classifying oral hygiene status. The J Am Dent Assoc. 1960;61(2):172\u2013179. https:\/\/doi.org\/10.14219\/jada.archive.1960.01. Article.","DOI":"10.14219\/jada.archive.1960.01"},{"key":"5017_CR19","doi-asserted-by":"publisher","unstructured":"Azodo CC, Umoh AO. Tooth mobility among rural dwellers in midwestern area of Nigeria. Savannah J Med Res Pract. 2014;3(2):64\u2009\u2013\u20099. https:\/\/doi.org\/10.4314\/sjmrp.v3i2.3. Article Google Scholar.","DOI":"10.4314\/sjmrp.v3i2.3"},{"key":"5017_CR20","doi-asserted-by":"publisher","first-page":"386","DOI":"10.2307\/2136404","volume":"24","author":"S Cohen","year":"1983","unstructured":"Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:386\u201396. Article PubMed.","journal-title":"J Health Soc Behav"},{"key":"5017_CR21","doi-asserted-by":"publisher","unstructured":"Corridore D, Saccucci M, Zumbo G, Fontana E, Lamazza L, Stamegna C et al. Impact of Stress on Periodontal Health: Literature Revision. Healthcare (Basel). 2023;22;11(10):1516. https:\/\/doi.org\/10.3390\/healthcare11101516. Article PubMed PubMed Central Google Scholar.","DOI":"10.3390\/healthcare11101516"},{"issue":"1","key":"5017_CR22","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1902\/annals.1998.3.1.288","volume":"3","author":"RJ Genco","year":"1998","unstructured":"Genco RJ, Ho AW, Kopman J, Grossi SG, Dunford RG, Tedesco LA. Models to evaluate the role of stress in periodontal disease. Ann Periodontol. 1998;3(1):288\u2013302. Article PubMed Google Scholar.","journal-title":"Ann Periodontol"},{"issue":"10","key":"5017_CR23","doi-asserted-by":"publisher","first-page":"e5160","DOI":"10.3390\/ijerph18105160","volume":"18","author":"SA Tanveer","year":"2021","unstructured":"Tanveer SA, Afaq A, Alqutub MN, Aldahiyan N, AlMubarak AM, Shaikh AC, et al. Association of self-perceived psychological stress with the periodontal health of socially deprived women in shelter homes. Int J Env Res Pub He. 2021;18(10):e5160. https:\/\/doi.org\/10.3390\/ijerph18105160. Article PubMed PubMed Central Google Scholar.","journal-title":"Int J Env Res Pub He"},{"key":"5017_CR24","doi-asserted-by":"publisher","unstructured":"Spector AM, Postolache TT, Akram F, Scott AJ, Wadhawan A, Reynolds MA. Psychological stress: a predisposing and exacerbating factor in periodontitis. Curr Oral Health Rep. 2020;7:208\u2009\u2013\u200915. https:\/\/doi.org\/10.1007\/s40496-020-00282-2. Article Research Gate Google Scholar.","DOI":"10.1007\/s40496-020-00282-2"},{"issue":"23","key":"5017_CR25","doi-asserted-by":"publisher","first-page":"2726","DOI":"10.3390\/cells12232726","volume":"12","author":"E Knezevic","year":"2023","unstructured":"Knezevic E, Nenic K, Milanovic V, Knezevic NN. The role of cortisol in chronic stress, neurodegenerative diseases, and Psychological disorders. Cells. 2023;12(23):2726. https:\/\/doi.org\/10.3390\/cells12232726. Article PubMed PubMed Central Google Scholar.","journal-title":"Cells"},{"key":"5017_CR26","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1007\/s00784-010-0458-y","volume":"15","author":"N Tamaki","year":"2011","unstructured":"Tamaki N, Tomofuji T, Ekuni D, et al. Periodontal treatment decreases plasma oxidized LDL level and oxidative stress. Clin Oral Invest. 2011;15:953\u20138. https:\/\/doi.org\/10.1007\/s00784-010-0458-y. Article PubMed Google Scholar.","journal-title":"Clin Oral Invest"},{"issue":"4","key":"5017_CR27","doi-asserted-by":"publisher","first-page":"e0250459","DOI":"10.1371\/journal.pone.0250459","volume":"16","author":"R Vlenterie","year":"2021","unstructured":"Vlenterie R, Geuijen PM, van Gelder MMHJ, Roeleveld N. Questionnaires and salivary cortisol to measure stress and depression in mid-pregnancy. PLoS ONE. 2021;16(4):e0250459. https:\/\/doi.org\/10.1371\/journal.pone.0250459. Article PubMed PubMed Central Google Scholar.","journal-title":"PLoS ONE"},{"issue":"2","key":"5017_CR28","doi-asserted-by":"publisher","first-page":"62","DOI":"10.26650\/eor.20192484","volume":"53","author":"A Tiznobaik","year":"2019","unstructured":"Tiznobaik A, Taheri S, Torkzaban P, Ghaleiha A, SOLTAN\u0130AN AR, Omrani R, et al. Relationship between dental plaque formation and salivary cortisol level in pregnant women. Eur Oral Res. 2019;53(2):62\u20136. https:\/\/doi.org\/10.26650\/eor.20192484. Article PubMed PubMed Central Google Scholar.","journal-title":"Eur Oral Res"},{"issue":"4","key":"5017_CR29","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1016\/j.jobcr.2020.07.020","volume":"10","author":"H Develioglu","year":"2020","unstructured":"Develioglu H, Korkmaz S, Dundar S, Schlagenhauf U. Investigation of the levels of different salivary stress markers in chronic periodontitis patients. J Oral Biol Craniofac Res. 2020;10(4):514\u20138. https:\/\/doi.org\/10.1016\/j.jobcr.2020.07.020. Article PubMed PubMed Central Google Scholar.","journal-title":"J Oral Biol Craniofac Res"},{"issue":"3","key":"5017_CR30","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1007\/s10266-022-00768-8","volume":"111","author":"J Zhang","year":"2023","unstructured":"Zhang J, Lin S, Luo L, Zhang Q, Jiao Y, Liu W. Psychological stress: neuroimmune roles in periodontal disease. Odontology. 2023;111(3):554\u201364. https:\/\/doi.org\/10.1007\/s10266-022-00768-8. Article PubMed Google Scholar.","journal-title":"Odontology"},{"issue":"1","key":"5017_CR31","first-page":"139","volume":"10","author":"SM Helmy","year":"2023","unstructured":"Helmy SM, Nassar HA, Ahmed OE. The effect of psychological stress on Periodontal Disease during COVID-19 virus threat: relation to salivary prostaglandin (PGE2). Al-Azhar Dent J Girls. 2023;10(1):139\u201350. Article Google Scholar.","journal-title":"Al-Azhar Dent J Girls"},{"issue":"1","key":"5017_CR32","first-page":"1152","volume":"7","author":"P Nouri","year":"2021","unstructured":"Nouri P, Fereidooni M, Faramarzi M, Sadeghi S, Qujeq D, Neamati N. Evaluation of Association between Perceived stress, anxiety, Depression, Salivary Alpha-Amylase and Salivary Cortisol with Chronic Periodontitis. J Dent Oral Disord. 2021;7(1):1152. Research Gate Google Scholar.","journal-title":"J Dent Oral Disord"},{"issue":"2","key":"5017_CR33","doi-asserted-by":"publisher","first-page":"82","DOI":"10.52403\/ijshr.20210416","volume":"6","author":"K Mankar","year":"2021","unstructured":"Mankar K, Bawankar P, Chavan P, Borkar S. Association of Stress, Depression and anxiety with Periodontal Health indicators among Professional Students. Int J Behav Healthc Res. 2021;6(2):82\u20137. https:\/\/doi.org\/10.52403\/ijshr.20210416. Article Google Scholar.","journal-title":"Int J Behav Healthc Res"},{"issue":"3","key":"5017_CR34","doi-asserted-by":"publisher","first-page":"517","DOI":"10.3390\/jcm10030517","volume":"10","author":"S Chojnowska","year":"2021","unstructured":"Chojnowska S, Ptaszy\u0144ska-Sarosiek I, K\u0119pka A, Kna\u015b M, Waszkiewicz N. Salivary biomarkers of stress, anxiety and depression. J Clin Med. 2021;10(3):517. https:\/\/doi.org\/10.3390\/jcm10030517. Article PubMed PubMed Central Google Scholar.","journal-title":"J Clin Med"},{"issue":"11","key":"5017_CR35","doi-asserted-by":"publisher","first-page":"e11548","DOI":"10.7759\/cureus.11548","volume":"12","author":"QU Khan","year":"2020","unstructured":"Khan QU. Relationship of salivary cortisol level with severe depression and family history. Cureus. 2020;12(11):e11548. https:\/\/doi.org\/10.7759\/cureus.11548. Article PubMed PubMed Central Google Scholar.","journal-title":"Cureus"},{"issue":"Suppl 2","key":"5017_CR36","doi-asserted-by":"publisher","first-page":"S299","DOI":"10.4103\/ccd.ccd_289_18","volume":"9","author":"VT Obulareddy","year":"2018","unstructured":"Obulareddy VT, Chava VK, Nagarakanti S. Association of stress, salivary cortisol, and chronic periodontitis: a clinico-biochemical study. Contemp Clin Dent. 2018;9(Suppl 2):S299. https:\/\/doi.org\/10.4103\/ccd.ccd_289_18. Article PubMed PubMed Central Google Scholar.","journal-title":"Contemp Clin Dent"},{"issue":"9","key":"5017_CR37","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1002\/JPER.18-0028","volume":"89","author":"PV Bawankar","year":"2018","unstructured":"Bawankar PV, Kolte AP, Kolte RA. Evaluation of stress, serum and salivary cortisol, and interleukin-1\u03b2 levels in smokers and non\u2010smokers with chronic periodontitis. J Periodontol. 2018;89(9):1061\u20138. https:\/\/doi.org\/10.1002\/JPER.18-0028. Article PubMed Google Scholar.","journal-title":"J Periodontol"},{"issue":"8","key":"5017_CR38","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1007\/s00420-017-1241-z","volume":"90","author":"S Mikkelsen","year":"2017","unstructured":"Mikkelsen S, Forman JL, Fink S, Vammen MA, Thomsen JF, Grynderup MB, et al. Prolonged perceived stress and saliva cortisol in a large cohort of Danish public service employees: cross-sectional and longitudinal associations. Int Arch Occup Environ Health. 2017;90(8):835\u201348. https:\/\/doi.org\/10.1007\/s00420-017-1241-z. Article PubMed PubMed Central Google Scholar.","journal-title":"Int Arch Occup Environ Health"},{"issue":"5","key":"5017_CR39","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1177\/0193841X16655665","volume":"41","author":"E Tipton","year":"2017","unstructured":"Tipton E, Hallberg K, Hedges LV, Chan W. Implications of small samples for generalization: adjustments and rules of Thumb. Eval Rev. 2017;41(5):472\u2013505. Article PubMed Google Scholar.","journal-title":"Eval Rev"},{"issue":"3","key":"5017_CR40","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1007\/s12529-019-09843-x","volume":"27","author":"N Ali","year":"2020","unstructured":"Ali N, Nater UM. Salivary alpha-amylase as a biomarker of stress in behavioral medicine. Int J Behav Med. 2020;27(3):337\u201342. https:\/\/doi.org\/10.1007\/s12529-019-09843-x.","journal-title":"Int J Behav Med"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-024-05017-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-024-05017-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-024-05017-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T10:41:20Z","timestamp":1740134480000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcoralhealth.biomedcentral.com\/articles\/10.1186\/s12903-024-05017-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,21]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["5017"],"URL":"https:\/\/doi.org\/10.1186\/s12903-024-05017-8","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,21]]},"assertion":[{"value":"12 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 October 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval of this study was obtained from the Institutional Review Board (IRB) committee of Dow University of Health Sciences, Karachi. (Ref: IRB-2382\/DUHS\/Approval\/2022\/758, dated 22nd February, 2022). All participants gave written informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This article was written from Physiology Thesis of MPhil Scholar Muhammad Owais.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}],"article-number":"276"}}