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The study protocol was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. After obtaining the necessary permissions and coordinating with the relevant authorities at Omid, Imam Reza, Shahid Hasheminejad, Qaem, and Nazaran hospitals in Mashhad, eligible patients were identified based on the inclusion criteria. The study objectives and the researcher\u2019s institutional affiliation were explained to all participants, and written informed and voluntary consent was obtained prior to participation. Participants were assured of the confidentiality and anonymity of their information. 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