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Article History

Received: 5 June 2025

Accepted: 23 July 2025

First Online: 1 September 2025

Declarations

:

: This study was performed in line with the principles of the Declaration of Helsinki. Ethical approval was obtained from Khyber Medical University (Approval No. DIR/KMU-EB/IA/000838) and its Advanced Study and Research Board (Approval No. DIR/KMU-AS&RB/IA/001202).

: During the preparation of this work, the authors used ChatGPT to enhance readability, as they are not native English speakers. The content was thoroughly reviewed and edited, and the authors take full responsibility for the final version of the published article.

: We attest that the subjects in this trial have not concomitantly been involved in other randomized trials. Data regarding any of the subjects in the study has not been previously published. Data will be made available to the editors of the journal for review or query upon request.

: Data will be made available upon reasonable request to the corresponding author.

: We declare that the work described has not been published previously, that it is not under consideration for publication elsewhere, that its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out, and that, if accepted, it will not be published elsewhere in the same form, in English or in any other language, including electronically without the written consent of the copyright- holder.

: The authors declare no competing interests.