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Article History

Accepted: 11 January 2026

First Online: 8 February 2026

Declarations

:

: AA conceptualized the study under the supervision of DB, BS and RS. BS assisted AA with patient verification during data collection. DB, SS and RS contributed to data analysis and were involved in all stages of manuscript preparation, from writing, and critical review of the manuscript. All authors read and approved the final version of the manuscript.

: The data that support the findings of this study are available from the first author upon reasonable request and with permission but restrictions may apply regarding participants’ confidential information.

: The authors have no competing interests to declare that are relevant to the content of this article.

: Ethical approval (Approval No. 13/25) for this study was obtained from the Institutional Review Committee of Kathmandu University School of Medical Sciences (KUSMS) on 3 February, 2025, and the study was conducted in accordance with the principles outlined in the Declaration of Helsinki (1975), as revised in 2024 [ ]. Confidentiality of patient information was strictly maintained, and all data were handled with full respect for participants’ privacy. Data collection commenced only after the study protocol received formal approval from the KUSMS IRC.

: Eligible participants were given a thorough explanation of the Participant Information Sheet, and written informed consent was obtained. Participants were informed of their right to withdraw at any time without any consequences and participation was completely voluntary.

: Not applicable.

: Not applicable.