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Article History

Received: 27 May 2024

Accepted: 17 December 2024

First Online: 2 January 2025

Competing Interests

: The author declares no competing interests.

: This is an observational study. The Ethics Committee of MAHE (Manipal Academy of Higher Education, the affiliated university), chaired by Dr. Rajesh Krishna Bhandary, has confirmed that no ethical approval is required. The exemption was granted as the research involves less than minimal risk, is primarily observational in nature, and includes fewer than ten informants whose identities are anonymized. This decision aligns with the criteria for exemption outlined in Table 4.2 of the ICMR (Indian Council for Medical Research) <i>National Ethical Guidelines</i> (2017), which permits exemption of approval for studies utilising anonymised data or involving observational research with less than minimal risk. The study also adheres to the principles of the Declaration of Helsinki, ensuring the protection of participants’ rights and well-being.

: Photographs and statements from participants were collected after obtaining informed consent.