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Article History

Received: 19 February 2025

Accepted: 27 April 2025

First Online: 28 August 2025

Declarations

:

: The research was conducted following approval from the Institutional Review Board of the Khesar Gyalpo University of Medical Sciences of Bhutan [Ref. No. IRB Approval/PN21-014/2021/521]. Additionally, the investigation was carried out in adherence to the ethical standards outlined in the 1964 Declaration of Helsinki and its subsequent amendments or comparable ethical standards. Written informed consent was obtained from all study participants or, in the case of being brought in dead, from a guardian. They expressed their willingness to permit the utilization of clinical data and the disclosure of this information for academic purposes. This consent specifies that all information capable of identifying or correlating to the individual will be anonymized to ensure their confidentiality.

: Not applicable.

: The authors declare no competing interests.