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Article History

Received: 28 April 2026

Accepted: 16 June 2026

First Online: 19 June 2026

Declarations

Ethical approval: The study protocol was reviewed and approved by the Research Ethics Committee at the Royal Hospital, Ministry of Health, Oman (MoH/CSR/24/28820) on 27 August 2024. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki. Following approval, clinical records of eligible patients (1 January 1992 to 31 December 2024) were extracted from the Royal Hospital’s Shifaa3 + electronic medical record. All personal identifiers were removed before analysis to ensure confidentiality. Each participant was assigned a unique study code (e.g., 1, 2, 3), and access to the dataset was strictly limited to the research team. Written informed consent was waived by the ethics committee for the retrospective component (1992–26 August 2024), as it involved de-identified routinely collected clinical data. For the prospective component (27 August 2024–31 December 2024), data were obtained from routine electronic medical records as part of standard clinical documentation. Given the anonymized nature of the dataset and the use of existing records, the ethics committee determined that informed consent was not required.

Consent for publication: Not applicable.

Declaration of AI-assisted technologies: During the preparation of this manuscript, the author used Grammarly software to assist with grammar, spelling, and sentence clarity.

Competing interests: The authors declare no competing interests.