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Article History

Received: 22 April 2026

Accepted: 24 June 2026

First Online: 29 June 2026

Declarations

Ethical approval: The study protocol was approved by the Scientific Research Committee at the Royal Hospital, Ministry of Health, Oman (Approval No. MoH/CSR/24/28820). The study was conducted in accordance with the Declaration of Helsinki. All data were fully anonymized before analysis, and confidentiality was strictly maintained through de-identification using unique study codes. No personally identifiable information was accessed, recorded, or disclosed. For the retrospective cohort (1992-26 August 2024), the requirement for informed consent to participate was waived by the Scientific Research Committee at the Royal Hospital, Ministry of Health, Oman, as the study used de-identified routinely collected hospital records. For the prospective cohort (27 August 2024-31 December 2024), data were obtained as part of routine clinical care from the hospital electronic medical record system (Shifa3+), without direct patient contact or interviews, and informed consent was not required in accordance with the approval of the Scientific Research Committee.

Consent for publication: Not applicable.

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.