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Article History

Received: 14 March 2025

Accepted: 23 July 2025

First Online: 13 August 2025

Declarations

:

: The present study has been approved by Ethics committee of Mazandaran University of Medical Sciences in Ramsar Campus (IR.MAZUMS.RIB.REC.1401.091).and certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.As part of hospital protocol, an informed consent form is routinely added to the medical file of all patients upon admission at Shahid Rajaee Hospital. This document outlines the patient’s voluntary cooperation with clinical evaluations and permits the ethical use of medical data in future scientific research. In this study, only the records of patients who signed the written consent form (attached) were included. In addition, each patient or their legal guardian was individually contacted, and the objectives of the study were thoroughly explained. Following these discussions, verbal consent was obtained once again. Patients who, after full clarification, declined participation for any reason were not enrolled in the study.

: All participants and their witnesses were verbally informed about the nature and purpose of the study, including the potential publication of anonymized clinical and demographic data. Participation was voluntary, and individuals who provided oral consent were enrolled in the study.In addition, upon admission, all patients or their legal representatives signed a written consent form acknowledging that Shahid Rajaei Hospital is a teaching and research-oriented medical center. The consent form clarified that information from medical records may be used for research purposes and academic publication, without compromising confidentiality. Only records with signed consent forms (attached) were reviewed and included in this analysis.

: The authors declare no competing interests.