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Article History

Received: 4 November 2025

Accepted: 2 February 2026

First Online: 5 March 2026

Declarations

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: Written informed consent was obtained from all participants or their legal guardians before enrollment in the study. Ethical committee approval was obtained, and procedures were performed in accordance with the moral standards outlined in the 1964 Declaration of Helsinki and its subsequent amendments, or with comparable ethical standards. This study was approved by the Ethics Committee of Hamadan University of Medical Sciences (ethical code IR.UMSHA.REC.1401.460). All ethical standards were observed, including obtaining permission, written informed consent from participants, permission to withdraw at any time if they did not wish to continue participating in the study, stating the objectives of the study, and confidentiality of information for study participants. This study was registered with the Iranian Clinical Trials Center under registration number IRCT20220820055756N1 on October 16, 2022. All parents of participants provided written informed consent before enrollment in this study.

: All patients’ parents included in this research or their guardians gave written informed consent to publish the data contained within this study.

: The authors declare no competing interests.