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Article History

Received: 9 April 2026

Accepted: 9 June 2026

First Online: 17 June 2026

Declarations

Ethics approval and consent to participate: The study was conducted with the approval of the Kuwait University Health Science Center Ethical Committee (HSCEC) (Approval Number: VDR/EC–2025–146 on 1 September 2025); and the Ministry of Health (MOH) Standing Committee for Coordination of Health and Medical Research (Approval Code: 2830/2025; 20 April 2025), both of which function as Institutional Review Boards (IRBs). As the study utilized de-identified retrospective administrative data extracted from the MOH information system and did not involve direct contact with individuals, the requirement for informed consent was waived by both the MOH Standing Committee for Coordination of Health and Medical Research and the HSCEC. This research has been performed in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent for publication: Not applicable.

Competing interests: The authors declare no competing interests.