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Article History

Received: 16 September 2025

Accepted: 2 June 2026

First Online: 19 June 2026

Declarations

:

: This study received ethical approval from the Institutional Review Committee of the Institute of Medicine at Tribhuvan University (Dec 22, 2023/ 286). All the participants provided written informed consent. All methods were carried out in accordance with relevant guidelines and regulations published by the Ethics committee.

: We used deidentified data and have not used any personal account. Therefore, this is not applicable.

: The authors declare no competing interests.