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Article History

Received: 27 February 2025

Accepted: 4 August 2025

First Online: 29 August 2025

Declarations

:

: This study is a retrospective observational analysis of clinical cases and does not involve any invasive interventions or direct contact with patients. As the research is based on the review of existing medical records and does not impact patient care or privacy, it was deemed exempt from ethical approval by our institution. Our outpatient clinic does not have an institutional ethics committee, and given the non-interventional nature of this study, formal ethical review was not considered necessary. Since this is a retrospective study using anonymized data, informed consent from patients was not required. All data were handled in strict compliance with patient confidentiality and privacy protection regulations.

: Not applicable.

: The authors declare no competing interests.