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Article History

Received: 15 June 2025

Accepted: 31 July 2025

First Online: 14 August 2025

Declarations

:

: The study was registered at the International Standard Randomized Controlled Trial, registration number ISRCTN11661014.().This study was conducted as a randomized clinical trial, in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Damascus University (date:9/5/2022/No.: 2609).Written informed consent was obtained from all participants prior to their inclusion in the study.

: It is contained in the ethical approval granted by the ethics committee of the university; no personal or clinical details of the participants compromise anonymity so that no further consent for publication from patients is required.

: The authors declare no competing interests.