Ethics approval and consent to participate
The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. All procedures were approved by the Research Ethics Committee of the Karachi Medical and Dental College (027/15) and the University of Manchester (2019–2610-10693). All participants provided written informed consent to participate in this study.