Statistical methods
Continuous variables were described using means and standard deviations. Counts and percentages were used to describe categorical variables. Continuous variables were checked for normal distribution using the Shapiro–Wilk test of normality, and parametric and non-parametric statistical tests were applied accordingly. An independent t test was used between two groups, and a paired t test was used within the same group for normally distributed outcome variables. For non-normally distributed outcome variables, the Wilcoxon Rank Sum test, also known as the Mann–Whitney u test, was used between two groups, while the Wilcoxon Signed Rank test was used within the same group. The Chi-square test was used to assess compliance within groups. A 