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<title>Abstract</title> <p>24 July, 2026. Research Square has withdrawn this preprint due to concerns regarding its integrity arising from the submitting author's involvement in a paper mill network. For further details, see this [related Retraction Watch post](⁠https://retractionwatch.com/2026/07/21/exclusive-medical-student-in-nepal-behind-busy-research-factory/).</p>

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