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Ethics declarations Ethics approval and consent to participate The study protocol was approved by the ethics committee of Guilan University of Medical Sciences (IR.GUMS.REC.1400.197) in accordance with the World Medical Associations code of ethics (Declaration of Helsinki, revised in Brazil 2013), and registered at an ICMJE and WHO recognized registry of clinical trials (www.irct.ir) at 28/08/2021 (registration number: IRCT20200920048782N1)

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We also have numbing spray to reduce the pinch of the needle