Arrhinia

Arrhinia means a baby is born without a nose. This can range from the near-total absence of the outside nose to complete absence of both the outside nose and the inside nasal passages. Because newborns prefer to breathe through the nose, arrhinia can cause breathing trouble right after birth, and it can also cause feeding difficulty, problems with smell, and sometimes eye and hormone (puberty) issues. Some babies have arrhinia alone (isolated). Others have arrhinia as part of a rare syndrome called Bosma arhinia microphthalmia syndrome (BAMS), which adds small eyes (microphthalmia), sometimes eye defects (like coloboma), and puberty problems due to low hormones (hypogonadotropic hypogonadism). The condition is extremely rare. PMC+2PMC+2

Arrhinia means a baby is born with no nose (complete absence) or a very underdeveloped nose (partial absence). In most cases the internal nasal passages and the smell system (olfactory bulbs/tracts) are also missing or very small. It is extremely rare (well under a few hundred cases in the medical literature). Many newborns need immediate help with breathing and feeding, because babies normally breathe through the nose. Arrhinia can occur alone (isolated) or with other findings such as small eyes (microphthalmia), palate differences, or delayed puberty as part of Bosma arhinia microphthalmia syndrome (BAMS). MedlinePlus+3PMC+3PMC+3

During early pregnancy, small thickened skin patches called nasal placodes are supposed to form and grow inward to make the nose and nasal cavities. In arrhinia, this step does not happen or happens only partly. Rare de novo variants in the SMCHD1 gene have been shown to disrupt nasal development and cause isolated arhinia or BAMS; most parents are unaffected. Scientists think other genetic or modifying factors may also be involved. PubMed+2Nature+2

During early pregnancy, the nose forms from small swellings on the face and the nasal placodes (tiny patches of tissue that should fold inward to make the nasal cavities). In arrhinia, experts think there is a disruption of this early facial development, especially failure of invagination of the placodes and abnormal growth or fusion of surrounding tissues. ScienceDirect+1

Over the last decade, researchers discovered that many people with isolated arhinia or BAMS have changes (mutations) in a gene called SMCHD1, an epigenetic regulator. These changes cluster in a specific part of the gene and appear to derail normal nasal development; they can also overlap with variants known from a type of muscular dystrophy (FSHD2). Still, not every case has a known genetic cause. Nature+1


Other Names

  • Arhinia (preferred medical spelling) / Arrhinia (variant spelling)

  • Congenital arhinia (when present at birth)

  • Total arhinia (complete absence of external and internal nose)

  • Partial arhinia / hyporrhinia (severe underdevelopment of the nose)

  • Bosma arhinia microphthalmia syndrome (BAMS) when it occurs with small eyes and puberty-hormone problems (syndromic form). Orpha+1


Types

  1. Isolated (non-syndromic) arhinia
    The baby has arhinia but otherwise normal body systems or only minor differences. Some isolated cases have SMCHD1 variants; others do not show a defined genetic change. Nature

  2. Syndromic arhinia (BAMS)
    Arhinia occurs with microphthalmia/coloboma and puberty hormone problems (low GnRH/LH/FSH → delayed or absent puberty). Intelligence and brain structure can be normal, but associated features vary from person to person. PubMed+1

  3. Partial arhinia (hyporrhinia)
    Some nasal structures are present, but severely underdeveloped. This may still cause major breathing and feeding issues in newborns. PMC


Causes

Important note: For many babies, the exact cause is unknown. The items below summarize what research and case reports suggest.

  1. Gene changes in SMCHD1
    This is the most strongly linked genetic cause so far, found in many isolated arhinia and BAMS cases. These mutations disrupt epigenetic control of facial development. Nature+1

  2. Developmental error of the nasal placodes
    If the placodes do not fold inward at the right time, the inner nose and openings do not form. ScienceDirect

  3. Abnormal fusion of facial processes
    The medial and lateral nasal processes must grow and fuse. Errors here can block the early formation of nasal passages. ScienceDirect

  4. Neural crest cell disturbance
    These cells help build facial structures. Disturbed migration/differentiation can contribute to arhinia. (Mechanism inferred from craniofacial development biology.) Nature

  5. Syndromic association (BAMS)
    In BAMS, the combination of nasal, ocular, and endocrine features reflects a shared developmental disruption, often with SMCHD1 mutations. MedlinePlus

  6. Midline facial patterning disturbance
    Subtle changes in early midline signaling may contribute, even when the brain is otherwise normal. Nature

  7. Unknown genetic causes (undiscovered genes)
    Some patients with arhinia test negative for SMCHD1; other genes are likely involved but remain to be identified. PMC

  8. Chromosomal variation in individual cases
    Some reports include chromosomal testing as part of the work-up; occasional anomalies may be found, though no single chromosomal change explains most cases. AIJCR

  9. Defects in olfactory system development
    Since the nasal placode also seeds the olfactory system, maldevelopment can remove both the nose and the sense of smell. PMC

  10. Pituitary-hypothalamic axis involvement (in BAMS)
    Low GnRH and related hormones suggest a developmental effect on the reproductive hormone pathway. MedlinePlus

  11. Mechanical constraint in early embryo (theory)
    Very rarely suggested in case reports—unproven but considered when no genetic cause is found.

  12. Epigenetic dysregulation beyond SMCHD1
    Arhinia likely involves gene-expression control problems in facial patterning pathways, even when DNA sequence is normal (theory grounded in epigenetic role of SMCHD1). Nature

  13. Failure of choanal formation
    In some partial forms, posterior nasal openings do not form, worsening airway issues. (Conceptual overlap with choanal atresia.) National Organization for Rare Disorders

  14. Associated ocular field development errors
    Shared developmental timing may explain why some babies have both nasal and eye underdevelopment. PubMed

  15. Family clustering (rare)
    A few families have had more than one affected person, supporting a hereditary component in some cases. BioMed Central

  16. Isolated single-gene variants other than SMCHD1 (suspected)
    Older literature suggested other facial-patterning genes might be candidates, but evidence is limited and inconsistent. PMC

  17. Disruption of local growth factors (theory)
    Disturbed signaling around the placode can impair invagination and canalization. ScienceDirect

  18. Vascular disruption sequence (theory)
    Hypothetical: a brief blood-flow problem during a critical window could prevent nasal formation.

  19. Maternal-fetal factors (unproven)
    Case reports sometimes look for maternal illnesses or drug exposures; no consistent factor has been confirmed.

  20. Truly idiopathic
    In many babies, no cause is found despite detailed testing; the condition remains unexplained. PMC


Symptoms and Signs

  1. Trouble breathing soon after birth
    Newborns are obligate nasal breathers. Without nasal passages, they can have cyanosis, retractions, or apneic spells, especially during quiet rest. SAGE Journals

  2. Feeding difficulty
    Babies must coordinate suck-swallow-breathe. Without a nose, breathing while feeding is hard, so feeds may be slow, tiring, or unsafe. PMC

  3. Mouth breathing
    Continuous mouth breathing is obvious and may cause dry mouth and disturbed sleep.

  4. No visible nose / very small nose
    Physical appearance varies from no external nose to a blunt or flat midface with minimal nasal tissue. PMC

  5. No smell (anosmia) and reduced taste
    Missing olfactory system leads to poor or absent smell; taste is often blunted because smell strongly supports flavor. PMC

  6. Nasal voice (hyponasal resonance)
    Speech may sound “blocked” later in childhood because air cannot pass through the nose.

  7. Eye differences
    In syndromic cases (BAMS): microphthalmia, coloboma, or other eye malformations. PubMed

  8. Puberty problems (BAMS)
    Delayed or absent puberty due to low pituitary gonadotropins (hypogonadotropic hypogonadism). MedlinePlus

  9. Feeding-related desaturation
    Oxygen levels can drop during bottle or breast feeds because the baby must choose between breathing and swallowing. PMC

  10. Sleep disturbance
    Mouth breathing and airway instability can fragment sleep.

  11. Recurrent chest symptoms
    Dry airways and aspiration risk can contribute to cough or infections.

  12. Midface hypoplasia
    The middle part of the face may look flat or underdeveloped in some children. BioMed Central

  13. Cleft palate or palatal differences (some cases)
    Palate abnormalities can co-occur and worsen feeding/speech issues. National Organization for Rare Disorders

  14. Dental and orthodontic issues
    Long-term mouth breathing can affect oral development and bite alignment.

  15. Psychosocial impact
    Facial difference may lead to social stress; families often need counseling and coordinated support.


Diagnostic Tests

A) Physical Examination

  1. Newborn airway and breathing check
    Clinicians assess breathing work, skin color, oxygen levels, and whether distress improves when the mouth is opened or an airway is placed. Early recognition prevents hypoxia. SAGE Journals

  2. Head and face exam
    Careful look and feel of the nose area, midface, mouth, tongue, and palate. This documents absence/underdevelopment and checks for clefts.

  3. Eye exam
    Because of BAMS and related associations, the team checks for microphthalmia and coloboma and plans ophthalmology follow-up. PubMed

  4. Neurologic exam
    Baseline tone, reflexes, and cranial nerves are checked; some infants are otherwise neurologically normal.

  5. Feeding and swallow observation
    Lactation/speech specialists observe suck-swallow-breathe and recommend safe feeding strategies. PMC

B) “Manual” Bedside Tests

  1. Mirror fog/paper test for nasal airflow
    A small mirror or tissue under the nostril area normally fogs or flutters with breathing; in arrhinia, there is no nasal airflow.

  2. Gentle catheter or nasogastric tube test
    In typical care, soft catheters check nasal passage patency; in arrhinia, passage is not possible due to absent cavities. Performed cautiously.

  3. Flexible endoscopy attempt (by specialist)
    Pediatric ENT may try endoscopy via the mouth/nasopharynx to map anatomy and confirm the absence of nasal chambers.

  4. Feeding stress test (monitored)
    Observing oxygen saturation and effort during test feeds helps plan airway and nutrition support. PMC

C) Laboratory & Pathology Tests

  1. Arterial/Capillary Blood Gas (ABG/CBG)
    Measures oxygen and carbon dioxide during distress to guide acute management. SAGE Journals

  2. Pulse oximetry
    Continuous oxygen monitoring detects desaturation during sleep or feeds. SAGE Journals

  3. Endocrine labs (LH, FSH, sex steroids ± GnRH testing)
    In BAMS or later childhood, testing confirms hypogonadotropic hypogonadism if puberty is delayed. MedlinePlus

  4. Genetic testing—SMCHD1 sequencing/variant analysis
    Targeted testing or a panel/exome can look for SMCHD1 and other candidate genes; results affect diagnosis and counseling. Nature

  5. Karyotype / chromosomal microarray (as indicated)
    Done to look for broader chromosomal changes when presentation is complex. AIJCR

  6. Routine newborn labs (CBC, electrolytes)
    These help manage intercurrent issues (infection, dehydration) during the neonatal period.

D) Electrodiagnostic Tests

  1. Polysomnography (sleep study)
    If snoring, apneas, or sleep problems occur later, a sleep study checks breathing pauses and oxygen dips to plan airway care.

  2. Olfactory evoked potentials or smell testing (when older)
    Research/tertiary centers may test olfactory function; in arhinia, objective smell is absent.

  3. EEG (only if seizures or brain concerns)
    Not routine, but used if there are events suggesting seizures or associated brain malformations.

E) Imaging Tests

  1. CT scan of facial bones and sinuses
    CT maps bony anatomy, confirms absence of nasal cavities/turbinates/choanae, and helps surgeons plan reconstruction. IJHSR

  2. MRI of face/brain (± pituitary)
    MRI shows soft tissues, olfactory bulbs/tracts, pituitary, and brain. It also assesses associated anomalies in BAMS and supports endocrine planning. IJHSR

  3. Prenatal ultrasound
    Experienced centers may detect severe nasal underdevelopment before birth, prompting delivery planning in a hospital with airway support. ScienceDirect

  4. Fetal MRI (selected cases)
    Provides a clearer map of facial and brain structures in utero to coordinate perinatal airway strategy. ScienceDirect

  5. Chest X-ray (neonatal distress)
    Checks for aspiration, lung expansion, and lines/tubes during NICU care. AIJCR

  6. Ophthalmic imaging/exam under anesthesia
    If eye malformations are suspected, detailed evaluation helps protect vision. PubMed

  7. 3-D photography/scan for craniofacial planning
    Non-invasive surface mapping helps plan staged reconstruction and follow growth.

Non-pharmacological treatments (therapy & other measures)

  1. Neonatal airway management (positioning, oropharyngeal airway, rarely tracheostomy) to maintain oxygenation until definitive plans are set. Purpose: keep baby breathing safely. Mechanism: bypasses absent nasal conduit. SAGE Journals

  2. Feeding support (special nipples, pacing; temporary NG/OG tube as needed). Purpose: safe nutrition while oral/nasal coordination is limited. Mechanism: reduces work of feeding. SAGE Journals

  3. Humidified air & saline instillation (if any nasopharyngeal opening exists). Purpose: reduce crusting; Mechanism: moisture keeps mucosa healthy. PMC

  4. Ophthalmology care (tear-duct care, lubrication, vision optimization; ocular prosthetics if anophthalmia). Purpose: protect vision and surface. PubMed

  5. Speech-language therapy (velopharyngeal and resonance coaching post-op). Purpose: optimize speech when anatomy is unusual. PMC

  6. Feeding/swallow therapy (OT/SLP). Purpose: reduce aspiration; Mechanism: adaptive strategies and textures. SAGE Journals

  7. Craniofacial surgical planning (team conference: plastics/ENT/maxillofacial/anesthesia). Purpose: agree on timing and sequence. Mechanism: coordinated staged plan. PMC

  8. Psychosocial support & counseling (child and family). Purpose: reduce anxiety, support coping, address appearance-related stress. PubMed

  9. Orthodontics/orthopedics of the face (when older). Purpose: align bite; Mechanism: appliances guiding growth. PMC

  10. Sleep hygiene & positional therapy if snoring/OSA features. Purpose: improve sleep quality; Mechanism: posture and routine. SAGE Journals

  11. Physiotherapy for chest clearance during respiratory infections. Purpose: keep lungs clear; Mechanism: airway clearance techniques. SAGE Journals

  12. Genetic counseling for families. Purpose: explain cause/recurrence risk (usually low de novo). PubMed

  13. Educational support (IEP/vision services if eye findings). Purpose: maximize learning. PubMed

  14. Dermatologic/wound care after grafts/flaps. Purpose: healthy healing. PMC

  15. Scar management (massage/silicone/pressure). Purpose: improve cosmesis and movement. PMC

  16. Pre- and postoperative photography/3D planning. Purpose: set goals and monitor outcomes. PMC

  17. Nasal stents/splints after reconstruction. Purpose: maintain created airway; Mechanism: scaffold while healing. PMC

  18. Sun protection of grafted skin. Purpose: protect color/texture of flaps. PMC

  19. Developmental surveillance (motor, language, social). Purpose: catch issues early; Mechanism: regular screenings. SAGE Journals

  20. Transition-to-adult-care planning, including endocrine follow-up in BAMS. Purpose: continuity of care into adulthood. MedlinePlus

Drug treatments

Because arrhinia is structural, medicines do not “fix” the nose. Drugs are used for airway comfort, infection control, eye protection, postoperative care, and endocrine issues in BAMS. Always individualize dosing to age/weight and local guidelines.

  1. Isotonic saline drops/gel (topical) – Class: emollient/irrigant; Dose: PRN. Time: daily care. Purpose: moisture & crust control. Mechanism: hydrates mucosa. Side effects: brief stinging. PMC

  2. Lubricating eye drops/ointment – Class: ocular lubricants; Dose: PRN. Purpose: corneal surface protection when microphthalmia/tear-duct issues. Side effects: blur briefly. PubMed

  3. Antibiotics (systemic) when infection is diagnosed – Class: per culture/local guideline; Dose: weight-based. Purpose: treat pneumonia/otitis/sinusitis (if sinuses present). Risks: allergy, resistance; avoid routine prophylaxis. SAGE Journals

  4. Analgesics (acetaminophen/ibuprofen where age-appropriate) – Class: analgesic/NSAID; Dose: standard pediatric dosing. Purpose: postoperative pain/fever. Risks: liver (acetaminophen), GI/renal (NSAID). PMC

  5. Topical antibiotic ointments (short course) on incisions – Class: topical antimicrobial; Purpose: wound care per surgeon. Risks: contact dermatitis/resistance. PMC

  6. Steroid nasal drops (only if an internal airway exists and surgeon advises) – Class: topical corticosteroid; Purpose: reduce edema/granulation post-op. Risks: mucosal irritation; avoid unsupervised use. PMC

  7. Proton-pump inhibitor/H2 blocker – Class: acid suppression; Purpose: reduce reflux-related airway irritation in selected infants with GERD contributing to breathing issues. Risks: gut flora changes; use only if true GERD. SAGE Journals

  8. Antiemetics (peri-anesthesia) – Class: ondansetron etc.; Purpose: reduce postoperative nausea/vomiting that can stress facial repairs. Risks: rare QT effects. PMC

  9. Intravenous fluids/perioperative antibiotics – Class: supportive; Purpose: safe anesthesia & surgical infection prophylaxis per institutional protocol. Risks: as per agents used. PMC

  10. Decongestants (generally avoided in infants; rarely indicated) – Class: sympathomimetics; Purpose: limited role; many babies have no nasal lumen. Risks: hypertension, irritability—usually not recommended. PMC

  11. Antihistamines (select cases of atopy in older children) – Class: H1 blocker; Purpose: reduce allergic symptoms if relevant. Risks: sedation/dryness. PMC

  12. GnRH therapy or sex-steroid induction (BAMS) – Class: endocrine replacement (GnRH pulses, testosterone/estrogen per age). Purpose: start and maintain puberty; Mechanism: replace missing hypothalamic/pituitary signaling. Risks: per agent (e.g., epiphyseal effects, mood). MedlinePlus

  13. Calcium + Vitamin D (if deficient or during puberty induction) – Class: supplements; Purpose: bone health. Risks: hypercalcemia if overdosed. MedlinePlus

  14. Lubricating eye gels at night – Class: thicker ocular lubricants; Purpose: overnight protection for exposure risks. Side effects: blurred vision. PubMed

  15. Topical silicone/oncology-grade gels for scars – Class: silicone elastomer; Purpose: reduce hypertrophic scarring after grafts. Risks: minimal. PMC

  16. Short systemic steroids (rare, surgeon-directed) – Class: corticosteroid; Purpose: reduce severe post-op edema. Risks: immunosuppression, glucose effects—not routine. PMC

  17. Antibiotic eye drops (if ocular surface infection occurs). Class: topical antimicrobial. Risks: resistance—culture when possible. PubMed

  18. Nasal mupirocin (if stents/internal skin colonization per surgeon) – Class: topical antibiotic; Purpose: decolonization. Risks: resistance/irritation. PMC

  19. Analgesic adjuncts (acetaminophen + regional blocks peri-op) – Purpose: multimodal pain control. Risks: agent-specific. PMC

  20. Vaccines on schedule – Class: immunizations; Purpose: reduce respiratory infection burden that can complicate airway care; standard of care, not disease-specific. SAGE Journals

Dietary molecular supplements

  1. Vitamin D – supports bone health during growth/puberty; dose per local pediatric guidance and labs. Mechanism: calcium absorption/regulation. MedlinePlus

  2. Calcium – pairs with vitamin D for bone accrual. Dose individualized. MedlinePlus

  3. Iron (if iron-deficiency anemia) – improves oxygen delivery and development. Dose: weight-based after labs. SAGE Journals

  4. Omega-3 fatty acids – general support for ocular surface/tear film and inflammation modulation; pediatric dosing varies. PubMed

  5. Vitamin Ause with caution; supports ocular surface but overdose is harmful; only when deficient and clinician-directed. PubMed

  6. Folate/B12 – treat documented deficiencies impacting growth and hematology. SAGE Journals

  7. Zinc – for poor wound healing where deficiency exists; lab-guided. PMC

  8. Selenium – antioxidant support only if deficient; avoid routine use. SAGE Journals

  9. Probiotics (peri-antibiotic periods if tolerated) – gut microbiome support; strain-specific evidence; avoid in severely immunocompromised hosts. SAGE Journals

  10. Multivitamin – general coverage in picky eaters after surgery; not a substitute for nutrition. SAGE Journals

Immunity booster / regenerative / stem-cell drugs

There are no approved immune-booster pills, regenerative medicines, or stem-cell drugs that treat arrhinia or regrow a normal human nose in clinical practice today. Using such products outside trials can be risky or fraudulent. Safer, evidence-based alternatives that do improve resilience include: keeping vaccinations up to date, correcting vitamin D/iron deficiencies, optimizing sleep/nutrition, and treating endocrine issues (e.g., GnRH/sex-steroid therapy in BAMS) under specialist care. MedlinePlus

Surgeries

  1. Airway creation/maintenance (e.g., temporary oral airway, rare tracheostomy) – to secure breathing in the newborn and before reconstruction. SAGE Journals

  2. Staged nasal reconstruction (most common strategy) using local flaps, cartilage/bone grafts, and skin; staged to allow growth and safer healing. Goal: build a stable, functional airway and normal-appearing nose. PMC

  3. Simultaneous internal + external reconstruction (selected centers) – fewer stages but higher complexity; chosen case-by-case. PMC

  4. Maxillary advancement/Le Fort osteotomy or distraction – lengthens midface, creates space for an internal nasal cavity, and improves proportions. PMC

  5. Post-reconstruction stenting and revisions – maintains new airway and refines shape/function as the child grows. PMC

Prevention tips

Arrhinia is usually not preventable because it’s driven by early embryonic events and often de novo genetics. Still, families can: pursue preconception health, avoid known teratogens (alcohol, certain drugs), manage maternal illnesses, take prenatal folate per guidelines, get early anomaly scans and fetal MRI when advised, seek genetic counseling if there’s a history of craniofacial anomalies, deliver at a tertiary center if arrhinia is suspected prenatally, and enroll in multidisciplinary follow-up after birth (these steps don’t “prevent” arrhinia, but they prevent complications). PubMed+3Radiopaedia+3SAGE Journals+3

When to see doctors (red flags)

Immediately at birth if nose is absent/underdeveloped; anytime there is trouble breathing, poor feeding/weight gain, blue spells, snoring/pauses in sleep, frequent chest or ear infections, eye irritation or corneal exposure, or signs of delayed puberty (no testicular enlargement by ~11–12 years in boys; no breast development by ~11–13 in girls). If arrhinia is suspected in pregnancy, request fetal MRI and delivery planning at a center with neonatal airway and craniofacial teams. SAGE Journals+1

What to eat and what to avoid

Eat: age-appropriate balanced diet rich in protein (healing), fruits/vegetables (micronutrients), whole grains (energy), healthy fats, and adequate calcium/vitamin D for bone health—especially if endocrine therapy is needed. Avoid/limit: choking-risk textures during feeding therapy phases; ultra-processed, high-sugar drinks that displace nutrition; unapproved “stem-cell” or “immune-booster” products marketed online. Follow local pediatric dietitian guidance during perioperative periods. MedlinePlus

FAQs

  1. Is arrhinia fatal? Not usually, if the airway is secured and feeding is supported; many children do well with staged reconstruction. SAGE Journals

  2. Can you smell with arrhinia? Often not; olfactory bulbs/tracts may be absent. PubMed

  3. Is intelligence affected? Typically normal, including in many BAMS reports. PubMed

  4. Is it inherited? Most cases are de novo; recurrence risk is generally low but ask genetics. PubMed

  5. Can it be seen before birth? Sometimes—fetal MRI and detailed ultrasound can detect it in the second trimester. SAGE Journals+1

  6. What age is surgery done? Staging varies by team and child needs; some reconstructions start in later childhood to balance growth and safety. PMC

  7. Will my child need a tracheostomy? Rarely; only if other methods cannot secure the airway safely. SAGE Journals

  8. Is there a single operation to fix everything? Usually staged surgeries give safer, better outcomes than one big operation. PMC

  9. Are eye problems common? Yes in BAMS (microphthalmia, tear-duct issues). PubMed

  10. What about puberty? BAMS often has hypogonadotropic hypogonadism; endocrine therapy can induce normal puberty. MedlinePlus

  11. Will my child be able to play and go to school? With airway stability and support, yes—plan for vision and speech services if needed. PubMed

  12. Are there miracle pills or stem cells? No approved pills or stem-cell treatments rebuild a nose; avoid unproven therapies. PMC

  13. Does it affect life span? When managed well, life expectancy can be near normal; risk relates to airway/feeding complications and associated anomalies. SAGE Journals

  14. Can adults be diagnosed? Yes—some BAMS cases are recognized later, especially for pubertal issues and characteristic facial/ocular findings. PubMed

  15. Where should we be treated? At a craniofacial center with ENT/plastic surgery, ophthalmology, genetics, endocrinology, speech/feeding, and pediatric anesthesia. PMC

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The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: September 22, 2025.

 

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