highly significantP <0.001
However, when the patients were grouped into three categories based on individual values of PES (score<10, score>11<12, and scores>13 and <14) and were analyzed for changes within and between the groups, there was a significant difference statistically between and within the groups, with a greater number of patients with PES values of (scores >13 and <14) in the SST group, which was highly significant statistically at P <0.001.