On the Manage Question Types page (admin/qtypes.php line 48), we are experiencing significant performance issues with a specific SQL query when executed on our large-scale database. The query, which I will attach as a picture, is extremely slow, taking more than 10 minutes to complete, resulting in timeouts.

This issue is critical as it negatively affects user experience due to these timeouts. We need to identify the root cause and optimize the query to ensure it runs efficiently on large datasets.