Objectives To determine whether a reduction in working hours of doctors in postgraduate medical training has had an effect on objective measures of medical education and clinical outcome. Design Systematic review. Data sources Medline, Embase, ISI Web of Science, Google Scholar, ERIC, and SIGLE were searched without language restriction for articles published between 1990 and December 2010. Reference lists and citations of selected articles. Study selection Studies that assessed the impact of a change in duty hours using any objective measure of outcome related to postgraduate medical training, patient safety, or clinical outcome. Any study design was eligible for inclusion. Results 72 studies were eligible for inclusion: 38 reporting training outcomes, 31 reporting outcomes in patients, and three reporting both. A reduction in working hours from greater than 80 hours a week (in accordance with US recommendations) does not seem to have adversely affected patient safety and has had limited effect on postgraduate training. Reports on the impact of European legislation limiting working hours to less than 56 or 48 a week are of poor quality and have conflicting results, meaning that firm conclusions cannot be made. Conclusions Reducing working hours to less than 80 a week has not adversely affected outcomes in patient or postgraduate training in the US. The impact of reducing hours to less than 56 or 48 a week in the UK has not yet been sufficiently evaluated in high quality studies. Further work is required, particularly in the European Union, using large multicentre evaluations of the impact of duty hours' legislation on objective educational and clinical outcomes.

Dilemmas regarding whether medical students’ participation ‘as doctor’ in disaster response is ethical remains unanswered. Although they prove to be an important addition to the workforce during such settings, their limited competency and likeliness to harm themselves and the patients in the process raises questions. Here we present our views on medical students’ involvement in disaster response based on our experiences at Patan Hospital, Patan Academy of Health Sciences (PAHS) during the Nepal earthquake 2015. Medical students play a crucial role in disaster management; however, they are not proficient in care for mass disasters. Nonetheless, being involved offered students first-hand experience on disaster response and also helped the disaster response by providing extra manpower. With more training, medical students can serve as a skillful workforce during disaster. The impact of regular drills strategically placed during medical school training in the curricula can be of immense help to build capacity for medical disaster response.

Introduction: COVID-19 is a global pandemic that has affected millions of people worldwide. It predominantly affects the respiratory tract causing various respiratory symptoms. It also causes various musculoskeletal symptoms in the form of arthralgia and myalgia which may be incapacitating for some patients. The objective of this study was to find out the prevalence of arthralgia among patients with COVID-19 infection admitted to the Department of Medicine. Methods: This descriptive cross-sectional study was carried out in the Department of Internal Medicine of a tertiary care centre. Data from March 2020 to May 2021 were collected between 2 December 2021 and 20 December 2021 from the hospital records. Ethical approval was obtained from the Ethical Review Board (Reference number: 1312). All patients who were admitted with the diagnosis of COVID-19 infection based on positive Reverse Transcriptase-Polymerase Chain Reaction for COVID-19 were included in the study. Convenience sampling method was used. Point estimate and 95% confidence interval were calculated. Results: Among 929 patients included in the study, the prevalence of arthralgia was found to be 106 (11.41%) (10.30-12.51, 95% Confidence Interval). The mean age of these patients was 52.81±17.46 years. Conclusions: The prevalence of arthralgia in COVID-19-infected patients was similar to other similar studies done in similar settings.