Background Medical students are more prone to burnout than the general population and students of other faculties due to the demanding nature of medical education with limited time and resources. Burnout has a negative impact on the academics and personal life of the students which can continue into their professional life and ultimately hamper patient care. The purpose of this study is to determine the prevalence of burnout among medical students of a medical college and find its association with age, gender, and year of study. Materials and methods This cross-sectional study was conducted among medical students of a medical college in Kathmandu, Nepal from 14 January to 7 March, 2021. Stratified sampling followed by a simple random sampling technique was employed to select study participants. Data was collected through a self-administered questionnaire using the English version of the Oldenburg Burnout Inventory adapted for students (OLBI-S) and analyzed in STATA version 15. Results The prevalence of burnout was found out to be 65.9% (n = 229). And of the remaining, 12.7% were exhausted, 11.4% were disengaged and 10.0% were neither exhausted nor disengaged. Burnout had no significant association with age in years, gender, and year of study. Conclusions This study shows an alarming prevalence of burnout in almost two-thirds of medical students. These results indicate the necessity of employing effective strategies by relevant authorities for the mental well-being of future physicians. Further multicenter prospective studies are required for a better understanding of the prevalence and associated factors of burnout.

Introduction and importance Delayed Splenic Rupture (DSR) is a rare but well-known presentation of Blunt Splenic Injury (BSI), most of which occur due to motor accidents, fall from height or direct blow to the left thorax or abdomen. Here we present a case of DSR five days after a trivial trauma. Case presentation A 37-year-old female presented with pain in the left-hypochondrium after an accidental bump against a furniture at home. Initially, it was a grade III splenic injury but upon arrival to our hospital from her hometown it had progressed to grade IV. Since the patient was hemodynamically stable, non-operative management (NOM) was chosen with close monitoring at the intensive care unit (ICU). However, the next morning, the patient deteriorated, showing signs of hemorrhagic shock, and a successful emergency splenectomy was done. Clinical discussion Over the last two decades, there has been an increasing inclination of surgeons towards NOM, even for high grade injury. NOM failure has been found to be associated with advancing age, high Injury Severity Score (ISS) or splenic injury. Some factors that improve the success of NOM are admission to ICU/floor, frequent monitoring of hemoglobin/hematocrit, vital signs, abdominal examination, and limiting heavy physical activity. Conclusion Clinicians should not limit the possibility of occurrence of DSR to only major traumatic events. It is imperative that a detailed history of major or trivial trauma in the preceding weeks be elicited for any patients presenting with abdominal pain.

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Introduction: Chronic kidney disease is defined as structural or functional damage of the kidney persisting for three or more months. Studies have shown hypertension and diabetes as the leading causes of chronic kidney disease. The aim of this study is to find out the prevalence of end-stage renal disease patients undergoing haemodialysis in a tertiary care hospital. Methods: This was a descriptive cross-sectional study conducted among 96 patients undergoing haemodialysis from February 13, 2021 to April 4, 2021 in the hemodialysis unit of a tertiary care centre after receiving ethical clearance from the Institutional Review Committee (Reference number: 354). Convenience sampling was done and all patients older than 18 years who were on maintenance haemodialysis on an outpatient basis were included in the study. Data were collected using a self-administered questionnaire. Data were analysed using the Statistical Package for the Social Science version 22.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentages for binary data and mean with standard deviation for continuous data. Results: Among 96 patients undergoing haemodialysis, the prevalence of end-stage renal disease was 83 (86.45%) (79.60-93.30 at 95% Confidence Interval). The most common underlying condition was hypertensive nephropathy in 34 (40.96%) patients, followed by both hypertensive and diabetic nephropathy in 26 (31.33%) patients. Conclusions: The prevalence of end-stage renal disease in our study was higher when compared to similar studies conducted in similar settings. Early diagnosis and adequate treatment of hypertension and diabetes could be crucial to reducing the prevalence of the end-stage renal disease.

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