Browsing by Author "Khanal, Inesh"
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Publication Perceptions of Undergraduate Medical Students Regarding Problem-Based Learning (PBL) at Kathmandu University : A Cross-sectional Study from Nepal(Nepal Health Research Council, 2026) Thapa, Sushma; Atreya, Alok; Rajbanshi, Roshani; Khanal, Inesh; Gnawali, LaxmanAbstract: Background: Problem-based learning (PBL) is a student-centered innovative instructional approach in which students define their learning objectives using triggers from predefined problems in case scenarios. The PBL approach in medicine emphasizes real-world problem-solving and develops students’ capacity for clinical reasoning. It also contributes to the development of interpersonal and communication skills, promotes self-directed learning (SDL), improves the motivation and enthusiasm of students for their profession and maintains professional ethics and behavior. This study aims to explore the perceptions of undergraduate medical students in a medical college in Nepal toward the PBL tutorial incorporated into the curriculum of Kathmandu University (KU). Methods: A mixed-methods cross-sectional study was conducted at the Nepal Manipal College of Medical Sciences, Pokhara, Nepal. Qualitative data were gathered through face-to-face semi structured interviews with 12 preclinical undergraduate medical students (six from first and six from second year) selected via convenience sampling. Quantitative data were collected through an online survey of 200 first- and second-year students. Thematic analysis was used for qualitative data whereas Statistical Package for Social Sciences (SPSS) version 20 for quantitative data. Results: Three themes were identified via thematic analysis: effective learning, the role of tutors, and learning resources. There were 120 students who responded to the online survey with a response rate of 60%. Male students comprised 53.3% of the respondents. Most students agreed that PBL sessions enhanced collaborative learning (n=93, 77.5%) and decision-making skills (n=80, 66.7%). Conclusions: Students reported that PBL enhanced their clinical reasoning skills, interpersonal communication skills, decision-making skills and promoted SDL. The findings also highlighted the need for updated case scenarios and proper tutor training, which are essential for successful PBL sessions. Keywords: Communication skills; collaborative learning; problem-based learning; self-directed learning; medical education.Publication Platelet Indices as Predictive Marker of Prognosis in Critically IllChildren Admitted to Pediatric Intensive Care Unit: An ObservationalStudy(Nepal APF Hospital, 2026) Shrestha, Sailesh; K.C., Sri Ram; Gautam, Tilak; Khanal, Inesh; Shrestha, Sheshna; Pradhan, BulbulAbstract: Introduction: Platelets play a key role in hemostasis and inflammatory processes. Routinely available platelet indices, platelet count, mean platelet volume, platelet distribution width, and plateletcrit may serve as useful prognostic markers in critically ill children. This study aimed to evaluate their role using routine complete blood count tests. Methods: A one-year prospective observational study was conducted in the Pediatric Intensive Care Unit of a tertiary hospital in Nepal from May 2023 to April 2024. Ethical approval was sought from the Institutional Review Committee (Ref: PMP2305161725). A convenience sampling technique was used. Platelet indices were compared with mortality, need for mechanical ventilation, inotropes, and hospital stay, using Receiver Operating Characteristic analysis to identify predictive cut-off values. Data were managed using Epidemiologic Information, Microsoft Excel, and Easy R. Results: Marked differences in platelet indices were noted across clinical outcomes. Survivors had significantly higher platelet count (270.75 ± 136.06) and plateletcrit (0.37 ± 0.15) than non-survivors (130.25 ± 86.72 and 0.21 ± 0.12, respectively; p < 0.001). Patients requiring inotropes had lower platelet count (184.32 ± 114.57) and plateletcrit (0.27 ± 0.16), but higher Mean platelet volume, platelet distribution width, and platelet distribution width-to-platelet count ratio (p < 0.001). Similarly, those requiring invasive mechanical ventilation had lower platelet count (195.01 ± 125.30) and plateletcrit (0.29 ± 0.16), but higher mean platelet volume and platelet distribution width-to-platelet count ratio (p < 0.001). Platelet count had the highest sensitivity (90.30%) for predicting mortality, while platelet distribution width had the highest specificity (86.7%). The platelet distribution width-to-platelet count ratio showed good sensitivity (77.40%) and specificity (79.20%) at a cutoff of 0.09. Conclusions: Platelet indices are valuable prognostic markers for critically ill children. However, further research with larger sample sizes, multicenter designs, and serial monitoring of platelet indices is needed to validate these findings.