SPHMMC Research Repository

The Institutional Research Repository of St. Paul’s Hospital Millennium Medical College (SPHMMC) serves as a centralized digital archive that preserves and showcases the scholarly output of the college community. It hosts research works produced by current and past members of SPHMMC, including undergraduate and postgraduate students as well as faculty across diverse departments.

By providing open access to theses, dissertations, faculty publications, and collaborative projects, the repository strengthens knowledge sharing, supports academic excellence, and ensures that the contributions of the college’s researchers remain accessible for future learning, innovation, and policy development.

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Recent Submissions

QUALITY OF LIFE AND ASSOCIATED FACTORS AMONG CHRONIC URTICARIA PATIENTS ATTENDING DERMATOLOGY OPD, IN DERMATOVENEREOLOGY TEACHING HOSPITAL, ADDIS ABABA, ETHIOPIA
(2026) KEBEDE, LIDET
Abstract Background: Chronic urticaria is a skin condition that significantly impairs patients’ quality of life, leading to significant physical limitations, psychological distress, and emotional impacts. However, no study has been done assessing its impact on patient’s day to day life in Ethiopia, which may contribute to underestimating the disease burden. This study aims to assess quality of vi life among Chronic urticaria patients, assess the associated factors including disease severity and improve patient outcome. Objective: this study aimed to assess quality of life and associated factors among chronic urticaria follow up patients attending Dermatovenerology outpatient department in Dermatology teaching hospital, Addis Ababa Methods: A hospital-based cross-sectional study was conducted among selected patients with chronic urticaria. A total of 234 study participants were included from two selected dermatology teaching hospitals in Addis Ababa. Study participants were recruited using systematic random sampling technique and selection for study area was carried out using simple random sampling methods. Disease severity was assessed using the Urticaria Activity Score, while quality of life was evaluated using the Dermatology Life Quality Index. Data was collected through face-to face interviews. Median, and Inter Quartile Range (IQR) were used to describe Continuous data; and frequency and percentage were used to describe categorical data. Non-parametric tests were applied to check association. Mann–Whitney U tests were used for binary variables, Kruskal Wallis H tests for variables with more than two groups, and Spearman correlations for continuous variables. Statistical significance was declared at p < 0.05. Finally, the result is presented using table charts and graphs. Result: There was female predominance in this study (59.4%). The median age (IQR) was 35 (28, 46.25) year. Median DLQI was 12 (IQR: 6 -17). Urticaria severity score showed most participants (54.7%) had moderate to severe disease activity. Most participants (65.9 %) had moderate to severe impact on their quality of life. Symptoms and feelings were the most affected domain from DLQI score. Conclusion: This study demonstrates that more than half of study participants with CU have moderate to severe impairment on their QoL, with higher disease severity, longer disease duration and patients who started sedating antihistamine being associated with poorer QoL. Key words: Quality of life, Chronic urticaria, ALERT, Ethiopia
Comparison of intubating conditions with propofol- suxamethonium versus propofol-lidocaine in pediatric patients aged 3 – 16 years old undergoing elective surgery: A randomized, double-blinded controlled trial
(2025) Ayalew, Yibeltal
Abstract Introduction: Suxamethonium, a depolarizing muscle relaxant, offers rapid onset and optimal intubating conditions. However, due to its adverse effects, researchers have sought safer alternatives. Propofol alone provides adequate but suboptimal intubation conditions, while studies suggest that combining intravenous lidocaine with propofol may improve outcomes. Therefor; this study aims to compared tracheal intubation conditions and ease between two regimens: propofol with suxamethonium (PS) versus propofol-lidocaine (PL). Materials and Methods: A prospective, randomized, double-blinded controlled trial was performed after ethical approval from the St. Paul Specialized Hospital institutional review board (IRB). Ninety-two eligible patients (aged 3 - 16 years) was randomized into PS (2 mg/kg propofol + 1.5 mg/kg suxamethonium) or PL (2 mg/kg propofol + 1.5 mg/kg IV lidocaine) groups. Intubating conditions were assessed using a 0–6 scale evaluating jaw relaxation, intubation ease, and reflex response. Scores were categorized as: Good (5–6), Moderate (3–4), and Poor (0–2). Results: this study revealed that 95.7% of the patients in the PS group achieved good intubating conditions and 100% successful intubation. In contrast, the PL group demonstrated moderate intubating conditions in 56.5% and poor conditions in 43.5% of patients. The overall intubation success rate in the PL group was 73.9%, with a 26.1% failure rate. Conclusion: Although propofol and lidocaine can facilitate laryngoscopy and tracheal intubation without suxamethonium, the combination is associated with a significantly lower success rate and less favorable intubating conditions compared to propofol-suxamethonium. Keywords: Endotracheal intubation, Propofol, Lidocaine, Suxamethonium, Opioids, Ethiopia
PREVALENCE AND ASSOCIATED FACTORS WITH THE DEVELOPMENT OF PRESSURE ULCER IN ADULT INTENSIVE CARE AND HIGH DEPENDENCY UNIT AT SAINT PAUL`S HOSPITAL MILLENIUM MEDICAL COLLEGE
(2026) DENDIR, YOHANNES
Abstract Background: Pressure ulcer is a localized area of damage to the skin and/or underlying tissue, usually over a bony prominence, resulting from sustained pressure or pressure in combination with shear, as defined by the European Pressure Ulcer Advisory Panel (EPUAP). It is a largely preventable but serious health problem in both acute and chronic healthcare settings. Pressure ulcers impose a significant burden on patients, caregivers, and healthcare systems by increasing morbidity, mortality, length of hospital stay, and healthcare costs. Although pressure ulcer development is considered an indicator of quality of care, concerns remain regarding circumstances in which they may be unavoidable. Understanding the magnitude of the problem and identifying associated risk factors are essential for effective prevention. Objective: the prevalence and associated risk factors for the development of pressure ulcers at critical care settings (intensive care units and high dependency units) of Saint Paul's Hospital Millennium Medical College was assessed. Methods: An institution-based cross-sectional study was conducted at Saint Paul’s Hospital Millennium Medical College from September 2025 to January 2026. Data was collected using an interviewer-administered structured questionnaire and observational checklist. Data has been entered into and analyzed using appropriate statistical software. Binary logistic regression analysis was performed to identify factors associated with pressure ulcer development. Variables with a p value ≤ 0.25 in the bi-variable analysis were entered into multivariate logistic regression. Variables with a p-value < 0.05 at a 95% confidence interval is considered statistically significant. The Findings are presented using text, tables, and graphs. Results: The prevalence of pressure ulcers was 12.5% (28/224; 95% CI: 8.5–17.6%), with the sacra l area being the most commonly affected site (10.3%). Grade 1 ulcers were most frequent (6.3%). Independent predictors of pressure ulcer development included smoking (AOR = 202.96, 95% CI: 4.70–8764.32, p = 0.006), incontinence (AOR = 0.001, 95% CI: 0.000–0.22, p = 0.012), repositioning every 4 hours compared to every 2 hours (AOR = 110.29, 95% CI: 3.14–3874.07, p = 0.010), impaired level of consciousness (AOR = 0.27, 95% CI: 0.12–0.61, p = 0.002), and longer hospital stay (AOR = 2.67 per day, 95% CI: 1.61–4.43, p < 0.001). Age, BMI, sex, and Branden risk levels showed marginal associations but were not statistically significant after adjustment. The multivariate model showed excellent fit (Hosmer-Lemeshow χ² = 0.721, Df = 8, p = 0.999) and classified 96.9% of cases correctly. Conclusion: Pressure ulcers remain a significant concern among hospitalized patients at Saint Paul’s Hospital. Major risk factors included smoking, incontinence, less frequent repositioning, impaired consciousness, and prolonged hospitalization. Preventive strategies, including early risk assessment, frequent repositioning, and careful monitoring of high-risk patients, are essential to reduce the burden of pressure ulcers in hospital settings. Keywords: Pressure ulcer, prevalence, risk factors, cross-sectional study, quality of care
The Impact of a Pre-anesthesia Clinic on Operating Room Utilization, Patient Safety Outcomes and Patient Satisfaction: A Prospective Cohort Study in Two Tertiary Hospitals in Addis Ababa, Ethiopia
(2026) Jemal, Hayat
Abstract Background: In Ethiopia, high surgical cancellation rates, prolonged operating room (OR) times and frequent perioperative complications are common. Inadequate preoperative assessments, undiagnosed comorbidities and systemic issues are the main drivers of these challenges. However, there is no local data on the implementation of preanesthesia clinic (PAC) on operating room utilization, patient safety outcomes and Patient Satisfaction in Ethiopia. Objective: To evaluate the impact of a PAC on OR utilization, patient safety outcomes and Patient Satisfaction among adult elective surgical patients at St. Paul’s Hospital Millennium Medical College (with PAC) compared to Addis Ababa Burn, Emergency, and Trauma Hospital (without PAC). Methods: This prospective cohort study compared adult patients undergoing moderate to complexity elective surgery (lasting 45 – 240 minutes under general/regional anesthesia) at SPHMMC and AaBET. A sample of 544 patients (272 per hospital) was calculated to detect differences in day of surgery cancellation rate, anesthesia controlled time and perioperative complication rate and patient satisfaction between AaBET and SPHMMC with 80% power, 5% significance, and 10% attrition. Consecutive sampling was used to enroll patients and data collected through operating room time log or cancelations, medical record review for complications, and structured patient interviews using a validated preoperative patient satisfaction questionnaire adapted to the local contex.. Multivariable regression analysis was used to adjust for differences in department case mix and patient characteristics. Results: The day of surgery cancellation was lower at SPHMMC (11.8%) compared to AaBET (16.5%). After multivariable adjustment, this difference was not statistically significant (AOR = 0.94; 95% CI: 0.25 to 3.54; p = 0.921), with the wide confidence interval reflecting residual confounding and limited precision. Mean anesthesia controlled time was 12.48 minutes at SPHMMC compared to 12.69 minutes at AaBET, with no significant association in multivariable analysis (β = 0.352; 95% CI: −0.568 to 1.272; p = 0.452). Perioperative complications assessed during the first 3 days after surgery (while patients are still hospitalized) occurred in 1.3% of patients at SPHMMC and 0.9% at AaBET, a difference that was not statistically significant (RR = 1.42; 95% CI: 0.24–8.60; p = 1.00, Fishers exact test) with complete follow up. Patient satisfaction scores were nearly similar between groups (3.30 vs 3.28), but PAC attendance was not associated with patient satisfaction (β = −0.043; 95% CI: −0.436 to 0.349; p = 0.829). Conclusion: The presence of a preanesthesia clinic was not independently associated with improved operating room efficiency, perioperative safety, or patient satisfaction in this study. These findings suggesting further large scale studies to confirm the finding. Keywords: Preanesthesia clinic, Operating room efficiency, Perioperative complications, cancellation, Ethiopia
Knowledge, Attitude, and Practice of Regional Anesthesia among Anesthesiology Residents in Government Teaching Referral Hospitals in Addis Ababa
(2026) Shewalem, Habtamu
Abstract Background: Studies have highlighted that regional anesthesia (RA) is associated with better pain control, fewer side effects, and improved patient satisfaction compared to general anesthesia. However, the knowledge, attitudes, and practices of anesthesiology residents towards regional anesthesia in Ethiopian teaching hospitals have not been studied. Objective: To assess the knowledge, attitude, and practice of regional anesthesia among anesthesiology residents in government teaching referral hospitals in Addis Ababa, Ethiopia. Methods: An institution-based descriptive cross-sectional study was conducted from October 2025 to December 2025. A structured, self-administered questionnaire was distributed to 130 anesthesiology residents. Data were collected using Google Forms and exported to SPSS version 27 for further analysis. Descriptive statistics such as mean, standard deviation, frequency, and percentage were computed and presented using tables and figures. Result: The study revealed that the majority of the residents had moderate knowledge (58.5%), followed by very good knowledge (33.8%), good knowledge (6.9%) and only 0.8% had very poor knowledge of regional anesthesia. Moreover, 51.5% of residents did not receive lectures on RA during their residency, and 76.9% did not receive hands-on training. Similarly, 51.5% had very good attitude, 26.9% had good attitude, 19% had medium attitude, and only 2% had a poor attitude toward RA. The results showed that 94.6% had practiced RA, whereas only 5.4% did not practice it. Conclusion: Overall, while the majority of anesthesiology residents in Addis Ababa’s government teaching referral hospitals exhibit moderate to very good knowledge, positive attitudes, and engagement in RA practice, there are notable gaps in specific knowledge and practice areas. Addressing these gaps through enhanced training programs and mentorship is essential to ensure residents are well-prepared to provide safe and effective RA in their future practice. Keywords: KAP, regional anesthesia, Anesthesiology residents, Addis Ababa