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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Undergraduate & Postgraduate Research

Recent Submissions

Assessment of acute and post-acute stroke rehabilitation practices among nonrehabilitation professionals at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
(2023) Abate, Liben
SUMMARY Background: Stroke is a main cause of obtained disability in adults. In regards to the prevalence, there has been a decline in high income countries and greater than 100% increase in stroke incidence in Low-and middle-income countries (LMIC) during the last four decades. Rehabilitation services are the main mechanism by which purposeful functional recovery are promoted in patients with acute stroke. Primary treating physicians are often the first to face patients with acute stroke and they play a key function in assessing patient's needs, determining their readiness for rehabilitation, and referring them to appropriate rehabilitation centers. Despite the role of physician engagement in stroke rehabilitation, there is limited studies on physician attitudes, knowledge, and practices in this area. Objective: To assess acute and post-acute stroke rehabilitation practices among nonrehabilitation professionals at SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA Methods: cross-sectional study will be conducted and data from physicians working at internal medicine department of SPHMMC during the study period will be collected by well-organized questionnaire focusing their practice about acute and post-acute stroke rehabilitation. Data will be entered to Epi Info 7 for database construction and exported to SPSS version 26. Different statistical analyses will be used including frequencies of variables, descriptive statistics including mean and standard deviation. Associations between dependent and independent variables will be assessed by using binary and multiple logistic regressions. Work plan & Budget: The research is planned to be finalized within 6 months starting from May 01 to October 30/2023 data will be collected, analysis will be done on November , 2023 and the final result will be submitted on January 1/2024. The research will cost a total of 29,411 Ethiopian birr.
Prevalence and associated factors of non-variceal upper gastrointestinal bleeding among Cirrhosis patients on follow up at Gastroenterology and hepatology follow up clinic, St. Paul’s Hospital Millennium Medical College (SPHMMC), from December 2020 to December 2023: A cross-sectional study.
(2024) Mitiku, Mahlet
Abstract Background: Liver cirrhosis is a pathologic entity defined as diffuse hepatic fibrosis with the replacement of the normal liver architecture by nodules. One complication of cirrhosis is upper gastrointestinal bleeding, which could be classified as variceal or non-variceal bleeding. Nonvariceal bleeding is reported in frequency of 24% - 42% and associated with a mortality of around 15%-30% and remains a significant cause of emergency admissions. Understanding the prevalence, and the factors associated with non-variceal bleeding can help in decreasing the incidence as well as improve clinical outcome of patients. Objective: The aim of this study is to assess the prevalence of Non-variceal upper gastrointestinal bleeding and associated factors among cirrhosis patients at gastroenterology and hepatology follow up clinic in SPHMMC, Addis Ababa, Ethiopia. Methods: A Hospital based cross-sectional study was conducted from December, 2020 to December, 2023. A total of 234 patients were taken into study. A structured checklist prepared in English language to collect data was used. The collected data was analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. Mean, standard deviations and percentages were calculated and presented with table. Bivariable and multivariable logistic regression model was used to assess association between dependent and independent variables. Adjusted odds ratio with a 95% confidence interval was used to estimate the strength of association and level of statistical significance was declared at p value <0.05. Results: The prevalence of Non-Variceal Upper Gastrointestinal bleeding (NVUGIB) is 31.6% (95% Confidence Interval 26% - 37.8%). Longer duration of Cirrhosis (p = .03 AOR = 1.01, 95% CI [1.001-1.019], and the presence of comorbid conditions such as Retroviral infection (p < .001, AOR = 51.72, 95% CI [5.65-471.8]) were strong predictors of Non-variceal upper gastrointestinal bleeding, whereas patients with relatively older age (p = .007, AOR = 0.96, 95% CI [0.93-0.99], patients with Hepatitis C virus (p=.009, AOR = .118, 95% CI [.05-.66], and Schistosomiasis (p < .001, AOR = 0.34, 95% CI [0.01-0.19]) as the cause of cirrhosis, patients with prior use of Beta blockers (p = .005, AOR = 0.32, 95% CI [0.14-0.70]), and with higher International Normalized ratio (INR) (p = .014, AOR = 0.57, 95% CI [0.36-0.89], were less x likely to develop Non-variceal upper gastrointestinal bleeding as compared to Variceal bleeding. In addition, patients with Non-variceal Upper gastrointestinal bleeding had a relatively lower Systolic Blood Pressure (SBP) measurements at presentation (p = .010, AOR = 0.97, 95% CI [0.95-0.99], however they had lesser requirement of blood products (p = .009, AOR = 0.25, 95% CI [0.08-0.71]. Conclusion: Non-variceal upper gastrointestinal bleeding is an important cause of morbidity and mortality in patients with cirrhosis. Factors such as a longer duration of cirrhosis, younger age, Prescence of comorbidities such as Retroviral infection are highly associated with development of Non-variceal upper gastrointestinal bleeding, while use of Beta-blockers, relatively higher International Normalized ratio are negatively associated. Methods to screen and identify those at risk and taking preventive measures is recommended in order to minimize its burden. Key words: Cirrhosis, Non-variceal Upper gastrointestinal bleeding in cirrhosis, Upper gastrointestinal bleeding, peptic ulcer 1
CLINICAL CHARACTERISTICS, OUTCOME, AND FACTORS ASSOCIATED WITH MORTALITY IN PATIENTS WITH STATUS EPILEPTICUS AT SELECTED PUBLIC HEALTH HOSPITALS IN ADDIS ABABA, ETHIOPIA
(2024) LEGESSE, MIHIRET
ABSTRACT Background: Status epilepticus is a severe neurological emergency condition characterized by continuous, generalized convulsive seizure lasting for more than 5 minutes or two or more seizures without regaining consciousness. It is frequently associated with high death and morbidity rates. Objective: To assess the clinical profile and in hospital outcome and associated factors of patients with convulsive status epilepticus among patients at St. Paul's Hospital Millennium Medical College, Tikur Anbessa Specialized Hospital and Aabet Hospital in Addis Ababa Ethiopia January 1, 2019 to September 30, 2022. Methods: Retrospective cross-sectional descriptive study was carried out on the medical records of on 224 SE patients admitted to three public hospitals in Addis Ababa during the study period. For data analysis SPSS version 26 was used. Multivariate logistic regression analysis was performed to determine associated factors of poor outcome. The results were presented using tables, graphs and pie chart. All tests with P-Value <0.05 were considered statistically significant. Results: Mean age was 37.8 years with 53.3% females. Pre-existing epilepsy was 34.4%. Major SE etiologies were stroke (20%), antiepileptic drug withdrawal (17.8%), central nervous system infections (13.3%), and brain tumors (12.2%). Over 50% had complications, largely aspiration pneumonia. Case fatality rate was 17.4%. Mortality predictors were HIV/AIDS with CNS complications (AOR 3.50, 95% CI 0.97-18.75), CNS infections (AOR 4.61, 95% CI 0.99-21.33) and having ≥2 complications (AOR 10.50, 95% CI 1.44-76.28). Conclusion: Stroke, infections and drug non-compliance were major SE causes. Case fatality was high, associated with CNS infections and complications. The study highlights that non-communicable diseases like stroke are emerging as major contributors, while preventable causes like treatment non-compliance and infections continue to play a significant role in status epilepticus. Recommendations: Guideline implementation, EEG access, medication compliance promotion, infection control and complication prevention should be prioritized to improve SE outcomes. Further studies on semiology and larger datasets could strengthen evidence
Clinical Characteristics and outcomes of Cryptococcal Meningitis Among ART-naive HIV-AIDS Patients at SPMMC and Zewditu memorial hospital: A Retrospective chart review; Addis Ababa, ETHIOPIA
(2024) Mesele, Bereket
Abstract Background: Cryptococcal Meningitis (CM) is one of the top causes of meningitis in adults in Sub-Saharan Africa (SSA) and other regions with a high prevalence of Human Immunodeficiency Virus (HIV), accounting for over 100,000 incident cases of meningitis per year in the region. It was further estimated that 10–20% of HIV related deaths in Africa are due to CM. Objectives: To assess the clinical charectersitces and treatement outcome of cryptococcal menigitise among ART naïve HIV patient at St. Paul’s Hospital Millennium Medical College and Zewiditu memorial hospital ,Addis Ababa Ethiopia. Methods and material : It is an institutional based retrospective study among new cases of HIVassociated CM who were treated at SPHMMC and Zeweditu memorial hospital ,Addis ababa from January 2018 to December 2022. Data was gathered from HMIS unit, manual registration book and patient’s charts. The collected data was analyzed using SPSS v. 29. Result: A total of 32 patients with CM were studied with female predominance of 53.1% (17).The mean age of patient with CM was 42.09 years (range: 23 and 64 years). The main clinical manifestation was headache and fever account for 81.2% (n=26). No significant difference was found in signs and symptoms between those who died and survived, except for lower GCS at disease onset, which had a significant effect on mortality(p=0.025).. In present study, no statistical difference was detected in the baseline CD 4 count and CSF parameter between survivors and non survivors. Fluconazole was used as monotherapy for all patients except one who used combination therapy with fluconazole and flucytocine. The mortality rate was found to be significantly lower (p-value = 0.027) in patients who had therapeutic lumbar tap. In hospital mortality rate was 34.5%. Conclusions: To reduce deaths and complication of CM, prompt initiation of effective antifungal treatment in line with WHO 2022 treatment guideline is an effective strategy. Keywords: Cryptococcal meningitis, HIV, immunocompromised patient, opportunistic infections
CLINICAL CHARACTERISTICS AND IN HOSPITAL OUTCOME OF ACUTE HEART FAILURE PATIENTS ADMITTED AT MEDICAL WARD, AT SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA.
(2024) TEFERA, TEMESGEN
Abstract Background :Heart failure, a debilitating condition, is increasingly prevalent in developing countries. However, information on how it manifests and responds to treatment in these settings is often scarce. This study addresses this gap by examining the clinical features and in-hospital outcomes of patients admitted with acute heart failure to the internal medicine department of St. Paul's Hospital Millennium Medical College in Addis Ababa, Ethiopia. Methods :This study retrospectively reviewed medical records of 332 patients admitted with acute heart failure at St. Paul's Hospital Millennium Medical College in Addis Ababa, Ethiopia, over a two-year period (September 2010 - September 2015). Data was collected using a standardized form and analyzed using statistical software (SPSS Version 26). Results :Out of the 332 patients, the median age of patients with acute heart failure was 55 years(IQR=38-67) and the median hospital was 12 days (IQR=6-20). The leading precipitating factor and underlying disease at the time of admission were pneumonia (39.2) and ischemic heart disease (23.4), respectively. The in- hospital mortality was found to be 13.8%. IHD (adjusted odd ratio ( AOR) = 9.96 , P = 0.05) , diabetes mellitus (AOR) = 0.78, P = 0.04), shock ( AOR) = 32.5 , P =0.01) and anemia (AOR) = 4.76, P =0.05 ) were predictors of in – hospital mortality. The findings on plural effusion on CXR predicted the prolonged length of stay (B=0.283,P<0.001) and in- hospital respiratory failure was associated with shorter length of stay ( B=-0.151 ,P= 0.005) Conclusion : This study in Ethiopia revealed a concerningly high in-hospital mortality rate of 13.8% among patients admitted with acute heart failure (AHF). Notably, the presence of IHD, diabetes mellitus (DM), anemia, and shock during hospitalization emerged as significant predictors of poor outcomes.