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

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PREDICTORS OF SHORT-TERM FUNCTIONAL OUTCOMES OF STROKE PATIENTS ADMITTED TO St. PAUL HOSPITAL MILLENNIUM MEDICAL COLLEGE
(2024) KEDIR, MOHAMMED
Abstract Background: All elements of health-related quality of life are impacted by stroke, but the physical, cognitive, and psycho-emotional spheres of life are severely affected. The most frequent neurologic complication found in stroke survivors is hemiparesis, which is a motor disability. The functional outcome of stroke patients is effectively measured by activities of daily life using measures like functional independent measure(FIM) score. Objective: The aim of this study is to assess predictors short-term functional outcomes in stroke patients admitted to Saint Paul’s Millennium Medical College. Methods: A prospective cohort study was conducted at St. Paul’s Millennium Medical College. By including all admitted patients who fulfilled the eligibility criteria until the preplanned sample size was achieved, seventy-six patients were included in the study from May 1, 2023, to October 30, 2023. Patients were classified based on their enrollment in physiotherapy care. The functional recovery at the third week from stroke onset was taken as an outcome variable to analyze between the groups. Bivariate and multivariate analyses were conducted using the chisquare test, independent sample t-test, and biniary logistic regression to determine the associations among variables. A p value less than 0.05 was taken to indicate the significance of the association between variables. Result: Thirty patients (39.5%) were enrolled in physiotherapy care. Enrollment in physiotherapy care was shown to have a significant positive association with short-term functional recovery with P = 0.006, OR = 5.361, 95% CI (4.499–10.745). The intensity of the physiotherapy session, as measured by the total physiotherapy hour, also had a significant positive association with short-term functional recovery. Age, presence of comorbidities, development of in-hospital complications, and intensity of physiotherapy had a significant negative association with short-term functional outcomes. Conclusion: Enrollment in physiotherapy care has been shown to bring better short-term functional recovery. Physiotherapy care should be included as a part of routine post-stroke management for all patients. Key words: Stroke, Functional outcome, Physiotherapy, Ethiopia
Assessment of the magnitude of non-valvular atrial fibrillation and associated factors among hypertensive patients at Saint Paul’s Hospital Millenium Medical College Cardiac Referral clinic, Addis Ababa, Ethiopia.
(2024) Wondim, Mehariw
Abstract Background: Atrial fibrillation is the most common clinically relevant arrythmia treated globally which is characterized by disorganized and ineffective atrial contraction. It is associated thromboembolic complications and HF which leads to increase risk of mortality and morbidity Atrial fibrillation accounts for 20-30% of ischemic stroke and 10% of cryptogenic stroke and increase mortality by 1.5 to 1.9 times from the general population. Hypertension is one independent risk factor associated with atrial fibrillation. Objectives: The main objective of this study was to assess the magnitude of non-valvular atrial fibrillation and associated factors among hypertensive patients. Method: An institution based cross-sectional study was conducted on 201 hypertensive patients at Saint Paul’s Hospital Millenium Medical college cardiac referral clinic. Study participants were selected by a systematic random sampling method. Interviewer administered structured questionnaire was used for data collection. Data entry and analysis was done by EPI DATA version 7 and SPSS version 26.0 respectively. Means, standard deviations, and percentages was computed for descriptive analysis and multivariate logistic regression analysis performed to determine factors associated with atrial fibrillation. Variable relationships are significant at a P value <0.05. Result: This study was done on 201 hypertensive patients with age range of 26-91 years and mean age of 56.38 years, among which 118 (58.9%) were females. The prevalence of nonvalvular atrial fibrillation was 12.9%. Age ≥ 50years (AOR=8.6, 95%CI2.74, 26.91), LVH (moderate and severe) (AOR=4.74, 95% CI: 1.32, 16.94), having diabetes mellitus (AOR: 8.23, 95% CI (2.75, 24.61) and having dyslipidemia (AOR=3.84, 95% CI: 1.40, 10.53) were significantly associated with non-valvular atrial fibrillation. Conclusion and recommendation: Non-valvular atrial fibrillation is common and found in more than one-tenth hypertensive population. Age ≥50 years, hypertensive heart disease, DM and dyslipidemia are particularly at high risk of non-valvular atrial fibrillation which need a clinician’s special attention for early diagnosis and management. Key word: atrial fibrillation, hypertension, Electrocardiogram
PREVALENCE AND ASSOCIATED FACTORS OF NON-ALCOHOLIC FATTY LIVER DISEASE IN PATIENTS WHO HAVE FOLLOW-UP AT THE ADULT GASTROENTEROLOGY AND HEPATOLOGY CLINIC AT ST. PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA: A HOSPITAL-BASED CROSS-SECTIONAL STUDY
(2024) WAGAYEHU, AKALEWOLD
Abstract Introduction: Non-alcoholic fatty liver disease is one of the leading causes of chronic liver disease worldwide. In developing countries trends indicate an increasing prevalence of NAFLD along with other non-communicable diseases. The increase in prevalence is closely associated to increasing prevalence of metabolic syndrome and associated co-morbidities. Objective: The study aimed to estimate the prevalence and associated factors of NAFLD in patients who have follow up at adult Gastroenterology/Hepatology clinic at SPHMMC Methodology: A hospital based Cross-sectional study design was used and data collected on patients attending adult GI/Hepatology clinic from October 1, 2023, to January 25, 2024. Data collected with structured data extraction tools from patients and their medical record. A total of 463 eligible patients who attended the GI/Hepatology clinic during the study period were included. Data was entered to Microsoft Excel for database construction and exported to SPSS version 20 software packages for analysis. Descriptive statistics were done and asso-ciations between dependent and independent variables was assessed by using binary and mul-tiple logistic regressions. Results: Prevalence of NAFLD was found to be 7.1% (95%CI: 5.0%-9.9%). Central obesity (Very high-risk group (AOR=13.525, 95%CI:2.475-73.914), High risk group (AOR=5.045, 95%CI:1.087-23.416), diabetes mellitus (AOR=4.455,95%CI: 1.683-11.793) and hyperten-sion (AOR=4.942, 95%CI:1.826-13.375) were found to be significantly associated with NAFLD. Among cases with NAFLD, only 56.7% were on follow-up at GI/Hepatology clinic for a primary diagnosis of NAFLD. NAFLD was found documented in the medical record as a diagnosis in 60.6% of cases. Conclusion: In this study prevalence of NAFLD was low compared to reported rates in other hospital-based studies. Central obesity, diabetes and hypertension were strongly associated with NAFLD. Thus, stakeholders need to create awareness about the higher prevalence of NAFLD among obese, diabetes and hypertensive patients. Further study is needed to know the nationwide prevalence of NAFLD. Keywords: NAFLD, Prevalence, Associated factors, Ethiopia
ASSESMENT OF THE ASSOCIATION OF KIDNEY FUNCTION WORSENING AND DIABETIC RETINOPATHY SEVERITY IN PATIENTS ON FOLLOW UP, AT SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA.
(2024) TIBEBU, AMARE
SUMMARY Background: Diabetic nephropathy (DN) and diabetic retinopathy (DR) are both complications of diabetic microangiopathy with similar pathogenesis and clinical relevance. Many literatures have shown the clear association of creatinine and eGFR worsening with presence and severity of retinopathy. There is paucity of evidence if this holds true in African setting and more in Ethiopia Objective: To assess the association of serum creation and estimated GFR worsening with diabetic retinopathy severity among type 2 DM patients on follow up at adult Endocrine, Nephrology and ophthalmology clinic, of St Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: An Institution based cross-sectional study was conducted through chart review among type 2 DM with diabetic retinopathy patients attending adult Endocrine, nephrology and ophthalmology clinic of Saint Paul’s Hospital Millennium Medical College. A total of 384 patients were planned and 365 participants were involved making a response rate of 95.1%. Data were collected by structured questionnaire focusing on serum creation value and documented diabetic retinopathy severity by chart reviewing. Data was entered and analyzed using SPSS version 26. The result was explained using frequencies of variables, descriptive statistics including mean and standard deviation. Associations between dependent and independent variables were assessed by using binary and multiple logistic regressions using 95%CI and a p-value <0.05 at multivariate logistic regression stated as statistically significant. Result: - In this study 41.9% of the study participants had proliferative stage of diabetic retinopathy. On the other had the multivariate logistic regression revealed that male (AOR=2.9, 1.41, 6.01), unstable creatinine (AOR=3.5, 95%CI=1.97, 12.53) and estimated GFR <60 (AOR=29.9, 95%CI=14.38, 62.1) were a significant relation with diabetic retinopathy. Conclusion and recommendation: - serum creation and estimated glomerular filtration rate worsening were a significant association with progression of diabetic retinopathy. This study showed clear/no association between Cr and GFR worsening and severity of DR. it is good to screen for severity of diabetic retinal change just because of Cr and GFR worsening.
Prevalence and Factors Associated with Renal Impairment Among Adult HIV Infected Patients who Have Follow Up in St. Paul’s and St. Peter Specialized Hospital ART Clinics, Addis Ababa, Ethiopia
(2024) Ademe, Animut
Abstract Background: It is almost four decades since Human Immune deficiency Virus (HIV) has become global issue of public health importance; a lot has changed about the disease since then. The occurrence of renal impairment in HIV infected individuals shown to be associated with both increased morbidity and mortality of the infected individuals. Due to which, finding the common causes of renal impairment in HIV infected individuals has paramount importance. Objective: To assess the prevalence of renal impairment and its associated factors among adult HIV infected patients in St. Paul’s and St. Peter Specialized Hospitals, Addis Ababa, Ethiopia,2023. Methods: A cross-sectional study was conducted from April to May 2023 in ART clinics in St. Paul’s and St. Peter Specialized Hospitals. The study participants were selected using a simple random sampling technique. Data was collected from patients’ medical chart review using check lists by nurses and physicians. Data was entered to Epi Info 7 for database construction and exported to SPSS version 26 for analysis. Different statistical analyses was done to describe variables. Bi-variable and multi-variable binary logistic regression used to assess associations between dependent and independent variable using 95% CI and AOR P<0.05. Result: A total of 262 patient records were included with the response rate of 100% and two-third 173(66%) were females. The mean age was 39.75 ±11 years and ranged from 18-70 years. The prevalence of renal impairment was 13.4% (95%CI, 9.9, and 17.6). Female gender (AOR: 3.91%, 95% CI. 1.41, 10.82), poor adherence (AOR: 13.14, 95% CI 3.36, 51.42), CD4 <200 cells/m3 (AOR: 5.81, 95% CI, 2.20, 15.28), baseline viral load ≥1000copies/ml,), were factors significantly associated with renal impairment. Conclusion: In this study, the prevalence of renal impairment among PLWHIV on ART is high. Female gender, poor adherence, baseline CD4 <200 cells/m3 and baseline viral load ≥1000copies/ml are significantly associated with renal impairment. Key words: Renal impairment, HIV positive, ART, St. Paul’s, St. Peter, Hospital, Addis Ababa