BACKGROUND: HeartFailure (HF) is a progressive clinical and pathophysiological syndrome caused by cardiovascular and noncardiovascular abnormalities. Childhood HF has not been well studied in Sub-Sharan Africa, particularly in Ethiopia. Hence, this study aimed at describing the pattern and outcome of pediatrics HF at a referral-teaching hospital.METHODS: Medical records of 216 HFchildren aged 2months to 14 years, and admitted between January 2014 and January 2016 were reviewed. Clinical information was collected, analyzed and presented in tables and pie charts.RESULTS: A total of 2000 children were admitted to Hawassa University Hospital during the study period. HF accounted for 10.8% (216) of pediatrics admissions, 51.9% males. The median age of the study subjects was 6years. Functionally, NYHA/Ross class III and IV consisted 65(30.1%) and 139(64.4%) of HF. Structural heart diseasewas the commonest cause of HF, 144(66.7%): Rheumatic heart disease (RHD),75(52%), and congenital heart disease (CHD),64(44.5%). Anemia and renal cases contributed to 50(23.1) and 12(5.6%) of HF.CHD was predominantly documented in <5years. Pneumonia 66(42.9%), and infective endocarditis 29(18.8%) were the common precipitating/comorbid conditions with HF.Thecase fatality rate of HF was 13.9 %( 30).CONCLUSION: In this study, HF accounted for a tenth of pediatrics admissions. Structural heart disease was the commonest cause of heart failure. CHD and RHD affected predominantly children of <5years of age and >5 years of age. Echocardiographic screening of HF cases for structural heart disease and optimal care for patients with underlying structural heart disease are recommended.

Background: Neonatal hip septic arthritis is one of the rarest clinical conditions epidemiologically but with momentous long-term sequelae. Early detection and proper intervention have a paramount role in alleviating the shattering long-term effects. The clinical presentation of neonatal hip septic arthritis is very non-specific, with limited movement of the extremities and excessive crying during manipulations such as diaper changing. Our case was a 17-day-old male newborn who presented to our hospital after a family noticed decreased left leg movement and crying while changing diapers for 5 days, with the associated complaint of holding the left leg in a flexed position. The newborn then underwent all the available investigations and the diagnosis of hip septic arthritis was made. We were stunned by the culture result, which isolated Klebsiella pneumonia from the sample that had been taken from joint fluid, which is a very unusual isolate. Conclusion:Hip septic arthritis is an orthopedic emergency, especially in neonates. It should be considered in newborns presenting with pseudoparalysis as the presentation is nonspecific. Considering a less common microorganism with culture and sensitivity is very important, especially if the response to treatment is delayed. We endorse proper workup and timely intervention as hip arthritis has a poor prognosis when the management is delayed.