Publications by authors named "Ajay S Koti"

Objective: Subconjunctival hemorrhages (SCHs) are uncommon injuries in young children beyond the neonatal period and have been associated with abuse. In otherwise well infants, they are sometimes attributed to commonly observed symptoms that invoke Valsalva maneuvers, such as cough, vomiting, and constipation. Our study aims to ascertain the prevalence of SCH among children presenting to emergency care with cough, vomiting, and constipation.

View Article and Find Full Text PDF

Child physical abuse is a common cause of pediatric morbidity and mortality. Up to half of all children presenting with abusive injuries have a history of a prior suspicious injury, suggesting a pattern of repeated physical abuse. Medical providers are responsible for identifying children with suspicious injuries, completing mandated reporting to child protective services for investigation, and screening for occult injuries and underlying medical conditions that can predispose to injuries.

View Article and Find Full Text PDF
Article Synopsis
  • Despite being a recognized subspecialty for 15 years, child abuse pediatrics lacks proper resources for board exam preparation.
  • This project aimed to create a reliable multiple-choice question bank to help trainees study for their board exams, validated through various methods including statistical analyses.
  • The resulting question bank was tested by over 80 participants, with high scores indicating its effectiveness, making it the first of its kind with a thorough validity assessment for child abuse pediatrics.
View Article and Find Full Text PDF

Subdural hemorrhages (SDHs) in children are most often observed in abusive head trauma (AHT), a distinct form of traumatic brain injury, but they may occur in other conditions as well, typically with clear signs and symptoms of an alternative diagnosis. We present a case of an infant whose SDH initially raised the question of AHT, but multidisciplinary evaluation identified multiple abnormalities, including rash, macrocephaly, growth failure, and elevated inflammatory markers, which were all atypical for trauma. These, along with significant cerebral atrophy, ventriculomegaly, and an absence of other injuries, raised concerns for a genetic disorder, prompting genetic consultation.

View Article and Find Full Text PDF

Objective: Mandible fractures are uncommon injuries in infants and young children and may raise concern for nonaccidental trauma. Our study describes several children with mandible fractures to identify features that might differentiate abuse from accident.

Methods: Records and imaging were reviewed for children aged 24 months and younger who were diagnosed with mandible fractures at 2 tertiary pediatric care centers.

View Article and Find Full Text PDF

Purpose: To assess the frequency and nature of occult injury screening in infants with subconjunctival hemorrhages (SCH), the incidence of occult injuries in these children, and the factors that may have influenced the decision to screen for additional injury.

Methods: Infants aged 14 days to 6 months with SCH who presented to two tertiary pediatric centers were identified from a local database (N = 84). A retrospective chart review collected demographics, examination findings, and imaging results.

View Article and Find Full Text PDF