NIRUDAK dehydration score (Barry)

NIRUDAK

Sum seven caller-assigned Barry 2021 NIRUDAK Table 2 items and return the published total (max 13) and dehydration band (no, some, or severe).

LIVE $0.005 USDC GET /api/calc/nirudak

Markdown: /docs/nirudak.md · Canonical: https://magentlab.com/docs/nirudak

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Sum seven caller-assigned Barry 2021 NIRUDAK Table 2 items and return the published total (max 13) and dehydration band (no, some, or severe).

When to use

When an agent has already assigned Barry 2021 Table 2 age, sex, eye level, radial pulse, respirations, skin pinch, and 24-hour vomiting and needs the published integer NIRUDAK total and band, not WHO IMCI/IMAI, the DHAKA child score, PLOS logistic models, or a fluids order.

When not to use

Not a medical device. Not a WHO IMCI or IMAI algorithm. Not the Levine 2015 DHAKA score. Not PLOS logistic models.
Each clinical sign is caller-assigned. magent does not examine the patient or order fluids.
Age is an integer from 5 to 120 (Barry 2021 NIRUDAK; not the adult 18–120 clamp).
Table 2 integer score only (max 13). Bands: no_dehydration 0–3, some_dehydration 4–6, severe_dehydration 7–13. Skin pinch reference is rapid, not DHAKA normal.

Formula

NIRUDAK = age (>59 0, 20-59 1, <20 2) + sex (female 0, male 1) + eye_level (normal 0, sunken 1) + radial_pulse (strong 0, decreased 1, absent 2) + respirations (normal 0, deep 1) + skin_pinch (rapid 0, slow 2, very_slow 4) + vomiting_episodes_24h (lt_1 0, 1_to_10 1, gt_10 2); Barry 2021 Table 2; max 13

Citation

Title: Derivation and Internal Validation of a Score to Predict Dehydration Severity in Patients over 5 Years with Acute Diarrhea
Authors: Barry MA, Garbern SC, Lee JA, Qu K, Gainey M, Schmid CH, Nasrin S, Alam NH, Nelson EJ, Rosen RK, Levine AC
Source: Am J Trop Med Hyg. 2021;105(5):1368-1375
DOI: 10.4269/ajtmh.21-0143

Worked example

All-reference elderly female

Given: age=70eye_level=normalradial_pulse=strongrespirations=normalsex=femaleskin_pinch=rapidvomiting_episodes_24h=lt_1

age 70 >59 0 + female 0 + eyes normal 0 + pulse strong 0 + respirations normal 0 + pinch rapid 0 + vomiting lt_1 0
Score = 0 (max 13); nirudak_band no_dehydration

Very slow skin pinch only

Given: age=70eye_level=normalradial_pulse=strongrespirations=normalsex=femaleskin_pinch=very_slowvomiting_episodes_24h=lt_1

skin_pinch very_slow 4; other items 0
Score = 4 (max 13); nirudak_band some_dehydration

Maximum Table 2 score

Given: age=10eye_level=sunkenradial_pulse=absentrespirations=deepsex=maleskin_pinch=very_slowvomiting_episodes_24h=gt_10

age <20 2 + male 1 + sunken 1 + absent 2 + deep 1 + very_slow 4 + gt_10 2
Score = 13 (max 13); nirudak_band severe_dehydration

Also searched as

nirudak score
NIRUDAK Table 2
Barry dehydration score
acute diarrhea dehydration
over 5 years dehydration
sunken eyes dehydration
skin pinch dehydration
NIRUDAK integer score

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/nirudak?age=70&sex=female&eye_level=normal&radial_pulse=strong&respirations=normal&skin_pinch=rapid&vomiting_episodes_24h=lt_1

Full URL: https://api.magentlab.com/api/calc/nirudak?age=70&sex=female&eye_level=normal&radial_pulse=strong&respirations=normal&skin_pinch=rapid&vomiting_episodes_24h=lt_1

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/nirudak?age=70&sex=female&eye_level=normal&radial_pulse=strong&respirations=normal&skin_pinch=rapid&vomiting_episodes_24h=lt_1"

Parameters

Name	Type	Required	Description
`age`	integer	required	Age in years, integer 5–120. Barry 2021 Table 2: >59 scores 0, 20–59 scores 1, <20 scores 2. Not the adult 18–120 clamp.
`sex`	string	required · female, male	female (0) or male (1) (Barry 2021 Table 2).
`eye_level`	string	required · normal, sunken	Caller-assigned Barry 2021 Table 2 eye level: normal (0) or sunken (1). magent does not examine the patient.
`radial_pulse`	string	required · strong, decreased, absent	Caller-assigned Barry 2021 Table 2 radial pulse: strong (0), decreased (1), or absent (2). magent does not examine the patient.
`respirations`	string	required · normal, deep	Caller-assigned Barry 2021 Table 2 respirations: normal (0) or deep (1). Deep scores 1, not DHAKA Table 3's 2. magent does not examine the patient.
`skin_pinch`	string	required · rapid, slow, very_slow	Caller-assigned Barry 2021 Table 2 skin pinch: rapid (0), slow (2), or very_slow (4). Reference is rapid, not DHAKA normal. magent does not examine the patient.
`vomiting_episodes_24h`	string	required · lt_1, 1_to_10, gt_10	Caller-assigned Barry 2021 Table 2 vomiting episodes in 24 hours: lt_1 (0; <1), 1_to_10 (1), or gt_10 (2; >10).

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/nirudak Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

1 to 25 items. Each item uses the same keys as the GET query parameters.
POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "age": "70",
      "eye_level": "normal",
      "radial_pulse": "strong",
      "respirations": "normal",
      "sex": "female",
      "skin_pinch": "rapid",
      "vomiting_episodes_24h": "lt_1"
    },
    {
      "age": "70",
      "eye_level": "normal",
      "radial_pulse": "strong",
      "respirations": "normal",
      "sex": "female",
      "skin_pinch": "rapid",
      "vomiting_episodes_24h": "lt_1"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/nirudak",
  "items": [
    {
      "components": [
        {
          "value": 70,
          "factor": "age",
          "points": 0,
          "present": true
        },
        {
          "value": "female",
          "factor": "sex",
          "points": 0,
          "present": true
        },
        {
          "value": "normal",
          "factor": "eye_level",
          "points": 0,
          "present": true
        },
        {
          "value": "strong",
          "factor": "radial_pulse",
          "points": 0,
          "present": true
        },
        {
          "value": "normal",
          "factor": "respirations",
          "points": 0,
          "present": true
        },
        {
          "value": "rapid",
          "factor": "skin_pinch",
          "points": 0,
          "present": true
        },
        {
          "value": "lt_1",
          "factor": "vomiting_episodes_24h",
          "points": 0,
          "present": true
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Barry MA, Garbern SC, Lee JA, Qu K, Gainey M, Schmid CH, Nasrin S, Alam NH, Nelson EJ, Rosen RK, Levine AC",
        "doi": "10.4269/ajtmh.21-0143",
        "id": "barry-2021",
        "pmid": "34398821",
        "source": "Am J Trop Med Hyg. 2021;105(5):1368-1375",
        "title": "Derivation and Internal Validation of a Score to Predict Dehydration Severity in Patients over 5 Years with Acute Diarrhea"
      },
      "formula": "nirudak",
      "formula_expression": "NIRUDAK = age (>59 0, 20-59 1, <20 2) + sex (female 0, male 1) + eye_level (normal 0, sunken 1) + radial_pulse (strong 0, decreased 1, absent 2) + respirations (normal 0, deep 1) + skin_pinch (rapid 0, slow 2, very_slow 4) + vomiting_episodes_24h (lt_1 0, 1_to_10 1, gt_10 2); Barry 2021 Table 2; max 13",
      "max_score": 13,
      "score": 0,
      "age_years": 70,
      "sex": "female",
      "respirations": "normal",
      "skin_pinch": "rapid",
      "eye_level": "normal",
      "nirudak_band": "no_dehydration",
      "radial_pulse": "strong",
      "vomiting_episodes_24h": "lt_1"
    },
    {
      "components": [
        {
          "value": 70,
          "factor": "age",
          "points": 0,
          "present": true
        },
        {
          "value": "female",
          "factor": "sex",
          "points": 0,
          "present": true
        },
        {
          "value": "normal",
          "factor": "eye_level",
          "points": 0,
          "present": true
        },
        {
          "value": "strong",
          "factor": "radial_pulse",
          "points": 0,
          "present": true
        },
        {
          "value": "normal",
          "factor": "respirations",
          "points": 0,
          "present": true
        },
        {
          "value": "rapid",
          "factor": "skin_pinch",
          "points": 0,
          "present": true
        },
        {
          "value": "lt_1",
          "factor": "vomiting_episodes_24h",
          "points": 0,
          "present": true
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Barry MA, Garbern SC, Lee JA, Qu K, Gainey M, Schmid CH, Nasrin S, Alam NH, Nelson EJ, Rosen RK, Levine AC",
        "doi": "10.4269/ajtmh.21-0143",
        "id": "barry-2021",
        "pmid": "34398821",
        "source": "Am J Trop Med Hyg. 2021;105(5):1368-1375",
        "title": "Derivation and Internal Validation of a Score to Predict Dehydration Severity in Patients over 5 Years with Acute Diarrhea"
      },
      "formula": "nirudak",
      "formula_expression": "NIRUDAK = age (>59 0, 20-59 1, <20 2) + sex (female 0, male 1) + eye_level (normal 0, sunken 1) + radial_pulse (strong 0, decreased 1, absent 2) + respirations (normal 0, deep 1) + skin_pinch (rapid 0, slow 2, very_slow 4) + vomiting_episodes_24h (lt_1 0, 1_to_10 1, gt_10 2); Barry 2021 Table 2; max 13",
      "max_score": 13,
      "score": 0,
      "age_years": 70,
      "sex": "female",
      "respirations": "normal",
      "skin_pinch": "rapid",
      "eye_level": "normal",
      "nirudak_band": "no_dehydration",
      "radial_pulse": "strong",
      "vomiting_episodes_24h": "lt_1"
    }
  ]
}

Response

Field	Type	Description
`formula`	string	nirudak
`formula_expression`	string	Exact expression used
`score`	integer	NIRUDAK Table 2 points 0-13
`max_score`	integer	Always 13
`nirudak_band`	string	Barry 2021 Table 2 category: no_dehydration (0-3), some_dehydration (4-6), or severe_dehydration (7-13). A score band, not a fluids order and not WHO IMCI/IMAI.
`age_years`	integer	Age in years used for the >59 / 20–59 / <20 split
`sex`	string	female or male
`eye_level`	string	Caller-assigned token used: normal or sunken
`radial_pulse`	string	Caller-assigned token used: strong, decreased, or absent
`respirations`	string	Caller-assigned token used: normal or deep
`skin_pinch`	string	Caller-assigned token used: rapid, slow, or very_slow
`vomiting_episodes_24h`	string	Caller-assigned token used: lt_1, 1_to_10, or gt_10
`components`	array	Per-item caller-assigned points
`citation`	object	Barry et al. Am J Trop Med Hyg 2021 citation
`disclaimer`	string	Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "components": [
    {
      "value": 70,
      "factor": "age",
      "points": 0,
      "present": true
    },
    {
      "value": "female",
      "factor": "sex",
      "points": 0,
      "present": true
    },
    {
      "value": "normal",
      "factor": "eye_level",
      "points": 0,
      "present": true
    },
    {
      "value": "strong",
      "factor": "radial_pulse",
      "points": 0,
      "present": true
    },
    {
      "value": "normal",
      "factor": "respirations",
      "points": 0,
      "present": true
    },
    {
      "value": "rapid",
      "factor": "skin_pinch",
      "points": 0,
      "present": true
    },
    {
      "value": "lt_1",
      "factor": "vomiting_episodes_24h",
      "points": 0,
      "present": true
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Barry MA, Garbern SC, Lee JA, Qu K, Gainey M, Schmid CH, Nasrin S, Alam NH, Nelson EJ, Rosen RK, Levine AC",
    "doi": "10.4269/ajtmh.21-0143",
    "id": "barry-2021",
    "pmid": "34398821",
    "source": "Am J Trop Med Hyg. 2021;105(5):1368-1375",
    "title": "Derivation and Internal Validation of a Score to Predict Dehydration Severity in Patients over 5 Years with Acute Diarrhea"
  },
  "formula": "nirudak",
  "formula_expression": "NIRUDAK = age (>59 0, 20-59 1, <20 2) + sex (female 0, male 1) + eye_level (normal 0, sunken 1) + radial_pulse (strong 0, decreased 1, absent 2) + respirations (normal 0, deep 1) + skin_pinch (rapid 0, slow 2, very_slow 4) + vomiting_episodes_24h (lt_1 0, 1_to_10 1, gt_10 2); Barry 2021 Table 2; max 13",
  "max_score": 13,
  "score": 0,
  "age_years": 70,
  "sex": "female",
  "respirations": "normal",
  "skin_pinch": "rapid",
  "eye_level": "normal",
  "nirudak_band": "no_dehydration",
  "radial_pulse": "strong",
  "vomiting_episodes_24h": "lt_1"
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_nirudak_age`	age must be an integer from 5 to 120 (Barry 2021 NIRUDAK; not the adult 18-120 clamp). Returned before settlement; you are not charged.
400	`invalid_sex`	sex must be female or male Returned before settlement; you are not charged.
400	`invalid_nirudak_eyes`	eye_level must be normal or sunken (Barry 2021 NIRUDAK Table 2). Returned before settlement; you are not charged.
400	`invalid_nirudak_pulse`	radial_pulse must be strong, decreased, or absent (Barry 2021 NIRUDAK Table 2). Returned before settlement; you are not charged.
400	`invalid_dhaka_respirations`	respirations must be normal or deep (Levine 2015 DHAKA Table 3). Returned before settlement; you are not charged.
400	`invalid_nirudak_skin_pinch`	skin_pinch must be rapid, slow, or very_slow (Barry 2021 NIRUDAK Table 2; rapid is the reference). Returned before settlement; you are not charged.
400	`invalid_nirudak_vomiting`	vomiting_episodes_24h must be lt_1, 1_to_10, or gt_10 (Barry 2021 NIRUDAK Table 2). Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

DHAKA — Sum four caller-assigned Levine 2015 DHAKA Table 3 items and return the published total (max 12) and dehydration band (no, some, or severe).

Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
Execution is timeout-bounded and concurrency-capped.
Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.