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Jacob M Puliyel

Publications and source records attributed to Jacob M Puliyel.

27 records · Page 2Linked to original sources
PubMed2002

The clinical risk index of babies (CRIB) score in India.

OBJECTIVE: To assess the usefulness of clinical risk index of babies (CRIB score) in predicting neonatal mortality in extremely preterm neonates, compared to birth weight and gestation. METHODS: 97 preterm neonates with gestational age less than 31 weeks or birth weight less than or equal to 1500 g were enrolled for the prospective longitudinal study. Relevant neonatal data was recorded. Blood gas analysis results and the maximum and the minimum FiO2 required by babies in first 12 hours of life were noted. Mortality was taken as death while the baby was in nursery. The prediction of mortality by birth weight, gestational age and CRIB score was done using the Logistic model, and expressed as area under the ROC curve. RESULTS: The area under the ROC curve for birth weight, gestational age and CRIB score was almost the same, the areas being 0.829, 0.819 and 0.823 respectively. Hence CRIB score did not fare better than birth weight and gestational age in predicting neonatal mortality. CONCLUSION: The CRIB score did not improve on the ability of birth weight and gestational age to predict neonatal mortality in the study.

Gestational Age↗
PubMed2002

Building for the future: influence of housing on intelligence quotients of children in an urban slum.

INTRODUCTION: Interventions on behalf of the marginalized in society can assume many formats. In an urban slum the Government of Delhi built one-room houses for some of the residents in what is termed a 'plot area'. Not all residents could be accommodated in the project and the remainder continued to live next door in shanty houses of the slum. Nineteen years later, young children who had migrated with their parents, have grown up and have children of their own. We looked at the development of the children living in the two types of accommodation. METHODS: A total of 373 children were studied. All children (n = 200) between the ages of 3.5 and 5.5 years in a cluster of five residential blocks in the plot area were studied. As a control, children in two large clusters of shanty houses (n = 173) were also studied. For development assessment the Central Institute of Education (CIE) Test was performed. This is an Indian adaptation of the Standford-Binet Test. Multiple regression analysis was utilized to determine the factors that influenced IQ most. RESULTS: The mean IQ of the children in the plot area was 92.5 (s.d. 13.38) and in the shanty houses 89.5 (s.d. 12.9) (p = 0.05). Analysis showed that the most significant factors affecting IQ were malnutrition in the first 6 months of life and attendance of the child at pre-school. For nutrition in the first 6 months, there was no difference between the groups. For attendance at pre-school, 110 of 200 in the plot area and 47 of 173 in the shanty houses were attending pre-school (p < 0.01). CONCLUSION: We find that children living in the permanent houses had a significantly better IQ than those in shanty houses. A review of the literature did not reveal a comparable study.

Child, Preschool↗
PubMedDate not supplied

Rotavirus vaccines.

Explore the source record for details and available documents.

Clinical Trials as Topic↗
PubMedDate not supplied

Hepatitis B immunization: cost calculation in a community-based study in India.

BACKGROUND AND AIM: In India, approximately 65% of mothers deliver at home, and a community-based study evaluating the cost of vaccinating newborns with the first dose of hepatitis B vaccine within 48 hours has not been undertaken previously. This policy planning study was done to evaluate the costs of such immunization in India. METHODS: All mothers delivering in the study area (population 65,000) over a 1-year period were tested for hepatitis B surface antigen (HBsAg; ELISA), and babies of positive mothers were vaccinated starting at birth. The cost of such selective vaccination was calculated. The cost of nursing time required for universal immunization was calculated from the data on nursing time required for vaccination in the selective vaccination program. The national cost of universal immunization without testing was calculated as well as cost-benefit and cost-utility in terms of cost per quality-adjusted life-year (QALY) saved. Sensitivity testing considering economies of scale was also factored in. RESULTS: 1100 mothers delivered during the study period. 252 were primiparous. Nationwide universal vaccination would cost Rs 48,000 per QALY saved, which was double the per capita GNP of the country; discounted at 3% the cost was Rs 260,000. CONCLUSIONS: Universal immunization vaccination with hepatitis B vaccine is not cost-beneficial in India, since cost of every life-year gained with it will exceed India's per capita GNP.

Cost-Benefit Analysis↗