ls -la /home/daytona/workspace/ 2>/dev/null || mkdir -p /home/daytona/workspace/pediatrics && echo "ready"

mkdir -p /home/daytona/workspace/pediatrics && ls /home/daytona/skills/docx/

python - <<'PY' from docx import Document from docx.shared import Pt from docx.enum.text import WD_ALIGN_PARAGRAPH out_path = '/home/daytona/workspace/pediatrics/40_Pediatric_Diseases_OPD_Handbook.docx' doc = Document() # Title p = doc.add_paragraph() r = p.add_run('40 Important Pediatric Diseases: Treatment, Investigations, Findings, Differential Diagnosis, Contraindications, ICO Management, and OPD Prescription') r.bold = True r.font.size = Pt(16) p.alignment = WD_ALIGN_PARAGRAPH.CENTER sub = doc.add_paragraph('Exam and OPD Quick Reference for Medical Students and Junior Residents') sub.alignment = WD_ALIGN_PARAGRAPH.CENTER intro = doc.add_paragraph() intro.add_run('Use format per disease: ').bold = True intro.add_run('Clinical findings | Investigations | Differential diagnosis | Treatment | Contraindications/cautions | ICO management | OPD prescription example.') # 40 diseases concise but useful entries = [ ("1. Neonatal Sepsis", "Poor feeding, lethargy, temp instability, respiratory distress.\nInvestigations: CBC, CRP/procalcitonin, blood culture, CSF if stable, urine C/S.\nDifferential: metabolic disorders, congenital heart disease, intracranial bleed.\nTreatment: Empiric IV ampicillin + gentamicin (or cefotaxime as per protocol), fluids, oxygen.\nContraindications/Cautions: Avoid ceftriaxone in neonates (bilirubin displacement).\nICO management: Isolate if suspected resistant organism, monitor perfusion, glucose, urine output.\nOPD Rx (post-discharge follow-up): Zinc/vitamin D support, feeding advice, danger sign counseling."), ("2. Neonatal Jaundice", "Findings: icterus, onset timing crucial.\nInvestigations: total/direct bilirubin, blood group, Coombs, CBC, retic count, G6PD where indicated.\nDifferential: physiologic jaundice, hemolysis, sepsis, biliary atresia.\nTreatment: Phototherapy; exchange transfusion if severe.\nContraindications: Ceftriaxone, sulfonamides in high-risk neonates.\nICO: bilirubin chart plotting, hydration, temperature control.\nOPD Rx: Feeding 2–3 hourly; follow bilirubin review plan."), ("3. Birth Asphyxia/HIE", "Findings: low Apgar, seizures, altered tone.\nInvestigations: ABG, glucose, electrolytes, neuroimaging, EEG.\nDifferential: sepsis, hypoglycemia, inborn errors.\nTreatment: Therapeutic hypothermia (eligible), seizure control, supportive ICU care.\nContraindications: Hyperoxia, rapid overcorrection of glucose/electrolytes.\nICO: airway, ventilation, perfusion, neuro-monitoring.\nOPD Rx: Neurodevelopment follow-up, physiotherapy referral."), ("4. Acute Gastroenteritis", "Findings: diarrhea ± vomiting, dehydration signs.\nInvestigations: Usually none; stool tests if blood, prolonged or severe.\nDifferential: UTI, appendicitis, lactose intolerance, sepsis.\nTreatment: ORS, zinc 20 mg/day (>6 mo) for 14 days; IV fluids if severe dehydration.\nContraindications: Avoid routine antidiarrheals and unnecessary antibiotics.\nICO: dehydration grade and rehydration plan A/B/C.\nOPD Rx: ORS after each stool + Zinc syrup/tablet + feeding continuation."), ("5. Dysentery (Shigellosis)", "Findings: fever, abdominal cramps, blood-mucus stool.\nInvestigations: stool microscopy/culture where available.\nDifferential: amoebiasis, intussusception, IBD.\nTreatment: Rehydration + antibiotic per local sensitivity (e.g., cefixime/azithro).\nContraindications: Loperamide in children.\nICO: monitor hydration and toxemia.\nOPD Rx: ORS + Zinc + prescribed antibiotic for full course."), ("6. Enteric Fever", "Findings: persistent fever, coated tongue, abdominal pain, hepatosplenomegaly.\nInvestigations: CBC, blood culture (early), LFT; Widal not definitive alone.\nDifferential: malaria, dengue, UTI, TB.\nTreatment: ceftriaxone/azithro/cefixime as per policy.\nContraindications: Empiric steroid unless severe complications.\nICO: monitor for GI bleed/perforation.\nOPD Rx: Oral antibiotic + paracetamol + hydration advice."), ("7. Iron Deficiency Anemia", "Findings: pallor, irritability, pica.\nInvestigations: CBC, indices, ferritin (if possible), smear.\nDifferential: thalassemia trait, anemia of chronic disease, lead toxicity.\nTreatment: oral elemental iron 3 mg/kg/day; dietary counseling, deworming where indicated.\nContraindications: avoid indiscriminate transfusion unless severe symptomatic anemia.\nICO: screen for occult blood loss/nutrition gaps.\nOPD Rx: Iron syrup + folate + diet chart."), ("8. Megaloblastic Anemia", "Findings: pallor, glossitis, macrocytosis.\nInvestigations: CBC, MCV, B12/folate if available.\nDifferential: hypothyroidism, liver disease.\nTreatment: folate and/or B12 replacement.\nContraindications: folate alone in pure B12 deficiency long-term.\nICO: evaluate malabsorption causes.\nOPD Rx: folic acid ± methylcobalamin."), ("9. ITP", "Findings: petechiae, mucosal bleed, isolated thrombocytopenia.\nInvestigations: CBC, peripheral smear; bone marrow only atypical cases.\nDifferential: leukemia, DIC, aplastic anemia.\nTreatment: observe if mild; steroids/IVIG if significant bleeding.\nContraindications: IM injections, NSAIDs.\nICO: bleeding severity grading.\nOPD Rx: prednisolone taper where indicated + bleed precautions."), ("10. Thalassemia Major", "Findings: severe anemia, frontal bossing, hepatosplenomegaly.\nInvestigations: Hb electrophoresis/HPLC, ferritin, CBC.\nDifferential: other hemolytic anemias.\nTreatment: regular transfusions + iron chelation + folate; transplant in selected cases.\nContraindications: iron therapy without deficiency.\nICO: transfusion protocol and ferritin monitoring.\nOPD Rx: deferasirox/deferiprone as advised + folate."), ("11. Acute Severe Asthma", "Findings: tachypnea, wheeze/silent chest, retractions.\nInvestigations: pulse ox, ABG if severe.\nDifferential: foreign body, bronchiolitis, anaphylaxis.\nTreatment: oxygen, repeated salbutamol neb, ipratropium, systemic steroid, MgSO4 if severe.\nContraindications: sedatives, delayed escalation.\nICO: severity scoring and response reassessment.\nOPD Rx: inhaled SABA PRN + inhaled corticosteroid controller."), ("12. Bronchiolitis", "Findings: infant with coryza followed by wheeze/crackles.\nInvestigations: clinical diagnosis; pulse ox.\nDifferential: asthma, pneumonia, CHF.\nTreatment: supportive care, oxygen, hydration.\nContraindications: routine antibiotics/steroids not indicated.\nICO: feeding tolerance, apnea risk in small infants.\nOPD Rx: saline nose drops, small frequent feeds, red flag counseling."), ("13. Pneumonia (CAP)", "Findings: fever, cough, tachypnea, chest indrawing.\nInvestigations: pulse ox; CXR/CRP if severe or uncertain.\nDifferential: bronchiolitis, asthma, TB, foreign body.\nTreatment: amoxicillin oral (non-severe), IV ampicillin/ceftriaxone severe + oxygen.\nContraindications: cough syrups in young children.\nICO: classify severe vs non-severe and hypoxemia.\nOPD Rx: amoxicillin + paracetamol + follow-up in 48h."), ("14. Croup", "Findings: barking cough, stridor.\nInvestigations: clinical.\nDifferential: epiglottitis, foreign body, anaphylaxis.\nTreatment: dexamethasone; nebulized epinephrine in moderate-severe.\nContraindications: throat examination in suspected epiglottitis without airway setup.\nICO: airway observation.\nOPD Rx: single dose dexamethasone, humidified air advice."), ("15. Pertussis", "Findings: paroxysmal cough, inspiratory whoop, post-tussive vomiting.\nInvestigations: CBC lymphocytosis, PCR/culture if available.\nDifferential: viral URI, asthma, TB.\nTreatment: azithromycin, supportive, contact prophylaxis.\nContraindications: delay in treatment for infants.\nICO: apnea monitoring in young infants.\nOPD Rx: azithromycin course + family prophylaxis advice."), ("16. Pulmonary TB", "Findings: chronic cough/fever, weight loss, contact history.\nInvestigations: TST/IGRA, CXR, gastric aspirate/CBNAAT.\nDifferential: lymphoma, fungal disease, chronic pneumonia.\nTreatment: HRZE then HR as per national program.\nContraindications: monotherapy, poor adherence.\nICO: contact tracing and nutrition rehabilitation.\nOPD Rx: weight-band ATT + pyridoxine + adherence card."), ("17. Congenital Heart Disease with Failure", "Findings: tachypnea, poor feeding, sweat during feeds, failure to thrive.\nInvestigations: Echo, CXR, ECG, pulse ox.\nDifferential: sepsis, bronchiolitis, anemia.\nTreatment: diuretics, ACE inhibitor, nutritional optimization, corrective surgery timing.\nContraindications: excess fluid bolus unless shock.\nICO: fluid balance and weight monitoring.\nOPD Rx: furosemide ± captopril with cardiology follow-up."), ("18. Rheumatic Fever", "Findings: migratory polyarthritis, carditis, chorea.\nInvestigations: ASO, ESR/CRP, ECG, echo.\nDifferential: septic arthritis, JIA, lupus.\nTreatment: penicillin + anti-inflammatory; secondary prophylaxis.\nContraindications: premature discontinuation prophylaxis.\nICO: Jones criteria-based documentation.\nOPD Rx: benzathine penicillin prophylaxis schedule."), ("19. Acute Glomerulonephritis", "Findings: edema, cola urine, hypertension.\nInvestigations: urine RBC/protein, C3, ASO, renal function.\nDifferential: nephrotic syndrome, HUS, IgA nephropathy.\nTreatment: salt/fluid restriction, diuretics, antihypertensive, treat trigger.\nContraindications: unnecessary high-volume fluids.\nICO: BP, urine output, electrolytes.\nOPD Rx: antihypertensive + low-salt diet advice."), ("20. Nephrotic Syndrome", "Findings: periorbital/generalized edema, frothy urine.\nInvestigations: urine protein, serum albumin/lipids, renal function.\nDifferential: liver disease, heart failure, protein-losing enteropathy.\nTreatment: prednisolone regimen, edema management, infection prevention.\nContraindications: live vaccines during high-dose steroids.\nICO: daily weight and edema chart.\nOPD Rx: prednisolone protocol + calcium/vitamin D + urine dipstick monitoring."), ("21. UTI", "Findings: fever without source, dysuria, vomiting in infants.\nInvestigations: urinalysis + urine culture before antibiotics.\nDifferential: vulvovaginitis, appendicitis, viral fever.\nTreatment: oral cephalosporin for cystitis; IV for pyelonephritis.\nContraindications: collecting urine bag sample for culture (contamination).\nICO: evaluate for underlying anomalies in recurrent UTI.\nOPD Rx: cefixime/cephalexin as indicated + hydration."), ("22. Acute Viral Hepatitis", "Findings: jaundice, anorexia, dark urine, hepatomegaly.\nInvestigations: LFT, PT/INR, viral markers.\nDifferential: hemolysis, drug-induced hepatitis, leptospirosis.\nTreatment: supportive, nutrition, monitor liver failure signs.\nContraindications: hepatotoxic drugs.\nICO: encephalopathy and INR monitoring.\nOPD Rx: symptomatic treatment and follow-up LFT."), ("23. Severe Acute Malnutrition", "Findings: wasting/edema, MUAC low, appetite loss.\nInvestigations: glucose, electrolytes, CBC as needed.\nDifferential: chronic systemic illness, malabsorption.\nTreatment: WHO 10-step protocol, F-75/F-100 or RUTF, treat infections.\nContraindications: rapid aggressive feeding initially.\nICO: hypoglycemia/hypothermia/dehydration management.\nOPD Rx: RUTF schedule + micronutrients + weekly monitoring."), ("24. Protein Energy Malnutrition", "Findings: underweight, stunting, recurrent infections.\nInvestigations: anthropometry, CBC, micronutrient profile if possible.\nDifferential: chronic disease, celiac disease, TB.\nTreatment: nutrition rehabilitation, deworming, immunization catch-up.\nContraindications: abrupt calorie overload.\nICO: growth chart plotting.\nOPD Rx: high-calorie diet plan + iron/folate + vitamins."), ("25. Vitamin D Deficiency Rickets", "Findings: wrist widening, bow legs, delayed milestones.\nInvestigations: Ca, PO4, ALP, X-ray wrist/knee.\nDifferential: renal rickets, hypophosphatasia.\nTreatment: vitamin D + calcium.\nContraindications: mega-dose misuse without monitoring.\nICO: assess dietary sun exposure causes.\nOPD Rx: cholecalciferol with calcium syrup/tablets."), ("26. Hypothyroidism (Congenital/Childhood)", "Findings: prolonged jaundice, constipation, developmental delay, growth failure.\nInvestigations: TSH, free T4, newborn screen.\nDifferential: Down syndrome, chronic malnutrition.\nTreatment: levothyroxine early and regular titration.\nContraindications: delayed therapy.\nICO: growth and neurodevelopment tracking.\nOPD Rx: levothyroxine daily fasting with periodic TFT."), ("27. Type 1 Diabetes Mellitus", "Findings: polyuria, polydipsia, weight loss.\nInvestigations: blood glucose, ketones, HbA1c, ABG in DKA.\nDifferential: diabetes insipidus, stress hyperglycemia.\nTreatment: basal-bolus insulin, nutrition and sick-day education.\nContraindications: stopping insulin during illness.\nICO: ketone and glucose logs.\nOPD Rx: insulin regimen + glucometer chart + hypoglycemia plan."), ("28. DKA", "Findings: dehydration, Kussmaul breathing, abdominal pain, altered sensorium.\nInvestigations: glucose, ketones, ABG, electrolytes.\nDifferential: sepsis, surgical abdomen.\nTreatment: fluid protocol + insulin infusion + potassium correction.\nContraindications: bicarbonate routine use, rapid fluid/Na correction.\nICO: hourly vitals, neuro checks (cerebral edema risk).\nOPD Rx after stabilization: insulin adjustment and education."), ("29. Meningitis", "Findings: fever, neck stiffness, bulging fontanelle, seizures.\nInvestigations: blood culture, LP (when safe), CSF analysis.\nDifferential: encephalitis, cerebral malaria, sepsis.\nTreatment: urgent IV ceftriaxone/cefotaxime + vancomycin based on age/setting.\nContraindications: LP in raised ICP signs without stabilization.\nICO: airway, seizure control, neuro monitoring.\nOPD Rx: post-discharge neuro/hearing follow-up."), ("30. Encephalitis", "Findings: altered behavior/sensorium, seizures, focal deficits.\nInvestigations: MRI/CT, CSF, PCR (HSV), EEG.\nDifferential: meningitis, toxic-metabolic encephalopathy.\nTreatment: empiric acyclovir + supportive ICU care.\nContraindications: delay in antiviral for suspected HSV.\nICO: raised ICP management protocol.\nOPD Rx: anticonvulsant continuation plan if needed."), ("31. Febrile Seizure", "Findings: seizure with fever 6 months–5 years, no CNS infection.\nInvestigations: focused cause-of-fever workup.\nDifferential: meningitis, epilepsy, metabolic seizures.\nTreatment: seizure first aid, antipyretics comfort care; rescue midazolam if prolonged.\nContraindications: routine long-term antiepileptics in simple febrile seizure.\nICO: classify simple vs complex.\nOPD Rx: fever control advice + rescue plan counseling."), ("32. Epilepsy (Childhood)", "Findings: recurrent unprovoked seizures.\nInvestigations: EEG, MRI when indicated, metabolic tests selective.\nDifferential: syncope, psychogenic events.\nTreatment: syndrome-based ASM monotherapy initially.\nContraindications: abrupt drug withdrawal.\nICO: seizure diary and adherence.\nOPD Rx: valproate/levetiracetam/carbamazepine per seizure type."), ("33. Cerebral Palsy", "Findings: non-progressive motor delay, spasticity/dyskinesia.\nInvestigations: neuroimaging, hearing/vision screening.\nDifferential: neuromuscular disorders, progressive neurodegeneration.\nTreatment: multidisciplinary rehab, spasticity management, nutrition.\nContraindications: delayed early intervention.\nICO: functional classification and therapy goals.\nOPD Rx: baclofen where indicated + physiotherapy schedule."), ("34. Acute Flaccid Paralysis (GBS)", "Findings: ascending weakness, areflexia.\nInvestigations: CSF albuminocytologic dissociation, NCS.\nDifferential: transverse myelitis, botulism, myositis.\nTreatment: IVIG/plasmapheresis, respiratory monitoring.\nContraindications: corticosteroids alone in GBS.\nICO: vital capacity trend and autonomic instability watch.\nOPD Rx: rehab and follow-up neurology."), ("35. Dengue", "Findings: fever, myalgia, rash, warning signs, thrombocytopenia.\nInvestigations: NS1/IgM, CBC serial hematocrit/platelets, LFT.\nDifferential: malaria, leptospirosis, enteric fever.\nTreatment: careful fluid management, paracetamol, monitor warning signs.\nContraindications: NSAIDs, unnecessary platelet transfusion.\nICO: hematocrit-guided fluids.\nOPD Rx: oral fluids + paracetamol + daily review if warning signs."), ("36. Malaria", "Findings: fever with chills, pallor, splenomegaly.\nInvestigations: peripheral smear, rapid antigen test, CBC.\nDifferential: dengue, typhoid, viral fever.\nTreatment: ACT for falciparum; chloroquine where sensitive vivax + primaquine (after G6PD eval).\nContraindications: primaquine without G6PD testing.\nICO: severe malaria criteria and referral.\nOPD Rx: antimalarial full course + fever charting."), ("37. Measles", "Findings: fever, cough, coryza, conjunctivitis, Koplik spots, rash.\nInvestigations: clinical; serology in outbreaks.\nDifferential: rubella, drug rash, dengue.\nTreatment: supportive + vitamin A.\nContraindications: aspirin in children.\nICO: isolation and complication screening (pneumonia, otitis).\nOPD Rx: vitamin A dose schedule + nutrition/fluids."), ("38. Diphtheria", "Findings: fever, sore throat, adherent gray membrane, bull neck.\nInvestigations: throat swab culture, ECG for myocarditis.\nDifferential: severe tonsillitis, infectious mononucleosis.\nTreatment: diphtheria antitoxin + erythromycin/penicillin + isolation.\nContraindications: forceful membrane removal.\nICO: airway preparedness and myocarditis monitoring.\nOPD Rx: completion antibiotics + contact prophylaxis/immunization update."), ("39. Kawasaki Disease", "Findings: fever >5 days + mucocutaneous signs, lymphadenopathy.\nInvestigations: ESR/CRP, CBC, echo for coronary involvement.\nDifferential: MIS-C, scarlet fever, adenovirus.\nTreatment: IVIG + aspirin, cardiology follow-up.\nContraindications: delay in IVIG beyond early window.\nICO: coronary artery monitoring.\nOPD Rx: aspirin continuation and repeat echocardiography schedule."), ("40. Pediatric HIV Infection", "Findings: recurrent infections, growth faltering, oral thrush, lymphadenopathy.\nInvestigations: age-appropriate HIV testing, CD4/viral load, OI screening.\nDifferential: primary immunodeficiency, TB, malnutrition.\nTreatment: lifelong ART, OI prophylaxis, nutrition support, immunization planning.\nContraindications: poor adherence/interruption of ART.\nICO: adherence counseling and opportunistic infection surveillance.\nOPD Rx: ART regimen per national protocol + cotrimoxazole where indicated.") ] for title, body in entries: h = doc.add_paragraph() hr = h.add_run(title) hr.bold = True hr.font.size = Pt(12) for line in body.split("\\n"): doc.add_paragraph(line, style='List Bullet') notes = doc.add_paragraph() notes.add_run('Important note: ').bold = True notes.add_run('Drug doses and specific regimens vary by weight, age, comorbidity, and local/national guidelines. Verify with your institutional pediatric protocol before prescribing.') doc.save(out_path) print(out_path) PY