ls /home/daytona/workspace/ 2>/dev/null && ls /home/daytona/skills/docx/scripts/…

mkdir -p /home/daytona/workspace/neet-pg && ls /home/daytona/workspace/neet-pg/

~/neet-pg/create_notes.js

const {
  Document, Packer, Paragraph, TextRun, Table, TableRow, TableCell,
  HeadingLevel, AlignmentType, BorderStyle, WidthType, ShadingType,
  PageNumber, Header, Footer, PageBreak, VerticalAlign
} = require('docx');
const fs = require('fs');

// Color scheme
const TITLE_COLOR = "1F3864";
const SUBJECT_COLOR = "C00000";
const SECTION_COLOR = "2E75B6";
const HIGHLIGHT_COLOR = "FFF2CC";
const TABLE_HEADER_COLOR = "2E75B6";
const TABLE_HEADER_TEXT = "FFFFFF";
const TABLE_ROW_ALT = "EBF3FB";

function titlePara(text) {
  return new Paragraph({
    heading: HeadingLevel.TITLE,
    alignment: AlignmentType.CENTER,
    children: [
      new TextRun({ text, bold: true, size: 48, color: TABLE_HEADER_TEXT, font: "Calibri" })
    ],
    shading: { type: ShadingType.SOLID, color: TITLE_COLOR },
    spacing: { before: 200, after: 200 },
    border: { bottom: { style: BorderStyle.THICK, size: 8, color: "C00000" } }
  });
}

function subjectHeading(num, text) {
  return new Paragraph({
    heading: HeadingLevel.HEADING_1,
    pageBreakBefore: num > 1,
    children: [
      new TextRun({ text: `${num}. ${text}`, bold: true, size: 36, color: TABLE_HEADER_TEXT, font: "Calibri" })
    ],
    shading: { type: ShadingType.SOLID, color: SUBJECT_COLOR },
    spacing: { before: 300, after: 160 },
  });
}

function sectionHeading(text) {
  return new Paragraph({
    heading: HeadingLevel.HEADING_2,
    children: [
      new TextRun({ text, bold: true, size: 26, color: TABLE_HEADER_TEXT, font: "Calibri" })
    ],
    shading: { type: ShadingType.SOLID, color: SECTION_COLOR },
    spacing: { before: 200, after: 80 },
  });
}

function bullet(text, highlight) {
  return new Paragraph({
    bullet: { level: 0 },
    children: [new TextRun({ text, size: 22, font: "Calibri", color: "000000" })],
    shading: highlight ? { type: ShadingType.SOLID, color: HIGHLIGHT_COLOR } : undefined,
    spacing: { before: 40, after: 40 },
  });
}

function subBullet(text) {
  return new Paragraph({
    bullet: { level: 1 },
    children: [new TextRun({ text, size: 21, font: "Calibri", color: "444444" })],
    spacing: { before: 20, after: 20 },
  });
}

function newTrendBullet(text) {
  return new Paragraph({
    bullet: { level: 0 },
    children: [
      new TextRun({ text: "NEW 2026: ", bold: true, size: 22, color: "C00000", font: "Calibri" }),
      new TextRun({ text, size: 22, font: "Calibri", color: "000000" })
    ],
    shading: { type: ShadingType.SOLID, color: "FFE4E4" },
    spacing: { before: 40, after: 40 },
  });
}

function spacer() {
  return new Paragraph({ children: [new TextRun({ text: "" })], spacing: { before: 60, after: 60 } });
}

function makeTable(headers, rows) {
  return new Table({
    width: { size: 100, type: WidthType.PERCENTAGE },
    rows: [
      new TableRow({
        tableHeader: true,
        children: headers.map(h => new TableCell({
          shading: { type: ShadingType.SOLID, color: TABLE_HEADER_COLOR },
          children: [new Paragraph({
            alignment: AlignmentType.CENTER,
            children: [new TextRun({ text: h, bold: true, color: TABLE_HEADER_TEXT, size: 22, font: "Calibri" })]
          })]
        }))
      }),
      ...rows.map((row, i) => new TableRow({
        children: row.map(cell => new TableCell({
          shading: i % 2 === 1 ? { type: ShadingType.SOLID, color: TABLE_ROW_ALT } : undefined,
          children: [new Paragraph({
            children: [new TextRun({ text: cell, size: 21, font: "Calibri" })]
          })]
        }))
      }))
    ]
  });
}

const children = [];

// ---- COVER PAGE ----
children.push(titlePara("NEET PG 2026"));
children.push(new Paragraph({
  alignment: AlignmentType.CENTER,
  children: [new TextRun({ text: "HIGH YIELD NOTES", bold: true, size: 52, color: SUBJECT_COLOR, font: "Calibri" })],
  spacing: { before: 200, after: 100 }
}));
children.push(new Paragraph({
  alignment: AlignmentType.CENTER,
  children: [new TextRun({ text: "ALL 19 SUBJECTS", bold: true, size: 36, color: SECTION_COLOR, font: "Calibri" })],
  spacing: { before: 100, after: 100 }
}));
children.push(new Paragraph({
  alignment: AlignmentType.CENTER,
  children: [new TextRun({ text: "Most Repeated Topics + New/Changed Topics for 2026", size: 28, color: "555555", font: "Calibri", italics: true })],
  spacing: { before: 100, after: 400 }
}));
children.push(new Paragraph({
  alignment: AlignmentType.CENTER,
  children: [new TextRun({ text: "Subjects Covered:", bold: true, size: 24, color: TITLE_COLOR, font: "Calibri" })],
  spacing: { before: 100, after: 100 }
}));
const subjects = [
  "1. Anatomy", "2. Physiology", "3. Biochemistry", "4. Pathology", "5. Pharmacology",
  "6. Microbiology", "7. Forensic Medicine", "8. ENT", "9. Ophthalmology", "10. Dermatology",
  "11. Psychiatry", "12. General Medicine", "13. General Surgery", "14. Obstetrics",
  "15. Gynecology", "16. Pediatrics", "17. Orthopedics", "18. Radiology", "19. Anesthesia"
];
subjects.forEach(s => children.push(new Paragraph({
  alignment: AlignmentType.CENTER,
  bullet: { level: 0 },
  children: [new TextRun({ text: s, size: 24, font: "Calibri", color: "000000" })],
  spacing: { before: 30, after: 30 }
})));
children.push(new Paragraph({ children: [new PageBreak()] }));

// ============================
// 1. ANATOMY
// ============================
children.push(subjectHeading(1, "ANATOMY"));
children.push(sectionHeading("Most Repeated Topics"));
children.push(bullet("Nerve injuries: Saturday night palsy = Radial nerve; Waiter's tip = Upper trunk brachial plexus; Claw hand = Ulnar nerve; Wrist drop = Radial nerve", true));
children.push(bullet("Femoral triangle: Contents - Nerve, Artery, Vein (lateral to medial: N-A-V-EL); Femoral canal = most medial structure"));
children.push(bullet("Foramen: Superior orbital fissure = CN 3, 4, 5a (V1), 6; Foramen ovale = CN V3; Foramen spinosum = Middle meningeal artery"));
children.push(bullet("Lymph drainage: Testis = Para-aortic nodes; Scrotum = Superficial inguinal nodes; Uterus = Internal iliac nodes"));
children.push(bullet("Ligamentum arteriosum = Remnant of ductus arteriosus; Left recurrent laryngeal nerve loops around it"));
children.push(bullet("McBurney's point = Junction of lateral 1/3 and medial 2/3 of line from ASIS to umbilicus"));
children.push(bullet("Coronary dominance: Right dominant 70% (posterior descending artery from RCA)"));
children.push(bullet("Circle of Willis: Anterior communicating artery = most common site of berry aneurysm"));
children.push(bullet("Portal-systemic anastomosis sites: Lower esophagus, rectum, umbilicus, bare area of liver, retroperitoneum"));
children.push(spacer());
children.push(sectionHeading("Embryology - High Yield"));
children.push(bullet("Branchial arch 1 (Mandibular): Meckel's cartilage, muscles of mastication, CN V; Mandible, malleus, incus"));
children.push(bullet("Branchial arch 2 (Hyoid): Reichert's cartilage, CN VII; Stapes, styloid process, lesser cornu of hyoid"));
children.push(bullet("Branchial arch 3: CN IX; Greater cornu of hyoid, stylopharyngeus"));
children.push(bullet("Branchial arch 4 & 6: CN X; Laryngeal cartilages"));
children.push(bullet("Gut rotation: 270 degrees anticlockwise; Non-rotation leads to malrotation"));
children.push(bullet("Waldeyer's ring: Palatine + Pharyngeal (adenoids) + Lingual tonsils + Tubal tonsils"));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("Embryology questions increasing significantly - focus on branchial arch derivatives"));
children.push(newTrendBullet("Molecular anatomy - HOX genes, signaling pathways"));
children.push(newTrendBullet("Clinical anatomy scenarios - nerve injury patterns in procedures"));

// ============================
// 2. PHYSIOLOGY
// ============================
children.push(subjectHeading(2, "PHYSIOLOGY"));
children.push(sectionHeading("Most Repeated Topics"));
children.push(bullet("Starling's law: Force of contraction proportional to initial fiber length (preload)"));
children.push(bullet("Cardiac output = HR x SV; Normal = 5 L/min; Cardiac index = CO/BSA = 2.8-3.2 L/min/m2"));
children.push(bullet("Resting membrane potential: Nerve = -70mV; Cardiac muscle = -90mV; SA node = -55mV"));
children.push(bullet("Spirometry: FRC = ERV + RV; TLC = VC + RV; Normal FEV1/FVC >80%"));
children.push(subBullet("Obstructive (asthma, COPD): FEV1/FVC reduced; FVC normal or reduced"));
children.push(subBullet("Restrictive (fibrosis, sarcoid): FEV1/FVC normal; FVC reduced; TLC reduced"));
children.push(bullet("Cushing reflex: Hypertension + Bradycardia + Irregular respiration (raised ICP)"));
children.push(bullet("GFR = 125 ml/min; RBF = 1200 ml/min; RPF = 650 ml/min; FF = GFR/RPF = 20%"));
children.push(bullet("Renin release: Decreased BP, decreased NaCl at macula densa, increased sympathetic activity"));
children.push(bullet("Oxyhemoglobin curve: Right shift (decreased affinity) = increased temp, CO2, 2,3-DPG, decreased pH, fever"));
children.push(bullet("P50 = 26.5 mmHg (partial pressure at which Hb is 50% saturated)"));
children.push(bullet("Blood-brain barrier: Tight junctions; Absent in area postrema, posterior pituitary, pineal gland"));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("Gut hormones: GIP and GLP-1 (incretin effect) - basis for GLP-1 agonist drugs (Semaglutide)"));
children.push(newTrendBullet("Sleep physiology: REM vs NREM; Slow wave sleep = growth hormone release; REM = dreaming, penile erection"));
children.push(newTrendBullet("Circadian rhythm: Suprachiasmatic nucleus; Melatonin; Disruption in shift workers"));
children.push(newTrendBullet("Epigenetics basics: DNA methylation (gene silencing), histone acetylation (gene activation)"));

// ============================
// 3. BIOCHEMISTRY
// ============================
children.push(subjectHeading(3, "BIOCHEMISTRY"));
children.push(sectionHeading("Enzyme Defects - Most Repeated"));
children.push(makeTable(
  ["Disease", "Enzyme Defect", "Key Feature"],
  [
    ["PKU", "Phenylalanine hydroxylase", "Musty odor, intellectual disability, fair skin"],
    ["Alkaptonuria", "Homogentisic acid oxidase", "Dark urine, ochronosis, arthritis"],
    ["Maple syrup urine disease", "BCKAD (branched chain keto acid dehydrogenase)", "Sweet-smelling urine, neurological"],
    ["Homocystinuria", "Cystathionine beta synthase", "Marfan-like, lens dislocation downward"],
    ["Albinism", "Tyrosinase", "Lack of melanin, photosensitivity"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Lysosomal Storage Diseases"));
children.push(makeTable(
  ["Disease", "Enzyme Defect", "Stored Material"],
  [
    ["Gaucher disease", "Glucocerebrosidase", "Glucocerebroside; Crinkled paper cells"],
    ["Niemann-Pick", "Sphingomyelinase", "Sphingomyelin; Cherry red spot"],
    ["Tay-Sachs", "Hexosaminidase A", "GM2 ganglioside; Cherry red spot; No organomegaly"],
    ["Fabry disease", "Alpha-galactosidase A", "Ceramide trihexoside; X-linked; Angiokeratoma"],
    ["Hurler syndrome", "Alpha-L-iduronidase", "Heparan/dermatan sulfate; Gargoylism; Corneal clouding"],
    ["Pompe disease", "Acid maltase (alpha-1,4-glucosidase)", "Glycogen; Cardiomegaly; Hypotonia"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Rate-Limiting Enzymes"));
children.push(bullet("Glycolysis = Phosphofructokinase-1 (PFK-1)"));
children.push(bullet("Gluconeogenesis = Fructose 1,6-bisphosphatase"));
children.push(bullet("TCA cycle = Isocitrate dehydrogenase"));
children.push(bullet("Fatty acid synthesis = Acetyl-CoA carboxylase"));
children.push(bullet("Fatty acid oxidation = Carnitine acyltransferase I"));
children.push(bullet("Cholesterol synthesis = HMG-CoA reductase"));
children.push(spacer());
children.push(sectionHeading("Vitamin Deficiencies"));
children.push(makeTable(
  ["Vitamin", "Deficiency Disease", "Key Points"],
  [
    ["B1 (Thiamine)", "Beriberi, Wernicke's encephalopathy", "Wet beriberi = heart failure; Dry = neuropathy; Wernicke = triad: confusion, ataxia, ophthalmoplegia"],
    ["B2 (Riboflavin)", "Angular stomatitis, cheilosis", "Corneal vascularization, scrotal dermatitis"],
    ["B3 (Niacin)", "Pellagra", "3 D's: Dermatitis, Diarrhea, Dementia; 4th D = Death"],
    ["B6 (Pyridoxine)", "Peripheral neuropathy", "Deficiency caused by INH; Homocystinuria treatment"],
    ["B12 (Cobalamin)", "Megaloblastic anemia + SACD", "Subacute combined degeneration of spinal cord; Schilling test"],
    ["Folate", "Megaloblastic anemia, NTD", "Neural tube defects in pregnancy; NO neurological symptoms"],
    ["Vit C", "Scurvy", "Perifollicular hemorrhage, corkscrew hairs, gum bleeding"],
    ["Vit D", "Rickets/Osteomalacia", "Craniotabes, rachitic rosary, Harrison's groove"],
    ["Vit K", "Bleeding tendency", "Factors 2,7,9,10 + Protein C&S; Warfarin antagonist"]
  ]
));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("Epigenetics: DNA methylation (gene silencing), histone acetylation (activation), miRNA regulation"));
children.push(newTrendBullet("mRNA vaccines: mechanism - mRNA translated to spike protein, immune response; no DNA integration"));
children.push(newTrendBullet("Oncogenes (RAS, MYC, HER2) vs Tumor suppressors (p53, Rb, BRCA1/2)"));
children.push(newTrendBullet("CRISPR-Cas9 mechanism: guide RNA directs Cas9 endonuclease to specific DNA sequence"));

// ============================
// 4. PATHOLOGY
// ============================
children.push(subjectHeading(4, "PATHOLOGY"));
children.push(sectionHeading("Amyloidosis"));
children.push(makeTable(
  ["Type", "Precursor Protein", "Associated Condition"],
  [
    ["AA (Secondary)", "Serum Amyloid A (SAA)", "Chronic inflammation: TB, RA, Crohn's, osteomyelitis"],
    ["AL (Primary)", "Immunoglobulin light chains", "Multiple myeloma, plasma cell dyscrasias"],
    ["AB2M", "Beta-2 microglobulin", "Long-term hemodialysis; Carpal tunnel syndrome"],
    ["ATTR", "Transthyretin (prealbumin)", "Senile cardiac amyloidosis, familial amyloidosis"],
    ["AB", "Amyloid precursor protein (APP)", "Alzheimer's disease (neuritic plaques)"]
  ]
));
children.push(bullet("Congo red stain: Apple-green birefringence under polarized light", true));
children.push(spacer());
children.push(sectionHeading("Types of Necrosis"));
children.push(makeTable(
  ["Type", "Cause", "Location"],
  [
    ["Coagulative", "Ischemia (except brain)", "Heart, kidney, spleen infarcts"],
    ["Liquefactive", "Bacterial infections, brain infarct", "Brain, abscesses"],
    ["Caseous", "TB, fungi", "TB granulomas; Soft cheese-like"],
    ["Fat necrosis", "Lipase action", "Pancreas (enzymatic), Breast (traumatic)"],
    ["Fibrinoid", "Immune complex deposition", "Blood vessel walls in vasculitis, hypertension"],
    ["Gangrenous", "Ischemia + superinfection", "Limbs; Wet = bacteria, Dry = no bacteria"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Tumor Markers"));
children.push(makeTable(
  ["Marker", "Associated Tumor(s)", "Notes"],
  [
    ["AFP", "HCC, Yolk sac tumor", "Also elevated in pregnancy, cirrhosis"],
    ["CEA", "Colorectal, pancreatic, lung Ca", "Non-specific; used for monitoring"],
    ["CA-125", "Ovarian carcinoma", "Serous type; also endometriosis"],
    ["CA 19-9", "Pancreatic carcinoma", "Also cholangiocarcinoma"],
    ["PSA", "Prostate carcinoma", "Elevated in BPH too; most organ-specific"],
    ["B-HCG", "Choriocarcinoma, testicular (non-seminoma)", "Also elevated in normal pregnancy"],
    ["PLAP", "Seminoma, dysgerminoma", "Placental-like alkaline phosphatase"],
    ["Calcitonin", "Medullary thyroid Ca", "MEN 2A and 2B"],
    ["Chromogranin A", "Carcinoid, pheochromocytoma", "Neuroendocrine tumors"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Classic Microscopic Findings"));
children.push(bullet("Reed-Sternberg cells (Owl eye) = Hodgkin's lymphoma", true));
children.push(bullet("Psammoma bodies = Papillary thyroid Ca, Serous cystadenocarcinoma ovary, Meningioma, Mesothelioma"));
children.push(bullet("Mallory bodies (hyaline) = Alcoholic hepatitis"));
children.push(bullet("Councilman bodies = Yellow fever (acidophilic apoptotic hepatocytes)"));
children.push(bullet("Kimmelstiel-Wilson nodules = Diabetic nephropathy"));
children.push(bullet("Negri bodies = Rabies (hippocampus, Purkinje cells)"));
children.push(bullet("Donovan bodies = Granuloma inguinale"));
children.push(bullet("Aschoff bodies = Rheumatic fever (perivascular granulomas in heart)"));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("Molecular pathology: EGFR (exon 19 del, L858R) and ALK mutations in lung adenocarcinoma - targetable"));
children.push(newTrendBullet("HER2/neu amplification in breast cancer - tested by FISH/IHC - determines Trastuzumab eligibility"));
children.push(newTrendBullet("PD-L1 expression and immunotherapy checkpoint inhibitors - Pembrolizumab, Nivolumab"));
children.push(newTrendBullet("KRAS mutation in colorectal/pancreatic Ca - resistance to anti-EGFR therapy"));

// ============================
// 5. PHARMACOLOGY
// ============================
children.push(subjectHeading(5, "PHARMACOLOGY"));
children.push(sectionHeading("Pharmacokinetics"));
children.push(bullet("Zero order kinetics (constant amount eliminated): Alcohol, Phenytoin, Aspirin (high dose), Warfarin", true));
children.push(bullet("First order kinetics (constant fraction eliminated): Most drugs"));
children.push(bullet("Enzyme INDUCERS (RCPP): Rifampicin, Carbamazepine, Phenytoin, Phenobarbitone"));
children.push(bullet("Enzyme INHIBITORS (SICK): Sulfonamides, Isoniazid, Ciprofloxacin, Ketoconazole / Cimetidine, Erythromycin"));
children.push(spacer());
children.push(sectionHeading("Important Drug Classes"));
children.push(makeTable(
  ["Class", "Examples", "Key Points"],
  [
    ["Cardioselective Beta-blockers", "Metoprolol, Atenolol, Bisoprolol (MAB)", "Beta-1 selective; Safe in mild asthma"],
    ["Non-selective Beta-blockers", "Propranolol, Timolol, Nadolol", "Contraindicated in asthma, COPD"],
    ["ACE Inhibitors", "Enalapril, Ramipril, Lisinopril", "Cough (bradykinin); Contraindicated in pregnancy"],
    ["ARBs", "Losartan, Valsartan, Olmesartan", "No cough; Contraindicated in pregnancy"],
    ["Statins", "Atorvastatin, Rosuvastatin", "HMG-CoA reductase inhibitors; Side effect: myopathy"],
    ["GLP-1 Agonists", "Semaglutide, Liraglutide, Dulaglutide", "Weight loss, cardioprotective; SE: nausea, pancreatitis"],
    ["SGLT2 Inhibitors", "Dapagliflozin, Empagliflozin, Canagliflozin", "Cardio and renoprotective; SE: UTI, DKA, Fournier's gangrene"],
    ["DOACs", "Dabigatran (thrombin), Rivaroxaban, Apixaban (Xa)", "No INR monitoring; Dabigatran antidote = Idarucizumab"],
    ["Checkpoint Inhibitors", "Pembrolizumab, Nivolumab (PD-1), Ipilimumab (CTLA-4)", "Immune-related adverse events: colitis, pneumonitis, thyroiditis"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Drugs in Pregnancy"));
children.push(makeTable(
  ["Condition", "Safe Drug", "Contraindicated"],
  [
    ["Hypertension", "Methyldopa, Labetalol, Nifedipine", "ACE inhibitors, ARBs (teratogenic - renal agenesis)"],
    ["Diabetes", "Insulin", "Oral hypoglycemics (most); Metformin - used in PCOD in pregnancy"],
    ["Epilepsy", "Lamotrigine, Levetiracetam", "Valproate (NTD, autism risk), Phenytoin, Carbamazepine"],
    ["TB", "HRZE (Isoniazid, Rifampicin, Pyrazinamide, Ethambutol)", "Streptomycin (ototoxic to fetus)"],
    ["UTI", "Nitrofurantoin (1st/2nd trimester), Cephalosporins", "Fluoroquinolones, Tetracyclines, Aminoglycosides"],
    ["Depression", "SSRIs (Sertraline preferred)", "MAOIs; Paroxetine (cardiac defects)"]
  ]
));
children.push(spacer());
children.push(sectionHeading("DOC Quick Reference"));
children.push(makeTable(
  ["Disease/Condition", "Drug of Choice"],
  [
    ["Malaria (P. vivax/P. falciparum sensitive)", "Chloroquine"],
    ["P. falciparum (severe)", "IV Artesunate"],
    ["P. vivax radical cure", "Primaquine (check G6PD before use)"],
    ["TB (new case)", "HRZE x 2 months, then HR x 4 months"],
    ["MDR-TB", "Bedaquiline-based regimen"],
    ["H. pylori", "PPI + Clarithromycin + Amoxicillin x 14 days (Triple therapy)"],
    ["MRSA", "Vancomycin / Linezolid"],
    ["Anaphylaxis", "Adrenaline 0.5 mg IM (thigh), 1:1000"],
    ["Eclampsia prevention", "MgSO4 (Pritchard regimen)"],
    ["Status epilepticus (1st line)", "IV Lorazepam / Diazepam"],
    ["Gout (acute)", "Colchicine / NSAIDs / Steroids"],
    ["Gout (prophylaxis)", "Allopurinol / Febuxostat"]
  ]
));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("Semaglutide (Ozempic/Wegovy) - GLP-1 agonist - now approved for weight loss and cardiovascular risk reduction"));
children.push(newTrendBullet("SGLT2 inhibitors - now standard in HFrEF and HFpEF regardless of diabetes"));
children.push(newTrendBullet("JAK inhibitors (Baricitinib, Tofacitinib, Upadacitinib) in RA, atopic dermatitis, alopecia areata"));
children.push(newTrendBullet("Sugammadex - reversal of rocuronium/vecuronium (replacing neostigmine in anesthesia)"));
children.push(newTrendBullet("RSV vaccines (Abrysvo, mRESVIA) - newly approved for elderly and pregnant women"));

// ============================
// 6. MICROBIOLOGY
// ============================
children.push(subjectHeading(6, "MICROBIOLOGY"));
children.push(sectionHeading("Gram Staining Quick Reference"));
children.push(makeTable(
  ["Gram Positive Cocci", "Key Feature"],
  [
    ["Staph aureus", "Coagulase POSITIVE; Golden colonies; MRSA - Vancomycin"],
    ["Staph epidermidis", "Coagulase NEGATIVE; Novobiocin sensitive; Biofilm (prosthetic devices)"],
    ["Staph saprophyticus", "Coagulase NEGATIVE; Novobiocin RESISTANT; UTI in young women"],
    ["Strep pyogenes (Group A)", "Beta-hemolytic; ASO titer; Rheumatic fever, PSGN"],
    ["Strep agalactiae (Group B)", "Beta-hemolytic; Neonatal meningitis/sepsis"],
    ["Strep pneumoniae", "Alpha-hemolytic; Diplococci; Lancet-shaped; Optochin sensitive; Bile soluble"]
  ]
));
children.push(spacer());
children.push(bullet("Capsulated organisms (SKHPNC): Strep pneumoniae, Klebsiella, H. influenzae, Pseudomonas, Neisseria, Cryptococcus", true));
children.push(bullet("Obligate aerobes: Pseudomonas, Mycobacterium, Nocardia, Bordetella (PMBN)"));
children.push(bullet("Obligate anaerobes: Bacteroides (most common), Clostridium, Actinomyces, Peptostreptococcus"));
children.push(bullet("Intracellular organisms: Rickettsia, Chlamydia, Coxiella, Brucella, Listeria, Mycobacterium"));
children.push(spacer());
children.push(sectionHeading("Special Stains"));
children.push(makeTable(
  ["Stain", "Organism/Structure"],
  [
    ["India ink", "Cryptococcus neoformans (capsule)"],
    ["ZN stain (Acid-fast)", "Mycobacterium, Nocardia (weakly), Cryptosporidium, Cyclospora"],
    ["PAS stain", "Fungi, Whipple's disease (Tropheryma whipplei)"],
    ["Silver stain (Gomori)", "Fungi (especially Pneumocystis jiroveci)"],
    ["Giemsa stain", "Malaria, Leishmania, Trypanosoma, Chlamydia"],
    ["Albert stain", "Corynebacterium diphtheriae (metachromatic granules)"],
    ["Loeffler's methylene blue", "C. diphtheriae (Chinese letter arrangement)"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Vaccines"));
children.push(bullet("Live attenuated: BCG, OPV, MMR, Varicella, Yellow fever, Rotavirus, Influenza (nasal)", true));
children.push(bullet("Killed/Inactivated: IPV, Rabies, Cholera, Pertussis (whole cell), HAV, Influenza (injectable)"));
children.push(bullet("Toxoid: Tetanus, Diphtheria"));
children.push(bullet("Subunit: Hepatitis B (recombinant), HPV, Typhoid Vi, Acellular pertussis"));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("Mpox (Monkeypox): Orthopoxvirus; Clade I (Central Africa) more severe; JYNNEOS vaccine; Tecovirimat treatment"));
children.push(newTrendBullet("AMR mechanisms: ESBL (extended spectrum beta-lactamase), Carbapenemases (KPC, NDM-1), MCR (colistin resistance)"));
children.push(newTrendBullet("Molecular diagnostics: CRISPR-based diagnostics, whole genome sequencing for outbreak investigation"));
children.push(newTrendBullet("COVID-19 long COVID complications: fatigue, cognitive dysfunction, postural tachycardia syndrome (POTS)"));

// ============================
// 7. FORENSIC MEDICINE
// ============================
children.push(subjectHeading(7, "FORENSIC MEDICINE"));
children.push(sectionHeading("Postmortem Changes"));
children.push(makeTable(
  ["Change", "Onset", "Duration", "Key Points"],
  [
    ["Algor mortis (cooling)", "Immediately", "Rate: 1 degree C/hr", "Depends on environment, clothing, obesity"],
    ["PM lividity (hypostasis)", "30 min - 2 hrs", "Fixed at 6-12 hrs", "Dependent parts; cherry red = CO poisoning"],
    ["Rigor mortis", "2-6 hrs", "Complete at 12 hrs; Passes 24-48 hrs", "First jaw; Cadaveric spasm = instantaneous rigor"],
    ["Putrefaction", "36-72 hrs (temperate)", "Variable", "Starts in cecum; greenish discoloration RIF; Marbling"],
    ["Adipocere", "Weeks-months", "Persistent", "Saponification of fat; wet/buried bodies"],
    ["Mummification", "Weeks-months", "Persistent", "Dry/hot/arid environment; preserved body"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Age Estimation - Key Points"));
children.push(bullet("Last epiphysis to fuse = Medial end of clavicle (25 years)", true));
children.push(bullet("3rd molar (wisdom tooth) eruption = 17-25 years"));
children.push(bullet("Gustafson's method = Dental age estimation in adults (6 features: ASRTCP)"));
children.push(bullet("Ossification centers: Primary = before birth; Secondary = after birth (except distal femur and proximal tibia)"));
children.push(spacer());
children.push(sectionHeading("Important IPC Sections"));
children.push(makeTable(
  ["IPC Section", "Offense"],
  [
    ["302", "Murder (punishment: death or life imprisonment)"],
    ["304A", "Death by negligence (Medical negligence)"],
    ["304B", "Dowry death"],
    ["307", "Attempt to murder"],
    ["376", "Rape"],
    ["312", "Causing miscarriage"],
    ["318", "Concealment of birth"],
    ["497", "Adultery (decriminalized by SC 2018)"]
  ]
));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("MTP Act 2021 Amendment: Up to 24 weeks for special categories (rape survivors, mentally ill, minors, fetal abnormalities)"));
children.push(newTrendBullet("POCSO Act: Protection of children under 18 years; Mandatory reporting; Stringent punishments"));
children.push(newTrendBullet("BNS (Bharatiya Nyaya Sanhita) replacing IPC - new section numbers; exam may test both"));
children.push(newTrendBullet("DNA profiling advances: STR analysis, touch DNA; Used in sexual assault cases"));

// ============================
// 8. ENT
// ============================
children.push(subjectHeading(8, "ENT"));
children.push(sectionHeading("Ear - Key Topics"));
children.push(bullet("Cholesteatoma: Attic (pars flaccida) perforation = UNSAFE ear; Pearly white mass; Keratin accumulation; Erodes ossicles", true));
children.push(bullet("Tuning fork tests:"));
children.push(subBullet("Rinne POSITIVE (AC > BC) = Normal OR Sensorineural hearing loss"));
children.push(subBullet("Rinne NEGATIVE (BC > AC) = Conductive hearing loss"));
children.push(subBullet("Weber LATERALIZES to AFFECTED ear = Conductive loss"));
children.push(subBullet("Weber LATERALIZES to NORMAL ear = Sensorineural loss"));
children.push(bullet("Acoustic neuroma (Vestibular schwannoma): CN VIII; CPA tumor; Unilateral SNHL + tinnitus + vertigo; Von Recklinghausen disease (bilateral)"));
children.push(bullet("Otosclerosis: Fixation of stapes footplate; Schwartze sign (flamingo pink); Carhart's notch at 2000 Hz; Treatment: Stapedectomy"));
children.push(spacer());
children.push(sectionHeading("Nose"));
children.push(bullet("DNS: C-shaped = cartilaginous; S-shaped = bone + cartilage; Symptoms: obstruction, headache, epistaxis"));
children.push(bullet("Epistaxis: Most common site = Little's area (Kiesselbach's plexus); Posterior bleeding from sphenopalatine artery"));
children.push(bullet("Angiofibroma: Adolescent males; Intense epistaxis; CT = sunburst; Fibroma on angiogram; Pterygopalatine fossa"));
children.push(spacer());
children.push(sectionHeading("Throat/Larynx"));
children.push(bullet("Trotter's triad = Conductive deafness + Soft palate paralysis + Trigeminal neuralgia (Nasopharyngeal carcinoma)", true));
children.push(bullet("Vocal cord paralysis: Unilateral = Hoarseness; Bilateral = Stridor; RLN injury in thyroid surgery"));
children.push(bullet("Reinke's edema = Subglottic edema; Associated with smoking; Steeple sign on X-ray (croup = subglottic narrowing)"));
children.push(bullet("Croup (Laryngotracheobronchitis): Parainfluenza virus; Steeple sign; Barking cough; Racemic epinephrine + steroids"));
children.push(bullet("Epiglottitis: H. influenzae type b; Thumb print sign on X-ray; Drooling; Do NOT examine throat; Airway first"));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("Cochlear implant: Criteria = profound SNHL (>90dB), failed hearing aid trial, no cochlear nerve aplasia"));
children.push(newTrendBullet("FESS (Functional Endoscopic Sinus Surgery) - gold standard for chronic rhinosinusitis with polyps"));
children.push(newTrendBullet("HPV-related oropharyngeal carcinoma - increasing incidence; better prognosis than HPV-negative"));

// ============================
// 9. OPHTHALMOLOGY
// ============================
children.push(subjectHeading(9, "OPHTHALMOLOGY"));
children.push(sectionHeading("Pupil Abnormalities"));
children.push(makeTable(
  ["Finding", "Lesion", "Clinical Association"],
  [
    ["RAPD (Marcus Gunn pupil)", "Afferent limb (optic nerve/retina)", "Optic neuritis, CRAO, severe retinal detachment"],
    ["Argyll Robertson pupil", "Pretectal nucleus (dorsal midbrain)", "Neurosyphilis; Accommodates but doesn't react to light"],
    ["Horner's syndrome", "Sympathetic chain", "Ptosis + Miosis + Anhidrosis; Pancoast tumor, carotid dissection"],
    ["Adie's tonic pupil", "Ciliary ganglion", "Young women; Sluggish reaction; Hyporeflexia"],
    ["Hutchinson's pupil", "CN III compression", "Uncal herniation; Ipsilateral dilated pupil"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Glaucoma"));
children.push(bullet("Normal IOP = 10-21 mmHg; Normal C/D ratio < 0.5; Suspicious > 0.6; Abnormal > 0.8", true));
children.push(bullet("POAG (Primary open angle): Silent, peripheral vision loss first; Arcuate scotoma; Tonometry screening"));
children.push(bullet("Acute angle closure glaucoma: EMERGENCY; Mid-dilated non-reactive pupil; Severe pain; Nausea; Hazy cornea"));
children.push(subBullet("Treatment: IV Acetazolamide + Topical timolol + Pilocarpine; Definitive: Laser iridotomy"));
children.push(spacer());
children.push(sectionHeading("Retinal Diseases"));
children.push(bullet("Diabetic retinopathy: VEGF key mediator; NPDR: microaneurysms, dot-blot hemorrhages; PDR: neovascularization"));
children.push(subBullet("Treatment: Anti-VEGF (Bevacizumab, Ranibizumab, Aflibercept), laser photocoagulation, vitrectomy"));
children.push(bullet("CRVO (Central Retinal Vein Occlusion): Stormy sunset fundus; Flame hemorrhages all 4 quadrants"));
children.push(bullet("CRAO (Central Retinal Artery Occlusion): Cherry red spot at fovea; Pale retina; Emergency; Immediate massage"));
children.push(bullet("Retinoblastoma: RB gene (13q14); Leukocoria (white pupil) + Strabismus; Trilateral RBT (bilateral + pinealoma)"));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("Anti-VEGF therapy: Now first-line for wet AMD, DME, RVO - Faricimab (bispecific antibody) - new agent"));
children.push(newTrendBullet("OCT (optical coherence tomography): Standard for macular diseases; OCT-A (angiography) - non-invasive"));
children.push(newTrendBullet("Gene therapy: Voretigene neparvovec (Luxturna) for RPE65-associated retinal dystrophy (Leber's)"));

// ============================
// 10. DERMATOLOGY
// ============================
children.push(subjectHeading(10, "DERMATOLOGY"));
children.push(sectionHeading("Classic Signs"));
children.push(makeTable(
  ["Sign", "Disease"],
  [
    ["Nikolsky's sign (positive)", "Pemphigus vulgaris, TEN, SSSS, Bullous pemphigoid (negative)"],
    ["Auspitz sign", "Psoriasis (bleeding on removing scale)"],
    ["Koebner (isomorphic) phenomenon", "Psoriasis, Vitiligo, Lichen planus, Warts"],
    ["Pathergy test", "Behcet's disease"],
    ["Darier's sign", "Urticaria pigmentosa (mastocytosis)"],
    ["Wickham's striae", "Lichen planus (white lacy lines on surface of papules)"],
    ["Buttonhole sign", "Neurofibromatosis (NF1)"],
    ["Russell's sign", "Bulimia nervosa (calluses on knuckles from self-induced vomiting)"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Blistering Disorders"));
children.push(makeTable(
  ["Disease", "Antibody", "Level of Split", "Key Feature"],
  [
    ["Pemphigus vulgaris", "Anti-desmoglein 1 & 3", "Intraepidermal (suprabasal)", "Nikolsky +; Flaccid bullae; Oral involvement; Acantholysis"],
    ["Bullous pemphigoid", "Anti-BP180 (type XVII collagen)", "Subepidermal", "Nikolsky -; Tense bullae; Elderly; Eosinophils"],
    ["Dermatitis herpetiformis", "Anti-endomysial, anti-tTG (IgA)", "Subepidermal", "IgA deposits at dermal papillae; Celiac disease; Dapsone"],
    ["Linear IgA disease", "Anti-BP180 (IgA)", "Subepidermal", "Drug-induced (Vancomycin); String of pearls sign"],
    ["EBA (Epidermolysis bullosa acquisita)", "Anti-type VII collagen", "Sub-lamina densa", "Non-inflammatory blisters; Scarring"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Leprosy"));
children.push(bullet("Tuberculoid leprosy: PB; Well-defined hypoesthetic patches; Few bacilli; Cell-mediated immunity strong"));
children.push(bullet("Lepromatous leprosy: MB; Diffuse infiltration; Many bacilli; Leonine facies; CMI poor"));
children.push(bullet("Type 1 reaction (Reversal): Upgrading; On or before starting treatment; Corticosteroids"));
children.push(bullet("Type 2 reaction (ENL): On treatment; Tender nodules + fever; Thalidomide/Steroids"));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("Biologics in psoriasis: IL-17 inhibitors (Secukinumab, Ixekizumab), IL-23 inhibitors (Guselkumab, Risankizumab)"));
children.push(newTrendBullet("JAK inhibitors in atopic dermatitis: Baricitinib, Upadacitinib, Abrocitinib"));
children.push(newTrendBullet("Dupilumab (anti-IL-4Ra) for atopic dermatitis, eosinophilic esophagitis, prurigo nodularis"));
children.push(newTrendBullet("Dermoscopy: Starburst pattern = Spitz nevus; Regression structures = melanoma; Milium cysts = seborrheic keratosis"));

// ============================
// 11. PSYCHIATRY
// ============================
children.push(subjectHeading(11, "PSYCHIATRY"));
children.push(sectionHeading("Schizophrenia"));
children.push(bullet("Schneider's First Rank Symptoms: Thought insertion/withdrawal/broadcasting; Passivity experiences; Somatic hallucinations; Voices commenting/arguing; Delusional perception", true));
children.push(bullet("Duration: > 6 months for schizophrenia (< 1 month = brief psychotic disorder; 1-6 months = schizophreniform)"));
children.push(bullet("DOC: Olanzapine, Risperidone; Clozapine for treatment-resistant (monitor WBC - agranulocytosis)"));
children.push(spacer());
children.push(sectionHeading("Mood Disorders"));
children.push(bullet("Bipolar disorder DOC: Lithium; Toxicity signs: tremors, polyuria, hypothyroidism, seizures (narrow therapeutic index)"));
children.push(subBullet("Lithium teratogenicity: Ebstein's anomaly (tricuspid valve)"));
children.push(subBullet("Valproate: Also used; Teratogenic (NTD, autism); Monitor LFT"));
children.push(bullet("Depression DOC: SSRIs (Fluoxetine, Sertraline, Escitalopram); TCA (Amitriptyline) - older; SNRIs (Venlafaxine)"));
children.push(bullet("ECT indications: Severe depression with suicidality, catatonia, treatment-resistant, severe mania, pregnancy + severe depression"));
children.push(spacer());
children.push(sectionHeading("Anxiety & Obsessive Disorders"));
children.push(bullet("OCD: Ego-dystonic (patient recognizes thoughts as own but distressing); SSRIs (high dose) + CBT (ERP)"));
children.push(bullet("PTSD: Re-experiencing + avoidance + hyperarousal > 1 month after trauma; First-line: Trauma-focused CBT + SSRIs"));
children.push(spacer());
children.push(sectionHeading("Cognitive Tests"));
children.push(makeTable(
  ["Test", "Max Score", "Cut-off", "Use"],
  [
    ["MMSE", "30", "< 24 = impairment; < 10 = severe", "Screening for dementia"],
    ["MoCA", "30", "< 26 = impairment", "More sensitive for MCI"],
    ["CDR (Clinical Dementia Rating)", "0-3", "0 = none; 3 = severe", "Staging dementia"],
    ["BPRS", "Various", "Higher = more severe", "Brief Psychiatric Rating Scale"]
  ]
));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("DSM-5-TR (2022): Prolonged grief disorder added; ICD-11 now implemented in India"));
children.push(newTrendBullet("Ketamine/Esketamine (Spravato): FDA-approved intranasal for treatment-resistant depression; Rapid onset"));
children.push(newTrendBullet("Gaming disorder (ICD-11): Recognized as mental health condition; Digital addiction spectrum"));
children.push(newTrendBullet("Autism Spectrum Disorder: M-CHAT screening at 18 months; ABA therapy; Increasing prevalence ~1 in 36"));

// ============================
// 12. GENERAL MEDICINE
// ============================
children.push(subjectHeading(12, "GENERAL MEDICINE"));
children.push(sectionHeading("Cardiovascular"));
children.push(bullet("MI biomarkers: Troponin I/T = most sensitive + specific; peaks at 24 hrs; elevated up to 14 days", true));
children.push(bullet("STEMI treatment: PCI within 90 min (door-to-balloon); Thrombolysis within 30 min if PCI unavailable"));
children.push(bullet("Heart Failure: HFrEF (EF<40%) treatment = ACEi/ARBi + Beta blocker + Spironolactone + SGLT2i (GDMT)"));
children.push(subBullet("SGLT2i (Dapagliflozin, Empagliflozin) now class I in both HFrEF AND HFpEF"));
children.push(spacer());
children.push(sectionHeading("Diabetes Mellitus"));
children.push(bullet("Diagnosis: FBS > 126 mg/dL or 2h OGTT > 200 or HbA1c > 6.5% or Random > 200 with symptoms"));
children.push(bullet("HbA1c < 7% = target; < 8% in elderly/comorbid; Reflects 3-month glucose control"));
children.push(bullet("First-line: Metformin (biguanide - decreases hepatic gluconeogenesis); Contraindicated: eGFR < 30"));
children.push(bullet("Add SGLT2i or GLP-1 agonist if established CVD, CKD, or HF (regardless of glucose control)"));
children.push(spacer());
children.push(sectionHeading("Autoimmune/Rheumatological"));
children.push(makeTable(
  ["Disease", "Specific Antibody", "Key Features"],
  [
    ["SLE", "Anti-dsDNA (activity), Anti-Sm (specific)", "SLICC/ACR criteria; Hydroxychloroquine for all; Lupus nephritis - class III/IV = MMF/cyclophosphamide"],
    ["RA", "Anti-CCP (most specific), RF", "Symmetrical small joints; MTX first DMARD; Biologics: Anti-TNF (Etanercept, Infliximab)"],
    ["Sjogren's", "Anti-Ro (SS-A), Anti-La (SS-B)", "Dry eyes + dry mouth; Schirmer's test; Primary biliary cholangitis association"],
    ["Scleroderma (SSc)", "Anti-Scl-70 (diffuse), Anti-centromere (limited)", "CREST syndrome = limited; ILD, renal crisis"],
    ["Polymyositis", "Anti-Jo-1 (anti-synthetase)", "Proximal muscle weakness; elevated CK; ILD association"],
    ["ANCA vasculitis", "c-ANCA (PR3) = GPA; p-ANCA (MPO) = MPA/EGPA", "Cyclophosphamide/Rituximab induction; Azathioprine maintenance"]
  ]
));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("HFpEF management: SGLT2i (Dapagliflozin - DELIVER trial, Empagliflozin - EMPEROR-Preserved) - Class I recommendation"));
children.push(newTrendBullet("GLP-1 agonists for T2DM + CVD/obesity: SELECT trial (Semaglutide) - 20% CV event reduction"));
children.push(newTrendBullet("CKD: Finerenone (non-steroidal MRA) + SGLT2i for diabetic kidney disease; new KDIGO 2024 guidelines"));
children.push(newTrendBullet("Long COVID: Fatigue, cognitive symptoms, POTS, shortness of breath > 12 weeks after acute illness"));

// ============================
// 13. GENERAL SURGERY
// ============================
children.push(subjectHeading(13, "GENERAL SURGERY"));
children.push(sectionHeading("Acute Abdomen"));
children.push(bullet("Acute appendicitis: Alvarado score (MANTRELS) > 7 = high probability; CT abdomen if uncertain", true));
children.push(subBullet("Signs: McBurney's point tenderness, Rovsing's sign, Psoas sign, Obturator sign"));
children.push(subBullet("Laparoscopic appendectomy = standard; Open if perforation with peritonitis"));
children.push(bullet("Acute pancreatitis: Most common cause = Gallstones; 2nd = Alcohol; Serum lipase > amylase (more specific)"));
children.push(subBullet("Ranson's criteria (5 on admission + 6 at 48h); CT Severity Index (Balthazar)"));
children.push(subBullet("Management: IVF, analgesia, NPO; ERCP if cholangitis; Necrosectomy for infected necrosis"));
children.push(spacer());
children.push(sectionHeading("Hernias"));
children.push(makeTable(
  ["Type", "Description"],
  [
    ["Inguinal (indirect)", "Most common; Through deep inguinal ring; Young males"],
    ["Inguinal (direct)", "Through Hesselbach's triangle; Middle-aged/elderly males"],
    ["Femoral", "Below and lateral to pubic tubercle; More common in females; High risk of strangulation"],
    ["Umbilical", "In infants (resolves by 2 years) and adults (obesity, ascites)"],
    ["Spigelian", "Between rectus and semilunar line; Interparietal hernia"],
    ["Richter's hernia", "Only part of circumference of bowel wall herniated; Can strangulate without obstruction"],
    ["Littre's hernia", "Contains Meckel's diverticulum in sac"],
    ["Maydl's hernia", "W-shaped loop of bowel; Intra-abdominal loop strangulates; Reversed Richter's"],
    ["Obturator hernia", "Through obturator foramen; Howship-Romberg sign (pain in inner thigh); Elderly females"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Thyroid"));
children.push(bullet("Papillary carcinoma: Most common (80%); Psammoma bodies; Orphan Annie nuclei; RET/PTC mutation; Best prognosis"));
children.push(bullet("Follicular carcinoma: Hematogenous spread; Capsular invasion; No psammoma bodies; FNAC cannot diagnose"));
children.push(bullet("Medullary carcinoma: Parafollicular C cells; Calcitonin marker; MEN 2A/2B (RET mutation)"));
children.push(bullet("Anaplastic carcinoma: Most aggressive; Elderly; Worst prognosis; Desmoplasia"));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("GIST: c-kit (CD117) mutation; Imatinib (Gleevec) - first targeted therapy for solid tumor; Miettinen classification"));
children.push(newTrendBullet("Sentinel lymph node biopsy (SLNB): Standard for clinically node-negative breast cancer > 1cm; Avoids axillary clearance"));
children.push(newTrendBullet("Colorectal cancer: Lynch syndrome (HNPCC) - MLH1/MSH2 mutation; Universal MMR testing of all CRC"));
children.push(newTrendBullet("Laparoscopic sleeve gastrectomy: Now most performed bariatric procedure worldwide"));

// ============================
// 14. OBSTETRICS
// ============================
children.push(subjectHeading(14, "OBSTETRICS"));
children.push(sectionHeading("Hypertensive Disorders of Pregnancy"));
children.push(bullet("Gestational HTN: BP > 140/90 after 20 weeks, NO proteinuria", true));
children.push(bullet("Preeclampsia: HTN + proteinuria (> 300 mg/24h) after 20 weeks"));
children.push(bullet("Severe features: BP > 160/110, creatinine > 1.1, platelets < 100,000, LFT 2x normal, pulmonary edema, headache, visual symptoms"));
children.push(bullet("Eclampsia: Seizures + preeclampsia; MgSO4 = DOC (Pritchard regimen: 4g IV loading + 10g IM (5g each buttock))"));
children.push(bullet("HELLP syndrome: Hemolysis + Elevated Liver enzymes + Low Platelets; Managed as severe preeclampsia"));
children.push(spacer());
children.push(sectionHeading("Antepartum Hemorrhage"));
children.push(makeTable(
  ["Feature", "Placenta Previa", "Abruptio Placentae"],
  [
    ["Pain", "Painless", "Painful (sudden onset)"],
    ["Bleeding", "Bright red, revealed", "Revealed, concealed, or both"],
    ["Uterus", "Soft, non-tender", "Woody hard, tender"],
    ["Fetal presentation", "Often malpresentation", "Normal"],
    ["DIC risk", "Low", "HIGH"],
    ["Delivery", "C-section (usually)", "Vaginal if stable; C-section if fetal distress"],
    ["Classic sign", "Recurrent painless bleeding", "Couvelaire uterus"]
  ]
));
children.push(spacer());
children.push(sectionHeading("CTG Interpretation"));
children.push(bullet("Normal baseline FHR: 110-160 bpm"));
children.push(bullet("Normal variability: 5-25 bpm; Reduced < 5 bpm; Absent = no variability; Sinusoidal = fetal anemia"));
children.push(bullet("Accelerations: > 15 bpm for > 15 sec = reassuring"));
children.push(bullet("Early decelerations: Mirror contractions = Head compression = BENIGN"));
children.push(bullet("Variable decelerations: Umbilical cord compression; Management = position change"));
children.push(bullet("Late decelerations: Uteroplacental insufficiency = OMINOUS; Immediate intervention required", true));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("Placenta accreta spectrum (PAS): FIGO classification; Increasing incidence due to rising C-section rates; MRI for diagnosis"));
children.push(newTrendBullet("Cell-free DNA / NIPT: Screens for trisomy 21, 18, 13 and sex chromosome anomalies; Done at 10+ weeks"));
children.push(newTrendBullet("Tranexamic acid (TXA): WHO recommends within 3 hours of PPH onset; WOMAN trial evidence"));
children.push(newTrendBullet("Progesterone (vaginal): Reduces preterm birth risk in singleton with short cervix (< 25mm) + prior preterm birth"));

// ============================
// 15. GYNECOLOGY
// ============================
children.push(subjectHeading(15, "GYNECOLOGY"));
children.push(sectionHeading("PCOD/PCOS"));
children.push(bullet("Rotterdam criteria (2 of 3): Oligo/anovulation + Clinical/biochemical hyperandrogenism + Polycystic ovaries on USG", true));
children.push(bullet("LH:FSH ratio > 2:1 (classic finding; not in current diagnostic criteria but high yield for exam)"));
children.push(bullet("Management: Lifestyle modification (first line); OCP for menstrual regulation + hyperandrogenism; Metformin for IR; Clomiphene/Letrozole for ovulation induction"));
children.push(spacer());
children.push(sectionHeading("Cervical Cancer"));
children.push(bullet("HPV 16 (squamous), HPV 18 (adenocarcinoma) = most oncogenic; E6 (degrades p53), E7 (inactivates Rb)"));
children.push(bullet("Pap smear screening: Every 3 years (Pap alone, age 21-65) or every 5 years (co-testing with HPV, age 30-65)"));
children.push(bullet("CIN grading: CIN 1 = mild dysplasia (lower 1/3); CIN 2 = moderate (lower 2/3); CIN 3/CIS = full thickness"));
children.push(bullet("Treatment: CIN 1 = observe; CIN 2/3 = LEEP/cone biopsy; Invasive = Wertheim's hysterectomy ± chemoradiation"));
children.push(spacer());
children.push(sectionHeading("AUB Classification (PALM-COEIN)"));
children.push(makeTable(
  ["Structural (PALM)", "Non-structural (COEIN)"],
  [
    ["Polyp", "Coagulopathy"],
    ["Adenomyosis", "Ovulatory dysfunction"],
    ["Leiomyoma", "Endometrial (primary)"],
    ["Malignancy/Hyperplasia", "Iatrogenic"],
    ["", "Not yet classified"]
  ]
));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("HPV vaccine: Gardasil 9 (9-valent) - covers HPV 6,11,16,18,31,33,45,52,58; India: Cervavac (quadrivalent, indigenous)"));
children.push(newTrendBullet("Endometrial ablation: For AUB in women who completed family; TCRE, NovaSure"));
children.push(newTrendBullet("UAE (Uterine Artery Embolization): For symptomatic fibroids; Preserves uterus; Contraindicated in pregnancy desire"));
children.push(newTrendBullet("Elagolix (GnRH antagonist): Oral; For endometriosis and uterine fibroids; New class of treatment"));

// ============================
// 16. PEDIATRICS
// ============================
children.push(subjectHeading(16, "PEDIATRICS"));
children.push(sectionHeading("Developmental Milestones"));
children.push(makeTable(
  ["Age", "Motor", "Social/Language"],
  [
    ["6 weeks", "Lifts head prone", "Social smile, follows face"],
    ["3 months", "Holds head steady (neck control)", "Cooing, responds to sound"],
    ["6 months", "Sits with support, rolls over", "Monosyllables (ba, da), stranger anxiety"],
    ["9 months", "Sits without support, crawls", "Waves bye-bye, ma-ma/da-da (non-specific)"],
    ["12 months", "Stands with support, cruising", "1-2 words meaningful, pincer grasp"],
    ["18 months", "Walks independently, runs", "10-25 words, points to body parts"],
    ["2 years", "Up/down stairs (2 feet/step)", "2-word sentences, 50+ words"],
    ["3 years", "Tricycle, up stairs alternately", "3-word sentences, name/age/sex"],
    ["4 years", "Hops, skips", "Tells stories, counts to 10"],
    ["5 years", "Skips, ties shoelace", "Complete sentences, reads simple words"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Vaccination Schedule (India - NIS 2023)"));
children.push(makeTable(
  ["Age", "Vaccines"],
  [
    ["Birth", "BCG, OPV-0, Hepatitis B-1"],
    ["6 weeks", "DTwP-1/DTaP-1, OPV-1, IPV-1, Hep B-2, Hib-1, Rotavirus-1, PCV-1"],
    ["10 weeks", "DTwP-2, OPV-2, IPV-2, Hib-2, Rotavirus-2, PCV-2"],
    ["14 weeks", "DTwP-3, OPV-3, IPV-3, Hib-3, Rotavirus-3, PCV-3"],
    ["6 months", "Hepatitis B-3"],
    ["9 months", "Measles/MR-1, Vitamin A-1 (1 lakh IU), JE-1 (endemic areas)"],
    ["12 months", "Hepatitis A-1, Varicella-1"],
    ["15 months", "MMR-1, PCV Booster, Varicella-2"],
    ["16-24 months", "DTwP B1, OPV B1, Hib B1, Hep A-2, MR-2, JE-2"],
    ["5-6 years", "DTwP B2, OPV B2, MMR-2"],
    ["10, 16 years", "TT booster"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Neonatal Conditions"));
children.push(bullet("Neonatal jaundice - physiological: Appears > 24 hrs, peaks day 3-5, resolves by day 14 (term) / day 21 (preterm)", true));
children.push(bullet("Pathological jaundice: Appears within 24 hours; causes = hemolysis (Rh, ABO incompatibility), infection, G6PD"));
children.push(bullet("Exchange transfusion: Bilirubin > 20 mg/dL in term; > 15 in preterm; Direct Coombs positive"));
children.push(bullet("RDS: Surfactant deficiency; L:S ratio < 2:1; Ground glass appearance; Antenatal steroids for prevention"));
children.push(bullet("NEC (Necrotizing Enterocolitis): Premature infants; Pneumatosis intestinalis on X-ray; Surgical emergency"));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("New vaccines in NIS: Rotavirus (Rotavac), PCV (Pneumococcal), IPV - all now universal"));
children.push(newTrendBullet("MIS-C (Multisystem Inflammatory Syndrome in Children): Post-COVID; Kawasaki-like; IVIG + Aspirin + Steroids"));
children.push(newTrendBullet("Childhood obesity: Cut-off BMI > 95th percentile; increasing prevalence; lifestyle + metformin + GLP-1 agonists in adolescents"));
children.push(newTrendBullet("Newborn screening: Expanded panel (> 40 conditions); Tandem mass spectrometry; Early treatment prevents morbidity"));

// ============================
// 17. ORTHOPEDICS
// ============================
children.push(subjectHeading(17, "ORTHOPEDICS"));
children.push(sectionHeading("Fractures"));
children.push(makeTable(
  ["Fracture", "Classic Feature", "Management"],
  [
    ["Colles' fracture", "Dinner fork deformity; FOOSH; distal radius", "Closed reduction + POP (cast)"],
    ["Smith's fracture", "Garden spade deformity; fall on flexed wrist", "Reverse Colles; ORIF often needed"],
    ["Scaphoid fracture", "Anatomical snuffbox tenderness; X-ray may miss", "Thumb spica; MRI if X-ray negative; AVN risk"],
    ["Monteggia fracture", "Proximal ulna # + radial head dislocation", "ORIF; PIN nerve injury"],
    ["Galeazzi fracture", "Distal radius # + DRUJ dislocation", "ORIF required"],
    ["Neck of femur", "Shortened externally rotated leg; Garden classification", "Internal fixation (young) or hemiarthroplasty (elderly)"],
    ["Intertrochanteric # femur", "Greater trochanter to lesser trochanter", "Dynamic hip screw (DHS) or PFNA"],
    ["Clavicle #", "Most common bone to fracture", "Figure of 8 bandage; ORIF if displaced"],
    ["Clavicle (medial end)", "Last epiphysis to fuse (age 25)", "Important for age estimation"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Bone Tumors"));
children.push(makeTable(
  ["Tumor", "Age", "Radiological Feature", "Location"],
  [
    ["Osteosarcoma", "10-20 yrs", "Codman's triangle + Sunburst pattern", "Metaphysis; distal femur/proximal tibia"],
    ["Ewing's sarcoma", "5-15 yrs", "Onion peel (laminated periosteal reaction)", "Diaphysis; pelvis, femur"],
    ["Giant cell tumor (GCT)", "20-40 yrs", "Soap bubble / Egg shell appearance", "Epiphysis; distal femur, proximal tibia"],
    ["Osteochondroma", "< 30 yrs", "Cap of cartilage; grows away from joint", "Most common benign; metaphysis"],
    ["Enchondroma", "20-40 yrs", "Endosteal scalloping; stippled calcification", "Small bones of hand"],
    ["Chondrosarcoma", "40-60 yrs", "Lobular low density; rings/arcs calcification", "Pelvis, proximal femur/humerus"]
  ]
));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("Osteoporosis treatment: Romosozumab (Evenity) - anti-sclerostin antibody; builds AND reduces resorption; 1 year then antiresorptive"));
children.push(newTrendBullet("3D printing in orthopedics: Custom implants, surgical planning"));
children.push(newTrendBullet("Robotic-assisted TKR/THR: Improved accuracy; increasing adoption"));
children.push(newTrendBullet("Regenerative medicine: PRP, stem cell therapy for cartilage repair; still emerging evidence"));

// ============================
// 18. RADIOLOGY
// ============================
children.push(subjectHeading(18, "RADIOLOGY"));
children.push(sectionHeading("Classic X-ray Signs"));
children.push(makeTable(
  ["Sign", "Condition"],
  [
    ["Snowman / Figure of 8 heart", "TAPVR (Total Anomalous Pulmonary Venous Return)"],
    ["Boot-shaped heart (coeur en sabot)", "Tetralogy of Fallot"],
    ["Egg on side (egg on string)", "Transposition of Great Arteries (TGA)"],
    ["Box-shaped heart", "Ebstein's anomaly"],
    ["Flask-shaped heart", "Pericardial effusion"],
    ["Dense MCA sign", "Early ischemic stroke (hyperdense on CT)"],
    ["Coffee bean sign", "Sigmoid volvulus"],
    ["Bird's beak / Rat tail", "Achalasia cardia (bird's beak) / Carcinoma esophagus (rat tail)"],
    ["Apple core", "Carcinoma colon"],
    ["String sign of Kantor", "Crohn's disease (terminal ileum)"],
    ["Thumb printing", "Ischemic colitis, intussusception"],
    ["Rigler's sign (double wall sign)", "Pneumoperitoneum (gas on both sides of bowel wall)"],
    ["Sail sign", "Thymic enlargement in neonates (normal variant)"],
    ["Bat wing / Butterfly opacity", "Pulmonary edema"],
    ["Ground glass opacity (GGO)", "Early interstitial disease, PCP, COVID-19 pneumonia"]
  ]
));
children.push(spacer());
children.push(sectionHeading("CT vs MRI Characteristics"));
children.push(makeTable(
  ["Modality", "Bright (Hyperintense/Hyperdense)", "Dark (Hypointense/Hypodense)"],
  [
    ["CT (Hounsfield units)", "Bone (400-1000 HU), Fresh blood, Calcium, Contrast", "Air (-1000 HU), Fat (-100 HU), Water (0 HU), Old infarct"],
    ["MRI - T1", "Fat, Blood (subacute - methemoglobin), Gadolinium, Melanin", "CSF/fluid, Acute blood, Air"],
    ["MRI - T2", "CSF/Fluid, Edema, Most pathology", "Fibrous tissue, Cortical bone, Air, Hemosiderin"],
    ["FLAIR", "Lesions near CSF (MS plaques, subarachnoid hemorrhage)", "CSF suppressed"]
  ]
));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("PET-CT: F-18 FDG for oncology staging and restaging; Rubidium-82 for myocardial perfusion"));
children.push(newTrendBullet("AI in radiology: Deep learning for chest X-ray interpretation, mammography, diabetic retinopathy screening - FDA approved"));
children.push(newTrendBullet("TACE (Trans-arterial Chemoembolization): For unresectable HCC; lipiodol + chemotherapy"));
children.push(newTrendBullet("TIPS (Transjugular Intrahepatic Portosystemic Shunt): For refractory ascites, variceal bleeding"));
children.push(newTrendBullet("Lung-RADS and BI-RADS reporting systems: Standardized reporting - now tested in exams"));

// ============================
// 19. ANESTHESIA
// ============================
children.push(subjectHeading(19, "ANESTHESIA"));
children.push(sectionHeading("Airway Assessment"));
children.push(makeTable(
  ["Classification", "Grading", "Key Points"],
  [
    ["Mallampati", "Class I: Soft palate, fauces, uvula, pillars visible; Class II: Soft palate, fauces, uvula visible; Class III: Soft palate, base of uvula visible; Class IV: Only hard palate visible", "Class III/IV = Predicted difficult airway"],
    ["Cormack-Lehane", "Grade 1: Full glottis; Grade 2: Posterior commissure; Grade 3: Epiglottis only; Grade 4: Nothing visible", "Grade 3/4 = Difficult laryngoscopy"],
    ["LEMON mnemonic", "Look, Evaluate 3-3-2, Mallampati, Obstruction, Neck mobility", "Bedside difficult airway prediction"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Neuromuscular Blocking Agents"));
children.push(makeTable(
  ["Drug", "Type", "Onset/Duration", "Key Points"],
  [
    ["Succinylcholine", "Depolarizing", "45 sec / 10-15 min", "RSI drug; Phase II block with repeated doses; Contraindicated: Burns >24h, crush injury, hyperkalemia, pseudocholinesterase deficiency"],
    ["Rocuronium", "Non-depolarizing", "60-90 sec (high dose) / 30-60 min", "Alternative to succinylcholine in RSI (high dose 1.2 mg/kg); Reversed by Sugammadex"],
    ["Vecuronium", "Non-depolarizing", "3-5 min / 25-40 min", "No cardiovascular effects; Reversed by Sugammadex"],
    ["Atracurium", "Non-depolarizing", "3-5 min / 20-35 min", "Hofmann elimination (liver/kidney independent); Safe in organ failure; Laudanosine toxicity"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Volatile Anesthetic Agents"));
children.push(makeTable(
  ["Agent", "MAC (%)", "Key Properties"],
  [
    ["Nitrous oxide (N2O)", "105% (no anesthesia alone)", "Carries cylinders; Contraindicated: air-filled cavities, B12 deficiency; Diffusion hypoxia"],
    ["Halothane", "0.75%", "Halothane hepatitis; sensitizes myocardium to catecholamines; Malignant hyperthermia trigger; Historical"],
    ["Isoflurane", "1.15%", "Coronary steal; Most used volatile agent; Pungent smell; Respiratory irritant"],
    ["Sevoflurane", "2.0%", "Pleasant smell; Smooth induction; Compound A (nephrotoxic in circle system); Popular for pediatrics"],
    ["Desflurane", "6.0%", "Fastest recovery; Requires heated vaporizer; Airway irritant; Low blood:gas coefficient"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Malignant Hyperthermia"));
children.push(bullet("Trigger: Succinylcholine + Halogenated volatile agents", true));
children.push(bullet("Cause: Ryanodine receptor (RYR1) mutation - uncontrolled Ca release from sarcoplasmic reticulum"));
children.push(bullet("Features: Masseter spasm, hyperthermia (rising temp), tachycardia, rigidity, metabolic acidosis, myoglobinuria"));
children.push(bullet("Treatment: DANTROLENE (2.5 mg/kg IV, repeat to max 10 mg/kg); Cooling; Hyperventilate; Bicarbonate"));
children.push(spacer());
children.push(sectionHeading("New/Changing Trends 2026"));
children.push(newTrendBullet("Sugammadex: Encapsulates rocuronium/vecuronium; Immediate reversal even at deep block; Replacing neostigmine"));
children.push(newTrendBullet("ERAS (Enhanced Recovery After Surgery): Pre-op carbohydrate loading, regional anesthesia, opioid-sparing, early mobilization"));
children.push(newTrendBullet("POCUS (Point-of-Care Ultrasound): Gastric ultrasound for aspiration risk, lung US for pneumothorax, cardiac US for function"));
children.push(newTrendBullet("TIVA (Total Intravenous Anesthesia): Propofol + Remifentanil infusion; Favored for neurosurgery, PONV risk reduction"));
children.push(newTrendBullet("Remimazolam: New ultra-short-acting benzodiazepine for procedural sedation; Reversible with Flumazenil"));

// ============================
// QUICK REFERENCE TABLE
// ============================
children.push(new Paragraph({ children: [new PageBreak()] }));
children.push(new Paragraph({
  alignment: AlignmentType.CENTER,
  children: [new TextRun({ text: "MASTER QUICK REFERENCE", bold: true, size: 40, color: TABLE_HEADER_TEXT, font: "Calibri" })],
  shading: { type: ShadingType.SOLID, color: TITLE_COLOR },
  spacing: { before: 200, after: 200 }
}));
children.push(spacer());
children.push(sectionHeading("DOC (Drug of Choice) - All Subjects"));
children.push(makeTable(
  ["Condition", "Drug of Choice", "Subject"],
  [
    ["Malaria (sensitive P. vivax)", "Chloroquine", "Pharmacology"],
    ["Malaria (P. falciparum severe)", "IV Artesunate", "Medicine"],
    ["TB (new case)", "HRZE x 2 months + HR x 4 months", "Medicine"],
    ["H. pylori", "PPI + Clarithromycin + Amoxicillin x 14 days", "Medicine"],
    ["Eclampsia", "MgSO4 (Pritchard regimen)", "Obstetrics"],
    ["HTN in pregnancy", "Methyldopa / Labetalol", "Obstetrics"],
    ["Epilepsy in pregnancy", "Lamotrigine / Levetiracetam", "Medicine"],
    ["Bipolar disorder", "Lithium", "Psychiatry"],
    ["OCD", "SSRIs (high dose)", "Psychiatry"],
    ["Anaphylaxis", "Adrenaline 0.5mg IM", "Medicine"],
    ["Status epilepticus (1st line)", "IV Lorazepam / Diazepam", "Medicine"],
    ["Gout (acute)", "Colchicine / NSAIDs", "Medicine"],
    ["Malignant hyperthermia", "Dantrolene 2.5 mg/kg IV", "Anesthesia"],
    ["MRSA", "Vancomycin", "Medicine"],
    ["TB meningitis", "HRZE + Dexamethasone", "Medicine"],
    ["SBP (spontaneous bacterial peritonitis)", "Cefotaxime", "Surgery/Medicine"],
    ["Diabetic foot infection", "Amoxicillin-clavulanate / Piperacillin-tazobactam", "Surgery"],
    ["Leprosy (PB)", "Rifampicin + Dapsone x 6 months", "Dermatology"],
    ["Leprosy (MB)", "Rifampicin + Dapsone + Clofazimine x 12 months", "Dermatology"]
  ]
));
children.push(spacer());
children.push(sectionHeading("Most Common Causes"));
children.push(makeTable(
  ["Condition", "Most Common Cause"],
  [
    ["Most common cancer in females (India)", "Cervical cancer (mortality); Breast cancer (incidence)"],
    ["Most common cancer in males (worldwide)", "Lung cancer (incidence and mortality)"],
    ["Most common GI malignancy worldwide", "Colorectal carcinoma"],
    ["Most common cause of acute pancreatitis", "Gallstones (most common); Alcohol (2nd)"],
    ["Most common cause of portal hypertension (India)", "Extrahepatic portal vein obstruction (EHPVO)"],
    ["Most common cause of hepatic encephalopathy trigger", "GI bleeding, infection, constipation, hypokalemia"],
    ["Most common cause of MI", "Atherosclerosis of coronary arteries (RCA most common in STEMI)"],
    ["Most common cause of death in SLE", "Renal failure, infection"],
    ["Most common organism in UTI", "E. coli (80%)"],
    ["Most common organism in neonatal meningitis", "Group B Streptococcus (term), E. coli (preterm)"],
    ["Most common bone tumor (benign)", "Osteochondroma"],
    ["Most common bone tumor (malignant)", "Metastasis"],
    ["Most common site of ectopic pregnancy", "Ampulla of fallopian tube (70%)"],
    ["Most common cause of PPH", "Uterine atony (80%)"],
    ["Most common cause of maternal mortality (India)", "Hemorrhage"]
  ]
));
children.push(spacer());
children.push(new Paragraph({
  alignment: AlignmentType.CENTER,
  children: [new TextRun({ text: "Best of Luck for NEET PG 2026!", bold: true, size: 32, color: SUBJECT_COLOR, font: "Calibri" })],
  spacing: { before: 300, after: 100 }
}));
children.push(new Paragraph({
  alignment: AlignmentType.CENTER,
  children: [new TextRun({ text: "Study Smart. Revise Often. Attempt Confidently.", size: 24, color: "555555", font: "Calibri", italics: true })],
  spacing: { before: 100, after: 200 }
}));

// Build document
const doc = new Document({
  styles: {
    default: {
      document: {
        run: { font: "Calibri", size: 22 }
      }
    }
  },
  sections: [{
    properties: {
      page: {
        margin: { top: 720, bottom: 720, left: 900, right: 900 }
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    headers: {
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        children: [new Paragraph({
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          children: [new TextRun({ text: "NEET PG 2026 - High Yield Notes (All 19 Subjects)", size: 18, color: "888888", font: "Calibri" })]
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      })
    },
    footers: {
      default: new Footer({
        children: [new Paragraph({
          alignment: AlignmentType.CENTER,
          children: [
            new TextRun({ text: "Page ", size: 18, color: "888888" }),
            new PageNumber(),
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      })
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    children
  }]
});

Packer.toBuffer(doc).then(buffer => {
  fs.writeFileSync('/home/daytona/workspace/neet-pg/NEET_PG_2026_HighYield_Notes.docx', buffer);
  console.log('Document created successfully!');
});

cd /home/daytona/workspace/neet-pg && node create_notes.js 2>&1

~/neet-pg/create_notes.js

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/neet-pg/create_notes.js'

cd /home/daytona/workspace/neet-pg && node create_notes.js 2>&1

python /home/daytona/skills/docx/scripts/office/validate.py /home/daytona/worksp…

ls -lh /home/daytona/workspace/neet-pg/NEET_PG_2026_HighYield_Notes.docx

~/neet-pg/create_schedule.js

const {
  Document, Packer, Paragraph, TextRun, Table, TableRow, TableCell,
  HeadingLevel, AlignmentType, BorderStyle, WidthType, ShadingType,
  Header, Footer, VerticalAlign, PageBreak
} = require('docx');
const fs = require('fs');

// Colors
const DARK_BLUE = "1F3864";
const RED = "C00000";
const BLUE = "2E75B6";
const GREEN = "375623";
const ORANGE = "C55A11";
const PURPLE = "7030A0";
const TEAL = "005050";
const LIGHT_YELLOW = "FFF2CC";
const LIGHT_GREEN = "E2EFDA";
const LIGHT_BLUE = "DEEAF1";
const LIGHT_RED = "FCE4D6";
const LIGHT_PURPLE = "EAE0F0";
const WHITE = "FFFFFF";

function coverTitle(text, color) {
  return new Paragraph({
    alignment: AlignmentType.CENTER,
    children: [new TextRun({ text, bold: true, size: 56, color: WHITE, font: "Calibri" })],
    shading: { type: ShadingType.SOLID, color },
    spacing: { before: 200, after: 100 }
  });
}

function sectionTitle(text, color) {
  return new Paragraph({
    alignment: AlignmentType.CENTER,
    children: [new TextRun({ text, bold: true, size: 36, color: WHITE, font: "Calibri" })],
    shading: { type: ShadingType.SOLID, color },
    spacing: { before: 240, after: 120 }
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}

function subHeading(text, color) {
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    children: [new TextRun({ text, bold: true, size: 26, color: WHITE, font: "Calibri" })],
    shading: { type: ShadingType.SOLID, color },
    spacing: { before: 160, after: 80 }
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}

function bullet(text, bgColor) {
  return new Paragraph({
    bullet: { level: 0 },
    children: [new TextRun({ text, size: 22, font: "Calibri" })],
    shading: bgColor ? { type: ShadingType.SOLID, color: bgColor } : undefined,
    spacing: { before: 40, after: 40 }
  });
}

function spacer() {
  return new Paragraph({ children: [new TextRun({ text: "" })], spacing: { before: 60, after: 60 } });
}

function normalPara(text, bold, color, size, align) {
  return new Paragraph({
    alignment: align || AlignmentType.LEFT,
    children: [new TextRun({ text, bold: bold || false, size: size || 22, color: color || "000000", font: "Calibri" })],
    spacing: { before: 60, after: 60 }
  });
}

function makeScheduleTable(headers, rows, headerColor, altColor) {
  return new Table({
    width: { size: 100, type: WidthType.PERCENTAGE },
    rows: [
      new TableRow({
        tableHeader: true,
        children: headers.map(h => new TableCell({
          shading: { type: ShadingType.SOLID, color: headerColor || BLUE },
          verticalAlign: VerticalAlign.CENTER,
          children: [new Paragraph({
            alignment: AlignmentType.CENTER,
            children: [new TextRun({ text: h, bold: true, color: WHITE, size: 22, font: "Calibri" })]
          })]
        }))
      }),
      ...rows.map((row, i) => new TableRow({
        children: row.map((cell, ci) => new TableCell({
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              font: "Calibri",
              bold: ci === 0,
              color: ci === 0 ? RED : "000000"
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          })]
        }))
      }))
    ]
  });
}

// =================== DOCUMENT CONTENT ===================
const children = [];

// COVER
children.push(spacer());
children.push(spacer());
children.push(coverTitle("NEET PG 2026", DARK_BLUE));
children.push(new Paragraph({
  alignment: AlignmentType.CENTER,
  children: [new TextRun({ text: "30-DAY REVISION SCHEDULE", bold: true, size: 48, color: RED, font: "Calibri" })],
  spacing: { before: 100, after: 100 }
}));
children.push(new Paragraph({
  alignment: AlignmentType.CENTER,
  children: [new TextRun({ text: "Using High-Yield Notes - All 19 Subjects", size: 28, color: BLUE, font: "Calibri", italics: true })],
  spacing: { before: 100, after: 300 }
}));

// Strategy overview table
children.push(makeScheduleTable(
  ["Phase", "Days", "Focus", "Goal"],
  [
    ["Phase 1", "Day 1-10", "Basic Sciences (Anatomy, Physiology, Biochemistry, Pathology, Pharmacology, Microbiology, Forensic)", "Complete 1st reading of theory subjects"],
    ["Phase 2", "Day 11-20", "Clinical Sciences (Medicine, Surgery, OBG, Pediatrics, Ortho, ENT, Ophthal, Derma, Psychiatry, Radiology, Anesthesia)", "Complete 1st reading of clinical subjects"],
    ["Phase 3", "Day 21-27", "Full Revision Round 2 + PYQ focus", "2nd rapid revision + MCQ solving"],
    ["Phase 4", "Day 28-30", "Final blitz - weak areas + mock test", "Consolidate + confidence boost"]
  ],
  DARK_BLUE, LIGHT_BLUE
));

children.push(spacer());
children.push(new Paragraph({
  alignment: AlignmentType.CENTER,
  children: [new TextRun({ text: "Daily Target: 6-8 hours study | 50-100 MCQs per day | 1 subject = 1 day", bold: true, size: 24, color: RED, font: "Calibri" })],
  shading: { type: ShadingType.SOLID, color: LIGHT_YELLOW },
  spacing: { before: 100, after: 200 }
}));

children.push(new Paragraph({ children: [new PageBreak()] }));

// =================== PHASE 1 ===================
children.push(sectionTitle("PHASE 1: BASIC SCIENCES (Day 1 - 10)", RED));
children.push(normalPara("Focus: Anatomy, Physiology, Biochemistry, Pathology, Pharmacology, Microbiology, Forensic Medicine", true, DARK_BLUE, 24));
children.push(spacer());

children.push(makeScheduleTable(
  ["Day", "Subject", "Topics to Cover from Notes", "MCQ Target", "Revision Task"],
  [
    [
      "Day 1",
      "ANATOMY",
      "Nerve injuries + Femoral triangle + Foramen & CN + Lymph drainage + Ligamentum arteriosum + Coronary anatomy + Circle of Willis + Portal-systemic anastomosis",
      "50 Anatomy MCQs",
      "Write 5 key nerve injuries from memory"
    ],
    [
      "Day 2",
      "ANATOMY (Embryology)",
      "All Branchial arch derivatives (1-6) + Gut rotation + Waldeyer's ring + Derivatives of fetal structures (Ductus arteriosus, Ductus venosus, Umbilical vessels)",
      "30 Embryology MCQs",
      "Draw branchial arch chart from memory"
    ],
    [
      "Day 3",
      "PHYSIOLOGY",
      "Cardiac output + Starling's law + Resting membrane potentials + Spirometry values + Cushing reflex + GFR/RBF/FF + Renin release + O2 dissociation curve + GLP-1/GIP (NEW 2026) + Sleep physiology",
      "50 Physiology MCQs",
      "Recall 5 spirometry values without notes"
    ],
    [
      "Day 4",
      "BIOCHEMISTRY",
      "All enzyme defects (PKU, Alkaptonuria, MSUD etc.) + All lysosomal storage diseases (table) + Rate-limiting enzymes + All vitamin deficiencies table + Epigenetics + Oncogenes/tumor suppressors",
      "50 Biochem MCQs",
      "Cover enzyme defect table and recall from memory"
    ],
    [
      "Day 5",
      "PATHOLOGY (Part 1)",
      "Amyloidosis (all types + Congo red) + All types of necrosis + Granuloma types (caseating vs non-caseating) + Classic microscopic findings (RS cells, psammoma bodies, Mallory bodies etc.)",
      "50 Pathology MCQs",
      "List all 5 structures that show psammoma bodies"
    ],
    [
      "Day 6",
      "PATHOLOGY (Part 2)",
      "All tumor markers table + Molecular pathology (EGFR, ALK, HER2, KRAS, PD-L1) + Oncogenes + Tumor suppressors + Cell cycle checkpoints + Apoptosis (intrinsic vs extrinsic)",
      "50 Pathology MCQs",
      "Match each tumor marker to its cancer"
    ],
    [
      "Day 7",
      "PHARMACOLOGY (Part 1)",
      "Zero order kinetics drugs + Enzyme inducers (RCPP) + Enzyme inhibitors (SICK) + Beta blockers (selective vs non-selective) + Drugs in pregnancy (safe + unsafe) table + DOC list (all conditions)",
      "60 Pharma MCQs",
      "Write RCPP and SICK from memory"
    ],
    [
      "Day 8",
      "PHARMACOLOGY (Part 2)",
      "All new 2026 drugs: GLP-1 agonists + SGLT2 inhibitors + JAK inhibitors + DOACs (mechanisms) + Checkpoint inhibitors + Biologics in rheumatology + Sugammadex + Remimazolam",
      "50 Pharma MCQs (new drugs)",
      "Write mechanism of each new drug class"
    ],
    [
      "Day 9",
      "MICROBIOLOGY",
      "Gram staining quick reference (all cocci) + Capsulated organisms (SKHPNC mnemonic) + Obligate aerobes/anaerobes + All special stains table + Vaccine types (live/killed/toxoid/subunit) + AMR mechanisms",
      "60 Micro MCQs",
      "Recall all live attenuated vaccines"
    ],
    [
      "Day 10",
      "FORENSIC MEDICINE",
      "All PM changes table (timings) + Age estimation (last epiphysis = clavicle 25 yrs) + Gustafson's method + All IPC sections table + MTP Act 2021 amendment + POCSO + BNS new sections + DNA profiling",
      "40 Forensic MCQs",
      "Write PM change timings from memory"
    ]
  ],
  RED, LIGHT_RED
));

children.push(spacer());
children.push(subHeading("Phase 1 - End of Day Checklist", RED));
children.push(bullet("Read the full subject section from High-Yield Notes", LIGHT_YELLOW));
children.push(bullet("Solve minimum 40-60 MCQs (Marrow/Prepladder/Previous Years)", LIGHT_YELLOW));
children.push(bullet("Make a 1-page self-written summary of the day's subject", LIGHT_YELLOW));
children.push(bullet("Mark all MCQs you got wrong for re-attempt tomorrow morning", LIGHT_YELLOW));
children.push(bullet("Sleep 7-8 hours - memory consolidation happens during sleep", LIGHT_YELLOW));

children.push(new Paragraph({ children: [new PageBreak()] }));

// =================== PHASE 2 ===================
children.push(sectionTitle("PHASE 2: CLINICAL SCIENCES (Day 11 - 20)", BLUE));
children.push(normalPara("Focus: Medicine, Surgery, OBG, Pediatrics + all smaller clinical subjects", true, DARK_BLUE, 24));
children.push(spacer());

children.push(makeScheduleTable(
  ["Day", "Subject", "Topics to Cover from Notes", "MCQ Target", "Revision Task"],
  [
    [
      "Day 11",
      "ENT",
      "Cholesteatoma (safe vs unsafe ear) + Tuning fork tests (Rinne + Weber) + Acoustic neuroma + Otosclerosis + Angiofibroma + Trotter's triad + Vocal cord palsy + Croup vs Epiglottitis + Cochlear implant (NEW 2026)",
      "50 ENT MCQs",
      "Draw tuning fork test decision tree"
    ],
    [
      "Day 12",
      "OPHTHALMOLOGY",
      "All pupil abnormalities table (RAPD, AR pupil, Horner's, Adie's) + Glaucoma (POAG vs AACG) + Diabetic retinopathy (VEGF, anti-VEGF drugs) + CRVO/CRAO + Retinoblastoma + Corneal graft + Anti-VEGF new agents",
      "50 Ophthal MCQs",
      "Describe management of AACG step-by-step"
    ],
    [
      "Day 13",
      "DERMATOLOGY",
      "All classic signs table (Nikolsky, Auspitz, Koebner, Darier's etc.) + Blistering disorders table (Pemphigus vs Pemphigoid vs DH) + Leprosy (PB vs MB + Type 1 vs Type 2 reactions) + Biologics in psoriasis (NEW 2026) + JAK inhibitors",
      "50 Derma MCQs",
      "List all diseases showing Koebner phenomenon"
    ],
    [
      "Day 14",
      "PSYCHIATRY",
      "Schneider's First Rank Symptoms (all 7) + Schizophrenia duration criteria + Bipolar - Lithium toxicity + ECT indications + OCD management + PTSD criteria + All cognitive tests table + Ketamine (NEW 2026) + Gaming disorder",
      "50 Psychiatry MCQs",
      "Write Schneider's FRS from memory"
    ],
    [
      "Day 15",
      "GENERAL MEDICINE (Part 1)",
      "MI biomarkers + STEMI management (door-to-balloon) + HF management (GDMT: ACEi + BB + Spiro + SGLT2i) + HFpEF (NEW 2026) + Diabetes diagnosis criteria + Metformin contraindications + SGLT2i/GLP-1 indications",
      "70 Medicine MCQs",
      "Write 4 pillars of HFrEF treatment"
    ],
    [
      "Day 16",
      "GENERAL MEDICINE (Part 2)",
      "All autoimmune table (SLE, RA, Sjogren's, Scleroderma, Polymyositis) + specific antibodies + ANCA vasculitis + TB Mantoux criteria + Long COVID (NEW 2026) + CKD staging + Finerenone (NEW 2026)",
      "70 Medicine MCQs",
      "Match each antibody to its disease"
    ],
    [
      "Day 17",
      "GENERAL SURGERY",
      "Acute appendicitis (Alvarado score, signs) + Acute pancreatitis (Ranson's, Balthazar) + All hernia types table + Thyroid carcinomas (types, features, markers) + GIST (NEW 2026) + SLNB in breast (NEW 2026) + Lynch syndrome",
      "60 Surgery MCQs",
      "List all 9 hernia types and their key features"
    ],
    [
      "Day 18",
      "OBSTETRICS",
      "Hypertensive disorders (GH vs PET vs Eclampsia) + MgSO4 Pritchard regimen + HELLP + APH (Previa vs Abruption table) + CTG interpretation (all decelerations) + NIPT/cell-free DNA + Tranexamic acid (NEW 2026) + PAS/accreta",
      "60 OBG MCQs",
      "Differentiate placenta previa vs abruption (8 features)"
    ],
    [
      "Day 19",
      "GYNECOLOGY + PEDIATRICS",
      "PCOS (Rotterdam criteria) + Cervical cancer (HPV, CIN grading) + AUB PALM-COEIN + Ectopic pregnancy management + HPV 9-valent vaccine (NEW 2026) | Developmental milestones table + NIS vaccination schedule + Neonatal jaundice + RDS + MIS-C (NEW 2026)",
      "60 Peds/Gynae MCQs",
      "Recall milestones at 6w, 3m, 6m, 1yr, 2yr"
    ],
    [
      "Day 20",
      "ORTHO + RADIOLOGY + ANESTHESIA",
      "All fractures table (Colles, Scaphoid, NOF etc.) + Bone tumor table (Osteosarcoma, Ewing's, GCT etc.) + All X-ray signs table (Snowman, Boot-shaped, Coffee bean etc.) + CT/MRI table + Mallampati + NMBA table + Malignant hyperthermia + Sugammadex (NEW 2026)",
      "60 Mixed MCQs",
      "Draw CT/MRI T1 vs T2 brightness table from memory"
    ]
  ],
  BLUE, LIGHT_BLUE
));

children.push(spacer());
children.push(subHeading("Phase 2 - End of Day Checklist", BLUE));
children.push(bullet("After each clinical subject - focus on understanding the CLINICAL SCENARIO pattern", LIGHT_BLUE));
children.push(bullet("Practice case-based MCQs (Prepladder clinical cases)", LIGHT_BLUE));
children.push(bullet("Revise previous day's 1-page summary each morning (15 min)", LIGHT_BLUE));
children.push(bullet("Flag difficult topics for Phase 3 focused revision", LIGHT_BLUE));

children.push(new Paragraph({ children: [new PageBreak()] }));

// =================== PHASE 3 ===================
children.push(sectionTitle("PHASE 3: RAPID REVISION + PYQ FOCUS (Day 21 - 27)", GREEN));
children.push(normalPara("This phase = 2nd read (50% faster) + Previous Year Questions (last 5 years)", true, DARK_BLUE, 24));
children.push(spacer());

children.push(makeScheduleTable(
  ["Day", "Subjects (Rapid Revision)", "Focus Area", "PYQ Target", "Special Task"],
  [
    [
      "Day 21",
      "Anatomy + Physiology + Biochemistry",
      "Only tables, mnemonics, and flagged topics. Skip what you already know well.",
      "30 PYQs each subject (90 total)",
      "Solve 2019-2020 NEET PG paper questions for these subjects"
    ],
    [
      "Day 22",
      "Pathology + Pharmacology",
      "Tumor markers, necrosis types, all DOC list. New drugs (GLP-1, SGLT2i, biologics). Focus on mechanism-based questions.",
      "50 PYQs each (100 total)",
      "Make a master DOC list on one page from memory"
    ],
    [
      "Day 23",
      "Microbiology + Forensic Medicine",
      "Special stains, capsulated organisms, vaccine types. PM changes timings, IPC sections, MTP Act amendment.",
      "50 PYQs each (100 total)",
      "Write all IPC sections from memory (legal medicine)"
    ],
    [
      "Day 24",
      "ENT + Ophthal + Dermatology + Psychiatry",
      "Classic signs (Trotter's triad, Nikolsky, AR pupil), tuning fork tests, blistering disorders, Schneider's FRS.",
      "25 PYQs each (100 total)",
      "Make a table of all classic eponymous signs across subjects"
    ],
    [
      "Day 25",
      "Medicine + Surgery",
      "Autoimmune antibodies, heart failure GDMT, hernia types, thyroid carcinomas. All NEW 2026 topics (SGLT2i in HFpEF, GIST, Lynch syndrome).",
      "50 PYQs each (100 total)",
      "Attempt one full 50-question mock on Medicine"
    ],
    [
      "Day 26",
      "OBG + Pediatrics + Gynecology",
      "CTG decelerations, eclampsia management, developmental milestones, vaccination schedule. PALM-COEIN classification.",
      "40 PYQs each (120 total)",
      "Attempt one full 50-question mock on OBG+Peds"
    ],
    [
      "Day 27",
      "Ortho + Radiology + Anesthesia + All NEW 2026 topics",
      "Bone tumors, X-ray signs, NMBA comparison, malignant hyperthermia. Compile all red 'NEW 2026' points from notes into one list.",
      "30 PYQs each (90 total)",
      "Create a single-page 'NEW 2026 TOPICS' cheat sheet"
    ]
  ],
  GREEN, LIGHT_GREEN
));

children.push(spacer());
children.push(subHeading("Phase 3 Key Strategy", GREEN));
children.push(bullet("Speed is key in Phase 3 - don't re-read everything, only flagged weak areas", LIGHT_GREEN));
children.push(bullet("PYQs reveal the ACTUAL exam pattern - never skip this", LIGHT_GREEN));
children.push(bullet("Track your accuracy: < 50% = needs more work; > 70% = you're on track", LIGHT_GREEN));
children.push(bullet("Revise 1-page summaries from Phase 1 and Phase 2 (30 min each morning)", LIGHT_GREEN));

children.push(new Paragraph({ children: [new PageBreak()] }));

// =================== PHASE 4 ===================
children.push(sectionTitle("PHASE 4: FINAL 3-DAY BLITZ (Day 28 - 30)", PURPLE));
children.push(spacer());

children.push(makeScheduleTable(
  ["Day", "Activity", "Details", "Target"],
  [
    [
      "Day 28",
      "WEAK AREA BLITZ",
      "Go through all wrong MCQs from Phase 1-3. Re-read only topics where accuracy < 50%. Focus on your personal weak subjects. Do NOT start new topics.",
      "Revise 200+ wrong MCQs. Aim for 70%+ accuracy on re-attempt."
    ],
    [
      "Day 29",
      "FULL MOCK TEST",
      "Attempt a full 200-question mock test under exam conditions (3.5 hours, no breaks, no phone). Mark and analyze immediately after.",
      "Target score: 60%+ (120+ questions correct). Analyze subject-wise performance."
    ],
    [
      "Day 30",
      "FINAL REVISION + REST",
      "Morning: Revise only your 'NEW 2026 topics' cheat sheet + DOC list + all classic signs. Afternoon: Light reading only. Evening: STOP studying. Sleep by 10 PM.",
      "Mental freshness is your biggest asset on exam day. Trust your preparation."
    ]
  ],
  PURPLE, LIGHT_PURPLE
));

children.push(spacer());
children.push(subHeading("Exam Day Tips", PURPLE));
children.push(bullet("Eat a light meal. Reach center 30 min early.", LIGHT_PURPLE));
children.push(bullet("Attempt easy questions first - don't get stuck on difficult ones.", LIGHT_PURPLE));
children.push(bullet("Negative marking = -1 per wrong answer. Attempt only if > 60% confident.", LIGHT_PURPLE));
children.push(bullet("High-yield subjects to attempt first: Pharmacology, Forensic, Pathology, Micro (most predictable).", LIGHT_PURPLE));
children.push(bullet("Clinical subjects (Medicine, Surgery): Careful reasoning - don't be hasty.", LIGHT_PURPLE));

children.push(new Paragraph({ children: [new PageBreak()] }));

// =================== DAILY TIMETABLE ===================
children.push(sectionTitle("DAILY TIMETABLE (6-8 Hours)", ORANGE));
children.push(spacer());

children.push(makeScheduleTable(
  ["Time Slot", "Activity", "Duration"],
  [
    ["6:00 - 6:30 AM", "Morning revision: Yesterday's 1-page summary + wrong MCQs", "30 min"],
    ["6:30 - 9:00 AM", "Main study session: Read High-Yield Notes (today's subject)", "2.5 hours"],
    ["9:00 - 9:30 AM", "Break + breakfast", "30 min"],
    ["9:30 - 11:30 AM", "MCQ practice: Solve 50-70 MCQs on today's subject", "2 hours"],
    ["11:30 AM - 12:00 PM", "Note errors, re-read explanations of wrong MCQs", "30 min"],
    ["12:00 - 1:00 PM", "Lunch + rest", "1 hour"],
    ["1:00 - 2:30 PM", "Second subject or PYQs (Phase 3)/weak area (Phase 4)", "1.5 hours"],
    ["2:30 - 3:00 PM", "Write 1-page self-summary of today's subject", "30 min"],
    ["3:00 - 4:00 PM", "Short nap / physical activity / total break", "1 hour"],
    ["4:00 - 6:00 PM", "MCQ bank (Marrow/Prepladder) - Subject test or grand test", "2 hours"],
    ["6:00 - 7:00 PM", "Dinner + break", "1 hour"],
    ["7:00 - 8:00 PM", "Quick revision: Mnemonics, tables, DOC list", "1 hour"],
    ["8:00 - 9:30 PM", "Optional: Watch 1 video lecture on difficult topic only", "1.5 hours"],
    ["10:00 PM", "SLEEP (non-negotiable for memory consolidation)", "-"]
  ],
  ORANGE, LIGHT_YELLOW
));

children.push(spacer());

// =================== SUBJECT PRIORITY ===================
children.push(sectionTitle("SUBJECT PRIORITY & MARKS WEIGHTAGE", TEAL));
children.push(spacer());
children.push(makeScheduleTable(
  ["Priority", "Subject", "Expected Questions", "Difficulty", "Strategy"],
  [
    ["1 - HIGHEST", "Pharmacology", "20-25 Qs", "Medium", "Memorize DOC, enzyme inducers/inhibitors, new 2026 drugs. Most scoring."],
    ["1 - HIGHEST", "Microbiology", "15-20 Qs", "Medium", "Special stains, capsulated organisms, vaccines. Very predictable."],
    ["1 - HIGHEST", "Pathology", "15-20 Qs", "Medium", "Tumor markers, classic cells, amyloid, necrosis. Pattern-based."],
    ["1 - HIGHEST", "Forensic Medicine", "10-15 Qs", "Easy", "PM changes + IPC sections = guaranteed marks. Don't miss."],
    ["2 - HIGH", "Biochemistry", "10-15 Qs", "Medium", "Enzyme defects + lysosomal storage diseases table = 5-8 marks."],
    ["2 - HIGH", "Physiology", "10-15 Qs", "Medium", "Values-based. Memorize all numbers (GFR, FEV1/FVC, potentials)."],
    ["2 - HIGH", "General Medicine", "20-25 Qs", "Hard", "Long cases; focus on criteria, criteria, criteria (diagnostic criteria)."],
    ["2 - HIGH", "OBG", "15-20 Qs", "Medium", "CTG, eclampsia, APH = guaranteed questions every year."],
    ["3 - MEDIUM", "Pediatrics", "10-15 Qs", "Medium", "Milestones + vaccines = 5-6 marks minimum."],
    ["3 - MEDIUM", "ENT", "8-10 Qs", "Easy-Med", "Tuning fork tests + Cholesteatoma + Trotter's = high yield."],
    ["3 - MEDIUM", "Dermatology", "8-10 Qs", "Easy-Med", "Signs table + blistering disorders = predictable."],
    ["3 - MEDIUM", "Surgery", "15-20 Qs", "Medium", "Hernias + fractures + thyroid = most repeated."],
    ["3 - MEDIUM", "Ophthalmology", "8-10 Qs", "Medium", "Pupil abnormalities + glaucoma = most tested."],
    ["4 - LOWER", "Anatomy", "8-10 Qs", "Medium-Hard", "Embryology increasing - cover branchial arches well."],
    ["4 - LOWER", "Psychiatry", "8-10 Qs", "Easy-Med", "Schneider's FRS + Lithium toxicity = high yield."],
    ["4 - LOWER", "Orthopedics", "8-10 Qs", "Medium", "Bone tumor X-ray features = very testable."],
    ["4 - LOWER", "Radiology", "8-10 Qs", "Easy", "X-ray signs = guaranteed marks if memorized."],
    ["4 - LOWER", "Anesthesia", "6-8 Qs", "Medium", "Mallampati + MH + Succinylcholine contraindications = core topics."]
  ],
  TEAL, "#E0F0F0"
));

children.push(spacer());

// =================== RESOURCES ===================
children.push(sectionTitle("RECOMMENDED FREE RESOURCES", DARK_BLUE));
children.push(spacer());
children.push(makeScheduleTable(
  ["Resource", "Type", "Best For", "Access"],
  [
    ["Marrow (free tier)", "MCQ Bank + Videos", "All subjects - Grand tests, subject tests", "marrow.ac (app)"],
    ["Prepladder YouTube", "Free Video Lectures", "Clinical subjects - case discussions", "YouTube"],
    ["DAMS free lectures", "Video Lectures", "Basic sciences (Physiology, Pathology)", "YouTube / daams.in"],
    ["Previous Year Papers (2018-2024)", "PYQs", "Pattern recognition - most important", "Telegram / coaching institutes"],
    ["Geeky Medics", "Clinical Cases", "OSCEs and clinical reasoning", "geekymedics.com"],
    ["High-Yield Notes (this document)", "Quick Revision", "Pre-exam rapid revision", "Downloaded - use it!"]
  ],
  DARK_BLUE, LIGHT_BLUE
));

children.push(spacer());

// =================== MOTIVATIONAL FOOTER ===================
children.push(new Paragraph({
  alignment: AlignmentType.CENTER,
  children: [new TextRun({ text: "\"Consistency beats intensity. Study every day, revise often, attempt confidently.\"", size: 24, color: DARK_BLUE, font: "Calibri", italics: true })],
  shading: { type: ShadingType.SOLID, color: LIGHT_YELLOW },
  spacing: { before: 200, after: 100 }
}));
children.push(new Paragraph({
  alignment: AlignmentType.CENTER,
  children: [new TextRun({ text: "Best of Luck for NEET PG 2026! You've got this!", bold: true, size: 28, color: RED, font: "Calibri" })],
  spacing: { before: 100, after: 200 }
}));

// =================== BUILD DOC ===================
const doc = new Document({
  styles: {
    default: {
      document: { run: { font: "Calibri", size: 22 } }
    }
  },
  sections: [{
    properties: {
      page: { margin: { top: 720, bottom: 720, left: 800, right: 800 } }
    },
    headers: {
      default: new Header({
        children: [new Paragraph({
          alignment: AlignmentType.CENTER,
          children: [new TextRun({ text: "NEET PG 2026 - 30-Day Revision Schedule", size: 18, color: "888888", font: "Calibri" })]
        })]
      })
    },
    footers: {
      default: new Footer({
        children: [new Paragraph({
          alignment: AlignmentType.CENTER,
          children: [new TextRun({ text: "Study Smart | Revise Often | Attempt Confidently", size: 18, color: "888888", font: "Calibri" })]
        })]
      })
    },
    children
  }]
});

Packer.toBuffer(doc).then(buffer => {
  fs.writeFileSync('/home/daytona/workspace/neet-pg/NEET_PG_2026_30Day_Revision_Schedule.docx', buffer);
  console.log('Schedule document created successfully!');
});

cd /home/daytona/workspace/neet-pg && node create_schedule.js 2>&1

ls -lh /home/daytona/workspace/neet-pg/NEET_PG_2026_30Day_Revision_Schedule.docx

~/neet-pg/create_flashcards.js

const {
  Document, Packer, Paragraph, TextRun, Table, TableRow, TableCell,
  AlignmentType, WidthType, ShadingType, BorderStyle, VerticalAlign,
  Header, HeadingLevel, PageBreak
} = require('docx');
const fs = require('fs');

// Colors
const CARD_FRONT_MNEMONIC = "1F3864";  // dark blue
const CARD_FRONT_DOC      = "7B0000";  // dark red
const CARD_BACK_BG        = "FFFBF0";  // cream
const HIGHLIGHT           = "FFF2CC";
const GREEN_BG            = "E2EFDA";
const BLUE_BG             = "DEEAF1";
const RED_BG              = "FCE4D6";
const WHITE               = "FFFFFF";
const BORDER_COLOR        = "AAAAAA";

// ── helpers ──────────────────────────────────────────────────────────────────

function sp(before = 60, after = 60) {
  return { spacing: { before, after } };
}

function centerRun(text, { bold = false, size = 22, color = "000000", italics = false } = {}) {
  return new Paragraph({
    alignment: AlignmentType.CENTER,
    children: [new TextRun({ text, bold, size, color, font: "Calibri", italics })],
    ...sp(40, 40)
  });
}

// A single flashcard = a 1-row, 2-column table (FRONT | BACK)
function flashcard(frontLabel, frontMain, frontSub, backTitle, backLines, frontColor) {
  const borderProps = {
    top:    { style: BorderStyle.SINGLE, size: 8,  color: BORDER_COLOR },
    bottom: { style: BorderStyle.SINGLE, size: 8,  color: BORDER_COLOR },
    left:   { style: BorderStyle.SINGLE, size: 8,  color: BORDER_COLOR },
    right:  { style: BorderStyle.SINGLE, size: 12, color: BORDER_COLOR },
  };

  // FRONT cell
  const frontChildren = [
    new Paragraph({
      alignment: AlignmentType.CENTER,
      children: [new TextRun({ text: frontLabel, bold: true, size: 18, color: "FFFF99", font: "Calibri" })],
      shading:  { type: ShadingType.SOLID, color: frontColor },
      ...sp(80, 40)
    }),
    new Paragraph({
      alignment: AlignmentType.CENTER,
      children: [new TextRun({ text: frontMain, bold: true, size: 28, color: WHITE, font: "Calibri" })],
      shading:  { type: ShadingType.SOLID, color: frontColor },
      ...sp(40, 20)
    }),
  ];
  if (frontSub) {
    frontChildren.push(new Paragraph({
      alignment: AlignmentType.CENTER,
      children: [new TextRun({ text: frontSub, size: 20, color: "CCDDFF", font: "Calibri", italics: true })],
      shading:  { type: ShadingType.SOLID, color: frontColor },
      ...sp(20, 80)
    }));
  }

  // BACK cell
  const backChildren = [
    new Paragraph({
      alignment: AlignmentType.CENTER,
      children: [new TextRun({ text: "ANSWER", bold: true, size: 18, color: "888888", font: "Calibri" })],
      ...sp(80, 40)
    }),
    new Paragraph({
      alignment: AlignmentType.CENTER,
      children: [new TextRun({ text: backTitle, bold: true, size: 24, color: frontColor, font: "Calibri" })],
      ...sp(20, 30)
    }),
  ];
  backLines.forEach(line => {
    backChildren.push(new Paragraph({
      alignment: AlignmentType.CENTER,
      children: [new TextRun({ text: line, size: 21, font: "Calibri" })],
      ...sp(20, 20)
    }));
  });

  return new Table({
    width: { size: 100, type: WidthType.PERCENTAGE },
    rows: [
      new TableRow({
        height: { value: 1800 },
        children: [
          new TableCell({
            width: { size: 48, type: WidthType.PERCENTAGE },
            shading: { type: ShadingType.SOLID, color: frontColor },
            borders: borderProps,
            verticalAlign: VerticalAlign.CENTER,
            children: frontChildren
          }),
          new TableCell({
            width: { size: 52, type: WidthType.PERCENTAGE },
            shading: { type: ShadingType.SOLID, color: CARD_BACK_BG },
            borders: borderProps,
            verticalAlign: VerticalAlign.CENTER,
            children: backChildren
          })
        ]
      })
    ]
  });
}

function sectionBanner(text, color) {
  return new Paragraph({
    alignment: AlignmentType.CENTER,
    children: [new TextRun({ text, bold: true, size: 36, color: WHITE, font: "Calibri" })],
    shading: { type: ShadingType.SOLID, color },
    ...sp(300, 160)
  });
}

function gap() {
  return new Paragraph({ children: [new TextRun({ text: "" })], ...sp(80, 80) });
}

// ── DATA ─────────────────────────────────────────────────────────────────────

// MNEMONICS — { front: {main, sub}, back: {title, lines} }
const mnemonics = [
  // Pharmacology
  {
    front: { main: "RCPP", sub: "Enzyme INDUCERS" },
    back:  { title: "R-C-P-P Inducers", lines: ["R - Rifampicin", "C - Carbamazepine", "P - Phenytoin", "P - Phenobarbitone", "(All increase CYP450 activity)"] }
  },
  {
    front: { main: "SICK", sub: "Enzyme INHIBITORS" },
    back:  { title: "S-I-C-K Inhibitors", lines: ["S - Sulfonamides / SSRIs", "I - Isoniazid", "C - Ciprofloxacin / Cimetidine", "K - Ketoconazole", "(+ Erythromycin, Metronidazole)"] }
  },
  {
    front: { main: "MAB", sub: "Cardioselective β-blockers" },
    back:  { title: "M-A-B (β1 selective)", lines: ["M - Metoprolol", "A - Atenolol", "B - Bisoprolol", "(Also: Nebivolol, Betaxolol)", "Safe in mild asthma"] }
  },
  {
    front: { main: "Zero Order Drugs", sub: "Constant amount eliminated" },
    back:  { title: "PAWW", lines: ["P - Phenytoin", "A - Alcohol (Ethanol)", "W - Warfarin (high dose)", "W - aspirin (high dose Salicylates)", "Saturation kinetics → toxicity risk"] }
  },
  // Microbiology
  {
    front: { main: "SKHPNC", sub: "Capsulated organisms" },
    back:  { title: "\"Some Killers Have Pretty Nice Capsules\"", lines: ["S - Streptococcus pneumoniae", "K - Klebsiella pneumoniae", "H - Haemophilus influenzae", "P - Pseudomonas aeruginosa", "N - Neisseria meningitidis", "C - Cryptococcus neoformans"] }
  },
  {
    front: { main: "PMBN", sub: "Obligate AEROBES" },
    back:  { title: "P-M-B-N Aerobes", lines: ["P - Pseudomonas aeruginosa", "M - Mycobacterium tuberculosis", "B - Bordetella pertussis", "N - Nocardia asteroides", "(Need O₂ to survive)"] }
  },
  {
    front: { main: "Live Attenuated Vaccines", sub: "Which vaccines are live?" },
    back:  { title: "\"Be Oral, My Very Yellow Rotavirus\"", lines: ["B - BCG", "O - OPV (oral polio)", "M - MMR", "V - Varicella", "Y - Yellow fever", "R - Rotavirus", "(+ Influenza nasal spray)"] }
  },
  // Anatomy
  {
    front: { main: "NAVeL", sub: "Femoral triangle (lateral → medial)" },
    back:  { title: "N-A-V-E-L", lines: ["N - Nerve (femoral)", "A - Artery (femoral)", "V - Vein (femoral)", "E - (Empty space)", "L - Lymphatics / Canal", "Most medial = Femoral canal"] }
  },
  {
    front: { main: "SOF Contents", sub: "Superior Orbital Fissure" },
    back:  { title: "\"Lazy French Tarts Sit Naked In Anticipation\"", lines: ["L - Lacrimal nerve (V1)", "F - Frontal nerve (V1)", "T - Trochlear nerve (CN IV)", "S - Superior ophthalmic vein", "N - Nasociliary nerve (V1)", "I - III (oculomotor)", "A - Abducens (CN VI)"] }
  },
  {
    front: { main: "Branchial Arch 1", sub: "Derivatives?" },
    back:  { title: "Arch 1 = CN V (Trigeminal)", lines: ["Cartilage: Meckel's (mandible, malleus, incus)", "Muscles of mastication:", "Temporalis, Masseter, Medial/Lateral pterygoid", "Mylohyoid, anterior belly digastric", "Tensor tympani, Tensor veli palatini"] }
  },
  {
    front: { main: "Branchial Arch 2", sub: "Derivatives?" },
    back:  { title: "Arch 2 = CN VII (Facial)", lines: ["Cartilage: Reichert's", "Stapes, styloid process", "Lesser cornu + upper hyoid", "Muscles of facial expression", "Stapedius, stylohyoid", "Posterior belly digastric"] }
  },
  // Pathology
  {
    front: { main: "Psammoma Bodies", sub: "Which tumors?" },
    back:  { title: "\"PSaMMoMa\"", lines: ["P - Papillary thyroid carcinoma", "S - Serous cystadenocarcinoma (ovary)", "M - Meningioma", "M - Mesothelioma", "(Concentric calcified laminations)"] }
  },
  {
    front: { main: "Koebner Phenomenon", sub: "Which diseases?" },
    back:  { title: "\"PVLW\" Koebner positive", lines: ["P - Psoriasis", "V - Vitiligo", "L - Lichen planus", "W - Warts (verruca vulgaris)", "(New lesions at sites of trauma/injury)"] }
  },
  {
    front: { main: "AA Amyloid", sub: "Secondary amyloidosis causes?" },
    back:  { title: "Secondary (AA) amyloid causes", lines: ["Chronic infections: TB, osteomyelitis", "Chronic inflammatory: RA, Crohn's", "Malignancy: Hodgkin's lymphoma, RCC", "Familial Mediterranean Fever (FMF)", "Precursor protein: Serum Amyloid A (SAA)"] }
  },
  // Medicine / Clinical
  {
    front: { main: "HELLP Syndrome", sub: "Components?" },
    back:  { title: "H-E-L-L-P", lines: ["H - Hemolysis", "E - Elevated Liver enzymes", "L - Low Platelets", "L - (all 3 together)", "P - Part of severe preeclampsia spectrum", "Management = as severe PET; deliver"] }
  },
  {
    front: { main: "PALM-COEIN", sub: "AUB Classification" },
    back:  { title: "Structural (PALM) + Non-structural (COEIN)", lines: ["P - Polyp", "A - Adenomyosis", "L - Leiomyoma", "M - Malignancy/Hyperplasia", "C - Coagulopathy  O - Ovulatory dysfunction", "E - Endometrial  I - Iatrogenic  N - Not classified"] }
  },
  {
    front: { main: "Cushing's TRIAD", sub: "Sign of raised ICP" },
    back:  { title: "Cushing's Reflex (raised ICP)", lines: ["1. Hypertension (wide pulse pressure)", "2. Bradycardia", "3. Irregular respiration", "Mechanism: brainstem compression", "Medical EMERGENCY → CT head immediately"] }
  },
  {
    front: { main: "LEMON", sub: "Difficult airway prediction" },
    back:  { title: "L-E-M-O-N Score", lines: ["L - Look (abnormal face/neck)", "E - Evaluate 3-3-2 rule", "M - Mallampati class III/IV", "O - Obstruction (stridor, mass)", "N - Neck mobility (limited)", "≥3 = predicted difficult airway"] }
  },
  {
    front: { main: "Schneider's FRS", sub: "1st Rank Symptoms of Schizophrenia" },
    back:  { title: "7 First Rank Symptoms", lines: ["1. Thought insertion", "2. Thought withdrawal", "3. Thought broadcasting", "4. Passivity (made feelings/actions)", "5. Somatic passivity", "6. Auditory hallucinations (3rd person/running commentary)", "7. Delusional perception"] }
  },
  {
    front: { main: "CAVE deformity", sub: "CTEV (Club foot)" },
    back:  { title: "C-A-V-E (Clubfoot)", lines: ["C - Cavus (high arch)", "A - Adductus (forefoot adduction)", "V - Varus (heel varus / inversion)", "E - Equinus (plantar flexion)", "Treatment: Ponseti method (serial casting)", "Correction order: CAVE (reverse)"] }
  },
  // ENT
  {
    front: { main: "Trotter's Triad", sub: "Nasopharyngeal Ca" },
    back:  { title: "Trotter's Triad = Nasopharyngeal Ca", lines: ["1. Conductive deafness", "   (Eustachian tube obstruction)", "2. Soft palate paralysis", "   (Levator veli palatini involvement)", "3. Trigeminal neuralgia", "   (V3 involvement)", "Investigate: Nasopharyngoscopy + Biopsy + CT/MRI"] }
  },
  {
    front: { main: "5 P's of Lichen Planus", sub: "Classic description" },
    back:  { title: "5 P's - Lichen Planus", lines: ["Purple", "Polygonal", "Planar (flat-topped)", "Pruritic", "Papules", "Extra: Wickham's striae (white lacy lines)", "CN: Flexor surface of wrists"] }
  },
];

// DOC FLASHCARDS
const docs = [
  // Antimicrobials
  { q: "DOC: Malaria\n(P. vivax, P. malariae\nsensitive)", a: "Chloroquine", detail: ["Mechanism: Interferes with heme polymerization", "Dose: 25 mg/kg over 3 days", "Resistance: Falciparum - use ACT", "Radical cure of P. vivax: Add Primaquine"] },
  { q: "DOC: Malaria\n(P. falciparum - severe)", a: "IV Artesunate", detail: ["Replaces quinine as 1st line (WHO)", "Given IV or IM", "Oral ACT: Artemether-Lumefantrine", "AQUAMAT trial evidence"] },
  { q: "DOC: TB\n(New case - all forms)", a: "HRZE × 2m → HR × 4m", detail: ["H = Isoniazid  R = Rifampicin", "Z = Pyrazinamide  E = Ethambutol", "Intensive phase: 2 months (HRZE)", "Continuation phase: 4 months (HR)", "MDR-TB: Bedaquiline-based regimen"] },
  { q: "DOC: H. pylori\neradication", a: "PPI + Clarithromycin\n+ Amoxicillin × 14 days", detail: ["Triple therapy (standard)", "PPI: Omeprazole/Esomeprazole", "Duration: 14 days > 7 days", "If Clarithromycin resistance: use Metronidazole", "Test of cure: Urea breath test (4 weeks later)"] },
  { q: "DOC: MRSA\ninfection", a: "Vancomycin", detail: ["IV Vancomycin (glycopeptide)", "Alternative: Linezolid, Daptomycin", "Skin/soft tissue MRSA: TMP-SMX, Doxycycline", "Monitor renal function + trough levels", "Teicoplanin = alternative glycopeptide"] },
  { q: "DOC: SBP\n(Spontaneous Bacterial Peritonitis)", a: "IV Cefotaxime × 5 days", detail: ["3rd generation cephalosporin", "Alternative: Amoxicillin-clavulanate", "Primary prophylaxis: Norfloxacin/Ciprofloxacin", "Secondary prophylaxis: Norfloxacin (lifelong)", "Add IV Albumin to reduce renal failure risk"] },
  { q: "DOC: Leprosy\n(PB = Paucibacillary)", a: "Rifampicin + Dapsone\n× 6 months", detail: ["PB = 1-5 skin lesions", "Rifampicin 600mg monthly (supervised)", "Dapsone 100mg daily (self-administered)", "Duration: 6 months total", "BL/LL (MB) = Triple therapy × 12 months"] },
  // Obstetrics
  { q: "DOC: Eclampsia\n(Seizure prevention)", a: "MgSO₄ (Pritchard Regimen)", detail: ["Loading: 4g IV (slow) + 10g IM (5g each buttock)", "Maintenance: 5g IM every 4 hours", "Monitor: Urine output, RR, patellar reflexes", "Antidote: Calcium gluconate 1g IV", "Therapeutic level: 4-7 mEq/L"] },
  { q: "DOC: HTN in Pregnancy\n(Chronic + Gestational)", a: "Methyldopa (1st line)\nLabetalol (2nd line)", detail: ["Methyldopa: Alpha-2 agonist; safest in 1st trimester", "Labetalol: Alpha+beta blocker; IV for acute severe HTN", "Nifedipine: CCB; 2nd/3rd trimester", "AVOID: ACE inhibitors, ARBs (renal agenesis)", "AVOID: Atenolol (IUGR), Diuretics"] },
  { q: "DOC: PPH\n(Postpartum Haemorrhage)\n1st line uterotonic", a: "Oxytocin 10 IU IM/IV", detail: ["Active management of 3rd stage of labour", "Adjuncts: Misoprostol, Ergometrine, Carboprost", "Tranexamic acid (TXA) within 3 hours (WOMAN trial)", "Balloon tamponade if medical Rx fails", "Last resort: Hysterectomy"] },
  // Medicine
  { q: "DOC: Anaphylaxis\n(EMERGENCY)", a: "Adrenaline 0.5mg IM\n(1:1000, anterolateral thigh)", detail: ["FIRST LINE - given IM not IV (unless cardiac arrest)", "Adrenaline 1:1000 → 0.5ml = 0.5mg", "Repeat every 5 min if no improvement", "Add: IV fluid, O₂, antihistamine, hydrocortisone", "IV Adrenaline: only in cardiac arrest"] },
  { q: "DOC: Status Epilepticus\n(1st line)", a: "IV Lorazepam 0.1mg/kg\n(or IV Diazepam)", detail: ["Lorazepam preferred (longer duration)", "If no IV access: Rectal diazepam / IM Midazolam", "2nd line: IV Phenytoin / Levetiracetam / Valproate", "3rd line: General anesthesia (Propofol/Thiopentone)", "Status = seizure > 5 min OR 2 seizures without recovery"] },
  { q: "DOC: Acute Gout\n(Attack)", a: "NSAIDs (Indomethacin)\nor Colchicine", detail: ["NSAIDs: Indomethacin 50mg TDS × 5-7 days", "Colchicine: 0.5mg BD (better tolerated)", "Steroids: If NSAIDs/Colchicine contraindicated", "Do NOT start allopurinol during acute attack", "Prophylaxis: Allopurinol / Febuxostat (start after attack settled)"] },
  { q: "DOC: Bipolar Disorder\n(Maintenance)", a: "Lithium carbonate", detail: ["Narrow therapeutic index (0.6-1.0 mEq/L)", "Toxicity: Tremor, polyuria, hypothyroidism, seizures", "Teratogenic: Ebstein's anomaly (tricuspid valve)", "Monitor: TFT, RFT, serum levels", "Alternative: Valproate, Lamotrigine, Quetiapine"] },
  { q: "DOC: OCD\n(Obsessive Compulsive Disorder)", a: "SSRIs (high dose)\n+ CBT (ERP)", detail: ["Fluoxetine 60-80mg (higher than depression dose)", "Fluvoxamine, Sertraline also used", "ERP = Exposure and Response Prevention therapy", "If resistant: Add Risperidone / Clomipramine", "Clomipramine: Most effective TCA for OCD"] },
  // Anaesthesia
  { q: "DOC: Malignant Hyperthermia\n(EMERGENCY)", a: "Dantrolene 2.5mg/kg IV\n(repeat to max 10mg/kg)", detail: ["Stop triggering agent immediately", "Hyperventilate with 100% O₂", "Cool the patient actively", "Correct acidosis (sodium bicarbonate)", "Dantrolene: inhibits RyR1, stops SR Ca release", "Monitor in ICU; recurrence in 25% → continue Dantrolene 24h"] },
  { q: "DOC: Reversal of\nRocuronium / Vecuronium", a: "Sugammadex\n(dose: 16mg/kg deep block)", detail: ["Modified gamma-cyclodextrin", "Encapsulates steroidal NMBAs (Rocuronium > Vecuronium)", "Dose: 2mg/kg (moderate), 4mg/kg (shallow), 16mg/kg (immediate reversal)", "Does NOT reverse Atracurium / Succinylcholine", "No muscarinic side effects (unlike neostigmine)"] },
  // Surgery / Dermatology
  { q: "DOC: Type 1 Leprosy\nReaction (Reversal)", a: "Prednisolone 40mg/day\n(taper over 3-6 months)", detail: ["Reversal reaction = upgrading reaction", "Can occur during or just before treatment", "Continue anti-leprosy treatment", "Protect nerve function: splint if foot drop", "Type 2 (ENL): Thalidomide / Steroids"] },
  { q: "DOC: Dermatitis\nHerpetiformis", a: "Dapsone + Gluten-free diet", detail: ["Associated with Celiac disease (HLA-DQ2)", "IgA deposits at dermal papillae (direct IF)", "Dapsone: rapid relief (within 24-48h)", "Gluten-free diet: treats both skin and gut", "Monitor: G6PD before Dapsone (hemolysis risk)"] },
  { q: "DOC: Epilepsy\nin Pregnancy", a: "Lamotrigine or\nLevetiracetam", detail: ["Lamotrigine: Safest; levels fall in pregnancy - increase dose", "Levetiracetam: Good safety profile; newer evidence", "AVOID: Valproate (NTD, autism, dysmorphism)", "AVOID: Phenytoin (fetal hydantoin syndrome)", "AVOID: Carbamazepine (NTD, craniofacial defects)"] },
  { q: "DOC: Heart Failure\nwith Reduced EF (HFrEF)", a: "ACEi + β-blocker +\nSpironolactone + SGLT2i", detail: ["ACEi: Ramipril/Enalapril (or ARB if intolerant)", "β-blocker: Carvedilol / Metoprolol / Bisoprolol", "MRA: Spironolactone / Eplerenone", "SGLT2i: Dapagliflozin / Empagliflozin (now CLASS I)", "Also: ARNI (Sacubitril-Valsartan) - superior to ACEi"] },
];

// ── BUILD DOCUMENT ────────────────────────────────────────────────────────────
const children = [];

// ─── COVER ───
children.push(new Paragraph({ ...sp(200, 100) }));
children.push(new Paragraph({
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  children: [new TextRun({ text: "NEET PG 2026", bold: true, size: 64, color: WHITE, font: "Calibri" })],
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[
  "Cover the RIGHT side (Answer) and attempt to recall from the LEFT side (Question/Mnemonic)",
  "Print double-sided OR fold each row in half for a physical card",
  "Shuffle and self-test daily in Phase 3 and Phase 4 of your revision schedule",
  "Mark cards you get wrong - revisit them the next day",
  "DOC cards: remember the drug AND 1-2 key clinical details (dose, mechanism, contraindication)",
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});
children.push(new Paragraph({ children: [new PageBreak()] }));

// ─── MNEMONIC SECTION ───
children.push(sectionBanner(`SECTION 1: MNEMONICS (${mnemonics.length} Cards)`, CARD_FRONT_MNEMONIC));
children.push(centerRun("LEFT = Mnemonic/Concept to recall  |  RIGHT = Full answer", { size: 20, color: "555555", italics: true }));
children.push(gap());

mnemonics.forEach((m, i) => {
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});

children.push(new Paragraph({ children: [new PageBreak()] }));

// ─── DOC SECTION ───
children.push(sectionBanner(`SECTION 2: DRUG OF CHOICE (${docs.length} Cards)`, CARD_FRONT_DOC));
children.push(centerRun("LEFT = Condition  |  RIGHT = DOC + Key Clinical Points", { size: 20, color: "555555", italics: true }));
children.push(gap());

docs.forEach((d, i) => {
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  children.push(gap());
});

// ─── QUICK SUMMARY TABLE ───
children.push(new Paragraph({ children: [new PageBreak()] }));
children.push(sectionBanner("QUICK SUMMARY: ALL DOCs AT A GLANCE", "1F3864"));
children.push(gap());

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// ─── ASSEMBLE ───
const doc = new Document({
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Packer.toBuffer(doc).then(buf => {
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});

cd /home/daytona/workspace/neet-pg && node create_flashcards.js 2>&1

ls -lh /home/daytona/workspace/neet-pg/NEET_PG_2026_Flashcards.docx

python /home/daytona/skills/docx/scripts/office/soffice.py --headless --convert-…

cp /home/daytona/workspace/neet-pg/NEET_PG_2026_HighYield_Notes.docx /tmp/notes_…

cp /tmp/notes_convert.pdf /home/daytona/workspace/neet-pg/NEET_PG_2026_HighYield…