ls /home/daytona/workspace/ && ls /home/daytona/skills/docx/

mkdir -p /home/daytona/workspace/community-medicine-cases

~/community-medicine-cases/generate.js

const {
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  Table, TableRow, TableCell, VerticalAlign, ShadingType,
  PageBreak
} = require('docx');
const fs = require('fs');

// ─────────────────────────────────────────────────────────────
// CASE STUDY DATA
// ─────────────────────────────────────────────────────────────
const cases = [
  {
    title: "CASE STUDY 1: HYPERTENSION",
    scenario: `Mr. Ramesh, a 52-year-old male government employee from a semi-urban area, presents to the PHC with complaints of headache, dizziness, and occasional blurring of vision for the past 3 months. He is a known smoker (15 cigarettes/day for 20 years) and consumes alcohol socially. His diet is high in salt and saturated fats. Family history reveals his father died of stroke at age 60. On examination: BP = 160/100 mmHg (on two separate occasions), BMI = 28.4 kg/m², pulse = 88/min. Random blood sugar = 112 mg/dL. Fundoscopy shows grade II hypertensive retinopathy. He is currently not on any medication.`,
    questions: [
      "Define hypertension as per JNC-8 / WHO criteria. How would you classify Mr. Ramesh's hypertension and what is its public health significance in India? (3 Marks)",
      "Enumerate the modifiable and non-modifiable risk factors for hypertension present in this patient. What is the concept of 'Rule of Halves' in hypertension control? (3 Marks)",
      "Describe the non-pharmacological (lifestyle) measures you would advise Mr. Ramesh to reduce his blood pressure. Include the DASH diet principles. (3 Marks)",
      "What are the complications of uncontrolled hypertension? Which target organs are at risk in this patient? Explain how hypertension leads to stroke. (3 Marks)",
      "Outline the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) – its objectives, strategies, and the role of the PHC in managing hypertension at the community level. (3 Marks)"
    ]
  },
  {
    title: "CASE STUDY 2: DIABETES MELLITUS",
    scenario: `Mrs. Sunita, 45-year-old housewife, comes to the urban health centre with complaints of polyuria, polydipsia, and unexplained weight loss for 2 months. She has a family history of Type 2 diabetes (mother and maternal uncle). BMI = 30.1 kg/m², waist circumference = 94 cm. Fasting blood glucose = 196 mg/dL, HbA1c = 8.4%. She leads a sedentary lifestyle and her diet is rich in refined carbohydrates. She was diagnosed with gestational diabetes during her second pregnancy 8 years ago. On examination, she has mild peripheral neuropathy in both feet.`,
    questions: [
      "Define diabetes mellitus. State the WHO/ADA diagnostic criteria for Type 2 DM. How is Mrs. Sunita's case classified and what was her gestational diabetes risk significance? (3 Marks)",
      "Describe the epidemiology of Type 2 diabetes in India, including prevalence, urban-rural differences, and why India is called the 'Diabetes Capital of the World.' (3 Marks)",
      "What are the micro- and macrovascular complications of diabetes? Identify which complications are already evident in Mrs. Sunita and explain the pathophysiology of diabetic peripheral neuropathy. (3 Marks)",
      "Outline the primary, secondary, and tertiary prevention strategies for Type 2 diabetes in the community. What is the role of the ASHA worker and the PHC medical officer in diabetes prevention? (3 Marks)",
      "Describe the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) with focus on diabetes – its screening protocol, treatment guidelines at primary care level, and monitoring indicators. (3 Marks)"
    ]
  },
  {
    title: "CASE STUDY 3: OBESITY",
    scenario: `Rohit, a 35-year-old software engineer, visits a health camp complaining of breathlessness on exertion, snoring, and knee pain. He has a desk job and commutes by car. He consumes fast food 4–5 times per week and drinks 3 cans of aerated beverages daily. He does no physical activity. Vitals: weight = 98 kg, height = 168 cm, BMI = 34.7 kg/m², waist circumference = 108 cm. BP = 138/88 mmHg. Fasting lipid profile: Total cholesterol = 228 mg/dL, LDL = 162 mg/dL, TG = 210 mg/dL, HDL = 32 mg/dL.`,
    questions: [
      "Define obesity as per WHO and Asian cut-offs. Calculate and classify Rohit's BMI. What is the clinical significance of waist circumference and waist-hip ratio in assessing metabolic risk? (3 Marks)",
      "Describe the health consequences of obesity. What is Metabolic Syndrome (IDF criteria)? Does Rohit fulfil the criteria? List all conditions for which obesity is an independent risk factor. (3 Marks)",
      "Explain the social and environmental determinants of obesity. What is the 'obesogenic environment' concept? How do food industry practices and urban design contribute to rising obesity rates in India? (3 Marks)",
      "Outline the preventive strategies for obesity at the individual, community, and policy levels. Describe the Eat Right India and Fit India Movement initiatives launched by the Government of India. (3 Marks)",
      "What is the role of the community physician in managing obesity? Describe the stepwise management of obesity including dietary intervention, physical activity prescription, behavioural therapy, pharmacotherapy indications, and bariatric surgery criteria. (3 Marks)"
    ]
  },
  {
    title: "CASE STUDY 4: TUBERCULOSIS (TB)",
    scenario: `Meena, 28-year-old female from a slum dwelling, presents with cough for 3 weeks, low-grade fever in evenings, night sweats, and weight loss of 5 kg over 2 months. She has 3 children and lives in a single room with 7 other family members. Her husband was treated for TB 2 years ago. On examination: thin built, pallor present, temperature 37.8°C. Chest X-ray shows patchy infiltrates in the right upper lobe with hilar adenopathy. Sputum for AFB (CBNAAT) positive. HIV status: negative. She has never received anti-TB treatment.`,
    questions: [
      "Classify Meena's TB according to RNTCP/NTEP classification (site, smear status, treatment history). What is the epidemiology of TB in India and its global burden as per latest WHO Global TB Report? (3 Marks)",
      "Describe the natural history of TB infection. What are the sources of infection, modes of transmission, and the concept of infectious period? What factors in this case increase the risk of household transmission? (3 Marks)",
      "What is the treatment regimen for Meena under the National TB Elimination Programme (NTEP)? Describe the current DR-TB (Drug Resistant TB) treatment protocols and DRTB definitions (MDR, XDR, RR-TB). (3 Marks)",
      "Explain the contact tracing protocol under NTEP. How would you screen Meena's household contacts including her children? What is TB Preventive Therapy (TPT) and when is it indicated? (3 Marks)",
      "Describe the Nikshay portal and Nikshay Poshan Yojana. What are the targets under the National Strategic Plan (NSP) 2017-2025 for TB Elimination? What is the role of the DOTS provider? (3 Marks)"
    ]
  },
  {
    title: "CASE STUDY 5: HIV/AIDS",
    scenario: `Suresh, a 32-year-old truck driver, presents to the ICTC (Integrated Counselling and Testing Centre) for voluntary HIV testing. He reports multiple sexual partners (without consistent condom use) over the past 5 years. He had an episode of herpes zoster 6 months ago. He smokes and occasionally uses intravenous drugs. On testing: HIV ELISA positive (confirmed by Western Blot). CD4 count = 280 cells/µL. He has no known TB symptoms currently. He lives with his wife and two young children.`,
    questions: [
      "Describe the epidemiology of HIV/AIDS in India – prevalence, high-risk groups (bridge populations), states with high burden, and the trend of the epidemic. What is the Window Period and its significance in HIV testing? (3 Marks)",
      "Explain the natural history of HIV infection – from primary infection to AIDS. What is the WHO clinical staging of HIV? At which stage does Suresh's CD4 count and clinical history place him? (3 Marks)",
      "Describe the NACP (National AIDS Control Programme) – its phases (NACP I to IV/V), key strategies, and current targets. What is the role of ICTC, ART centre, and DAPCU in the programme? (3 Marks)",
      "What are the Universal Precautions for prevention of HIV transmission in healthcare settings? What is Post-Exposure Prophylaxis (PEP) and Pre-Exposure Prophylaxis (PrEP)? When are they indicated? (3 Marks)",
      "How would you counsel Suresh regarding disclosure to his wife, partner notification, and condom use? What is PPTCT (Prevention of Parent to Child Transmission)? Outline the PPTCT protocol for Suresh's wife if she is found to be HIV positive and is pregnant. (3 Marks)"
    ]
  },
  {
    title: "CASE STUDY 6: LEPROSY",
    scenario: `Lakshmi, a 38-year-old woman from a rural village in Odisha, presents to the PHC with a single hypopigmented, anaesthetic patch on her left forearm, which she noticed 4 months ago. There is no history of itching. On examination, the patch is well-defined, hypoaesthetic to touch, with loss of sweating. The ulnar nerve is slightly thickened bilaterally. Skin smear for AFB: negative (BI = 0). She has a family member who was treated for leprosy 3 years ago.`,
    questions: [
      "Classify Lakshmi's leprosy according to WHO classification and Ridley-Jopling classification. What is the bacterial index (BI) and morphological index (MI)? What is the significance of classifying leprosy for treatment purposes? (3 Marks)",
      "Describe the epidemiology of leprosy in India – incidence, prevalence, Grade II disability rate, endemic states, and the National Leprosy Eradication Programme (NLEP) targets. Define 'elimination' of leprosy as a public health problem. (3 Marks)",
      "What is the Multi-Drug Therapy (MDT) regimen for Lakshmi? Compare the PB and MB MDT regimens. Why is MDT used instead of dapsone monotherapy? What are the common side effects of MDT drugs? (3 Marks)",
      "Explain the concept of leprosy reactions (Type 1 / Reversal Reaction and Type 2 / ENL). How would you identify and manage them? What is the role of steroids in leprosy management? (3 Marks)",
      "Describe the disability prevention and rehabilitation measures for leprosy patients. What is the role of self-care and MCR footwear? Discuss the social stigma of leprosy and strategies to address it in the community. (3 Marks)"
    ]
  },
  {
    title: "CASE STUDY 7: PROTEIN ENERGY MALNUTRITION (PEM)",
    scenario: `Ananya, an 18-month-old girl, is brought to the nutrition rehabilitation centre by her mother. The child is lethargic, has pitting oedema of both feet and legs, thin sparse reddish hair, and a 'moon face.' Her weight is 6.8 kg (expected 11 kg for age). MUAC = 10.5 cm. She has not been breastfed since 6 months of age and her diet has mainly consisted of thin rice gruel. Her immunisation is incomplete. She had two episodes of diarrhoea in the past month.`,
    questions: [
      "Classify Ananya's nutritional status using WHO criteria, Wellcome classification, and IAP classification. Differentiate between Kwashiorkor, Marasmus, and Marasmic-Kwashiorkor on clinical and biochemical grounds. (3 Marks)",
      "Describe the epidemiology of PEM in India – NFHS-5 data on stunting, wasting, underweight in children under 5. What are the immediate, underlying, and basic causes of malnutrition as per the UNICEF framework? (3 Marks)",
      "Outline the 10 steps of management of Severe Acute Malnutrition (SAM) as recommended by WHO. What is the role of therapeutic feeding (F-75, F-100 and RUTF)? What is the criteria for discharge from NRC? (3 Marks)",
      "Describe the Integrated Child Development Services (ICDS) scheme – its beneficiaries, services provided (package of 6 services), organisational structure, and limitations. What is the role of the Anganwadi worker in preventing PEM? (3 Marks)",
      "What is POSHAN Abhiyaan (National Nutrition Mission)? What are its targets for reduction of stunting, wasting, undernutrition, and anaemia? Describe the concept of 'First 1000 Days' and its relevance to the prevention of PEM. (3 Marks)"
    ]
  },
  {
    title: "CASE STUDY 8: MALARIA",
    scenario: `Rajiv, a 22-year-old labourer who recently returned from a construction site in Assam, presents with high-grade fever, chills, and rigors for 4 days. The fever follows a pattern of every 48 hours. He also complains of headache, vomiting, and dark coloured urine. On examination: temperature 104°F, pallor, mild jaundice, splenomegaly (Grade II). Peripheral blood smear: ring forms and banana-shaped gametocytes of Plasmodium falciparum. RDT: positive for HRP-2 antigen. He has not taken any chemoprophylaxis.`,
    questions: [
      "Describe the life cycle of Plasmodium falciparum – both the sexual cycle in the mosquito and asexual cycle in the human host. What is the periodicity of fever in P. falciparum vs P. vivax? Why is P. falciparum more dangerous? (3 Marks)",
      "What are the criteria for severe/complicated malaria (WHO definition)? Which features in Rajiv suggest severe malaria? What is blackwater fever and what caused dark urine in this patient? (3 Marks)",
      "Describe the treatment of uncomplicated and severe P. falciparum malaria as per the NVBDCP guidelines. What is the role of Artesunate and Artemisinin Combination Therapy (ACT)? What are the indications for Primaquine in falciparum malaria? (3 Marks)",
      "Describe the vector control measures for malaria – indoor residual spraying (IRS), insecticide-treated bed nets (ITN/LLIN), larval source management, and biological control. What are the major malaria vectors in India? (3 Marks)",
      "Outline the National Vector Borne Disease Control Programme (NVBDCP) – objectives, strategies (ABER, SPR, SFR), case detection methods, and the National Framework for Malaria Elimination (NFME) 2016-2030 targets. (3 Marks)"
    ]
  },
  {
    title: "CASE STUDY 9: DENGUE",
    scenario: `Priya, a 16-year-old girl from an urban locality, presents to the emergency department with sudden onset high fever (104°F), severe headache, retro-orbital pain, myalgia, and arthralgia for 3 days. She developed a petechial rash on her trunk and limbs on Day 3. On examination: BP = 100/70 mmHg, pulse = 98/min, tourniquet test positive (>20 petechiae). Lab reports: Platelet count = 72,000/µL, Hematocrit = 46% (baseline 38%), NS1 antigen positive. Her house has coolers and potted plants with stagnant water.`,
    questions: [
      "Define dengue fever, dengue haemorrhagic fever (DHF), and dengue shock syndrome (DSS). Classify Priya's case as per the revised WHO 2009 classification. What is the pathophysiology of plasma leakage and thrombocytopenia in dengue? (3 Marks)",
      "Describe the serological diagnosis of dengue – NS1 antigen, IgM/IgG ELISA, and PCR. What is the significance of secondary dengue infection and antibody-dependent enhancement (ADE)? What are the warning signs of dengue? (3 Marks)",
      "Outline the clinical management of dengue with warning signs as per WHO/NVBDCP guidelines. What are the indications for platelet transfusion? What is the critical phase of dengue and how is it identified? (3 Marks)",
      "Describe the vector Aedes aegypti – its breeding habits, biting time, and flight range. What is the House Index (HI), Container Index (CI), and Breteau Index (BI)? How do these indices guide vector control activities? (3 Marks)",
      "Explain the source reduction methods for Aedes control in urban areas. What is the role of community participation in dengue prevention? Describe the integrated vector management strategy and India's National Dengue Control Programme. (3 Marks)"
    ]
  },
  {
    title: "CASE STUDY 10: MEASLES",
    scenario: `Raju, a 3-year-old boy from a rural area, is brought with high fever, runny nose, cough, and red eyes for 4 days, followed by appearance of a maculopapular rash starting from the face and spreading downward. He was born at home and his immunisation card shows he received only BCG at birth. On examination: temp 103°F, Koplik's spots on buccal mucosa, generalised maculopapular rash, bilateral conjunctivitis, bilateral cervical lymphadenopathy. His younger sibling (8 months old) and two unvaccinated neighbourhood children have developed similar symptoms.`,
    questions: [
      "Describe the clinical features and natural history of measles. What are Koplik's spots and what is their diagnostic significance? What is the pathophysiology of the measles rash and how does measles cause immunosuppression? (3 Marks)",
      "Enumerate the complications of measles. What is Subacute Sclerosing Panencephalitis (SSPE)? What complications may arise in a malnourished child like Raju? How does Vitamin A deficiency interact with measles? (3 Marks)",
      "Describe the epidemiology of measles – herd immunity threshold, incubation period, infectious period, and secondary attack rate. What is the concept of 'measles-mumps-rubella (MMR) vaccine' and schedule under India's Universal Immunisation Programme (UIP)? (3 Marks)",
      "How would you manage Raju? Include Vitamin A supplementation protocol, supportive care, and isolation measures. What is the notification requirement for measles in India? How would you conduct an outbreak investigation for this cluster of cases? (3 Marks)",
      "Describe the Measles-Rubella (MR) Elimination strategy in India. What are the WHO targets for measles elimination? Describe the concept of Supplementary Immunisation Activities (SIA) and the role of surveillance (case-based surveillance, AFP surveillance integration). (3 Marks)"
    ]
  },
  {
    title: "CASE STUDY 11: VACCINATION – MEASLES (IMMUNISATION FOCUS)",
    scenario: `During a routine outreach immunisation session in a tribal village, the health worker identifies that 40% of children aged 12–23 months are unvaccinated against measles. A recent measles outbreak has affected 18 children in the village. The village has poor road connectivity, and parents believe the vaccine causes fever and fits. The cold chain at the sub-centre was found to be non-functional for 2 weeks last month. There is a cluster of 25 children who have never visited any immunisation session.`,
    questions: [
      "What is the immunological basis of vaccination? Define herd immunity and calculate the herd immunity threshold for measles (R₀ = 12–18). What is the significance of maintaining high vaccination coverage? (3 Marks)",
      "Describe the cold chain system for vaccines in India – from national to peripheral level. What are the vaccines requiring different temperature storage (2–8°C vs –15 to –25°C)? What is the Vaccine Vial Monitor (VVM) and its significance? (3 Marks)",
      "What are the key vaccines in the Universal Immunisation Programme (UIP) of India along with their schedule, route, dose, and site of administration? Include recent additions like PCV, Rotavirus, IPV, and MR vaccine. (3 Marks)",
      "Define vaccine efficacy, vaccine effectiveness, and seroconversion. What are the contraindications to measles vaccine? What is an Adverse Event Following Immunisation (AEFI) and how is it classified and reported under the National AEFI Surveillance system? (3 Marks)",
      "Describe the strategies to improve immunisation coverage in hard-to-reach areas. What is the 'Left-out, Drop-out, and Missed-out' concept? How would you conduct a mop-up immunisation campaign in this tribal village? (3 Marks)"
    ]
  },
  {
    title: "CASE STUDY 12: POLIO – VACCINATION FOCUS",
    scenario: `During a Pulse Polio Immunisation day in a district, a health worker reports a case of a 4-year-old child who received 4 doses of OPV and developed acute flaccid paralysis (AFP) of the left lower limb 30 days after the last OPV dose. Investigation reveals the child is from a household with poor sanitation and open defaecation. Stool samples were collected for virus isolation. The child had no fever during the paralysis. The district AFP rate is 1.5/100,000 children under 15.`,
    questions: [
      "Describe the epidemiology of poliomyelitis – causative agent, serotypes, mode of transmission, incubation period, and the basis of eradication strategy. What is the difference between wild poliovirus (WPV), vaccine-derived poliovirus (VDPV), and vaccine-associated paralytic polio (VAPP)? (3 Marks)",
      "Define Acute Flaccid Paralysis (AFP) surveillance. What are the recommended AFP surveillance indicators (AFP detection rate, stool adequacy rate)? How would you investigate this AFP case as per the Pulse Polio Programme protocol? (3 Marks)",
      "Compare Oral Polio Vaccine (OPV) and Inactivated Polio Vaccine (IPV) – mechanism, advantages, disadvantages, immunogenicity, and their combined role in the Polio Endgame Strategy. What is the switch from tOPV to bOPV and why was it done? (3 Marks)",
      "Describe the Pulse Polio Immunisation Programme (PPI) in India – its origin, National Immunisation Days (NIDs), Sub-NIDs, mop-up rounds, and strategies for reaching mobile and migrant populations. What is India's polio-free certification history? (3 Marks)",
      "What is the Global Polio Eradication Initiative (GPEI)? What are the remaining challenges to global polio eradication? Describe the Polio Endgame Strategic Plan 2019-2023 and the role of IPV introduction in India's routine immunisation schedule. (3 Marks)"
    ]
  },
  {
    title: "CASE STUDY 13: ANTENATAL CARE (ANC) MOTHER",
    scenario: `Rekha, a 24-year-old primigravida, presents to the PHC at 14 weeks of gestation. She has not registered for ANC previously. She lives in a village 12 km from the PHC. Her LMP was 14 weeks ago and her cycles are regular. On examination: weight = 48 kg, height = 152 cm (BMI = 20.8), pallor present (Hb = 9.2 g/dL), BP = 118/76 mmHg. She has no ante-natal card and is unaware of available maternal health services. This is her first pregnancy and she is anxious. Her in-laws prefer home delivery by a traditional birth attendant (TBA).`,
    questions: [
      "Describe the components of the Focused Antenatal Care (FANC) model and the recommended number and timing of ANC visits as per WHO 2016 guidelines (8-contact model) and the Government of India guidelines. What is the PMSMA (Pradhan Mantri Surakshit Matritva Abhiyan) and its objectives? (3 Marks)",
      "Rekha has a Haemoglobin of 9.2 g/dL. Define anaemia in pregnancy as per WHO/ICMR criteria. What is the aetiology, classification, and management of anaemia in pregnancy? Describe the WIFS (Weekly Iron and Folic Acid Supplementation) and anaemia control strategies under NHM. (3 Marks)",
      "What danger signs during pregnancy require immediate referral? How would you counsel Rekha on birth preparedness and complication readiness (BPCR)? What is the role of the ASHA worker in antenatal care and in ensuring institutional delivery? (3 Marks)",
      "Describe all the screening tests and investigations to be performed during Rekha's ANC visits (routine and special). Include VDRL, HIV, HBsAg, blood group, urine examination, USG, and gestational diabetes screening. What is the Triple Test? (3 Marks)",
      "Describe the Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakram (JSSK) schemes – eligibility, benefits, incentive amounts, and how they promote institutional delivery. What is the Modified Radde criteria (3 delays model) for maternal mortality? (3 Marks)"
    ]
  },
  {
    title: "CASE STUDY 14: POSTNATAL CARE (PNC) MOTHER",
    scenario: `Seema, a 26-year-old woman, delivered a male baby (birth weight 2.3 kg) at home with the help of a TBA in a rural setting. She is visited by the ASHA worker 24 hours after delivery. Seema complains of excessive vaginal bleeding, a foul-smelling lochia, and fever of 101°F since delivery. The baby appears jaundiced and has not been breastfed. The baby has not received any vaccinations. Seema has no previous PNC contact and is unaware of family planning methods. She lives with her husband and in-laws who discourage breastfeeding.`,
    questions: [
      "What are the recommended postnatal care (PNC) contacts as per WHO/GOI guidelines (timing, number, and content of each visit)? What is the Home Based Newborn Care (HBNC) protocol followed by ASHA workers? What observations should be made during these visits? (3 Marks)",
      "Seema has signs of puerperal sepsis. Define puerperal sepsis, list its causes, clinical features, and management. What are the obstetric causes of maternal mortality in India? How does puerperal sepsis contribute to maternal mortality? (3 Marks)",
      "Describe the essential newborn care for Seema's baby including: warm chain, early breastfeeding initiation, eye care, cord care, Vitamin K administration, and newborn vaccination (OPV-0, BCG, Hep-B). What is the significance of the birth weight of 2.3 kg? How is LBW defined and classified? (3 Marks)",
      "The baby has not been breastfed. Describe the benefits of exclusive breastfeeding and the WHO/GOI recommended breastfeeding schedule. What is the Baby-Friendly Hospital Initiative (BFHI)? How would you counsel Seema and her in-laws on breastfeeding? (3 Marks)",
      "Seema is unaware of family planning. Describe the postpartum family planning methods available. What is LAM (Lactational Amenorrhea Method) and its criteria? Describe the Mission Parivar Vikas and the National Family Planning Programme's contraceptive basket of choice. (3 Marks)"
    ]
  },
  {
    title: "CASE STUDY 15: ADOLESCENCE",
    scenario: `Kavita, a 15-year-old girl studying in Class 9 in a government school, is referred to the AFHC (Adolescent Friendly Health Clinic) by her teacher. Her weight is 36 kg, height 155 cm (BMI = 14.98 – severely underweight). She has been menstruating irregularly since menarche at 13 years. She reports excessive tiredness, pallor, and hair fall. She often skips meals and is found to be anaemic (Hb = 8.4 g/dL). She has poor knowledge of menstrual hygiene and reproductive health. There are no facilities for handwashing at her school. She is under significant academic stress and her parents are considering her early marriage.`,
    questions: [
      "Define adolescence as per WHO. What are the physical, psychological, and social changes during adolescence? What are the key nutritional requirements of adolescent girls and why are they at higher risk for anaemia and undernutrition? (3 Marks)",
      "Describe the Rashtriya Kishor Swasthya Karyakram (RKSK) – its six thematic areas, key strategies (peer education, AFHC, community-based interventions), and target population. What is the role of Peer Educators in RKSK? (3 Marks)",
      "Kavita has Hb = 8.4 g/dL. Describe the Weekly Iron and Folic Acid Supplementation (WIFS) programme – target groups, dose, schedule, and monitoring. What is the role of the school health programme (RBSK) in addressing nutritional deficiencies in adolescents? (3 Marks)",
      "What are the menstrual hygiene management (MHM) interventions recommended for adolescent girls? Describe the Menstrual Hygiene Scheme under NHM – including sanitary napkin provision, awareness, and disposal. What are the health risks of poor menstrual hygiene? (3 Marks)",
      "Kavita's parents are considering child marriage. What is the legal age of marriage in India? Describe the health consequences of early marriage and adolescent pregnancy. What is the Prevention of Child Marriage Act 2006 and the POCSO Act? What is the role of the community physician in preventing child marriage? (3 Marks)"
    ]
  }
];

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    children.push(questionPara(qi + 1, q));
  });
  if (idx < cases.length - 1) {
    children.push(dividerPara());
    children.push(pageBreakPara());
  }
});

const doc = new Document({
  styles: {
    default: {
      document: {
        run: { font: "Arial", size: 22 }
      }
    },
    paragraphStyles: [
      {
        id: "Heading1",
        name: "Heading 1",
        basedOn: "Normal",
        next: "Normal",
        quickFormat: true,
        run: { size: 28, bold: true, font: "Arial", color: "1F3864" },
        paragraph: { spacing: { before: 400, after: 120 }, outlineLevel: 0 }
      },
      {
        id: "Heading2",
        name: "Heading 2",
        basedOn: "Normal",
        next: "Normal",
        quickFormat: true,
        run: { size: 24, bold: true, font: "Arial", color: "2E5EAA" },
        paragraph: { spacing: { before: 200, after: 80 }, outlineLevel: 1 }
      }
    ]
  },
  sections: [{
    properties: {
      page: {
        margin: { top: 1080, bottom: 1080, left: 1080, right: 1080 }
      }
    },
    children
  }]
});

Packer.toBuffer(doc).then(buffer => {
  fs.writeFileSync("/home/daytona/workspace/community-medicine-cases/Community_Medicine_Case_Studies.docx", buffer);
  console.log("SUCCESS: Document written.");
}).catch(err => {
  console.error("ERROR:", err);
  process.exit(1);
});

cd /home/daytona/workspace/community-medicine-cases && node generate.js

python3 /home/daytona/skills/docx/scripts/office/validate.py /home/daytona/works…

ls -lh /home/daytona/workspace/community-medicine-cases/ && python3 -c " import …

python3 -c " import zipfile, re with zipfile.ZipFile('/home/daytona/workspace/co…