Create a performa for thalassemia examination ( physical and systemic) along with symptoms seen
Reading File
Finding Sources
Finding Sources
Reading File
Reading File
Reading File
Reading File
Reading File
Loading Image
Reading File
Finding Sources
Reading File
Finding Sources
Reading File
Reading File
Running Command
ls /home/daytona/workspace/ && ls /home/daytona/skills/docx/
Running Command
mkdir -p /home/daytona/workspace/thalassemia-proforma && ls /home/daytona/skills/docx/
Writing File
~/thalassemia-proforma/create_proforma.js
const {
Document, Packer, Paragraph, TextRun, Table, TableRow, TableCell,
HeadingLevel, AlignmentType, BorderStyle, WidthType, VerticalAlign,
ShadingType, PageOrientation, Header, Footer, PageNumber, NumberFormat
} = require('docx');
const fs = require('fs');
// Helper: shaded header row cell
function headerCell(text, options = {}) {
return new TableCell({
shading: { type: ShadingType.SOLID, color: "1F4E79" },
verticalAlign: VerticalAlign.CENTER,
margins: { top: 80, bottom: 80, left: 120, right: 120 },
columnSpan: options.columnSpan || 1,
children: [
new Paragraph({
alignment: AlignmentType.CENTER,
children: [new TextRun({ text, bold: true, color: "FFFFFF", size: 20, font: "Calibri" })]
})
]
});
}
// Helper: light subheader cell
function subHeaderCell(text, options = {}) {
return new TableCell({
shading: { type: ShadingType.SOLID, color: "BDD7EE" },
verticalAlign: VerticalAlign.CENTER,
margins: { top: 60, bottom: 60, left: 120, right: 120 },
columnSpan: options.columnSpan || 1,
children: [
new Paragraph({
children: [new TextRun({ text, bold: true, size: 19, font: "Calibri", color: "1F4E79" })]
})
]
});
}
// Helper: data cell
function dataCell(text, options = {}) {
return new TableCell({
verticalAlign: VerticalAlign.CENTER,
margins: { top: 60, bottom: 60, left: 120, right: 120 },
columnSpan: options.columnSpan || 1,
children: [
new Paragraph({
children: [new TextRun({ text, size: 18, font: "Calibri" })]
})
]
});
}
// Helper: write field cell (label | blank)
function fieldCell(label, options = {}) {
return new TableCell({
verticalAlign: VerticalAlign.CENTER,
margins: { top: 60, bottom: 60, left: 120, right: 120 },
columnSpan: options.columnSpan || 1,
children: [
new Paragraph({
children: [
new TextRun({ text: label + ": ", bold: true, size: 18, font: "Calibri" }),
new TextRun({ text: "_".repeat(options.lineLen || 30), size: 18, font: "Calibri", color: "AAAAAA" })
]
})
]
});
}
// Helper: checkbox cell
function checkCell(label) {
return new TableCell({
verticalAlign: VerticalAlign.CENTER,
margins: { top: 60, bottom: 60, left: 120, right: 120 },
children: [
new Paragraph({
children: [new TextRun({ text: "☐ " + label, size: 18, font: "Calibri" })]
})
]
});
}
// Helper: empty cell for findings
function findingRow(label) {
return new TableRow({
children: [
new TableCell({
width: { size: 35, type: WidthType.PERCENTAGE },
shading: { type: ShadingType.SOLID, color: "F2F7FB" },
margins: { top: 60, bottom: 60, left: 120, right: 120 },
children: [new Paragraph({ children: [new TextRun({ text: label, bold: true, size: 18, font: "Calibri" })] })]
}),
new TableCell({
width: { size: 65, type: WidthType.PERCENTAGE },
margins: { top: 60, bottom: 60, left: 120, right: 120 },
children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(60), size: 18, font: "Calibri", color: "BBBBBB" })] })]
})
]
});
}
function sectionHeading(text) {
return new Paragraph({
spacing: { before: 280, after: 100 },
children: [
new TextRun({
text: text,
bold: true,
size: 24,
font: "Calibri",
color: "1F4E79",
underline: { type: "single" }
})
]
});
}
function subHeading(text) {
return new Paragraph({
spacing: { before: 160, after: 80 },
children: [
new TextRun({ text: text, bold: true, size: 21, font: "Calibri", color: "2E75B6" })
]
});
}
function note(text) {
return new Paragraph({
spacing: { before: 60, after: 60 },
children: [new TextRun({ text: " ▸ " + text, italics: true, size: 17, font: "Calibri", color: "555555" })]
});
}
function blankLine() {
return new Paragraph({ children: [new TextRun({ text: "" })] });
}
// ─── DOCUMENT ──────────────────────────────────────────────────────────────
const doc = new Document({
styles: {
default: {
document: {
run: { font: "Calibri", size: 20 }
}
}
},
sections: [
{
properties: {
page: {
size: { width: 12240, height: 15840 }, // Letter size
margin: { top: 720, bottom: 720, left: 900, right: 900 }
}
},
children: [
// ══════════════════════════════════════════════════════════
// TITLE BLOCK
// ══════════════════════════════════════════════════════════
new Paragraph({
alignment: AlignmentType.CENTER,
spacing: { before: 0, after: 60 },
children: [new TextRun({ text: "THALASSEMIA EXAMINATION PROFORMA", bold: true, size: 36, font: "Calibri", color: "1F4E79" })]
}),
new Paragraph({
alignment: AlignmentType.CENTER,
spacing: { before: 0, after: 240 },
children: [new TextRun({ text: "Comprehensive Clinical Assessment Sheet", size: 24, font: "Calibri", color: "2E75B6", italics: true })]
}),
// ══════════════════════════════════════════════════════════
// SECTION 1: PATIENT DEMOGRAPHICS
// ══════════════════════════════════════════════════════════
sectionHeading("SECTION 1: PATIENT IDENTIFICATION"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({
children: [
new TableCell({ width: { size: 25, type: WidthType.PERCENTAGE }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Patient Name:", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ width: { size: 75, type: WidthType.PERCENTAGE }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(80), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}),
new TableRow({
children: [
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Age / Date of Birth:", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(30) + " Gender: ☐ Male ☐ Female ☐ Other", size: 18, font: "Calibri", color: "444444" })] })] }),
]
}),
new TableRow({
children: [
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Hospital / MRN:", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(40) + " Date of Assessment: " + "_".repeat(20), size: 18, font: "Calibri", color: "444444" })] })] }),
]
}),
new TableRow({
children: [
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Ethnicity / Origin:", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "☐ Mediterranean ☐ South Asian ☐ Southeast Asian ☐ African ☐ Middle Eastern ☐ Other: " + "_".repeat(15), size: 18, font: "Calibri" })] })] }),
]
}),
new TableRow({
children: [
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Diagnosis Type:", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "☐ β-Thal Major ☐ β-Thal Intermedia ☐ β-Thal Minor/Trait ☐ α-Thal (HbH) ☐ α-Thal Trait ☐ Hb Bart's ☐ Unknown", size: 18, font: "Calibri" })] })] }),
]
}),
new TableRow({
children: [
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Examiner Name:", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(40) + " Designation: " + "_".repeat(25), size: 18, font: "Calibri", color: "444444" })] })] }),
]
}),
]
}),
blankLine(),
// ══════════════════════════════════════════════════════════
// SECTION 2: PRESENTING SYMPTOMS
// ══════════════════════════════════════════════════════════
sectionHeading("SECTION 2: PRESENTING SYMPTOMS"),
note("Tick all that apply. Indicate duration / severity in 'Remarks'."),
// 2A Anemia-related
subHeading("2A. Symptoms of Anemia & Hemolysis"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({
children: [
new TableCell({ columnSpan: 4, shading: { type: ShadingType.SOLID, color: "BDD7EE" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Anemia / Hemolysis Symptoms", bold: true, size: 19, font: "Calibri", color: "1F4E79" })] })] })
]
}),
new TableRow({
children: [
checkCell("Pallor / Fatigue"),
checkCell("Dyspnea on exertion"),
checkCell("Palpitations"),
checkCell("Dizziness / Syncope"),
]
}),
new TableRow({
children: [
checkCell("Jaundice (icterus)"),
checkCell("Dark-colored urine"),
checkCell("Poor exercise tolerance"),
checkCell("Weakness / Lethargy"),
]
}),
]
}),
blankLine(),
subHeading("2B. Growth & Development Symptoms"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({
children: [
checkCell("Short stature / Growth retardation"),
checkCell("Delayed puberty"),
checkCell("Delayed dentition"),
checkCell("Poor weight gain"),
]
}),
new TableRow({
children: [
checkCell("Delayed milestones"),
checkCell("Secondary amenorrhea"),
checkCell("Infertility"),
checkCell("Reduced bone density / fractures"),
]
}),
]
}),
blankLine(),
subHeading("2C. Facial / Skeletal Symptoms"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({
children: [
checkCell("Frontal bossing"),
checkCell("Prominent malar eminences"),
checkCell("Dental malocclusion"),
checkCell("Bone pain"),
]
}),
new TableRow({
children: [
checkCell("Pathological fractures"),
checkCell("Nasal bridge depression"),
checkCell("Puffiness of face"),
checkCell("Leg pains"),
]
}),
]
}),
blankLine(),
subHeading("2D. Abdominal & Hepatosplenic Symptoms"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({
children: [
checkCell("Abdominal distension"),
checkCell("Left upper quadrant pain/heaviness"),
checkCell("Early satiety"),
checkCell("Right upper quadrant pain"),
]
}),
]
}),
blankLine(),
subHeading("2E. Endocrine & Metabolic Symptoms (Iron Overload)"),
note("Especially relevant in transfusion-dependent thalassemia. Source: Harrison's Table 103-5"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({
children: [
checkCell("Polyuria / polydipsia (Diabetes)"),
checkCell("Cold intolerance (Hypothyroidism)"),
checkCell("Tetany / carpopedal spasm (Hypoparathyroidism)"),
checkCell("Adrenal insufficiency symptoms"),
]
}),
]
}),
blankLine(),
subHeading("2F. Cardiac Symptoms"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({
children: [
checkCell("Chest pain"),
checkCell("Palpitations / arrhythmia"),
checkCell("Breathlessness at rest"),
checkCell("Pedal edema"),
]
}),
new TableRow({
children: [
checkCell("Paroxysmal nocturnal dyspnea"),
checkCell("Orthopnea"),
checkCell("Reduced exercise capacity"),
checkCell("Syncope"),
]
}),
]
}),
blankLine(),
subHeading("2G. Other Symptoms"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({
children: [
checkCell("Leg ulcers"),
checkCell("Recurrent infections"),
checkCell("Headaches"),
checkCell("Visual disturbances"),
]
}),
new TableRow({
children: [
checkCell("Thromboembolic events (DVT/PE)"),
checkCell("Pulmonary hypertension symptoms"),
checkCell("Abdominal pain (splenomegaly)"),
checkCell("Neurological symptoms"),
]
}),
]
}),
blankLine(),
new Paragraph({ children: [new TextRun({ text: "Additional Symptom Remarks: " + "_".repeat(100), size: 18, font: "Calibri" })] }),
blankLine(),
// ══════════════════════════════════════════════════════════
// SECTION 3: GENERAL PHYSICAL EXAMINATION
// ══════════════════════════════════════════════════════════
sectionHeading("SECTION 3: GENERAL PHYSICAL EXAMINATION"),
subHeading("3A. Vital Signs"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({
children: [
headerCell("Parameter"),
headerCell("Value"),
headerCell("Parameter"),
headerCell("Value"),
]
}),
new TableRow({
children: [
dataCell("Heart Rate (bpm)", {}),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(25), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
dataCell("Blood Pressure (mmHg)", {}),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_____/_____", size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}),
new TableRow({
children: [
dataCell("Respiratory Rate (/min)", {}),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(25), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
dataCell("Temperature (°C)", {}),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(25), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}),
new TableRow({
children: [
dataCell("SpO₂ (%)", {}),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(25), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
dataCell("Weight (kg) / Height (cm)", {}),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_____ / _____", size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}),
new TableRow({
children: [
dataCell("BMI (kg/m²)", {}),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(25), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
dataCell("Head Circumference (pediatric)", {}),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(25), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}),
]
}),
blankLine(),
subHeading("3B. General Appearance & Build"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({
children: [
checkCell("Well-nourished"),
checkCell("Malnourished"),
checkCell("Short stature for age"),
checkCell("Cachexic appearance"),
]
}),
new TableRow({
children: [
checkCell("Distressed / Irritable"),
checkCell("Lethargic"),
checkCell("Well-oriented / Alert"),
checkCell("Chronic illness facies"),
]
}),
]
}),
blankLine(),
subHeading("3C. Skin & Mucous Membrane"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({
children: [
headerCell("Sign", { columnSpan: 1 }),
headerCell("Present / Absent", { columnSpan: 1 }),
headerCell("Severity / Remarks", { columnSpan: 2 }),
]
}),
...([
["Pallor (conjunctival / palmar / nail bed)", ""],
["Jaundice / Icterus (sclerae, skin)", ""],
["Skin bronzing / slate-grey pigmentation (iron overload)", ""],
["Leg ulcers (lower limb)", ""],
["Petechiae / purpura", ""],
["Cyanosis (peripheral / central)", ""],
].map(([label]) => new TableRow({
children: [
new TableCell({ width: { size: 35, type: WidthType.PERCENTAGE }, shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: label, size: 18, font: "Calibri" })] })] }),
new TableCell({ width: { size: 20, type: WidthType.PERCENTAGE }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "☐ Present ☐ Absent", size: 18, font: "Calibri" })] })] }),
new TableCell({ width: { size: 45, type: WidthType.PERCENTAGE }, columnSpan: 2, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(55), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}))),
]
}),
blankLine(),
subHeading("3D. Lymphadenopathy"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({
children: [
checkCell("Cervical nodes"),
checkCell("Axillary nodes"),
checkCell("Inguinal nodes"),
checkCell("None palpable"),
]
}),
new TableRow({
children: [
new TableCell({ columnSpan: 4, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Remarks: " + "_".repeat(90), size: 18, font: "Calibri", color: "444444" })] })] })
]
}),
]
}),
blankLine(),
// ══════════════════════════════════════════════════════════
// SECTION 4: HEAD & FACE
// ══════════════════════════════════════════════════════════
sectionHeading("SECTION 4: HEAD, FACE & SKULL EXAMINATION"),
note("Bone marrow expansion causes characteristic skeletal deformities — Robbins & Kumar Pathologic Basis of Disease"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({ children: [headerCell("Finding"), headerCell("Present / Absent"), headerCell("Severity / Remarks")] }),
...([
"Frontal bossing (prominent forehead)",
"Parietal bossing",
'Crew-cut appearance on skull X-ray (hair-on-end pattern)',
"Prominent malar / zygomatic eminences (chipmunk facies)",
"Depression of nasal bridge",
"Maxillary hypertrophy (protruding teeth / malocclusion)",
"Skull bossing (generalized enlargement)",
"Prominent eyes (pseudo-proptosis)",
"Dental crowding / malocclusion",
].map((label) => new TableRow({
children: [
new TableCell({ width: { size: 40, type: WidthType.PERCENTAGE }, shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: label, size: 18, font: "Calibri" })] })] }),
new TableCell({ width: { size: 20, type: WidthType.PERCENTAGE }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "☐ Present ☐ Absent", size: 18, font: "Calibri" })] })] }),
new TableCell({ width: { size: 40, type: WidthType.PERCENTAGE }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(45), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
})))
]
}),
blankLine(),
// ══════════════════════════════════════════════════════════
// SECTION 5: SYSTEMIC EXAMINATION
// ══════════════════════════════════════════════════════════
sectionHeading("SECTION 5: SYSTEMIC EXAMINATION"),
// 5A Cardiovascular
subHeading("5A. Cardiovascular System"),
note("Iron overload causes cardiomyopathy, arrhythmias, and congestive heart failure — Harrison's 22E, Table 103-5"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({ children: [headerCell("Finding"), headerCell("Finding"), headerCell("Remarks")] }),
new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Apex beat position", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "ICS: ___ Lat: MCL / Lateral to MCL / Medial to MCL", size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(35), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}),
new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Heart sounds", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "☐ S1+S2 normal ☐ S3 gallop ☐ S4 ☐ Murmur present", size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(35), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}),
new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Murmur (if present)", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "☐ Systolic ejection (flow) ☐ Pansystolic ☐ Diastolic Location: ______", size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(35), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}),
...([
["Cardiomegaly", "☐ Present ☐ Absent"],
["JVP elevation", "☐ Normal ☐ Raised cm above sternal angle: ___"],
["Peripheral edema (pedal)", "☐ None ☐ Pitting ☐ Non-pitting Grade: ___"],
["Pulsus alternans / irregular pulse", "☐ Present ☐ Absent"],
["Signs of cardiac failure", "☐ None ☐ Right ☐ Left ☐ Biventricular"],
].map(([label, value]) => new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: label, bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: value, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(35), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}))),
]
}),
blankLine(),
// 5B Respiratory
subHeading("5B. Respiratory System"),
note("Pulmonary fibrosis, pulmonary hypertension, and restrictive disease occur in thalassemia — Harrison's 22E"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({ children: [headerCell("Finding"), headerCell("Result"), headerCell("Remarks")] }),
...([
["Chest shape / expansion", "☐ Normal ☐ Barrel-shaped ☐ Asymmetric"],
["Trachea position", "☐ Central ☐ Deviated (L/R)"],
["Percussion note", "☐ Resonant ☐ Dull (basal) ☐ Stony dull"],
["Air entry (auscultation)", "☐ Equal bilateral ☐ Reduced (L) ☐ Reduced (R)"],
["Adventitious sounds", "☐ None ☐ Crackles (basal) ☐ Wheeze ☐ Pleural rub"],
["Signs of pulmonary hypertension", "☐ None ☐ Loud P2 ☐ Right ventricular heave"],
].map(([label, value]) => new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: label, bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: value, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(35), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}))),
]
}),
blankLine(),
// 5C Gastrointestinal / Abdominal
subHeading("5C. Gastrointestinal / Abdominal System"),
note("Splenomegaly (up to 1500 g), hepatomegaly due to extramedullary hematopoiesis and iron deposition — Robbins & Kumar"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({ children: [headerCell("Finding"), headerCell("Result"), headerCell("Remarks")] }),
new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Abdominal shape", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "☐ Flat ☐ Scaphoid ☐ Distended (↑ liver/spleen) ☐ Obese", size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(35), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}),
new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Splenomegaly", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "☐ Absent ☐ Just palpable ☐ Mild (<5 cm BCM) ☐ Moderate (5-10 cm) ☐ Massive (>10 cm)", size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_____ cm BCM", size: 18, font: "Calibri", color: "444444" })] })] }),
]
}),
new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Hepatomegaly", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "☐ Absent ☐ Just palpable ☐ Mild (<3 cm BCM) ☐ Moderate ☐ Severe", size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_____ cm BCM", size: 18, font: "Calibri", color: "444444" })] })] }),
]
}),
...([
["Liver consistency", "☐ Normal ☐ Firm / Enlarged (iron overload) ☐ Tender"],
["Spleen consistency", "☐ Firm ☐ Hard ☐ Tender on palpation"],
["Ascites", "☐ Absent ☐ Shifting dullness ☐ Fluid thrill"],
["Hepatic bruit / rub", "☐ Absent ☐ Bruit ☐ Friction rub"],
["Evidence of portal hypertension", "☐ None ☐ Caput medusae ☐ Varices history"],
["Abdominal collaterals", "☐ None ☐ Visible"],
].map(([label, value]) => new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: label, bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: value, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(35), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}))),
]
}),
blankLine(),
// 5D Musculoskeletal
subHeading("5D. Musculoskeletal System"),
note("Bone marrow expansion erodes cortical bone; osteoporosis in ~50% of patients — Harrison's 22E"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({ children: [headerCell("Finding"), headerCell("Result"), headerCell("Remarks")] }),
...([
["Long bone deformities", "☐ None ☐ Bowing (femur/tibia) ☐ Fracture"],
["Spinal deformity", "☐ None ☐ Kyphosis ☐ Scoliosis ☐ Loss of lumbar lordosis"],
["Joint swelling / tenderness", "☐ None ☐ Present — specify: _______"],
["Muscle wasting", "☐ None ☐ Mild ☐ Moderate ☐ Severe"],
["Osteoporosis / fracture sites", "☐ None ☐ Vertebrae ☐ Rib ☐ Long bone"],
["Extramedullary hematopoietic masses", "☐ None ☐ Paraspinal ☐ Other: ________"],
].map(([label, value]) => new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: label, bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: value, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(35), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}))),
]
}),
blankLine(),
// 5E Endocrine
subHeading("5E. Endocrine System (Iron Overload Assessment)"),
note("Hypothalamic-pituitary axis especially sensitive to iron — Harrison's 22E; endocrinopathies include DM, hypothyroidism, hypoparathyroidism"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({ children: [headerCell("Finding"), headerCell("Result"), headerCell("Remarks")] }),
...([
["Tanner staging (puberty)", "Stage: ___ (expected for age?)"],
["Thyroid gland (palpation)", "☐ Normal ☐ Enlarged ☐ Nodular"],
["Pubertal development", "☐ Age-appropriate ☐ Delayed"],
["Features of hypogonadism", "☐ None ☐ Sparse hair ☐ Small testes ☐ Amenorrhea"],
["Features of diabetes mellitus", "☐ None ☐ Acanthosis ☐ Injection sites visible"],
["Features of hypothyroidism", "☐ None ☐ Dry skin ☐ Bradycardia ☐ Edema"],
["Signs of hypoparathyroidism", "☐ None ☐ Chvostek sign +ve ☐ Trousseau sign +ve"],
].map(([label, value]) => new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: label, bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: value, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(35), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}))),
]
}),
blankLine(),
// 5F Neurological
subHeading("5F. Neurological System"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({ children: [headerCell("Finding"), headerCell("Result"), headerCell("Remarks")] }),
...([
["Higher mental functions", "☐ Intact ☐ Impaired (Note: ATR-X syndrome — intellectual disability)"],
["Cranial nerves", "☐ Intact ☐ Abnormal — specify: _______"],
["Motor examination", "☐ Normal power ☐ Weakness ☐ Spasticity"],
["Sensory examination", "☐ Normal ☐ Peripheral neuropathy features"],
["Signs of spinal cord compression (extramedullary masses)", "☐ None ☐ Present — level: ______"],
["Stroke / hemiplegia (thromboembolic)", "☐ None ☐ History ☐ Residual deficit"],
].map(([label, value]) => new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: label, bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: value, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "_".repeat(35), size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
]
}))),
]
}),
blankLine(),
// ══════════════════════════════════════════════════════════
// SECTION 6: TRANSFUSION HISTORY & IRON CHELATION
// ══════════════════════════════════════════════════════════
sectionHeading("SECTION 6: TRANSFUSION & TREATMENT HISTORY"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({ children: [headerCell("Parameter"), headerCell("Details")] }),
new TableRow({
children: [
new TableCell({ width: { size: 35, type: WidthType.PERCENTAGE }, shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Transfusion-dependent?", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "☐ Yes ☐ No Frequency: _________ Last transfusion: _________", size: 18, font: "Calibri" })] })] }),
]
}),
new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Pre-transfusion Hb target", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Target: 9-10.5 g/dL. Last pre-transfusion Hb: _______ g/dL", size: 18, font: "Calibri" })] })] }),
]
}),
new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Iron chelation therapy", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "☐ Deferoxamine ☐ Deferasirox ☐ Deferiprone ☐ None Dose: _______", size: 18, font: "Calibri" })] })] }),
]
}),
new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Splenectomy", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "☐ Yes (date: ________) ☐ No ☐ Partial On prophylactic penicillin: ☐ Yes ☐ No", size: 18, font: "Calibri" })] })] }),
]
}),
new TableRow({
children: [
new TableCell({ shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "HSCT / Gene therapy", bold: true, size: 18, font: "Calibri" })] })] }),
new TableCell({ margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "☐ Underwent HSCT (date: ________) ☐ Gene therapy ☐ None planned ☐ Planned", size: 18, font: "Calibri" })] })] }),
]
}),
]
}),
blankLine(),
// ══════════════════════════════════════════════════════════
// SECTION 7: INVESTIGATIONS SUMMARY
// ══════════════════════════════════════════════════════════
sectionHeading("SECTION 7: KEY INVESTIGATIONS SUMMARY"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({
children: [
headerCell("Investigation"),
headerCell("Result"),
headerCell("Reference / Expected in Thal Major"),
]
}),
...([
["Hb (g/dL)", "___", "Thal Major: 2-4 g/dL (untransfused); Thal Minor: 10-14 g/dL"],
["MCV (fL)", "___", "↓↓ (50-80 fL in major; 55-70 fL in minor)"],
["MCH (pg)", "___", "↓ (<22 pg in minor); markedly ↓ in major"],
["MCHC (g/dL)", "___", "Normal or ↓"],
["RBC count (×10⁶/µL)", "___", "↑ in minor (5-7 M/µL)"],
["Reticulocyte count (%)", "___", "↑ (ineffective erythropoiesis)"],
["Serum ferritin (ng/mL)", "___", "↑↑ in iron overload; monitor for chelation"],
["Serum iron / TIBC", "___", "↑ iron; ↑ saturation"],
["Peripheral blood smear", "___", "Target cells, microcytosis, hypochromia, anisocytosis, nucleated RBCs"],
["HbA₂ (%) — HPLC", "___", "↑ 3.5-7% in β-thal minor (diagnostic)"],
["HbF (%) — HPLC", "___", "↑↑ in thal major (90-100%); mild ↑ in minor"],
["Serum bilirubin (Total/Indirect)", "___", "↑ indirect (hemolysis)"],
["LFT (ALT, AST)", "___", "↑ in iron overload / hepatitis"],
["Blood glucose / HbA1c", "___", "DM screen (iron overload)"],
["Thyroid function (TSH, T4)", "___", "Hypothyroidism screening"],
["Serum calcium / PTH", "___", "Hypoparathyroidism screening"],
["Cardiac MRI (T2*)", "___", "Iron deposition assessment"],
["Echocardiogram", "___", "Cardiomyopathy / pulmonary hypertension"],
["Skull / long bone X-ray", "___", "Crew-cut pattern; thinned cortex"],
["Genetic mutation analysis", "___", "β-globin mutation characterization"],
].map(([inv, res, ref]) => new TableRow({
children: [
new TableCell({ width: { size: 30, type: WidthType.PERCENTAGE }, shading: { type: ShadingType.SOLID, color: "F2F7FB" }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: inv, size: 18, font: "Calibri" })] })] }),
new TableCell({ width: { size: 15, type: WidthType.PERCENTAGE }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: res, size: 18, font: "Calibri", color: "AAAAAA" })] })] }),
new TableCell({ width: { size: 55, type: WidthType.PERCENTAGE }, margins: { top: 80, bottom: 80, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: ref, size: 17, font: "Calibri", italics: true, color: "444444" })] })] }),
]
}))),
]
}),
blankLine(),
// ══════════════════════════════════════════════════════════
// SECTION 8: CLINICIAN SUMMARY
// ══════════════════════════════════════════════════════════
sectionHeading("SECTION 8: CLINICAL SUMMARY & IMPRESSION"),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
findingRow("Diagnosis (type & severity)"),
findingRow("Key physical findings"),
findingRow("Complications identified"),
findingRow("Transfusion / Chelation adequacy"),
findingRow("Plan / Next steps"),
findingRow("Referrals needed"),
]
}),
blankLine(),
new Table({
width: { size: 100, type: WidthType.PERCENTAGE },
rows: [
new TableRow({
children: [
new TableCell({ width: { size: 50, type: WidthType.PERCENTAGE }, margins: { top: 100, bottom: 100, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Examiner Signature: " + "_".repeat(35), size: 18, font: "Calibri" })] })] }),
new TableCell({ width: { size: 50, type: WidthType.PERCENTAGE }, margins: { top: 100, bottom: 100, left: 120, right: 120 }, children: [new Paragraph({ children: [new TextRun({ text: "Date & Time: " + "_".repeat(40), size: 18, font: "Calibri" })] })] }),
]
}),
]
}),
blankLine(),
new Paragraph({
alignment: AlignmentType.CENTER,
spacing: { before: 200 },
children: [
new TextRun({ text: "Sources: Robbins, Cotran & Kumar Pathologic Basis of Disease 10e | Harrison's Principles of Internal Medicine 22E | Henry's Clinical Diagnosis and Management", size: 16, font: "Calibri", italics: true, color: "666666" })
]
}),
]
}
]
});
Packer.toBuffer(doc).then(buffer => {
fs.writeFileSync('/home/daytona/workspace/thalassemia-proforma/Thalassemia_Examination_Proforma.docx', buffer);
console.log('SUCCESS: Thalassemia_Examination_Proforma.docx created');
}).catch(err => {
console.error('ERROR:', err);
process.exit(1);
});
Running Command
cd /home/daytona/workspace/thalassemia-proforma && node create_proforma.js 2>&1
You've run out of free credits. Sign up for a free account to continue using Orris.
This is a shared conversation. Sign in to Orris to start your own chat.