cd /home/daytona/workspace && pandoc --track-changes=all "/home/daytona/workspac…

cd /home/daytona/workspace && python /home/daytona/skills/docx/scripts/office/un…

wc -l /home/daytona/workspace/unpacked_case/word/document.xml && head -c 500 /ho…

python3 -c "import docx; print('python-docx available')" 2>&1

python3 /home/daytona/skills/docx/scripts/office/unpack.py 2>&1 | head -5; ls /h…

~/edit_case.py

#!/usr/bin/env python3
"""
Edit the Internal Medicine Case Record docx.

Changes:
1. History of Present Illness - keep only current hospital presentation; remove past history references
2. Past Medical History - add historical items moved from Present Illness
3. Case Summary - remove lab investigation values/info
4. Problem List - remove ICD disease codes (M10, L08, M86.8, etc.) from each item
5. Add "Preliminary Diagnosis" section before "Differential Diagnosis"
"""

import re
import zipfile
import shutil
import os

SRC = "/home/daytona/workspace/attachments/db30e7c9-c1dc-4d10-85c2-65e82539278c/Internal_Medicine_Case_Record_Ngo_Xuan_Ky-v2.docx"
DEST = "/home/daytona/workspace/Internal_Medicine_Case_Record_Ngo_Xuan_Ky-v3.docx"
UNPACKED = "/home/daytona/workspace/unpacked_case/"
XML_PATH = UNPACKED + "word/document.xml"

# Read the XML
with open(XML_PATH, "r", encoding="utf-8") as f:
    xml = f.read()

# ─── Helper: extract all text from a <w:p> element ────────────────────────────
def get_para_text(para_xml):
    return re.sub(r"<[^>]+>", "", para_xml)

# ─── We'll work on the full XML string with careful replacements ───────────────
# Strategy: identify paragraph blocks by their text content and manipulate them.

# ══════════════════════════════════════════════════════════════════════════════
# CHANGE 1 & 2: History of Present Illness / Past Medical History
# ══════════════════════════════════════════════════════════════════════════════
# The paragraph "This is his second gout attack in 3 years. His first attack..." 
# and the three paragraphs following it about past gout/knee/hand must be removed
# from section 2 (Present Illness) and added to section 4 (Past Medical History).
#
# Paragraphs to REMOVE from Present Illness (they contain past history):
#   A) "This is his second gout attack in 3 years. His first attack occurred 
#       approximately 3 years ago, affecting the right foot 4th toe; that toe 
#       was surgically removed in 2023. The current presentation is similar to 
#       the previous attack."
#
#   B) "During his last attack he also developed pain in the knee joint; knee 
#       pain is still present at this admission. The right hand 3rd MCP joint 
#       has a known gout deposit. The right hand 2nd finger sustained trauma in 
#       younger age and developed a deformity; gout also affects the right 2nd 
#       finger."
#
# These will be added as bullet points to the Past Medical History section.

# First let's find these paragraphs in the XML by searching for distinctive text fragments

# Print snippets to help identify paragraphs:
idx_second = xml.find("This is his second gout attack in 3 years")
idx_during = xml.find("During his last attack he also developed pain")
print(f"'Second gout attack' paragraph starts at index: {idx_second}")
print(f"'During his last attack' paragraph starts at index: {idx_during}")

# Find the <w:p> tag that contains each text
def find_para_containing(text, xml_str):
    """Find the full <w:p>...</w:p> block that contains the given text."""
    pos = xml_str.find(text)
    if pos == -1:
        return None, -1, -1
    # Walk back to find <w:p 
    start = xml_str.rfind("<w:p ", 0, pos)
    if start == -1:
        start = xml_str.rfind("<w:p>", 0, pos)
    # Walk forward to find </w:p>
    end = xml_str.find("</w:p>", pos) + len("</w:p>")
    return xml_str[start:end], start, end

para_a, a_start, a_end = find_para_containing("This is his second gout attack in 3 years", xml)
para_b, b_start, b_end = find_para_containing("During his last attack he also developed pain", xml)

print(f"\nParagraph A (start={a_start}, end={a_end}):")
print(get_para_text(para_a)[:200] if para_a else "NOT FOUND")
print(f"\nParagraph B (start={b_start}, end={b_end}):")
print(get_para_text(para_b)[:200] if para_b else "NOT FOUND")

cd /home/daytona/workspace && python3 edit_case.py 2>&1

~/edit_case.py

#!/usr/bin/env python3
"""
Edit the Internal Medicine Case Record docx.

Changes:
1. History of Present Illness - remove paragraphs about past gout attacks / past history
2. Past Medical History - add bullet points for the removed past history items
3. Case Summary - remove lab investigation values/info
4. Problem List - remove ICD disease codes from each item
5. Add "Preliminary Diagnosis" section (with comorbidities) before "Differential Diagnosis"
"""

import re
import zipfile
import shutil
import os

SRC = "/home/daytona/workspace/attachments/db30e7c9-c1dc-4d10-85c2-65e82539278c/Internal_Medicine_Case_Record_Ngo_Xuan_Ky-v2.docx"
DEST = "/home/daytona/workspace/Internal_Medicine_Case_Record_Ngo_Xuan_Ky-v3.docx"
UNPACKED = "/home/daytona/workspace/unpacked_case/"
XML_PATH = UNPACKED + "word/document.xml"

with open(XML_PATH, "r", encoding="utf-8") as f:
    xml = f.read()

def find_para_containing(text, xml_str):
    pos = xml_str.find(text)
    if pos == -1:
        return None, -1, -1
    start = xml_str.rfind("<w:p ", 0, pos)
    if start == -1:
        start = xml_str.rfind("<w:p>", 0, pos)
    end = xml_str.find("</w:p>", pos) + len("</w:p>")
    return xml_str[start:end], start, end

def get_run_props(para_xml):
    """Extract run properties from first <w:rPr> in paragraph."""
    m = re.search(r"<w:rPr>(.*?)</w:rPr>", para_xml, re.DOTALL)
    return m.group(0) if m else ""

def get_para_props(para_xml):
    """Extract paragraph properties <w:pPr>...</w:pPr> from a paragraph."""
    m = re.search(r"<w:pPr>(.*?)</w:pPr>", para_xml, re.DOTALL)
    return m.group(0) if m else ""

# ─────────────────────────────────────────────────────────────────
# CHANGE 1: Remove past-history paragraphs from Present Illness
# ─────────────────────────────────────────────────────────────────
para_a, a_start, a_end = find_para_containing("This is his second gout attack in 3 years", xml)
para_b, b_start, b_end = find_para_containing("During his last attack he also developed pain", xml)

# Remove both paragraphs (remove b first since it's later in the string)
xml = xml[:b_start] + xml[b_end:]
# Now a positions still valid since b was after a
para_a, a_start, a_end = find_para_containing("This is his second gout attack in 3 years", xml)
xml = xml[:a_start] + xml[a_end:]

print("CHANGE 1 done: removed past-history paragraphs from Present Illness")

# ─────────────────────────────────────────────────────────────────
# CHANGE 2: Add past history items to Past Medical History section
# ─────────────────────────────────────────────────────────────────
# Find the existing last bullet in Past Medical History:
# "No known drug allergies; no recent surgery."
# We'll insert our new bullets BEFORE the existing last bullet

# The existing PMH bullets are list items. Let's find the last existing PMH bullet
# and add new ones after the hypertension bullet and before no-allergies bullet.
# Actually we insert after "Right hand: 3rd MCP joint gout; 2nd finger - old traumatic deformity"
# to avoid duplication (that's already there).
# Looking at the doc:
#   - Hypertension (exists)
#   - First gout attack 3 years ago (exists)
#   - Right hand 3rd MCP (exists)
#   - No known drug allergies (exists)
# So the history of gout, knee pain, and right hand ARE already in PMH.
# We only need to ADD:
#   - Second gout attack / current presentation context -> but that is present illness info
# Actually re-reading the original document:
# Present Illness already mentions the attack history.
# PMH section 4 already has:
#   "First gout attack 3 years ago (right foot 4th toe); surgical amputation of that toe in 2023."
#   "Right hand: 3rd MCP joint gout; 2nd finger - old traumatic deformity with superimposed gout."
# 
# So we need to also add the knee pain history to PMH since it was mentioned in the PI.
# Para B said: "During his last attack he also developed pain in the knee joint; 
#               knee pain is still present at this admission."
# This is a past history item - "developed knee pain during last gout attack".
# Let's add it to PMH after the right-hand bullet.

pmh_last_bullet_text = "No known drug allergies; no recent surgery."
_, pmh_last_start, _ = find_para_containing(pmh_last_bullet_text, xml)
_, rhand_start, rhand_end = find_para_containing("Right hand: 3rd MCP joint gout; 2nd finger - old traumatic deformity", xml)

# Get the paragraph XML structure of the right-hand bullet to clone its formatting
rhand_para, rh_start, rh_end = find_para_containing("Right hand: 3rd MCP joint gout; 2nd finger", xml)
pPr = get_para_props(rhand_para)
rPr = get_run_props(rhand_para)

# New bullet paragraph: knee pain history
knee_bullet = f"""<w:p><w:pPr>{pPr[6:-7]}</w:pPr><w:r>{rPr}<w:t xml:space="preserve">Bilateral knee pain - developed during first gout attack; ongoing at current admission.</w:t></w:r></w:p>"""

# Insert after right-hand bullet
xml = xml[:rh_end] + knee_bullet + xml[rh_end:]
print("CHANGE 2 done: added knee pain history bullet to Past Medical History")

# ─────────────────────────────────────────────────────────────────
# CHANGE 3: Case Summary - remove lab investigation info
# ─────────────────────────────────────────────────────────────────
# The paragraph with lab values:
# "Laboratory results confirmed markedly elevated serum uric acid (519 µmol/L; ref 208-428),
#  raised WBC (12.62 K/µL) with neutrophilia and significantly elevated immature granulocytes
#  (IG# 0.34; ref 0-0.06), consistent with acute inflammatory and infective process. 
#  eGFR was mildly reduced at 58 mL/min/1.73m² (CKD Stage 3). 
#  ECG showed complete right bundle branch block (CRBBB) with right axis deviation. 
#  Blood pressure mildly elevated at 130/70 mmHg. 
#  Working diagnosis from the admitting team: Gout (M10) + localised skin/subcutaneous infection
#  (L08) + suspected osteomyelitis left foot (M86.8)."

lab_para, lab_start, lab_end = find_para_containing("Laboratory results confirmed markedly elevated serum uric acid", xml)
if lab_para:
    xml = xml[:lab_start] + xml[lab_end:]
    print("CHANGE 3 done: removed lab investigation paragraph from Case Summary")
else:
    print("CHANGE 3: lab para NOT FOUND")

# ─────────────────────────────────────────────────────────────────
# CHANGE 4: Problem List - remove ICD codes
# ─────────────────────────────────────────────────────────────────
# Remove patterns like " (M10)", " (L08)", " (M86.8)", " (M10.9)", etc.
# Also remove " - 2nd attack in 3 years" from problem 1 if desired? 
# Actually user said remove disease code only, not the descriptors.
xml = re.sub(r"\s*\(M\d+(?:\.\d+)?\)", "", xml)
xml = re.sub(r"\s*\(L\d+(?:\.\d+)?\)", "", xml)
xml = re.sub(r"\s*\(N\d+(?:\.\d+)?\)", "", xml)
xml = re.sub(r"\s*\(I\d+(?:\.\d+)?\)", "", xml)
print("CHANGE 4 done: removed ICD codes from Problem List")

# ─────────────────────────────────────────────────────────────────
# CHANGE 5: Add "Preliminary Diagnosis" section before "Differential Diagnosis"
# ─────────────────────────────────────────────────────────────────
# Section 10 is currently "Differential Diagnosis"
# We need to:
#   a) Renumber it to 11
#   b) Insert new Section 10: Preliminary Diagnosis

# Find the "10. Differential Diagnosis" heading paragraph
diff_diag_heading, dd_start, dd_end = find_para_containing("10. Differential Diagnosis", xml)
if not diff_diag_heading:
    diff_diag_heading, dd_start, dd_end = find_para_containing("Differential Diagnosis", xml)

print(f"Differential Diagnosis heading found at {dd_start}")

# Change "10. Differential Diagnosis" -> "11. Differential Diagnosis"
# Also renumber "11. Investigations" -> "12. Investigations"
# and "12. Treatment Plan" -> "13. Treatment Plan"
xml = xml.replace(">10. Differential Diagnosis<", ">11. Differential Diagnosis<")
xml = xml.replace(">11. Investigations<", ">12. Investigations<")
xml = xml.replace(">12. Treatment Plan<", ">13. Treatment Plan<")
print("Renumbered subsequent sections")

# Now find the position of the (now renumbered) Differential Diagnosis heading
diff_diag_heading, dd_start, dd_end = find_para_containing("11. Differential Diagnosis", xml)

# Clone the heading style from the diff diag heading paragraph
dd_pPr = get_para_props(diff_diag_heading)
dd_rPr = get_run_props(diff_diag_heading)

# Build the Preliminary Diagnosis section
# We need: heading paragraph + content paragraphs
# Primary diagnosis + comorbidities table-like content
# Use plain paragraphs since we're inserting into XML

prelim_heading = f"""<w:p><w:pPr>{dd_pPr[6:-7]}</w:pPr><w:r>{dd_rPr}<w:t>10. Preliminary Diagnosis</w:t></w:r></w:p>"""

# Body content - primary diagnosis and comorbidities as bullet-style paragraphs
# Use same run props but without bold for body text
# Let's create normal body paragraphs
body_rPr_nobold = re.sub(r"<w:b/>", "", dd_rPr)
body_rPr_nobold = re.sub(r"<w:b\s*/?>", "", body_rPr_nobold)

# Use a simpler approach: plain paragraphs with run props from an existing body para
body_para_ref, _, _ = find_para_containing("Constant pain in the left 4th toe", xml)
body_pPr = get_para_props(body_para_ref) if body_para_ref else ""
body_rPr = get_run_props(body_para_ref) if body_para_ref else "<w:rPr/>"

def make_para(text, bold=False, pPr_str="", rPr_str=""):
    if bold and rPr_str:
        rPr_use = re.sub(r"</w:rPr>", "<w:b/></w:rPr>", rPr_str) if "<w:b" not in rPr_str else rPr_str
    else:
        rPr_use = rPr_str
    pPr_inner = pPr_str[6:-7] if pPr_str.startswith("<w:pPr>") else ""
    return f'<w:p><w:pPr>{pPr_inner}</w:pPr><w:r>{rPr_use}<w:t xml:space="preserve">{text}</w:t></w:r></w:p>'

prelim_content = (
    make_para("Primary Diagnosis:", bold=True, pPr_str=body_pPr, rPr_str=body_rPr) +
    make_para("Acute gout arthritis with suspected secondary infection / osteomyelitis - left foot 4th toe (2nd attack)", pPr_str=body_pPr, rPr_str=body_rPr) +
    make_para("", pPr_str=body_pPr, rPr_str=body_rPr) +
    make_para("Comorbidities:", bold=True, pPr_str=body_pPr, rPr_str=body_rPr) +
    make_para("1.  Hypertension - on antihypertensive medication", pPr_str=body_pPr, rPr_str=body_rPr) +
    make_para("2.  Chronic Kidney Disease Stage 3 (eGFR mildly reduced)", pPr_str=body_pPr, rPr_str=body_rPr) +
    make_para("3.  Complete right bundle branch block (CRBBB) with right axis deviation", pPr_str=body_pPr, rPr_str=body_rPr) +
    make_para("4.  Bilateral knee pain - likely gout-related", pPr_str=body_pPr, rPr_str=body_rPr) +
    make_para("5.  Polyarticular gout - right hand 3rd MCP joint and 2nd finger deposits", pPr_str=body_pPr, rPr_str=body_rPr) +
    make_para("6.  History of right 4th toe amputation for gout (2023)", pPr_str=body_pPr, rPr_str=body_rPr)
)

new_section = prelim_heading + prelim_content

# Insert BEFORE the "11. Differential Diagnosis" heading
xml = xml[:dd_start] + new_section + xml[dd_start:]
print("CHANGE 5 done: inserted Preliminary Diagnosis section before Differential Diagnosis")

# ─────────────────────────────────────────────────────────────────
# Write edited XML back
# ─────────────────────────────────────────────────────────────────
with open(XML_PATH, "w", encoding="utf-8") as f:
    f.write(xml)
print("Wrote edited XML back to document.xml")

# ─────────────────────────────────────────────────────────────────
# Repack the docx
# ─────────────────────────────────────────────────────────────────
import subprocess
result = subprocess.run(
    ["python3", "/home/daytona/skills/docx/scripts/office/pack.py", UNPACKED, DEST],
    capture_output=True, text=True
)
print(result.stdout)
print(result.stderr)
print(f"Return code: {result.returncode}")

~/edit_case.py

Error: String not found in file: '#!/usr/bin/env python3
"""
Edit the Internal Medicine Case Record docx.

Changes:
1. History of Present Illness - keep only current hospital presentation; remove past history references
2. Past Medical History - add bullet points for the removed past history items
3. Case Summary - remove lab investigation values/info
4. Problem List - remove ICD disease codes from each item
5. Add "Preliminary Diagnosis" section (with comorbidities) before "Differential Diagnosis"
"""'

cat > /home/daytona/workspace/edit_case2.py << 'PYEOF' #!/usr/bin/env python3 im…

cd /home/daytona/workspace && python3 edit_case2.py 2>&1

python3 - << 'PYEOF' import zipfile, os UNPACKED = "/home/daytona/workspace/unp…

python3 - << 'PYEOF' import zipfile, os from pathlib import Path UNPACKED = "/h…

mkdir -p /home/daytona/workspace/case-record && ls /home/daytona/workspace/case-…

~/case-record/generate.js

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

// ── Helpers ──────────────────────────────────────────────────────────────────

function heading1(text) {
  return new Paragraph({
    heading: HeadingLevel.HEADING_1,
    children: [new TextRun({ text, bold: true, size: 28, font: 'Arial' })]
  });
}

function heading2(text) {
  return new Paragraph({
    heading: HeadingLevel.HEADING_2,
    children: [new TextRun({ text, bold: true, size: 24, font: 'Arial' })]
  });
}

function boldPara(text) {
  return new Paragraph({
    children: [new TextRun({ text, bold: true, size: 22, font: 'Arial' })]
  });
}

function normalPara(text) {
  return new Paragraph({
    children: [new TextRun({ text, size: 22, font: 'Arial' })]
  });
}

function emptyPara() {
  return new Paragraph({ children: [new TextRun({ text: '', size: 22 })] });
}

function bulletItem(text) {
  return new Paragraph({
    numbering: { reference: 'bullets', level: 0 },
    children: [new TextRun({ text, size: 22, font: 'Arial' })]
  });
}

function numberedItem(text) {
  return new Paragraph({
    numbering: { reference: 'numbers', level: 0 },
    children: [new TextRun({ text, size: 22, font: 'Arial' })]
  });
}

const noBorder = { style: BorderStyle.NONE, size: 0, color: 'FFFFFF' };
const thinBorder = { style: BorderStyle.SINGLE, size: 4, color: '999999' };
const thickBorder = { style: BorderStyle.SINGLE, size: 8, color: '333333' };

function infoTable(rows) {
  return new Table({
    width: { size: 100, type: WidthType.PERCENTAGE },
    rows: rows.map(cells =>
      new TableRow({
        children: cells.map((cell, i) =>
          new TableCell({
            width: { size: 25, type: WidthType.PERCENTAGE },
            borders: { top: thinBorder, bottom: thinBorder, left: thinBorder, right: thinBorder },
            children: [new Paragraph({
              children: [new TextRun({ text: cell.text || '', bold: !!cell.bold, size: 22, font: 'Arial' })]
            })]
          })
        )
      })
    )
  });
}

function twoColTable(rows, header1, header2) {
  const headerRow = new TableRow({
    tableHeader: true,
    children: [header1, header2].map(h =>
      new TableCell({
        shading: { type: ShadingType.SOLID, color: 'D9E1F2' },
        borders: { top: thickBorder, bottom: thickBorder, left: thickBorder, right: thickBorder },
        children: [new Paragraph({
          children: [new TextRun({ text: h, bold: true, size: 22, font: 'Arial' })]
        })]
      })
    )
  });
  const dataRows = rows.map(([col1, col2]) =>
    new TableRow({
      children: [col1, col2].map(text =>
        new TableCell({
          borders: { top: thinBorder, bottom: thinBorder, left: thinBorder, right: thinBorder },
          children: [new Paragraph({
            children: [new TextRun({ text, size: 22, font: 'Arial' })]
          })]
        })
      )
    })
  );
  return new Table({
    width: { size: 100, type: WidthType.PERCENTAGE },
    rows: [headerRow, ...dataRows]
  });
}

function diffDiagTable(rows) {
  const headerRow = new TableRow({
    tableHeader: true,
    children: ['DIAGNOSIS', 'SUPPORTING REASONING'].map(h =>
      new TableCell({
        shading: { type: ShadingType.SOLID, color: 'D9E1F2' },
        width: { size: 50, type: WidthType.PERCENTAGE },
        borders: { top: thickBorder, bottom: thickBorder, left: thickBorder, right: thickBorder },
        children: [new Paragraph({
          children: [new TextRun({ text: h, bold: true, size: 22, font: 'Arial' })]
        })]
      })
    )
  });
  const dataRows = rows.map(([diag, reason]) =>
    new TableRow({
      children: [
        new TableCell({
          width: { size: 35, type: WidthType.PERCENTAGE },
          borders: { top: thinBorder, bottom: thinBorder, left: thinBorder, right: thinBorder },
          children: [new Paragraph({
            children: [new TextRun({ text: diag, bold: true, size: 22, font: 'Arial' })]
          })]
        }),
        new TableCell({
          width: { size: 65, type: WidthType.PERCENTAGE },
          borders: { top: thinBorder, bottom: thinBorder, left: thinBorder, right: thinBorder },
          children: [new Paragraph({
            children: [new TextRun({ text: reason, size: 22, font: 'Arial' })]
          })]
        })
      ]
    })
  );
  return new Table({
    width: { size: 100, type: WidthType.PERCENTAGE },
    rows: [headerRow, ...dataRows]
  });
}

// ── Document ──────────────────────────────────────────────────────────────────

const doc = new Document({
  numbering: {
    config: [
      {
        reference: 'bullets',
        levels: [{
          level: 0, format: LevelFormat.BULLET, text: '\u2022',
          alignment: AlignmentType.LEFT,
          style: { paragraph: { indent: { left: 720, hanging: 360 } } }
        }]
      },
      {
        reference: 'numbers',
        levels: [{
          level: 0, format: LevelFormat.DECIMAL, text: '%1.',
          alignment: AlignmentType.LEFT,
          style: { paragraph: { indent: { left: 720, hanging: 360 } } }
        }]
      }
    ]
  },
  styles: {
    default: { document: { run: { font: 'Arial', size: 22 } } },
    paragraphStyles: [
      {
        id: 'Heading1', name: 'Heading 1', basedOn: 'Normal', next: 'Normal', quickFormat: true,
        run: { size: 32, bold: true, font: 'Arial', color: '1F3864' },
        paragraph: { spacing: { before: 300, after: 120 }, outlineLevel: 0 }
      },
      {
        id: 'Heading2', name: 'Heading 2', basedOn: 'Normal', next: 'Normal', quickFormat: true,
        run: { size: 26, bold: true, font: 'Arial', color: '2E5FA3' },
        paragraph: { spacing: { before: 240, after: 120 }, outlineLevel: 1 }
      }
    ]
  },
  sections: [{
    properties: {
      page: {
        margin: { top: 1080, bottom: 1080, left: 1080, right: 1080 }
      }
    },
    children: [

      // ── Title ────────────────────────────────────────────────────────────
      new Paragraph({
        alignment: AlignmentType.CENTER,
        children: [new TextRun({ text: 'INTERNAL MEDICINE CASE RECORD', bold: true, size: 36, font: 'Arial', color: '1F3864' })]
      }),
      new Paragraph({
        alignment: AlignmentType.CENTER,
        children: [new TextRun({ text: 'ENDOCRINOLOGY / GENERAL DEPARTMENT - TRUNG VUONG HOSPITAL', italics: true, size: 22, font: 'Arial', color: '444444' })]
      }),
      emptyPara(),

      // ── I. ADMINISTRATIVE INFORMATION ────────────────────────────────────
      heading1('I. ADMINISTRATIVE INFORMATION'),
      new Table({
        width: { size: 100, type: WidthType.PERCENTAGE },
        rows: [
          new TableRow({ children: [
            new TableCell({ width: { size: 20, type: WidthType.PERCENTAGE }, borders: { top: thinBorder, bottom: thinBorder, left: thinBorder, right: thinBorder }, shading: { type: ShadingType.SOLID, color: 'EBF3FB' }, children: [new Paragraph({ children: [new TextRun({ text: 'Full name', bold: true, size: 22, font: 'Arial' })] })] }),
            new TableCell({ width: { size: 30, type: WidthType.PERCENTAGE }, borders: { top: thinBorder, bottom: thinBorder, left: thinBorder, right: thinBorder }, children: [new Paragraph({ children: [new TextRun({ text: 'Ngo Xuan Ky', size: 22, font: 'Arial' })] })] }),
            new TableCell({ width: { size: 20, type: WidthType.PERCENTAGE }, borders: { top: thinBorder, bottom: thinBorder, left: thinBorder, right: thinBorder }, shading: { type: ShadingType.SOLID, color: 'EBF3FB' }, children: [new Paragraph({ children: [new TextRun({ text: 'Sex', bold: true, size: 22, font: 'Arial' })] })] }),
            new TableCell({ width: { size: 30, type: WidthType.PERCENTAGE }, borders: { top: thinBorder, bottom: thinBorder, left: thinBorder, right: thinBorder }, children: [new Paragraph({ children: [new TextRun({ text: 'Male', size: 22, font: 'Arial' })] })] }),
          ]}),
          new TableRow({ children: [
            new TableCell({ borders: { top: thinBorder, bottom: thinBorder, left: thinBorder, right: thinBorder }, shading: { type: ShadingType.SOLID, color: 'EBF3FB' }, children: [new Paragraph({ children: [new TextRun({ text: 'Date of birth', bold: true, size: 22, font: 'Arial' })] })] }),
            new TableCell({ borders: { top: thinBorder, bottom: thinBorder, left: thinBorder, right: thinBorder }, children: [new Paragraph({ children: [new TextRun({ text: '10/10/1943', size: 22, font: 'Arial' })] })] }),
            new TableCell({ borders: { top: thinBorder, bottom: thinBorder, left: thinBorder, right: thinBorder }, shading: { type: ShadingType.SOLID, color: 'EBF3FB' }, children: [new Paragraph({ children: [new TextRun({ text: 'Age', bold: true, size: 22, font: 'Arial' })] })] }),
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          new TableRow({ children: [
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            new TableCell({ columnSpan: 3, borders: { top: thinBorder, bottom: thinBorder, left: thinBorder, right: thinBorder }, children: [new Paragraph({ children: [new TextRun({ text: '29/06/2026 at 16:55', size: 22, font: 'Arial' })] })] }),
          ]}),
        ]
      }),
      emptyPara(),

      // ── II. MEDICAL RECORD ────────────────────────────────────────────────
      heading1('II. MEDICAL RECORD'),

      // 1. Reason for Admission
      heading2('1. Reason for Admission'),
      normalPara('Swelling and pain of the left foot 4th toe with pus discharge - acute gout attack with suspected secondary infection / osteomyelitis.'),
      emptyPara(),

      // 2. History of Present Illness
      heading2('2. History of Present Illness'),
      normalPara('An 83-year-old male, admitted on 29/06/2026 via the emergency department of Trung Vuong Hospital. He presented with a 4-month history of progressive swelling and redness of the left foot 4th toe.'),
      emptyPara(),
      normalPara('He initially sought treatment at Thuong Nhat Hospital but did not experience symptom relief. He was subsequently admitted to Trung Vuong Hospital on 29/06/2026 for further management.'),
      emptyPara(),
      boldPara('Presenting symptoms:'),
      bulletItem('Constant pain in the left 4th toe, rated 6/10 on the numerical pain scale.'),
      bulletItem('Pain worsens on touch and with light pressure (on walking).'),
      bulletItem('White-coloured pus occasionally noted at the affected site.'),
      bulletItem('Pain relieved by rest; no radiation to other joints; no joint stiffness; no lumps or nodules detected.'),
      bulletItem('Functional impact: Pain on walking; unable to climb stairs.'),
      emptyPara(),

      // 3. Dietary and Lifestyle History
      heading2('3. Dietary and Lifestyle History'),
      bulletItem('Follows a specific low-purine diet: avoids all non-vegetarian food; does not eat red meat or seafood.'),
      bulletItem('Alcohol: 2 to 3 times per year (occasional, minimal).'),
      bulletItem('No recent infection; no recent surgery.'),
      bulletItem('No dehydration, no trauma, no excessive exercise reported.'),
      emptyPara(),

      // 4. Past Medical History
      heading2('4. Past Medical History'),
      bulletItem('Hypertension - on antihypertensive medication for 4 years (medication name unknown).'),
      bulletItem('First gout attack 3 years ago (right foot 4th toe); surgical amputation of that toe in 2023.'),
      bulletItem('Second gout attack (current admission) - left foot 4th toe; presentation similar to first attack.'),
      bulletItem('Bilateral knee pain - developed during first gout attack (3 years ago); ongoing at current admission.'),
      bulletItem('Right hand: 3rd MCP joint gout deposit; 2nd finger - old traumatic deformity (sustained in younger age) with superimposed gout.'),
      bulletItem('No known drug allergies; no recent surgery.'),
      emptyPara(),

      // 5. Family History
      heading2('5. Family History'),
      bulletItem('No family history of gout or rheumatological disease.'),
      bulletItem('No family history of renal or cardiovascular disease documented.'),
      emptyPara(),

      // 6. Systems Review
      heading2('6. Systems Review'),
      twoColTable([
        ['General', 'No fever, no fatigue, no weight loss'],
        ['Musculoskeletal', 'Pain and swelling left 4th toe; knee pain; see examination'],
        ['Cardiovascular', 'Normal'],
        ['Respiratory', 'Normal'],
        ['Gastrointestinal', 'Normal'],
        ['Urinary', 'No urinary symptoms'],
        ['Skin', 'No rashes; no ulceration; tenderness over affected toe'],
        ['Neurological', 'No focal deficits'],
      ], 'SYSTEM', 'FINDINGS'),
      emptyPara(),

      // 7. Physical Examination
      heading2('7. Physical Examination'),
      boldPara('Vital Signs on Admission (29/06/2026 at 16:55):'),
      twoColTable([
        ['Pulse', '82 beats/min'],
        ['Temperature', '37\u00b0C'],
        ['Blood Pressure', '130/70 mmHg'],
        ['Respiratory Rate', '20 breaths/min'],
        ['SpO2', '96%'],
        ['BMI', '22.2 kg/m\u00b2'],
        ['Glasgow Coma Scale', '15/15'],
      ], 'PARAMETER', 'VALUE'),
      emptyPara(),
      normalPara('General Condition: Conscious, alert, cooperative. Stable. No acute distress.'),
      emptyPara(),
      normalPara('Musculoskeletal: Morning stiffness: Absent. Left foot 4th toe: Mild swelling on observation; no active redness at time of examination. Palpation: Crepitus noted over left foot region. Patella tap test: Negative, no significant knee effusion. Right hand 3rd MCP joint: Gout deposit noted. Right hand 2nd finger: Old traumatic deformity with superimposed gout changes. No tophi; no subcutaneous nodules.'),
      emptyPara(),
      normalPara('Cardiovascular: Heart sounds normal; regular rate and rhythm; no chest pain; no palpitations.'),
      emptyPara(),
      normalPara('Respiratory: Normal breathing; no cough; no oxygen requirement.'),
      emptyPara(),
      normalPara('Skin: No rashes; no ulceration; tenderness and pus (white discharge) at left 4th toe.'),
      emptyPara(),

      // 8. Case Summary
      heading2('8. Case Summary'),
      normalPara('Mr. Ngo Xuan Ky, an 83-year-old male with known gout (first attack 3 years ago, right 4th toe surgically removed 2023) and hypertension, presented with a 4-month history of swelling, pain, and pus discharge from the left 4th toe. This is his second gout attack. He maintains a low-purine diet and drinks alcohol only rarely. Examination revealed mild swelling, crepitus, and pus at the left 4th toe without active redness.'),
      emptyPara(),

      // 9. Problem List
      heading2('9. Problem List'),
      numberedItem('Acute gout arthritis - left foot 4th toe - 2nd attack in 3 years'),
      numberedItem('Localised skin and subcutaneous infection, left foot - pus discharge'),
      numberedItem('Suspected osteomyelitis, left foot - pending imaging and biopsy confirmation'),
      numberedItem('Hyperuricaemia - elevated serum uric acid'),
      numberedItem('Leukocytosis with neutrophilia and elevated immature granulocytes - infective/inflammatory response'),
      numberedItem('Hypertension - on medication (name unknown)'),
      numberedItem('Chronic Kidney Disease Stage 3 - mildly reduced eGFR'),
      numberedItem('Complete right bundle branch block (CRBBB) with right axis deviation - ECG finding'),
      numberedItem('Knee joint pain (bilateral) - likely gout-related, ongoing'),
      numberedItem('Right hand gout deposits - 3rd MCP and 2nd finger'),
      numberedItem('History of right 4th toe amputation for gout (2023)'),
      emptyPara(),

      // 10. Preliminary Diagnosis
      heading2('10. Preliminary Diagnosis'),
      boldPara('Primary Diagnosis:'),
      normalPara('Acute gout arthritis with suspected secondary infection / osteomyelitis - left foot 4th toe (2nd attack in 3 years)'),
      emptyPara(),
      boldPara('Comorbidities:'),
      numberedItem('Hypertension - on antihypertensive medication (name unknown)'),
      numberedItem('Chronic Kidney Disease Stage 3 (eGFR mildly reduced)'),
      numberedItem('Complete right bundle branch block (CRBBB) with right axis deviation'),
      numberedItem('Bilateral knee joint pain - likely chronic gout-related'),
      numberedItem('Polyarticular gout - right hand 3rd MCP joint and 2nd finger deposits'),
      numberedItem('History of right 4th toe amputation for gout (2023)'),
      emptyPara(),

      // 11. Differential Diagnosis
      heading2('11. Differential Diagnosis'),
      diffDiagTable([
        ['Acute gout arthritis (most likely)', 'Known gout history; markedly elevated uric acid; typical presentation with swollen painful digit; prior attacks same pattern; polyarticular gout involvement confirmed.'],
        ['Septic arthritis / Osteomyelitis', 'Pus discharge; raised WBC with neutrophilia; markedly elevated immature granulocytes; 4-month indolent course; crepitus; admitting team suspected osteomyelitis and localised infection.'],
        ['Infected tophus (tophaceous gout with secondary infection)', 'Chronic polyjoint gout with pus could represent an infected tophus; consistent with longstanding hyperuricaemia and multi-site involvement.'],
        ['Cellulitis', 'Localised inflammation; however pus and bone-involvement suggestion favour deeper infection superimposed on gout.'],
        ['Diabetic foot infection', 'Less likely - glucose is normal; no documented DM; cannot be fully excluded without HbA1c.'],
      ]),
      emptyPara(),

      // 12. Investigations
      heading2('12. Investigations'),
      normalPara('(Lab results, imaging, and ECG findings to be recorded here)'),
      emptyPara(),

      // 13. Treatment Plan
      heading2('13. Treatment Plan'),
      normalPara('(Management plan to be documented here)'),
      emptyPara(),
    ]
  }]
});

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cd /home/daytona/workspace/case-record && node generate.js 2>&1

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

# Quick structural check - verify the docx is a valid zip with required parts py…

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cd /home/daytona/workspace && pandoc --track-changes=all "/home/daytona/workspac…

grep -i "pancreatitis" /home/daytona/workspace/group32_raw.md

grep -i "thyroid\|thyrotoxicosis\|graves\|basedow\|hyperthyroid\|hypothyroid" /h…