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pres.layout = "LAYOUT_WIDE";
pres.title = "PSM Study Guide - 2nd Year MBBS";
pres.author = "PSM Study Guide";

// ─── THEME ──────────────────────────────────────────────────────────────────
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// ─── SLIDE 1: TITLE ─────────────────────────────────────────────────────────
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  s.addText("Preventive & Social Medicine", { x: 0.5, y: 3.15, w: 12.3, h: 0.65, fontSize: 28, color: C.white, fontFace: "Calibri", align: "center" });
  s.addText("COMPREHENSIVE STUDY GUIDE  |  2nd Year MBBS", { x: 0.5, y: 3.85, w: 12.3, h: 0.45, fontSize: 14, color: C.accent2, fontFace: "Calibri", align: "center", charSpacing: 3 });
  s.addText("Based on NMC Competency-Based Curriculum  •  Park's PSM", {
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// ─── SLIDE 2: TABLE OF CONTENTS ─────────────────────────────────────────────
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    ["Unit 5", "Nutrition & Deficiency Diseases"],
    ["Unit 6", "Environmental Health"],
    ["Unit 7", "Occupational Health"],
    ["Unit 8", "Biostatistics"],
    ["Unit 9", "Demography & Family Planning"],
    ["Unit 10", "Health Care Delivery in India"],
    ["Unit 11", "National Health Programmes"],
    ["Unit 12", "International Health & SDGs"],
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// ══════════════════════════════════════════════════════════════════
// UNIT 1: CONCEPTS OF HEALTH & DISEASE
// ══════════════════════════════════════════════════════════════════
sectionSlide("Unit 1", "Concepts of Health & Disease", C.accent1);

{
  let s = contentSlide("Definitions of Health", C.accent1);
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{
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    { level: "Secondary", color: C.accent2, desc: "Early diagnosis & prompt treatment • Screening programs, case detection" },
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{
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  s.addText("Disease occurs when equilibrium\nbetween the three is disturbed", { x: 0.35, y: 3.5, w: 6.2, h: 0.6, fontSize: 11, color: C.bodyText, fontFace: "Calibri", italic: true });

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// ══════════════════════════════════════════════════════════════════
// UNIT 2: EPIDEMIOLOGY
// ══════════════════════════════════════════════════════════════════
sectionSlide("Unit 2", "Epidemiology", C.accent2);

{
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  const rows = [
    ["Measure", "Formula / Definition", "Key Point"],
    ["Incidence Rate", "New cases ÷ Population at risk × 1000 (or 100,000)", "Measures RISK; used for acute diseases"],
    ["Prevalence Rate", "All existing cases ÷ Total population × 100", "Measures BURDEN; used for chronic diseases"],
    ["Attack Rate", "Cases ÷ Exposed population × 100", "Used in epidemics/outbreaks"],
    ["CFR", "Deaths ÷ Cases × 100", "Case Fatality Rate - disease severity"],
    ["Mortality Rate", "Deaths ÷ Population × 1000", "All-cause or cause-specific"],
    ["IMR", "Infant deaths (<1 yr) ÷ Live births × 1000", "Sensitive indicator of health status"],
    ["MMR", "Maternal deaths ÷ Live births × 100,000", "Pregnancy-related deaths"],
  ];
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{
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    { type: "RCT", color: C.accent3, items: ["Randomized Controlled Trial", "Gold standard for causation", "Random allocation, blinding", "Intervention vs placebo/control"] },
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{
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    ["PPV", "TP ÷ (TP+FP) × 100", "Prob. of disease if test +ve"],
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// ══════════════════════════════════════════════════════════════════
// UNIT 3: COMMUNICABLE DISEASES
// ══════════════════════════════════════════════════════════════════
sectionSlide("Unit 3", "Communicable Diseases", C.accent3);

{
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    ["Tuberculosis", "M. tuberculosis", "AFB, droplet nuclei; Ghon focus", "DOTS, BCG vaccine, NTEP"],
    ["Measles", "Paramyxovirus", "Koplik spots; maculopapular rash", "MMR vaccine (2 doses)"],
    ["Diphtheria", "C. diphtheriae", "Pseudomembrane throat; bull neck", "DPT vaccine; antitoxin"],
    ["Pertussis", "B. pertussis", "Whooping cough; inspiratory whoop", "DPT vaccine; erythromycin"],
    ["Influenza", "Influenza A/B virus", "Antigenic shift/drift; pandemics", "Annual influenza vaccine"],
    ["COVID-19", "SARS-CoV-2", "IHR Public Health Emergency", "mRNA vaccines, masking, distancing"],
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    ["Malaria", "Female Anopheles", "Plasmodium spp.", "P. falciparum - most dangerous; RDT, ACT treatment"],
    ["Dengue", "Aedes aegypti", "Dengue virus (DENV 1-4)", "Breakbone fever; DHF/DSS; no specific antiviral"],
    ["Filariasis", "Culex quinquefasciatus", "W. bancrofti", "Elephantiasis; DEC (Diethylcarbamazine)"],
    ["Kala-azar", "Phlebotomus sandfly", "L. donovani", "Visceral leishmaniasis; Miltefosine"],
    ["Chikungunya", "Aedes aegypti", "Alphavirus", "Severe joint pain; no vaccine"],
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{
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    ["Hepatitis A", "HAV (RNA)", "Feco-oral", "HAV vaccine; improved sanitation"],
    ["Hepatitis E", "HEV (RNA)", "Feco-oral (pregnant - severe)", "No vaccine; safe water"],
    ["Polio", "Poliovirus 1,2,3", "Feco-oral", "OPV (Oral) + IPV; pulse polio"],
    ["Rabies", "Rhabdovirus (zoonosis)", "Animal bite", "PEP: wound wash + RIG + vaccine"],
    ["Tetanus", "C. tetani (soil)", "Wound entry", "TT vaccination; neonatal TT for mothers"],
    ["HIV/AIDS", "HIV retrovirus", "Sexual/blood/perinatal", "ART; NACP; condom; PPTCT"],
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}

// ══════════════════════════════════════════════════════════════════
// UNIT 4: NON-COMMUNICABLE DISEASES
// ══════════════════════════════════════════════════════════════════
sectionSlide("Unit 4", "Non-Communicable Diseases (NCDs)", C.accent1);

{
  let s = contentSlide("Major NCDs - Overview", C.accent1);
  const ncds = [
    { name: "Cardiovascular\nDisease (CVD)", color: C.accent3, points: ["Leading cause of death globally", "Risk factors: HTN, DM, smoking, obesity", "Prevention: DASH diet, exercise, statins", "National Programme: NPCDCS"] },
    { name: "Hypertension", color: C.accent2, points: ["BP ≥ 140/90 mmHg", "Silent killer - often asymptomatic", "JNC 8 / WHO guidelines for management", "Lifestyle modification + pharmacotherapy"] },
    { name: "Diabetes\nMellitus", color: C.accent1, points: ["FBS ≥ 126 mg/dl or RBS ≥ 200 mg/dl or HbA1c ≥ 6.5%", "T2DM most common; linked to obesity", "Complications: retinopathy, nephropathy, neuropathy", "NPCDCS screening integrated"] },
    { name: "Cancer", color: "9B59B6", points: ["Commonest in India: Oral, Cervix, Breast (women)", "Cervical: HPV vaccine + Pap smear", "Breast: BSE, mammography", "Tobacco control - most impactful intervention"] },
  ];
  ncds.forEach((n, i) => {
    const x = 0.3 + (i % 2) * 6.5;
    const y = 1.0 + Math.floor(i / 2) * 3.0;
    s.addShape(pres.ShapeType.rect, { x, y, w: 6.1, h: 0.55, fill: { color: n.color }, line: { color: n.color }, rounding: 0.08 });
    s.addText(n.name, { x, y, w: 6.1, h: 0.55, fontSize: 13, bold: true, color: C.darkBg, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
    s.addText(n.points.map(p => "• " + p).join("\n"), { x, y: y + 0.6, w: 6.1, h: 2.2, fontSize: 10.5, color: C.white, fontFace: "Calibri" });
  });
}

// ══════════════════════════════════════════════════════════════════
// UNIT 5: NUTRITION
// ══════════════════════════════════════════════════════════════════
sectionSlide("Unit 5", "Nutrition & Deficiency Diseases", C.accent2);

{
  let s = contentSlide("Protein-Energy Malnutrition & Micronutrient Deficiencies", C.accent2);
  s.addText("PEM: Kwashiorkor vs Marasmus", { x: 0.35, y: 1.0, w: 12.6, h: 0.38, fontSize: 14, bold: true, color: C.accent1, fontFace: "Calibri" });
  const pemRows = [
    ["Feature", "Kwashiorkor", "Marasmus"],
    ["Cause", "Protein deficiency (adequate calories)", "Both protein & calorie deficiency"],
    ["Onset", "After weaning (1-3 years)", "< 1 year"],
    ["Edema", "Present (hallmark)", "Absent"],
    ["Appearance", "Moon face, flaky paint dermatosis", "Baggy pants, old man face, skin & bones"],
    ["Hair", "Flag sign (depigmented)", "Sparse, thin"],
    ["Fatty liver", "Present", "Absent"],
  ];
  s.addTable(pemRows, {
    x: 0.3, y: 1.45, w: 12.7, h: 3.5,
    border: { type: "solid", pt: 0.5, color: "1D4E7A" },
    fill: C.darkBg, color: C.white, fontFace: "Calibri", fontSize: 10.5, rowH: 0.45,
    colW: [2.5, 5.1, 5.1],
  });
  const defs = [
    { vit: "Vit A", disease: "Night blindness → Xerophthalmia → Keratomalacia", mgmt: "Vit A supplement (high dose)" },
    { vit: "Vit D", disease: "Rickets (children), Osteomalacia (adults)", mgmt: "Sunlight, Vit D + Calcium" },
    { vit: "Vit C", disease: "Scurvy (perifollicular hemorrhage, swollen gums)", mgmt: "Vit C 100mg/day; fresh fruits" },
    { vit: "Iron", disease: "Hypochromic microcytic anemia (IDA)", mgmt: "Oral iron; WIFS programme" },
    { vit: "Iodine", disease: "Goiter, Cretinism (congenital)", mgmt: "Iodized salt; NIP India" },
  ];
  s.addText("Key Micronutrient Deficiencies:", { x: 0.35, y: 5.05, w: 12.6, h: 0.35, fontSize: 12, bold: true, color: C.accent2, fontFace: "Calibri" });
  s.addText(defs.map(d => `${d.vit}: ${d.disease} → ${d.mgmt}`).join("   |   "), {
    x: 0.35, y: 5.45, w: 12.6, h: 0.6, fontSize: 9.5, color: C.bodyText, fontFace: "Calibri"
  });
}

// ══════════════════════════════════════════════════════════════════
// UNIT 6: ENVIRONMENTAL HEALTH
// ══════════════════════════════════════════════════════════════════
sectionSlide("Unit 6", "Environmental Health", C.accent1);

{
  let s = contentSlide("Water Purification & Air Pollution", C.accent1);
  s.addText("Water Purification Methods", { x: 0.35, y: 1.0, w: 6.0, h: 0.38, fontSize: 14, bold: true, color: C.accent1, fontFace: "Calibri" });
  const wRows = [
    ["Method", "Details"],
    ["Boiling", "Most effective for household; kills all pathogens"],
    ["Chlorination", "Chlorine 0.5mg/L; residual chlorine 0.2mg/L after 1h"],
    ["Slow Sand Filter", "Removes >99% bacteria; Schmutzdecke layer key"],
    ["Rapid Sand Filter", "Needs coagulation first (alum); faster output"],
    ["UV", "No residual effect; good for clear water"],
    ["WHO standards", "E.coli = 0 per 100 mL; TDS < 500 mg/L"],
  ];
  s.addTable(wRows, {
    x: 0.3, y: 1.45, w: 6.3, h: 3.8,
    border: { type: "solid", pt: 0.5, color: "1D4E7A" },
    fill: C.darkBg, color: C.white, fontFace: "Calibri", fontSize: 10, rowH: 0.52,
    colW: [2.1, 4.2],
  });
  s.addText("Air Pollution", { x: 7.0, y: 1.0, w: 6.0, h: 0.38, fontSize: 14, bold: true, color: C.accent2, fontFace: "Calibri" });
  const apData = [
    "Pollutants: SO2, NOx, CO, PM2.5, PM10, Lead, Ozone",
    "Sources: Industry, vehicles, burning biomass",
    "Health effects: COPD, lung cancer, cardiovascular disease",
    "Indoor air pollution: Biomass combustion biggest cause globally",
    "Control: Catalytic converters, clean fuel, green zones",
    "Smog: Photochemical (O3) vs London (SO2+fog)",
    "National Clean Air Programme (NCAP): 20-30% reduction target",
  ];
  s.addText(apData.map(x => "• " + x).join("\n"), {
    x: 7.0, y: 1.45, w: 6.0, h: 3.8, fontSize: 10.5, color: C.white, fontFace: "Calibri"
  });
}

// ══════════════════════════════════════════════════════════════════
// UNIT 7: OCCUPATIONAL HEALTH
// ══════════════════════════════════════════════════════════════════
sectionSlide("Unit 7", "Occupational Health", C.accent3);

{
  let s = contentSlide("Occupational Diseases & Hazards", C.accent3);
  const rows = [
    ["Disease", "Occupation/Exposure", "Key Feature"],
    ["Silicosis", "Mines, quarries, sandblasting", "Silica dust; progressive massive fibrosis; no cure"],
    ["Coal Worker's Pneumoconiosis", "Coal mining", "Black lung; Caplan syndrome if RA coexists"],
    ["Asbestosis", "Ship-building, insulation", "Mesothelioma risk; pleural plaques"],
    ["Byssinosis", "Cotton textile mills", "Monday fever; chest tightness; cotton dust"],
    ["Bagassosis", "Sugarcane bagasse handling", "Thermophilic actinomycetes; hypersensitivity"],
    ["Mesothelioma", "Asbestos (MOST specific)", "Pleural malignancy; long latency 20-40 yrs"],
    ["Lead poisoning", "Painting, battery, smelting", "Basophilic stippling; wrist/foot drop"],
    ["Noise-induced HL", "Factories, airports", "First: 4000 Hz dip on audiogram"],
  ];
  s.addTable(rows, {
    x: 0.3, y: 0.9, w: 12.7, h: 6.0,
    border: { type: "solid", pt: 0.5, color: "1D4E7A" },
    fill: C.darkBg, color: C.white, fontFace: "Calibri", fontSize: 10, rowH: 0.58,
    colW: [2.5, 3.5, 6.7],
  });
}

// ══════════════════════════════════════════════════════════════════
// UNIT 8: BIOSTATISTICS
// ══════════════════════════════════════════════════════════════════
sectionSlide("Unit 8", "Biostatistics", C.accent2);

{
  let s = contentSlide("Measures of Central Tendency & Dispersion", C.accent2);
  const left = [
    ["Measure", "Definition", "When to Use"],
    ["Mean", "Sum ÷ N", "Normally distributed data; no outliers"],
    ["Median", "Middle value", "Skewed data, ordinal scale"],
    ["Mode", "Most frequent value", "Nominal data; multimodal distributions"],
    ["SD", "Spread around mean", "Normal distribution (68-95-99.7 rule)"],
    ["SE", "SD ÷ √N", "How well sample estimates population mean"],
    ["Range", "Max - Min", "Quick, rough measure; sensitive to outliers"],
    ["Variance", "SD²", "Used in statistical calculations"],
  ];
  s.addTable(left, {
    x: 0.3, y: 0.9, w: 8.5, h: 5.6,
    border: { type: "solid", pt: 0.5, color: "1D4E7A" },
    fill: C.darkBg, color: C.white, fontFace: "Calibri", fontSize: 10, rowH: 0.6,
    colW: [1.8, 2.5, 4.2],
  });
  s.addText("Normal Distribution:", { x: 9.0, y: 1.0, w: 4.0, h: 0.38, fontSize: 13, bold: true, color: C.accent1, fontFace: "Calibri" });
  s.addText("• Mean = Median = Mode\n• Symmetric bell curve\n• ±1 SD = 68.2% of data\n• ±2 SD = 95.4% of data\n• ±3 SD = 99.7% of data\n\nSkewness:\n• +ve skew: tail to right\n  (Mode < Median < Mean)\n• -ve skew: tail to left\n  (Mean < Median < Mode)", {
    x: 9.0, y: 1.45, w: 4.1, h: 4.5, fontSize: 10.5, color: C.white, fontFace: "Calibri"
  });
}

{
  let s = contentSlide("Tests of Significance & Sampling", C.accent2);
  const tests = [
    ["Test", "Use Case", "p-value < 0.05"],
    ["t-test (unpaired)", "Compare means of 2 independent groups", "Statistically significant"],
    ["t-test (paired)", "Compare means before/after in same group", "Same sample, 2 time points"],
    ["Chi-square (χ²)", "Compare proportions / categorical data", "Reject null hypothesis"],
    ["ANOVA", "Compare means of 3 or more groups", "F-ratio used"],
    ["Correlation (r)", "Strength of linear relationship (-1 to +1)", "r=0 no relation; r=±1 perfect"],
    ["Regression", "Predict dependent from independent variable", "R² = coefficient of determination"],
  ];
  s.addTable(tests, {
    x: 0.3, y: 0.9, w: 12.7, h: 4.1,
    border: { type: "solid", pt: 0.5, color: "1D4E7A" },
    fill: C.darkBg, color: C.white, fontFace: "Calibri", fontSize: 10.5, rowH: 0.55,
    colW: [2.5, 6.3, 3.9],
  });
  s.addText("Sampling Methods:", { x: 0.35, y: 5.1, w: 12.6, h: 0.38, fontSize: 13, bold: true, color: C.accent2, fontFace: "Calibri" });
  s.addText("Simple Random  •  Systematic  •  Stratified  •  Cluster  •  Purposive  •  Convenience  •  Snowball\nType I error (α): Reject true H₀ (false positive)   |   Type II error (β): Accept false H₀ (false negative)   |   Power = 1-β", {
    x: 0.35, y: 5.52, w: 12.6, h: 0.7, fontSize: 11, color: C.white, fontFace: "Calibri"
  });
}

// ══════════════════════════════════════════════════════════════════
// UNIT 9: DEMOGRAPHY & FAMILY PLANNING
// ══════════════════════════════════════════════════════════════════
sectionSlide("Unit 9", "Demography & Family Planning", C.accent1);

{
  let s = contentSlide("Vital Statistics & Demographic Indicators", C.accent1);
  const rows = [
    ["Indicator", "Formula", "India Value (approx)"],
    ["Crude Birth Rate (CBR)", "Live births ÷ Mid-yr pop × 1000", "~19.7 (NFHS-5 2021)"],
    ["Crude Death Rate (CDR)", "Deaths ÷ Mid-yr pop × 1000", "~6.0"],
    ["Infant Mortality Rate (IMR)", "Infant deaths ÷ Live births × 1000", "~35 (NFHS-5)"],
    ["Maternal Mortality Rate", "Maternal deaths ÷ Live births × 100,000", "~97 (SRS 2018-20)"],
    ["Total Fertility Rate (TFR)", "Sum of age-specific fertility rates", "2.0 (replacement = 2.1)"],
    ["Net Reproduction Rate (NRR)", "TFR × proportion of female births × survival", "NRR=1 means stable population"],
    ["Natural Growth Rate", "CBR - CDR", "~13.7 per 1000"],
  ];
  s.addTable(rows, {
    x: 0.3, y: 0.9, w: 12.7, h: 5.9,
    border: { type: "solid", pt: 0.5, color: "1D4E7A" },
    fill: C.darkBg, color: C.white, fontFace: "Calibri", fontSize: 10.5, rowH: 0.65,
    colW: [3.2, 4.8, 4.7],
  });
}

{
  let s = contentSlide("Family Planning Methods & Legislation", C.accent1);
  s.addText("Temporary Methods", { x: 0.35, y: 1.0, w: 5.8, h: 0.38, fontSize: 14, bold: true, color: C.accent1, fontFace: "Calibri" });
  const tempMethods = ["Barrier: Condom (M/F), Diaphragm, Cervical cap", "Hormonal: OCP (estrogen+progestin), Progestin-only pill", "Emergency contraception: LNG 0.75mg × 2 (within 72h)", "IUCD: Cu-T 380A (10 yrs), LNG-IUS (5 yrs)", "Hormonal injectables: DMPA (Antara programme)"];
  s.addText(tempMethods.map(x => "• " + x).join("\n"), { x: 0.35, y: 1.45, w: 5.8, h: 2.6, fontSize: 11, color: C.white, fontFace: "Calibri" });

  s.addText("Permanent Methods", { x: 6.5, y: 1.0, w: 6.4, h: 0.38, fontSize: 14, bold: true, color: C.accent2, fontFace: "Calibri" });
  const permMethods = ["Tubectomy (female): Pomeroy / Laparoscopic", "Vasectomy (male): No-scalpel vasectomy (NSV) - preferred", "NSV advantages: Faster, less complications, OPD procedure"];
  s.addText(permMethods.map(x => "• " + x).join("\n"), { x: 6.5, y: 1.45, w: 6.4, h: 1.5, fontSize: 11, color: C.white, fontFace: "Calibri" });

  s.addText("Key Legislation", { x: 0.35, y: 4.2, w: 12.6, h: 0.38, fontSize: 14, bold: true, color: C.accent3, fontFace: "Calibri" });
  const laws = [
    "MTP Act 1971 (amended 2021): Abortion up to 20 weeks on request; 20-24 wks for special categories with 2 RMP opinion",
    "PCPNDT Act 1994: Prohibits sex determination of fetus; punishable offence",
    "Legal age of marriage: Female 18 yrs, Male 21 yrs (Prohibition of Child Marriage Act)",
  ];
  s.addText(laws.map(x => "• " + x).join("\n"), { x: 0.35, y: 4.65, w: 12.6, h: 1.0, fontSize: 10.5, color: C.white, fontFace: "Calibri" });
}

// ══════════════════════════════════════════════════════════════════
// UNIT 10: HEALTH CARE DELIVERY
// ══════════════════════════════════════════════════════════════════
sectionSlide("Unit 10", "Health Care Delivery in India", C.accent2);

{
  let s = contentSlide("Health Infrastructure in India", C.accent2);
  const infra = [
    { level: "Sub-Centre (SC)", pop: "3,000-5,000 (plains)\n1,500-3,000 (hilly/tribal)", staff: "1 ANM + 1 MPW(M)", services: "Basic health care; first contact" },
    { level: "Primary Health Centre (PHC)", pop: "30,000 (plains)\n20,000 (hilly)", staff: "1 Doctor + 14 paramedical", services: "6 beds; OPD; delivery; family planning" },
    { level: "Community Health Centre (CHC)", pop: "1,20,000 (plains)\n80,000 (hilly)", staff: "4 specialists; 30 beds", services: "IPHS: Surgery, Medicine, OBG, Pediatrics" },
    { level: "Sub-District/SDH", pop: "~5 lakhs", staff: "Specialists + nursing staff", services: "Specialist care; 31-100 beds" },
    { level: "District Hospital (DH)", pop: "~20 lakhs", staff: "Full specialist team", services: "100-500 beds; referral for CHC" },
  ];
  const hdColors = [C.accent1, C.accent2, C.accent3, "7B68EE", "20B2AA"];
  infra.forEach((item, i) => {
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.0 + i * 1.1, w: 3.2, h: 0.9, fill: { color: hdColors[i] }, line: { color: hdColors[i] }, rounding: 0.08 });
    s.addText(item.level, { x: 0.3, y: 1.0 + i * 1.1, w: 3.2, h: 0.9, fontSize: 11, bold: true, color: C.darkBg, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
    s.addText(`Population: ${item.pop}`, { x: 3.6, y: 1.03 + i * 1.1, w: 4.0, h: 0.42, fontSize: 9.5, color: C.bodyText, fontFace: "Calibri" });
    s.addText(`Staff: ${item.staff}`, { x: 3.6, y: 1.48 + i * 1.1, w: 4.0, h: 0.38, fontSize: 9, color: C.white, fontFace: "Calibri" });
    s.addText(`Services: ${item.services}`, { x: 7.7, y: 1.05 + i * 1.1, w: 5.3, h: 0.78, fontSize: 9.5, color: C.bodyText, fontFace: "Calibri", valign: "middle" });
  });
}

{
  let s = contentSlide("Primary Health Care & Key Concepts", C.accent2);
  s.addText("Alma Ata Declaration (1978)", { x: 0.35, y: 1.0, w: 6.0, h: 0.38, fontSize: 14, bold: true, color: C.accent1, fontFace: "Calibri" });
  const almaAta = [
    "Health for All by 2000 AD",
    "Primary Health Care = cornerstone of health system",
    "8 essential elements: Education, Food & Nutrition, Safe Water, MCH + FP, Immunization, Endemic disease control, Essential drugs, Treatment of common diseases",
    "Mnemonic for 8 elements: ENFMIEET",
    "Equity, community participation, intersectoral coordination",
  ];
  s.addText(almaAta.map(x => "• " + x).join("\n"), { x: 0.35, y: 1.45, w: 6.0, h: 2.9, fontSize: 11, color: C.white, fontFace: "Calibri" });

  s.addText("Ayushman Bharat", { x: 6.6, y: 1.0, w: 6.3, h: 0.38, fontSize: 14, bold: true, color: C.accent2, fontFace: "Calibri" });
  const ab = [
    "Health & Wellness Centres (HWCs): Upgrade SCs & PHCs; comprehensive primary care",
    "PM-JAY (Pradhan Mantri Jan Arogya Yojana): 5 lakhs per family per year for secondary/tertiary care",
    "Target: Bottom 40% poor families (~10.74 crore families)",
    "ASHA role: Community health worker; link between community and health system; incentive based",
    "National Health Policy 2017: Progressive achievement of UHC",
  ];
  s.addText(ab.map(x => "• " + x).join("\n"), { x: 6.6, y: 1.45, w: 6.3, h: 3.0, fontSize: 11, color: C.white, fontFace: "Calibri" });
}

// ══════════════════════════════════════════════════════════════════
// UNIT 11: NATIONAL HEALTH PROGRAMMES
// ══════════════════════════════════════════════════════════════════
sectionSlide("Unit 11", "National Health Programmes", C.accent3);

{
  let s = contentSlide("Universal Immunization Programme (UIP)", C.accent3);
  const immRows = [
    ["Vaccine", "Age", "Route", "Target Disease"],
    ["BCG", "At birth", "ID (left arm)", "Tuberculosis"],
    ["OPV 0 (birth dose)", "At birth", "Oral", "Poliomyelitis"],
    ["Hepatitis B (birth)", "At birth (within 24h)", "IM", "Hepatitis B"],
    ["OPV 1,2,3 + IPV", "6,10,14 weeks", "Oral/IM", "Polio"],
    ["Pentavalent (DPT+HepB+Hib)", "6,10,14 weeks", "IM", "Diphtheria, Pertussis, Tetanus, HepB, Hib"],
    ["PCV (Pneumococcal)", "6,14 weeks + 9 months", "IM", "Pneumonia, Meningitis"],
    ["Rotavirus vaccine", "6,10,14 weeks", "Oral", "Rotavirus diarrhea"],
    ["Measles-Rubella (MR)", "9-12 months + 16-24 months", "SC", "Measles, Rubella"],
    ["JE vaccine", "9-12 months (endemic areas)", "SC", "Japanese Encephalitis"],
    ["DPT booster", "16-24 months, 5-6 yrs", "IM", "Diphtheria, Pertussis, Tetanus"],
    ["TT/Td", "10 yrs, 16 yrs, pregnancy", "IM", "Tetanus"],
  ];
  s.addTable(immRows, {
    x: 0.3, y: 0.85, w: 12.7, h: 6.2,
    border: { type: "solid", pt: 0.5, color: "1D4E7A" },
    fill: C.darkBg, color: C.white, fontFace: "Calibri", fontSize: 9.5, rowH: 0.46,
    colW: [2.8, 2.8, 1.5, 5.6],
  });
}

{
  let s = contentSlide("NTEP, NVBDCP & NACP", C.accent3);
  s.addText("NTEP (National TB Elimination Programme)", { x: 0.35, y: 1.0, w: 12.6, h: 0.38, fontSize: 14, bold: true, color: C.accent1, fontFace: "Calibri" });
  const ntep = ["Goal: End TB by 2025 (5 yrs ahead of SDG)", "Diagnosis: NAAT (CBNAAT/TrueNat) preferred; X-ray", "Treatment: Nikshay Poshan Yojana (Rs 500/month nutrition support)", "DOTS-Plus for MDR-TB; Bedaquiline for XDR-TB", "Cascade: Presumptive → Test → Diagnosed → Treated → Successfully treated"];
  s.addText(ntep.map(x => "• " + x).join("\n"), { x: 0.35, y: 1.45, w: 12.6, h: 1.5, fontSize: 11, color: C.white, fontFace: "Calibri" });

  s.addText("NVBDCP & NACP", { x: 0.35, y: 3.1, w: 12.6, h: 0.38, fontSize: 14, bold: true, color: C.accent2, fontFace: "Calibri" });
  const nvNacp = [
    "NVBDCP: Integrates control of Malaria, Dengue, Filaria, Kala-azar, JE, Chikungunya",
    "Malaria: ACT (Artemisinin Combination Therapy); LLINs; IRS (Indoor Residual Spraying)",
    "Filariasis: Mass Drug Administration - DEC + Albendazole annually",
    "NACP: ART centres, ICTC, PPTCT, STI clinics; target zero new infections",
    "NACP Phase V: Focus on key populations (MSM, FSW, PWID, TG); Test & Treat strategy",
  ];
  s.addText(nvNacp.map(x => "• " + x).join("\n"), { x: 0.35, y: 3.55, w: 12.6, h: 2.1, fontSize: 11, color: C.white, fontFace: "Calibri" });
}

{
  let s = contentSlide("RMNCH+A & Reproductive Health Programmes", C.accent3);
  const rmnch = [
    { prog: "RMNCH+A Strategy", detail: "Reproductive, Maternal, Newborn, Child and Adolescent Health - continuum of care across life cycle" },
    { prog: "Janani Suraksha Yojana (JSY)", detail: "Cash incentive for institutional delivery; focus on BPL/SC/ST families; ASHA facilitator" },
    { prog: "JSSK", detail: "Janani Shishu Suraksha Karyakram: Free delivery, C-section, drugs, diagnostics, blood, transport" },
    { prog: "PMSMA", detail: "PM Surakshit Matritva Abhiyan: Free antenatal care on 9th of every month by specialist" },
    { prog: "RBSK", detail: "Rashtriya Bal Swasthya Karyakram: 4Ds (Defects, Deficiencies, Diseases, Development delays) screening 0-18 yrs" },
    { prog: "MAA Programme", detail: "Mothers' Absolute Affection: Promoting breastfeeding; exclusive BF for 6 months" },
    { prog: "Mission Indradhanush", detail: "Intensified immunization for left-out/drop-out children; 90%+ coverage target" },
    { prog: "NHM (National Health Mission)", detail: "NRHM + NUHM; flexipool funding; ASHA, RKS, untied funds at facility level" },
  ];
  rmnch.forEach((item, i) => {
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.0 + i * 0.8, w: 3.5, h: 0.65, fill: { color: i % 2 === 0 ? C.accent3 : C.accent1 }, line: { color: i % 2 === 0 ? C.accent3 : C.accent1 }, rounding: 0.06 });
    s.addText(item.prog, { x: 0.3, y: 1.0 + i * 0.8, w: 3.5, h: 0.65, fontSize: 9.5, bold: true, color: C.darkBg, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
    s.addText(item.detail, { x: 3.95, y: 1.05 + i * 0.8, w: 9.1, h: 0.6, fontSize: 10, color: C.white, fontFace: "Calibri", valign: "middle" });
  });
}

// ══════════════════════════════════════════════════════════════════
// UNIT 12: INTERNATIONAL HEALTH & SDGs
// ══════════════════════════════════════════════════════════════════
sectionSlide("Unit 12", "International Health & SDGs", C.accent2);

{
  let s = contentSlide("WHO & International Health Organizations", C.accent2);
  s.addText("World Health Organization (WHO)", { x: 0.35, y: 1.0, w: 6.0, h: 0.38, fontSize: 14, bold: true, color: C.accent1, fontFace: "Calibri" });
  const who = ["Founded: 1948; HQ: Geneva, Switzerland", "Member states: 194; Regional offices: 6 (SEARO for India)", "Governing body: World Health Assembly (WHA)", "Functions: Standard setting, technical assistance, global health security", "IHR 2005: Binding regulations for PHEIC (Public Health Emergency of International Concern)", "WHO Director General declares PHEIC (e.g., COVID-19, Mpox)"];
  s.addText(who.map(x => "• " + x).join("\n"), { x: 0.35, y: 1.45, w: 6.0, h: 2.8, fontSize: 11, color: C.white, fontFace: "Calibri" });

  s.addText("Other Key Organizations", { x: 6.6, y: 1.0, w: 6.3, h: 0.38, fontSize: 14, bold: true, color: C.accent2, fontFace: "Calibri" });
  const orgs = ["UNICEF: Child health, immunization, nutrition; GOBI-FFF strategy", "UNFPA: Reproductive health; population programmes", "World Bank: Health financing; global disease burden studies", "UNDP: Human Development Index (HDI)", "UNAIDS: Coordinates global HIV/AIDS response", "ILO: Occupational health; labour standards"];
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  s.addText("Sustainable Development Goals (SDGs) - Health Relevant:", { x: 0.35, y: 4.5, w: 12.6, h: 0.38, fontSize: 13, bold: true, color: C.accent3, fontFace: "Calibri" });
  s.addText("SDG 1: No poverty  •  SDG 2: Zero hunger  •  SDG 3: Good Health (end AIDS, TB, Malaria; achieve UHC)  •  SDG 6: Clean water  •  SDG 13: Climate action\nSDG 3 targets: Reduce MMR <70/100,000; End preventable child deaths; UHC; Halve deaths from NCDs; Universal access to SRH", {
    x: 0.35, y: 4.95, w: 12.6, h: 0.75, fontSize: 10.5, color: C.white, fontFace: "Calibri"
  });
}

// ══════════════════════════════════════════════════════════════════
// EXAM HIGH-YIELD TIPS
// ══════════════════════════════════════════════════════════════════
sectionSlide("Exam High-Yield Topics", "Key Points & Mnemonics for University Exams", C.accent2);

{
  let s = contentSlide("Mnemonics & High-Yield Facts", C.accent2);
  const mnemonics = [
    { topic: "Bradford Hill (9 criteria)", mnemonic: "\"SCSTBPCEN\" - Strength, Consistency, Specificity, Temporality, Biologic gradient, Plausibility, Coherence, Experiment, Analogy" },
    { topic: "Alma Ata 8 elements", mnemonic: "\"ENFMIEET\" - Education, Nutrition, Food supply, MCH/FP, Immunization, Endemic control, Essential drugs, Treatment" },
    { topic: "Sensitivity vs Specificity", mnemonic: "SnNout (Sensitive = rule out) | SpPin (Specific = rule in)" },
    { topic: "Kwashiorkor vs Marasmus", mnemonic: "Kwashiorkor = edema (K for Keda/swollen); Marasmus = muscle wasting" },
    { topic: "Levels of Prevention", mnemonic: "Primordial = Prevent risk factor; Primary = Prevent disease; Secondary = Detect early; Tertiary = Limit disability" },
    { topic: "Water chlorination dose", mnemonic: "0.5 mg/L added; 0.2 mg/L residual after 1 hour contact" },
    { topic: "IMR formula", mnemonic: "Deaths of <1 year ÷ Live births × 1000 (in same year)" },
    { topic: "Cohort vs Case-Control", mnemonic: "Cohort = Cause → Effect (RR); Case-Control = Effect → Cause (OR)" },
  ];
  mnemonics.forEach((m, i) => {
    const x = 0.3 + (i % 2) * 6.5;
    const y = 1.0 + Math.floor(i / 2) * 1.3;
    s.addShape(pres.ShapeType.rect, { x, y, w: 6.2, h: 0.38, fill: { color: C.accent2 }, line: { color: C.accent2 }, rounding: 0.06 });
    s.addText(m.topic, { x, y, w: 6.2, h: 0.38, fontSize: 11, bold: true, color: C.darkBg, align: "left", valign: "middle", fontFace: "Calibri", margin: 4 });
    s.addText(m.mnemonic, { x, y: y + 0.42, w: 6.2, h: 0.8, fontSize: 9.5, color: C.white, fontFace: "Calibri", valign: "top" });
  });
}

{
  let s = contentSlide("Frequently Asked Exam Questions (Short & Long)", C.accent3);
  s.addText("Commonly Asked Topics in University Exams:", { x: 0.35, y: 1.0, w: 12.6, h: 0.38, fontSize: 14, bold: true, color: C.accent1, fontFace: "Calibri" });
  const faqs = [
    ["Epidemiology", "Define incidence & prevalence; Case-control vs Cohort; RCT design; Bradford Hill criteria"],
    ["Biostatistics", "SD vs SE; t-test vs chi-square; Normal distribution; Sampling methods"],
    ["Communicable Diseases", "Chain of infection; Malaria life cycle; TB treatment under NTEP; Oral rehydration therapy"],
    ["Nutrition", "Kwashiorkor vs Marasmus; Vitamin A deficiency manifestations; Iodine deficiency disorders"],
    ["Environmental Health", "Chlorination of water; Purification steps; Air pollutants and health effects"],
    ["Family Planning", "Sterilization methods; MTP Act provisions; IUCD types and duration"],
    ["Demography", "Calculate IMR, CBR, TFR; Demographic transition theory; Census findings"],
    ["Health Programs", "UIP schedule; NTEP DOTS protocol; RMNCH+A components; Ayushman Bharat"],
  ];
  faqs.forEach((faq, i) => {
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.5 + i * 0.73, w: 2.5, h: 0.6, fill: { color: i % 2 === 0 ? C.accent3 : C.accent1 }, line: { color: i % 2 === 0 ? C.accent3 : C.accent1 }, rounding: 0.06 });
    s.addText(faq[0], { x: 0.3, y: 1.5 + i * 0.73, w: 2.5, h: 0.6, fontSize: 10.5, bold: true, color: C.darkBg, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
    s.addText(faq[1], { x: 2.95, y: 1.55 + i * 0.73, w: 10.1, h: 0.55, fontSize: 10, color: C.white, fontFace: "Calibri", valign: "middle" });
  });
}

// ─── CLOSING SLIDE ──────────────────────────────────────────────────────────
{
  let s = darkSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 0.12, fill: { color: C.accent1 }, line: { color: C.accent1 } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 7.38, w: 13.3, h: 0.12, fill: { color: C.accent2 }, line: { color: C.accent2 } });
  s.addText("All the Best!", { x: 0.5, y: 2.2, w: 12.3, h: 1.0, fontSize: 52, bold: true, color: C.accent1, fontFace: "Calibri", align: "center" });
  s.addText("PSM is HIGH-YIELD and SCORING", { x: 0.5, y: 3.3, w: 12.3, h: 0.6, fontSize: 24, color: C.white, fontFace: "Calibri", align: "center" });
  s.addText("Revise Park's • Practice MCQs • Focus on National Programs & Epidemiology", {
    x: 0.5, y: 4.05, w: 12.3, h: 0.5, fontSize: 14, color: C.accent2, fontFace: "Calibri", align: "center", italic: true
  });
  s.addText("PSM Study Guide  |  2nd Year MBBS  |  NMC Curriculum", {
    x: 0.5, y: 6.7, w: 12.3, h: 0.4, fontSize: 11, color: C.bodyText, fontFace: "Calibri", align: "center"
  });
}

// ─── WRITE FILE ─────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/psm-studyguide/PSM_Study_Guide_2ndYear.pptx" })
  .then(() => console.log("Done! File saved."))
  .catch(e => console.error("Error:", e));

const pptxgen = require("pptxgenjs");
const pres = new pptxgen();
pres.layout = "LAYOUT_WIDE"; // 13.3 x 7.5 inches
pres.title = "PSM + FMT Distinction Cheat Sheet";

// ── COLORS ──────────────────────────────────────────────────────
const C = {
  bg:       "0A0F1E",   // very dark navy
  panel:    "111827",   // dark card bg
  panel2:   "0F1F35",
  teal:     "00C9A7",
  amber:    "FFB830",
  coral:    "FF6B6B",
  purple:   "A78BFA",
  blue:     "60A5FA",
  green:    "34D399",
  white:    "FFFFFF",
  gray:     "94A3B8",
  dgray:    "1E293B",
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// ── HELPERS ─────────────────────────────────────────────────────
function addSlide(bgColor) {
  let s = pres.addSlide();
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  return s;
}

function hdr(s, title, accent) {
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function tbl(s, rows, x, y, w, h, colW, fontSize) {
  s.addTable(rows, {
    x, y, w, h,
    border: { type:"solid", pt:0.4, color:"1E293B" },
    fill: C.panel,
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    fontFace: "Calibri",
    fontSize: fontSize || 9.5,
    rowH: h / rows.length,
    align: "left",
    valign: "middle",
    colW,
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}

// ═══════════════════════════════════════════════════════════════
// SLIDE 1 – COVER
// ═══════════════════════════════════════════════════════════════
{
  let s = addSlide("060D1A");
  // top stripe
  s.addShape(pres.ShapeType.rect, {x:0,y:0,w:13.3,h:0.1,fill:{color:C.teal},line:{color:C.teal}});
  s.addShape(pres.ShapeType.rect, {x:0,y:7.4,w:13.3,h:0.1,fill:{color:C.amber},line:{color:C.amber}});
  // glow block
  s.addShape(pres.ShapeType.rect, {x:1.5,y:1.6,w:10.3,h:4.2,fill:{color:"0D1A2E"},line:{color:"0D1A2E"}});
  s.addText("DISTINCTION", {x:1.5,y:1.75,w:10.3,h:1.0,fontSize:62,bold:true,color:C.teal,fontFace:"Calibri",align:"center",charSpacing:8});
  s.addText("CHEAT SHEET", {x:1.5,y:2.72,w:10.3,h:0.75,fontSize:40,bold:true,color:C.white,fontFace:"Calibri",align:"center",charSpacing:4});
  s.addShape(pres.ShapeType.rect, {x:3.5,y:3.55,w:6.3,h:0.05,fill:{color:C.amber},line:{color:C.amber}});
  s.addText("PSM  +  FMT  |  2nd Year MBBS", {x:1.5,y:3.65,w:10.3,h:0.55,fontSize:18,color:C.amber,fontFace:"Calibri",align:"center",charSpacing:3});
  s.addText("Key Numbers  •  IPC Sections  •  Antidotes  •  Mnemonics  •  National Programs  •  Biostatistics", {
    x:1.5,y:4.3,w:10.3,h:0.45,fontSize:12,color:C.gray,fontFace:"Calibri",align:"center",italic:true
  });
  s.addText("Exam: August 1  |  17 Days To Go  |  You've Got This!", {
    x:1.5,y:6.7,w:10.3,h:0.4,fontSize:12,color:C.teal,fontFace:"Calibri",align:"center",italic:true
  });
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 2 – PSM KEY NUMBERS (NFHS-5 & Vital Stats)
// ═══════════════════════════════════════════════════════════════
{
  let s = addSlide();
  hdr(s, "PSM — Key Numbers & Vital Statistics (NFHS-5, 2019-21)", C.teal);

  const numRows = [
    [{text:"INDICATOR",options:{bold:true,color:C.teal}}, {text:"VALUE",options:{bold:true,color:C.teal}}, {text:"FORMULA / NOTE",options:{bold:true,color:C.teal}}],
    ["Infant Mortality Rate (IMR)", "35.2 per 1000 LB", "Deaths <1 yr ÷ Live births × 1000"],
    ["Neonatal Mortality Rate (NMR)", "24.9 per 1000 LB", "Deaths <28 days ÷ Live births × 1000"],
    ["Under-5 Mortality Rate (U5MR)", "41.9 per 1000 LB", "Deaths <5 yr ÷ Live births × 1000"],
    ["Maternal Mortality Ratio (MMR)", "97 per 100,000 LB (SRS 2018-20)", "Maternal deaths ÷ Live births × 100,000"],
    ["Crude Birth Rate (CBR)", "19.5 per 1000 population", "Live births ÷ Mid-yr pop × 1000"],
    ["Crude Death Rate (CDR)", "6.0 per 1000 population", "Deaths ÷ Mid-yr pop × 1000"],
    ["Total Fertility Rate (TFR)", "2.0 (Replacement = 2.1)", "Sum of age-specific fertility rates"],
    ["Net Reproduction Rate (NRR)", "NRR = 1 → stable population", "TFR × female births proportion × survival"],
    ["Natural Growth Rate", "~13.5 per 1000", "CBR − CDR"],
    ["Life Expectancy at birth", "69.7 yrs (M: 68.2, F: 70.7) SRS 2014-18", "Average years expected to live"],
    ["Sex ratio (Census 2011)", "943 females per 1000 males", "Females ÷ Males × 1000"],
    ["Literacy rate (Census 2011)", "74% (M: 82%, F: 65%)", "Persons ≥7 yrs who can read/write"],
  ];
  tbl(s, numRows, 0.3, 0.8, 12.7, 6.55, [3.8, 3.2, 5.7], 9.5);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 3 – PSM WATER & ENVIRONMENT KEY NUMBERS
// ═══════════════════════════════════════════════════════════════
{
  let s = addSlide();
  hdr(s, "PSM — Water, Environment & Epidemiology Key Numbers", C.blue);

  // Left: Water
  card(s, 0.3, 0.82, 6.1, 3.35, "WATER STANDARDS & CHLORINATION", C.blue);
  const water = [
    "Chlorine added: 0.5 mg/L",
    "Residual chlorine after 1 hr contact: 0.2 mg/L",
    "WHO TDS limit: 500 mg/L (max 1000 mg/L)",
    "E. coli in drinking water: 0 per 100 mL",
    "Total coliforms: 0 per 100 mL (piped)",
    "Turbidity: <1 NTU (WHO), <5 NTU (BIS)",
    "Per capita water requirement (urban): 135 L/day",
    "Per capita water requirement (rural): 40 L/day",
    "Slow Sand Filter: removes >99% bacteria; Schmutzdecke layer",
    "Rapid Sand Filter: needs coagulation (alum) first",
  ];
  s.addText(water.map(x=>"• "+x).join("\n"), {x:0.4,y:1.25,w:5.9,h:2.8,fontSize:10,color:C.white,fontFace:"Calibri"});

  // Right: Air
  card(s, 6.6, 0.82, 6.4, 3.35, "AIR QUALITY & ENVIRONMENT", C.teal);
  const air = [
    "WHO PM2.5 annual guideline: 5 µg/m³ (2021)",
    "WHO PM10 annual guideline: 15 µg/m³",
    "CO - Odorless; binds Hb 250× more than O2",
    "Lead in blood (toxic): >10 µg/dL in children",
    "Noise pollution limit: 45 dB (night), 55 dB (day) residential",
    "First audiogram change in noise: 4000 Hz dip",
    "Radiation: ionizing (X-ray, γ) vs non-ionizing (UV, microwave)",
    "Per capita domestic solid waste: ~450 g/day (urban India)",
  ];
  s.addText(air.map(x=>"• "+x).join("\n"), {x:6.7,y:1.25,w:6.2,h:2.8,fontSize:10,color:C.white,fontFace:"Calibri"});

  // Bottom: Epi
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  const epi = [
    ["Sensitivity (SnNout)", "TP ÷ (TP+FN) × 100", "High sensitivity → rules OUT disease"],
    ["Specificity (SpPin)", "TN ÷ (TN+FP) × 100", "High specificity → rules IN disease"],
    ["PPV", "TP ÷ (TP+FP) × 100", "Depends on prevalence of disease"],
    ["NPV", "TN ÷ (TN+FN) × 100", "High NPV = safe to rule out"],
    ["Odds Ratio (OR)", "Case-control study", "OR = (a×d) ÷ (b×c)"],
    ["Relative Risk (RR)", "Cohort study", "RR = Incidence exposed ÷ Incidence unexposed"],
    ["Attributable Risk", "Cohort", "Incidence exposed − Incidence unexposed"],
  ];
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  );
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 4 – BIOSTATISTICS QUICK REFERENCE
// ═══════════════════════════════════════════════════════════════
{
  let s = addSlide();
  hdr(s, "PSM — Biostatistics Quick Reference", C.purple);

  // Top row: 3 cards
  const cards3 = [
    {title:"CENTRAL TENDENCY", color:C.purple, x:0.3, content:[
      "Mean = Sum ÷ N  (use: normal data, no outliers)",
      "Median = Middle value  (use: skewed data, ordinal)",
      "Mode = Most frequent  (use: nominal data)",
      "+ve skew → tail right → Mode < Median < Mean",
      "-ve skew → tail left → Mean < Median < Mode",
      "Normal distribution: Mean = Median = Mode",
    ]},
    {title:"NORMAL DISTRIBUTION", color:C.blue, x:4.65, content:[
      "±1 SD = 68.27% of data",
      "±2 SD = 95.45% of data",
      "±1.96 SD = 95% (CI formula)",
      "±3 SD = 99.73% of data",
      "SE = SD ÷ √N",
      "95% CI = Mean ± 1.96 × SE",
    ]},
    {title:"DISPERSION", color:C.teal, x:9.0, content:[
      "Range = Max − Min",
      "Variance = SD²",
      "SD = √(Σ(x−x̄)² ÷ N)",
      "Large SD = wide spread",
      "Small SE = precise estimate",
      "CV = (SD ÷ Mean) × 100",
    ]},
  ];
  cards3.forEach(c => {
    card(s, c.x, 0.82, 4.2, 3.2, c.title, c.color);
    s.addText(c.content.map(x=>"• "+x).join("\n"), {x:c.x+0.1,y:1.25,w:4.0,h:2.7,fontSize:9.5,color:C.white,fontFace:"Calibri"});
  });

  // Bottom: Tests table
  const testRows = [
    [{text:"TEST",options:{bold:true,color:C.purple}},{text:"USE WHEN",options:{bold:true,color:C.purple}},{text:"KEY FACT",options:{bold:true,color:C.purple}}],
    ["Unpaired t-test","Compare means of 2 INDEPENDENT groups","Parametric; assumes normal distribution"],
    ["Paired t-test","Compare means BEFORE & AFTER in SAME group","Same subjects, 2 time points"],
    ["Chi-square (χ²)","Compare PROPORTIONS / categorical data","Non-parametric; df = (r-1)(c-1)"],
    ["ANOVA","Compare means of 3 OR MORE groups","F-ratio; post-hoc test needed if significant"],
    ["Mann-Whitney U","Non-parametric alternative to unpaired t-test","Use when data not normally distributed"],
    ["Correlation (r)","Strength of LINEAR relationship between 2 variables","r = +1 (perfect +ve); r = -1 (perfect -ve); r = 0 (none)"],
    ["p-value","Probability result is due to chance","p < 0.05 = significant; p < 0.01 = highly significant"],
    ["Type I error (α)","Rejecting TRUE null hypothesis","False positive; α = 0.05 usually"],
    ["Type II error (β)","Accepting FALSE null hypothesis","False negative; Power = 1 − β"],
  ];
  tbl(s, testRows, 0.3, 4.15, 12.7, 3.2, [2.5, 5.0, 5.2], 9.5);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 5 – NATIONAL HEALTH PROGRAMMES
// ═══════════════════════════════════════════════════════════════
{
  let s = addSlide();
  hdr(s, "PSM — National Health Programmes Master Table", C.green);

  const progRows = [
    [{text:"PROGRAMME",options:{bold:true,color:C.green}},{text:"FULL FORM / TARGET",options:{bold:true,color:C.green}},{text:"KEY UNIQUE FEATURE",options:{bold:true,color:C.green}}],
    ["NTEP","National TB Elimination Programme | End TB by 2025","CBNAAT/TrueNat diagnosis; Nikshay Poshan Yojana (Rs 500/month); DOTS"],
    ["NACP","National AIDS Control Programme | Zero new infections","ART free; ICTC, PPTCT, VCTC; 4th phase focus on key populations"],
    ["NVBDCP","National Vector Borne Disease Control Programme","Integrates Malaria, Dengue, Filaria, Kala-azar, JE, Chikungunya"],
    ["UIP","Universal Immunization Programme | 90%+ coverage","12 vaccines; cold chain maintained 2-8°C; AEFI monitoring"],
    ["Mission Indradhanush","Intensified immunization left-out children","Target: 90% full immunization; 7 vaccine-preventable diseases"],
    ["RBSK","Rashtriya Bal Swasthya Karyakram | 0-18 yrs","4Ds: Defects, Deficiencies, Diseases, Development delays; Mobile Health Teams"],
    ["JSY","Janani Suraksha Yojana | Institutional delivery","Cash incentive (Rs 1400 rural, Rs 1000 urban); ASHA facilitator"],
    ["JSSK","Janani Shishu Suraksha Karyakram","Free delivery, C-section, drugs, diagnostics, blood, diet, transport"],
    ["PMSMA","PM Surakshit Matritva Abhiyan","Free ANC on 9th of every month by specialist/OBG"],
    ["MAA","Mothers' Absolute Affection","Exclusive breastfeeding for 6 months; Lactation Management Centres"],
    ["WIFS","Weekly Iron Folic Acid Supplementation","Adolescent girls 10-19 yrs; IFA tablet every Monday"],
    ["NIP","National Iodine Deficiency Programme","Universal iodization of salt; ≥15 ppm iodine at consumer level"],
    ["NPCB","National Programme for Control of Blindness","Target: Blindness <0.3%; Cataract surgery main intervention"],
    ["NPCDCS","NCD Prevention & Control: DM, CVD, Cancer, Stroke","Opportunistic screening at PHC; 30+ yrs population"],
    ["Ayushman Bharat PM-JAY","Rs 5 lakh/family/yr; Bottom 40% families (~10.74 cr)","Cashless, paperless; Secondary + Tertiary care"],
    ["NHM","National Health Mission (NRHM + NUHM)","ASHA, RKS, Untied Funds, IPHS standards; flexible pool financing"],
  ];
  tbl(s, progRows, 0.3, 0.8, 12.7, 6.6, [2.5, 4.3, 5.9], 9);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 6 – VACCINE SCHEDULE (UIP)
// ═══════════════════════════════════════════════════════════════
{
  let s = addSlide();
  hdr(s, "PSM — Universal Immunization Programme (UIP) Schedule", C.amber);
  const vaxRows = [
    [{text:"VACCINE",options:{bold:true,color:C.amber}},{text:"AGE",options:{bold:true,color:C.amber}},{text:"ROUTE & SITE",options:{bold:true,color:C.amber}},{text:"DISEASE PREVENTED",options:{bold:true,color:C.amber}}],
    ["BCG","At birth","ID – Left upper arm","Tuberculosis (miliary, meningitis)"],
    ["OPV 0 (Zero dose)","At birth","Oral","Poliomyelitis"],
    ["Hepatitis B (birth dose)","Within 24 hours of birth","IM – Right anterolateral thigh","Hepatitis B"],
    ["OPV 1, 2, 3","6, 10, 14 weeks","Oral","Poliomyelitis"],
    ["IPV","6 & 14 weeks (2 doses)","IM","Poliomyelitis (inactivated)"],
    ["Pentavalent (DPT+HepB+Hib)","6, 10, 14 weeks","IM – Left anterolateral thigh","Diphtheria, Pertussis, Tetanus, HepB, Hib"],
    ["PCV (Pneumococcal)","6, 14 weeks + 9 months","IM","Pneumonia, Meningitis (S. pneumoniae)"],
    ["Rotavirus Vaccine (RVV)","6, 10, 14 weeks","Oral","Rotavirus diarrhea"],
    ["Fractional IPV (fIPV)","6 & 14 weeks","ID – Right upper arm","Polio (intradermal fractional dose)"],
    ["Measles-Rubella (MR)","9-12 months + 16-24 months","SC – Right upper arm","Measles, Rubella (CRS)"],
    ["JE Vaccine","9-12 months (endemic areas)","SC","Japanese Encephalitis"],
    ["Vitamin A","9 months; then 6-monthly till 5 yrs","Oral","Vitamin A deficiency, Night blindness"],
    ["DPT Booster 1","16-24 months","IM","Diphtheria, Pertussis, Tetanus"],
    ["OPV Booster","16-24 months","Oral","Polio"],
    ["DPT Booster 2","5-6 years","IM","Diphtheria, Pertussis, Tetanus"],
    ["Td (Tetanus-diphtheria)","10 years & 16 years","IM","Tetanus, Diphtheria"],
    ["TT in pregnancy","1st contact + 4 wks later (if unimmunized)","IM","Neonatal tetanus, maternal tetanus"],
  ];
  tbl(s, vaxRows, 0.3, 0.82, 12.7, 6.55, [2.8, 2.0, 2.3, 5.6], 9);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 7 – FMT: IPC SECTIONS
// ═══════════════════════════════════════════════════════════════
{
  let s = addSlide();
  hdr(s, "FMT — Important IPC Sections & Medicolegal Facts", C.coral);

  const ipcRows = [
    [{text:"IPC SECTION",options:{bold:true,color:C.coral}},{text:"OFFENCE",options:{bold:true,color:C.coral}},{text:"PUNISHMENT / KEY FACT",options:{bold:true,color:C.coral}}],
    ["Sec 44","Hurt","Simple bodily pain"],
    ["Sec 319","Hurt","Causing bodily pain, disease or infirmity"],
    ["Sec 320","Grievous Hurt","8 types: emasculation, loss of eye/ear/limb, fracture, etc."],
    ["Sec 302","Murder","Death sentence OR life imprisonment"],
    ["Sec 304","Culpable homicide NOT amounting to murder","10 yrs RI / life"],
    ["Sec 304-A","Causing death by NEGLIGENCE","2 yrs + fine; most important for doctors"],
    ["Sec 307","Attempt to murder","Up to 10 yrs; if hurt – life imprisonment"],
    ["Sec 308","Attempt to culpable homicide","Up to 3 yrs / 7 yrs if hurt"],
    ["Sec 312","Causing miscarriage (without consent)","3 yrs; MTP Act is legal exception"],
    ["Sec 315","Act preventing child being born alive","10 yrs or fine or both"],
    ["Sec 354","Assault/criminal force to woman (outrage modesty)","Minimum 1 yr, up to 5 yrs"],
    ["Sec 375/376","Rape / Punishment for rape","Minimum 7-10 yrs; life; POCSO for <18 yrs"],
    ["Sec 377","Unnatural offence","Life or up to 10 yrs + fine (now partially read down)"],
    ["Sec 326-A","Acid attack","Minimum 10 yrs up to life imprisonment"],
    ["Sec 89","Act done in good faith for benefit of child/insane","Protects doctor acting in good faith"],
    ["Sec 92","Act done in good faith without consent in emergency","Key protection for emergency care doctors"],
    ["Sec 176","False information to public servant","Relevant in MLC reporting"],
    ["Sec 201","Causing disappearance of evidence of offence","Relevant in death cases"],
  ];
  tbl(s, ipcRows, 0.3, 0.82, 12.7, 6.55, [2.0, 4.5, 6.2], 9);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 8 – FMT: DEATH & POST-MORTEM CHANGES
// ═══════════════════════════════════════════════════════════════
{
  let s = addSlide();
  hdr(s, "FMT — Death, Post-Mortem Changes & Wounds", C.amber);

  // Left: Rigor mortis etc
  card(s, 0.3, 0.82, 6.2, 3.5, "POST-MORTEM CHANGES (TIMING)", C.amber);
  const pm = [
    ["Change","Onset","Duration / Peak"],
    ["Cooling (Algor mortis)","Immediately","1°C/hr (first 6 hrs); ambient dependent"],
    ["Hypostasis (Livor mortis)","30 min – 2 hrs","Fixed at 6-12 hrs; absent in CO poisoning"],
    ["Rigor mortis","2-6 hrs after death","Complete 6-12 hrs; resolves 24-48 hrs"],
    ["Decomposition","24-48 hrs (tropical)","Abdomen first; cadaveric spasm ≠ rigor"],
  ];
  s.addTable(pm, {x:0.3,y:1.25,w:6.2,h:2.0,border:{type:"solid",pt:0.4,color:"1E293B"},fill:C.panel,color:C.white,fontFace:"Calibri",fontSize:9,rowH:0.4,colW:[2.5,1.5,2.2]});
  s.addText("Henssge Nomogram: Estimates time of death using body core temp\nCadaveric spasm = instantaneous rigor at moment of death (drowning, shooting)\nCause of Death → Manner of Death → Mode of Death", {
    x:0.4,y:3.32,w:6.0,h:0.9,fontSize:9.5,color:C.white,fontFace:"Calibri"});

  // Right: Types of wounds
  card(s, 6.7, 0.82, 6.3, 3.5, "TYPES OF MECHANICAL INJURIES", C.coral);
  const wounds = [
    ["Wound Type","Key Features","Weapon"],
    ["Abrasion","Superficial; epidermis only; direction determinable","Rough surface"],
    ["Contusion","Bruise; bleeding into tissues; no skin break","Blunt"],
    ["Laceration","Irregular edges; tissue bridging; no sharp cut","Blunt force"],
    ["Incised wound","Clean edges; longer than deep; bleeds profusely","Sharp (knife)"],
    ["Stab wound","Deeper than wide; entry > exit","Pointed/sharp"],
    ["Firearm","Entry: small, inverted; Exit: large, everted","Bullet"],
    ["Chop wound","Features of both cut + contusion","Heavy sharp (axe)"],
  ];
  s.addTable(wounds, {x:6.7,y:1.25,w:6.3,h:2.85,border:{type:"solid",pt:0.4,color:"1E293B"},fill:C.panel,color:C.white,fontFace:"Calibri",fontSize:9,rowH:0.35,colW:[2.0,2.7,1.6]});

  // Bottom: Asphyxia
  card(s, 0.3, 4.45, 12.7, 2.9, "ASPHYXIA — HANGING vs STRANGULATION vs THROTTLING", C.purple);
  const asph = [
    ["Feature","Hanging","Strangulation (ligature)","Throttling (manual)"],
    ["Mechanism","Suspension; ligature around neck","Constriction by ligature/cord","Hands around neck"],
    ["Ligature mark","Oblique, high, interrupted at knot","Horizontal, continuous, low","Nail marks, finger impressions"],
    ["Nature","Usually suicidal","Usually homicidal","Always homicidal"],
    ["Fracture","C2 (judicial); rare (suicidal)","Hyoid fracture common","Hyoid fracture very common"],
    ["Face","Pale & compressed (judicial); congested (suicidal)","Congested, cyanosed","Congested, petechiae"],
  ];
  s.addTable(asph, {x:0.3,y:4.88,w:12.7,h:2.4,border:{type:"solid",pt:0.4,color:"1E293B"},fill:C.panel,color:C.white,fontFace:"Calibri",fontSize:9,rowH:0.38,colW:[2.2,3.5,3.5,3.5]});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 9 – TOXICOLOGY: ANTIDOTES MASTER TABLE
// ═══════════════════════════════════════════════════════════════
{
  let s = addSlide();
  hdr(s, "FMT — Toxicology: Poisons, Features & Antidotes", C.coral);

  const toxRows = [
    [{text:"POISON",options:{bold:true,color:C.coral}},{text:"MECHANISM",options:{bold:true,color:C.coral}},{text:"KEY CLINICAL FEATURES",options:{bold:true,color:C.coral}},{text:"ANTIDOTE / TREATMENT",options:{bold:true,color:C.coral}}],
    ["Organophosphorus\n(Malathion, Parathion)","Inhibits acetylcholinesterase → ACh accumulation","SLUDGE: Salivation, Lacrimation, Urination, Defecation, GI cramps, Emesis + Miosis, bradycardia, bronchospasm","Atropine (large doses) + PAM/Pralidoxime (within 24-48 hrs)"],
    ["Arsenic (chronic)","Inhibits SH-containing enzymes; Mees' lines hallmark","Rain drop pigmentation, Mees' lines (nails), peripheral neuropathy, GI symptoms, garlic odor, keratosis","BAL (Dimercaprol) IM; D-Penicillamine oral"],
    ["Lead (Pb)","Inhibits heme synthesis (ALA dehydratase); basophilic stippling","Burton's line (blue-black gum line), basophilic stippling in RBC, wrist drop/foot drop, colic, anemia","EDTA (IV for acute); Succimer DMSA (oral); BAL for encephalopathy"],
    ["Mercury (Hg) - inorganic","Renal tubular damage; mercuric chloride most toxic","Acrodynia (pink disease in children), tremor, gingivitis, metallic taste, renal failure","BAL (Dimercaprol); Succimer DMSA"],
    ["Dhatura / Belladonna\n(Atropine)","Anticholinergic: blocks muscarinic receptors","Dry as bone, blind as bat, red as beet, mad as hatter, hot as hare; dilated pupils, tachycardia","Physostigmine (specific); supportive"],
    ["Opium / Morphine","μ-opioid receptor agonist; CNS + respiratory depression","Pinpoint pupils (miosis), respiratory depression, coma, bradycardia, constipation","Naloxone (IV/IM); supportive; O2"],
    ["Cyanide (HCN)","Inhibits cytochrome c oxidase → histotoxic hypoxia","Bitter almond smell, rapid death, cherry red blood, convulsions, coma","Amyl nitrite (inhale) → Sodium nitrite IV → Sodium thiosulfate IV"],
    ["Carbon Monoxide","Binds Hb 250× > O2 → carboxyhemoglobin","Cherry red discoloration skin/mucosa, headache, nausea, confusion, coma","100% O2 (high-flow); Hyperbaric O2 if severe"],
    ["Barbiturates","CNS depression; GABA potentiation","Respiratory depression, hypothermia, hypotension, coma, bullous lesions","No specific antidote; supportive; alkaline diuresis; dialysis"],
    ["Alcohol (Ethanol)","CNS depressant; GABA enhancement","Breath odor, staggering, slurred speech, blackouts; Wernicke-Korsakoff (chronic)","Supportive; Thiamine; Naltrexone (chronic)"],
    ["Benzodiazepines","GABA-A potentiation; CNS depression","Sedation, respiratory depression, ataxia; rarely fatal alone","Flumazenil (specific antagonist); supportive"],
    ["Paracetamol (overdose)","NAPQI metabolite; hepatocellular necrosis","N-acetyl cysteine (NAC) most effective within 10 hrs; liver failure","N-acetyl cysteine (NAC) — specific antidote; liver transplant if fulminant"],
    ["Copper (CuSO4)","Direct GI irritant; hepatotoxic","Blue-green vomitus, gastric corrosion, methemoglobinemia, jaundice","BAL (Dimercaprol); D-Penicillamine; potassium ferrocyanide emetic"],
    ["Dhatura seeds","Alkaloids: hyoscine, hyoscyamine","Anticholinergic; date rape drug; used in road side thefts in India","Physostigmine; supportive"],
    ["Cannabis (Bhang/Ganja/Charas)","THC; CB1 receptor agonist; CNS effects","Euphoria, hunger (munchies), red eyes, paranoia; time distortion","Supportive; no specific antidote; benzodiazepines for agitation"],
  ];
  tbl(s, toxRows, 0.3, 0.82, 12.7, 6.55, [2.3, 2.4, 4.3, 3.7], 8.5);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 10 – FMT: SEXUAL OFFENCES, IDENTIFICATION, MISC
// ═══════════════════════════════════════════════════════════════
{
  let s = addSlide();
  hdr(s, "FMT — Sexual Offences, Identification & Medical Negligence", C.purple);

  // Sexual offences
  card(s, 0.3, 0.82, 6.2, 3.2, "SEXUAL OFFENCES — KEY MEDICOLEGAL FACTS", C.purple);
  const sexFacts = [
    "Rape definition (IPC 375): Penetration without consent; 7 circumstances",
    "Age of consent: 18 years (below = statutory rape regardless of consent)",
    "Examination of rape victim: Only by registered female doctor (preferably)",
    "Two-finger test: BANNED by Supreme Court (not to be used)",
    "Hymen: NOT proof of virginity; can be intact even after intercourse",
    "POCSO Act 2012: Protection of Children from Sexual Offences (<18 yrs)",
    "Semen: Acid phosphatase test (presumptive); DNA profiling (confirmatory)",
    "Virginity: Cannot be medically certified; hymen NOT a reliable indicator",
    "Injuries in rape: Look for bruising, torn fourchette, petechiae on palate",
    "MLC report: Seal all evidence; hand over to police; maintain chain of custody",
  ];
  s.addText(sexFacts.map(x=>"• "+x).join("\n"), {x:0.4,y:1.25,w:6.0,h:2.7,fontSize:9.5,color:C.white,fontFace:"Calibri"});

  // Identification
  card(s, 6.7, 0.82, 6.3, 3.2, "IDENTIFICATION — AGE ESTIMATION", C.blue);
  const ident = [
    ["Method","Key Age Indicator"],
    ["Dental eruption","Deciduous 6m-2.5 yrs; Permanent 6-25 yrs; Wisdom 17-25 yrs"],
    ["Ossification centres","Appear & fuse at specific ages; Medial clavicle last (25-31 yrs)"],
    ["Gustafson's method","Dental changes: attrition, periodontosis, secondary dentine (adults)"],
    ["Greulich & Pyle","X-ray hand/wrist for bone age (children)"],
    ["Radiological (long bone)","Epiphyseal fusion; growth plate closure"],
    ["DNA (telomere length)","Research; not routine medicolegal use"],
  ];
  s.addTable(ident, {x:6.7,y:1.25,w:6.3,h:2.65,border:{type:"solid",pt:0.4,color:"1E293B"},fill:C.panel,color:C.white,fontFace:"Calibri",fontSize:9,rowH:0.38,colW:[2.5,3.8]});

  // Bottom: Medical negligence
  card(s, 0.3, 4.15, 12.7, 3.2, "MEDICAL NEGLIGENCE — BOLAM TEST, CONSENT & KEY ACTS", C.coral);
  const neg = [
    ["Topic","Key Fact"],
    ["Bolam Test","Standard of care = what a reasonable body of medical opinion would accept as proper practice"],
    ["Consent types","Informed > Implied > Expressed; Emergency = treated without consent (IPC 92)"],
    ["Therapeutic privilege","Withholding info if disclosure would harm patient — NOT accepted in India"],
    ["Consumer Protection Act","Doctors providing paid services under CPA; government hospitals excluded (paid services included)"],
    ["Clinical Establishment Act","Registration of all clinical establishments; quality standards; grievance redressal"],
    ["Doctrine of res ipsa loquitur","'The thing speaks for itself' — negligence self-evident from facts (swab left in abdomen)"],
    ["Brain death criteria","Harvard criteria (1968): Unreceptive, unresponsive; no movements; no reflexes; no breathing; flat EEG"],
    ["Dying declaration","Statement of dying person; admissible as evidence (IPC 32); no oath required; any person can record"],
  ];
  s.addTable(neg, {x:0.3,y:4.57,w:12.7,h:2.8,border:{type:"solid",pt:0.4,color:"1E293B"},fill:C.panel,color:C.white,fontFace:"Calibri",fontSize:9,rowH:0.32,colW:[2.8,9.9]});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 11 – MNEMONICS MASTER SLIDE
// ═══════════════════════════════════════════════════════════════
{
  let s = addSlide();
  hdr(s, "PSM + FMT — High-Yield Mnemonics & Quick Recalls", C.teal);

  const mnems = [
    {topic:"OP Poisoning features", color:C.coral, mnem:"SLUDGE: Salivation • Lacrimation • Urination • Defecation • GI cramps • Emesis", extra:"Also: DUMBELS (Diarrhoea, Urination, Miosis, Bradycardia, Emesis, Lacrimation, Salivation)"},
    {topic:"Bradford Hill Criteria (9)", color:C.teal, mnem:"\"SCSTBPCEN\": Strength, Consistency, Specificity, Temporality, Biologic gradient, Plausibility, Coherence, Experiment, Analogy", extra:"Temporality = MOST important (cause must precede effect)"},
    {topic:"Alma Ata 8 Elements", color:C.amber, mnem:"\"ENFMIEET\": Education • Nutrition • Food supply • MCH+FP • Immunization • Endemic control • Essential drugs • Treatment", extra:"1978 declaration; HFA 2000 AD; PHC cornerstone"},
    {topic:"Sensitivity vs Specificity", color:C.purple, mnem:"SnNout: High Sensitivity rules OUT disease | SpPin: High Specificity rules IN disease", extra:"Se = TP/(TP+FN); Sp = TN/(TN+FP)"},
    {topic:"Grievoushurt (IPC 320) - 8 types", color:C.blue, mnem:"\"EL-FEJPC\": Emasculation, Loss of eye, Loss of ear, Fracture, Ejection of tooth, Joints (permanent), Permanent disfiguration, Coma-like endangering life", extra:"IPC 319 = Hurt (simple); IPC 320 = Grievous hurt"},
    {topic:"Kwashiorkor vs Marasmus", color:C.green, mnem:"Kwashiorkor = K for 'Keda' (swollen): EDEMA present, Fatty liver, Flag sign in hair, Moon face, After weaning", extra:"Marasmus = Baggy pants, old man face, muscle wasting, <1 yr"},
    {topic:"Dhatura toxidrome", color:C.coral, mnem:"Dry as BONE • Blind as BAT • Red as BEET • Mad as HATTER • Hot as HARE • Full as FLASK (retention)", extra:"Antidote = Physostigmine"},
    {topic:"Levels of Prevention", color:C.teal, mnem:"Primordial=prevent risk factors | Primary=prevent disease | Secondary=detect early | Tertiary=limit disability", extra:"Primordial added by Rose 1985 (not in original Leavell & Clark)"},
    {topic:"Communicable Disease Control", color:C.amber, mnem:"4 F's (feco-oral route): Food, Fingers, Flies, Fomites", extra:"For Typhoid, Cholera, Hepatitis A, Polio"},
    {topic:"GOBI-FFF (UNICEF strategy)", color:C.purple, mnem:"Growth monitoring, Oral rehydration, Breastfeeding, Immunization + Female education, Family planning, Food supplementation", extra:"UNICEF strategy for child survival"},
    {topic:"Rigor mortis sequence", color:C.blue, mnem:"Head→ Neck→ Trunk→ Upper limbs→ Lower limbs (descends; Nysten's law)", extra:"Onset 2-6 hrs; Complete 6-12 hrs; Passes 24-48 hrs"},
    {topic:"Grievous Hurt mnemonic", color:C.green, mnem:"8 types under IPC 320; Any wound that endangers life OR causes >20 day incapacitation", extra:"Vs Simple hurt (IPC 319) = any bodily pain"},
  ];

  const perRow = 3;
  const cardW = 4.2;
  const cardH = 1.55;
  const xStarts = [0.25, 4.6, 8.95];
  mnems.forEach((m, i) => {
    const col = i % perRow;
    const row = Math.floor(i / perRow);
    const x = xStarts[col];
    const y = 0.85 + row * (cardH + 0.08);
    card(s, x, y, cardW, cardH, m.topic, m.color);
    s.addText(m.mnem, {x:x+0.1,y:y+0.42,w:cardW-0.15,h:0.65,fontSize:8.5,color:C.white,fontFace:"Calibri",bold:true});
    s.addText(m.extra, {x:x+0.1,y:y+1.1,w:cardW-0.15,h:0.38,fontSize:8,color:C.gray,fontFace:"Calibri",italic:true});
  });
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 12 – CLOSING / EXAM STRATEGY
// ═══════════════════════════════════════════════════════════════
{
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  s.addText("EXAM STRATEGY", {x:0.5,y:0.35,w:12.3,h:0.65,fontSize:30,bold:true,color:C.teal,fontFace:"Calibri",align:"center",charSpacing:6});

  const tips = [
    {icon:"01", color:C.teal, tip:"MCQs: In PSM, if a number is given — memorize it. IMR, MMR, TFR, chlorine dose, population norms are DIRECT MCQ sources."},
    {icon:"02", color:C.amber, tip:"MCQs: In FMT, IPC sections + antidotes win. Learn ALL antidotes and at least 10 key IPC sections cold."},
    {icon:"03", color:C.coral, tip:"Long answers: Always use headings, subheadings, bullets, tables, diagrams. Never write a paragraph in exams."},
    {icon:"04", color:C.purple, tip:"Short notes: Template = Definition → Classification → Features → Management. Target 1 full page per 5-mark answer."},
    {icon:"05", color:C.blue, tip:"Toxicology long answer formula: Source → Toxic dose → Mechanism → Acute features → Chronic features → Diagnosis → Antidote."},
    {icon:"06", color:C.green, tip:"National programs: Know full form + target population + one unique fact for EVERY programme. That covers MCQs + short notes."},
    {icon:"07", color:C.amber, tip:"Day before exam: ONLY read notes. No new topics. Sleep by 10 PM. Eat well. Reach hall 30 min early."},
    {icon:"08", color:C.teal, tip:"In the hall: Attempt ALL questions. Write neatly. Marks are NOT deducted for wrong MCQs (usually). Never leave blanks."},
  ];

  tips.forEach((t, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    const x = 0.3 + col * 6.5;
    const y = 1.15 + row * 1.45;
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}

// ── WRITE ────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/psm-studyguide/PSM_FMT_Distinction_CheatSheet.pptx" })
  .then(() => console.log("Cheat sheet saved!"))
  .catch(e => console.error(e));

const pptxgen = require("pptxgenjs");
const pres = new pptxgen();
pres.layout = "LAYOUT_WIDE";
pres.title = "PSM + FMT Distinction Cheat Sheet";

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// ── SLIDE 1: COVER ──────────────────────────────────────────────
{
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  s.addText("DISTINCTION",{x:1.5,y:1.65,w:10.3,h:1.05,fontSize:62,bold:true,color:C.teal,fontFace:"Calibri",align:"center",charSpacing:8});
  s.addText("CHEAT SHEET",{x:1.5,y:2.68,w:10.3,h:0.75,fontSize:40,bold:true,color:C.white,fontFace:"Calibri",align:"center",charSpacing:4});
  s.addShape(pres.ShapeType.rect,{x:3.5,y:3.52,w:6.3,h:0.05,fill:{color:C.amber},line:{color:C.amber}});
  s.addText("PSM  +  FMT  |  2nd Year MBBS",{x:1.5,y:3.62,w:10.3,h:0.52,fontSize:18,color:C.amber,fontFace:"Calibri",align:"center",charSpacing:3});
  s.addText("Key Numbers  •  IPC Sections  •  Antidotes  •  Mnemonics  •  National Programs  •  Biostatistics",{x:1.5,y:4.22,w:10.3,h:0.42,fontSize:12,color:C.gray,fontFace:"Calibri",align:"center",italic:true});
  s.addText("Exam: August 1  |  17 Days To Go  |  You've Got This! 🏆",{x:1.5,y:6.7,w:10.3,h:0.4,fontSize:12,color:C.teal,fontFace:"Calibri",align:"center",italic:true});
}

// ── SLIDE 2: PSM KEY NUMBERS ─────────────────────────────────────
{
  let s=addSlide();
  hdr(s,"PSM — Key Numbers & Vital Statistics (NFHS-5 2019-21 | SRS)",C.teal);
  const rows=[
    [{text:"INDICATOR",options:{bold:true,color:C.teal}},{text:"VALUE",options:{bold:true,color:C.teal}},{text:"FORMULA / NOTE",options:{bold:true,color:C.teal}}],
    ["Infant Mortality Rate (IMR)","35.2 per 1000 LB","Deaths <1 yr ÷ Live births × 1000"],
    ["Neonatal Mortality Rate (NMR)","24.9 per 1000 LB","Deaths <28 days ÷ Live births × 1000"],
    ["Under-5 Mortality Rate (U5MR)","41.9 per 1000 LB","Deaths <5 yr ÷ Live births × 1000"],
    ["Maternal Mortality Ratio (MMR)","97 per 100,000 LB (SRS 2018-20)","Maternal deaths ÷ Live births × 100,000"],
    ["Crude Birth Rate (CBR)","19.5 per 1000 population","Live births ÷ Mid-yr pop × 1000"],
    ["Crude Death Rate (CDR)","6.0 per 1000 population","Deaths ÷ Mid-yr pop × 1000"],
    ["Total Fertility Rate (TFR)","2.0  (Replacement level = 2.1)","Sum of all age-specific fertility rates"],
    ["Net Reproduction Rate (NRR)","NRR=1 → stable population","TFR × prop. female births × survival"],
    ["Natural Growth Rate","~13.5 per 1000","CBR − CDR"],
    ["Life Expectancy at birth","69.7 yrs (M: 68.2 | F: 70.7) SRS 2014-18","Average expected years of life at birth"],
    ["Sex ratio (Census 2011)","943 females per 1000 males","Females ÷ Males × 1000"],
    ["Chlorine added to water","0.5 mg/L","Residual after 1 hr contact = 0.2 mg/L"],
    ["Per capita water (urban)","135 L/person/day","Rural = 40 L/person/day"],
    ["WHO TDS limit","500 mg/L (max 1000 mg/L)","E.coli = 0 per 100 mL in drinking water"],
  ];
  tbl(s,rows,0.3,0.8,12.7,6.55,[4.0,3.2,5.5],9.5);
}

// ── SLIDE 3: BIOSTATISTICS ────────────────────────────────────────
{
  let s=addSlide();
  hdr(s,"PSM — Biostatistics Quick Reference",C.purple);

  card(s,0.3,0.82,4.2,3.2,"CENTRAL TENDENCY & DISTRIBUTION",C.purple);
  s.addText("• Mean = Sum÷N  (normal data; no outliers)\n• Median = Middle value  (skewed data; ordinal)\n• Mode = Most frequent  (nominal data)\n• +ve skew → tail RIGHT → Mode<Median<Mean\n• -ve skew → tail LEFT → Mean<Median<Mode\n• Normal dist: Mean=Median=Mode\n• ±1SD=68.27%  ±2SD=95.45%  ±3SD=99.73%\n• 95% CI = Mean ± 1.96×SE\n• SE = SD÷√N",
    {x:0.4,y:1.23,w:4.0,h:2.72,fontSize:9.5,color:C.white,fontFace:"Calibri"});

  card(s,4.65,0.82,4.2,3.2,"TESTS OF SIGNIFICANCE",C.blue);
  s.addText("• Unpaired t-test: 2 independent groups (means)\n• Paired t-test: Same group before & after\n• Chi-square (χ²): Categorical/proportions\n• ANOVA: 3+ groups (F-ratio)\n• Mann-Whitney U: Non-parametric unpaired t\n• p<0.05 = significant; p<0.01 = highly significant\n• Type I error (α): Reject TRUE H₀ (false +ve)\n• Type II error (β): Accept FALSE H₀ (false -ve)\n• Power = 1−β",
    {x:4.75,y:1.23,w:4.0,h:2.72,fontSize:9.5,color:C.white,fontFace:"Calibri"});

  card(s,9.0,0.82,4.1,3.2,"SCREENING TEST VALIDITY",C.teal);
  s.addText("• Sensitivity = TP÷(TP+FN)×100\n• Specificity = TN÷(TN+FP)×100\n• PPV = TP÷(TP+FP)×100\n• NPV = TN÷(TN+FN)×100\n• SnNout: High Sensitivity → rules OUT\n• SpPin: High Specificity → rules IN\n• PPV increases with higher prevalence\n• NPV increases with lower prevalence\n• Likelihood ratio +ve = Se÷(1-Sp)",
    {x:9.1,y:1.23,w:3.9,h:2.72,fontSize:9.5,color:C.white,fontFace:"Calibri"});

  const epiRows=[
    [{text:"STUDY DESIGN",options:{bold:true,color:C.purple}},{text:"DIRECTION",options:{bold:true,color:C.purple}},{text:"MEASURE",options:{bold:true,color:C.purple}},{text:"KEY POINT",options:{bold:true,color:C.purple}}],
    ["Case-control","Retrospective (Effect→Cause)","Odds Ratio (OR)","Good for rare diseases; fast; cheap"],
    ["Cohort","Prospective (Cause→Effect)","Relative Risk (RR)","Best for incidence; long; expensive"],
    ["RCT","Intervention","Relative Risk Reduction","Gold standard; randomisation; blinding"],
    ["Cross-sectional","Snapshot","Prevalence","Quick; cannot determine cause"],
    ["Ecological","Population level","Correlation","Ecological fallacy possible"],
    ["Bradford Hill 9 criteria","","Temporality = MOST important","SCSTBPCEN mnemonic"],
  ];
  tbl(s,epiRows,0.3,4.15,12.7,3.2,[2.8,2.8,2.5,4.6],9.5);
}

// ── SLIDE 4: NATIONAL HEALTH PROGRAMMES ──────────────────────────
{
  let s=addSlide();
  hdr(s,"PSM — National Health Programmes Master Table",C.green);
  const rows=[
    [{text:"PROGRAMME",options:{bold:true,color:C.green}},{text:"FULL FORM / TARGET",options:{bold:true,color:C.green}},{text:"KEY UNIQUE FEATURE",options:{bold:true,color:C.green}}],
    ["NTEP","National TB Elimination Programme | End TB by 2025","CBNAAT/TrueNat diagnosis; Nikshay Poshan Yojana Rs500/month; DOTS"],
    ["NACP","National AIDS Control Programme | Zero new infections","Free ART; ICTC, PPTCT; 4th phase - key populations (MSM, FSW, PWID)"],
    ["NVBDCP","National Vector Borne Disease Control Programme","Integrates Malaria, Dengue, Filaria, Kala-azar, JE, Chikungunya"],
    ["UIP","Universal Immunization Programme | 90%+ coverage","12 vaccines; cold chain 2-8°C; AEFI monitoring; Mission Indradhanush"],
    ["RBSK","Rashtriya Bal Swasthya Karyakram | 0-18 yrs","4Ds: Defects, Deficiencies, Diseases, Development delays; Mobile Health Teams"],
    ["JSY","Janani Suraksha Yojana | Institutional delivery","Cash incentive Rs1400 (rural) Rs1000 (urban); ASHA facilitator"],
    ["JSSK","Janani Shishu Suraksha Karyakram","Free delivery, C-section, drugs, diagnostics, blood, diet, transport — all free"],
    ["PMSMA","PM Surakshit Matritva Abhiyan","Free ANC by specialist/OBG on 9th of every month"],
    ["MAA","Mothers' Absolute Affection","Exclusive breastfeeding 6 months; Lactation Management Centres"],
    ["WIFS","Weekly Iron Folic Acid Supplementation","Adolescent girls 10-19 yrs; IFA tablet every Monday at school"],
    ["NIP","National Iodine Deficiency Programme","Universal salt iodisation ≥15 ppm at consumer level"],
    ["NPCB","National Programme for Control of Blindness","Target: Blindness <0.3%; Cataract surgery main intervention"],
    ["NPCDCS","NCD Prevention & Control (DM, CVD, Cancer, Stroke)","Opportunistic screening at PHC level; 30+ yrs population"],
    ["Ayushman Bharat PM-JAY","Rs5 lakh/family/yr; Bottom 40% families (~10.74 cr)","Cashless, paperless; Secondary + Tertiary hospitalisation"],
    ["NHM","National Health Mission (NRHM + NUHM)","ASHA, RKS, Untied Funds, IPHS standards; flexible pool financing"],
    ["Mission Indradhanush","Intensified immunisation | 90%+ full immunisation","Left-out/drop-out children; 7 vaccine-preventable diseases targeted"],
  ];
  tbl(s,rows,0.3,0.8,12.7,6.6,[2.5,4.4,5.8],9);
}

// ── SLIDE 5: VACCINE SCHEDULE ────────────────────────────────────
{
  let s=addSlide();
  hdr(s,"PSM — Universal Immunization Programme (UIP) Schedule",C.amber);
  const rows=[
    [{text:"VACCINE",options:{bold:true,color:C.amber}},{text:"AGE",options:{bold:true,color:C.amber}},{text:"ROUTE & SITE",options:{bold:true,color:C.amber}},{text:"DISEASE PREVENTED",options:{bold:true,color:C.amber}}],
    ["BCG","At birth","ID — Left upper arm","Tuberculosis (miliary TB, TB meningitis)"],
    ["OPV 0 (zero dose)","At birth","Oral","Poliomyelitis"],
    ["Hepatitis B (birth dose)","Within 24 hours of birth","IM — Right anterolateral thigh","Hepatitis B"],
    ["OPV 1, 2, 3","6, 10, 14 weeks","Oral","Poliomyelitis"],
    ["IPV (2 doses)","6 & 14 weeks","IM","Poliomyelitis (inactivated)"],
    ["Pentavalent (DPT+HepB+Hib)","6, 10, 14 weeks","IM — Left anterolateral thigh","Diphtheria, Pertussis, Tetanus, Hepatitis B, Hib"],
    ["PCV (Pneumococcal)","6 wks, 14 wks + 9 months","IM","Pneumonia, Meningitis (S. pneumoniae)"],
    ["Rotavirus Vaccine (RVV)","6, 10, 14 weeks","Oral","Rotavirus diarrhoea"],
    ["Measles-Rubella (MR)","9-12 months + 16-24 months","SC — Right upper arm","Measles, Rubella (CRS prevention)"],
    ["JE Vaccine","9-12 months (endemic areas)","SC","Japanese Encephalitis"],
    ["Vitamin A (1st dose)","9 months; then 6-monthly till 5 yrs","Oral","Vitamin A deficiency, Night blindness"],
    ["DPT Booster 1","16-24 months","IM","Diphtheria, Pertussis, Tetanus"],
    ["OPV Booster","16-24 months","Oral","Poliomyelitis"],
    ["DPT Booster 2","5-6 years","IM","Diphtheria, Pertussis, Tetanus"],
    ["Td (Tetanus-diphtheria)","10 years & 16 years","IM","Tetanus, Diphtheria"],
    ["TT in pregnancy","1st contact + 4 wks later (if unimmunized)","IM","Neonatal tetanus, Maternal tetanus"],
  ];
  tbl(s,rows,0.3,0.82,12.7,6.55,[2.8,2.1,2.2,5.6],9);
}

// ── SLIDE 6: IPC SECTIONS ────────────────────────────────────────
{
  let s=addSlide();
  hdr(s,"FMT — Important IPC Sections & Medicolegal Facts",C.coral);
  const rows=[
    [{text:"IPC SECTION",options:{bold:true,color:C.coral}},{text:"OFFENCE",options:{bold:true,color:C.coral}},{text:"PUNISHMENT / KEY FACT",options:{bold:true,color:C.coral}}],
    ["Sec 319","Hurt","Causing bodily pain, disease or infirmity to any person"],
    ["Sec 320","Grievous Hurt","8 types: emasculation, loss of eye/ear, fracture, disfiguration, loss of limb/joint, endangering life"],
    ["Sec 302","Murder","Death sentence OR life imprisonment + fine"],
    ["Sec 304","Culpable homicide NOT amounting to murder","Life imprisonment or 10 yrs RI + fine"],
    ["Sec 304-A","Causing death by NEGLIGENCE (most imp for doctors)","Up to 2 yrs + fine; key section in medical negligence"],
    ["Sec 307","Attempt to murder","Up to 10 yrs; if hurt caused — life imprisonment"],
    ["Sec 312","Causing miscarriage (MTP Act is legal exception)","3 yrs + fine; 7 yrs if without woman's consent"],
    ["Sec 354","Outraging modesty of woman","Minimum 1 yr, up to 5 yrs + fine"],
    ["Sec 375/376","Rape / Punishment for rape","Min 7 yrs; up to life; POCSO for victim <18 yrs"],
    ["Sec 377","Unnatural offences","Life or up to 10 yrs (Section partially read down by SC 2018)"],
    ["Sec 326-A","Acid attack","Minimum 10 yrs up to life imprisonment"],
    ["Sec 89","Good faith act for child/insane person (with guardian consent)","Protects doctor acting bona fide"],
    ["Sec 92","Good faith act without consent in EMERGENCY","Key protection for emergency medical care"],
    ["Sec 201","Disappearance of evidence of offence","Relevant in medicolegal death investigations"],
    ["Sec 44 IEA","Dying declaration (Evidence Act)","Admissible in court; no oath needed; any person can record; victim can write/speak/gesture"],
    ["POCSO Act 2012","Protection of Children from Sexual Offences","Children <18 yrs; mandatory reporting; special courts"],
    ["Consumer Protection Act","Paid medical services covered","Govt hospital free services excluded; paid included"],
  ];
  tbl(s,rows,0.3,0.82,12.7,6.55,[1.9,4.2,6.6],8.8);
}

// ── SLIDE 7: DEATH & POST-MORTEM CHANGES ─────────────────────────
{
  let s=addSlide();
  hdr(s,"FMT — Death, Post-Mortem Changes, Wounds & Asphyxia",C.amber);

  card(s,0.3,0.82,6.2,2.85,"POST-MORTEM CHANGES (TIMING)",C.amber);
  const pm=[
    [{text:"CHANGE",options:{bold:true}},{text:"ONSET",options:{bold:true}},{text:"DURATION / KEY FACT",options:{bold:true}}],
    ["Algor mortis (cooling)","Immediately after death","1°C/hr first 6 hrs; ambient dependent"],
    ["Livor mortis (hypostasis)","30 min – 2 hrs","Fixed at 6-12 hrs; absent in CO poisoning"],
    ["Rigor mortis","2-6 hrs after death","Complete 6-12 hrs; resolves 24-48 hrs"],
    ["Putrefaction","24-48 hrs (tropical)","Abdomen first; green discolouration"],
    ["Cadaveric spasm","Instantaneous at death","Drowning, shooting; NOT true rigor"],
  ];
  s.addTable(pm,{x:0.3,y:1.23,w:6.2,h:2.35,border:{type:"solid",pt:0.4,color:"1E293B"},fill:C.panel,color:C.white,fontFace:"Calibri",fontSize:9,rowH:0.39,colW:[2.4,1.5,2.3]});

  card(s,6.7,0.82,6.3,2.85,"WOUNDS — KEY DIFFERENTIATING FEATURES",C.coral);
  const wounds=[
    [{text:"WOUND TYPE",options:{bold:true}},{text:"KEY FEATURES",options:{bold:true}},{text:"WEAPON",options:{bold:true}}],
    ["Abrasion","Epidermis only; direction determinable; scab formation","Rough surface"],
    ["Contusion","Bruise; bleeding into tissue; no break in skin","Blunt force"],
    ["Laceration","Irregular edges; tissue bridging; contused margins","Blunt force"],
    ["Incised wound","Clean edges; longer than deep; profuse bleeding","Sharp (knife)"],
    ["Stab wound","Deeper than wide; entry wound > exit wound","Pointed/sharp"],
    ["Chop wound","Features of both incised + contusion","Heavy sharp (axe, dao)"],
    ["Firearm entry","Small, inverted, regular; tattooing near range","Bullet/gunshot"],
  ];
  s.addTable(wounds,{x:6.7,y:1.23,w:6.3,h:2.35,border:{type:"solid",pt:0.4,color:"1E293B"},fill:C.panel,color:C.white,fontFace:"Calibri",fontSize:9,rowH:0.33,colW:[2.0,2.8,1.5]});

  card(s,0.3,3.8,12.7,3.55,"ASPHYXIA — HANGING vs STRANGULATION vs THROTTLING",C.purple);
  const asph=[
    [{text:"FEATURE",options:{bold:true,color:C.purple}},{text:"HANGING",options:{bold:true,color:C.purple}},{text:"LIGATURE STRANGULATION",options:{bold:true,color:C.purple}},{text:"THROTTLING (Manual)",options:{bold:true,color:C.purple}}],
    ["Mechanism","Suspension; weight of body","Constriction by ligature/cord around neck","Hands/fingers compress neck"],
    ["Ligature mark","Oblique, high, interrupted at knot","Horizontal, continuous, low on neck","Nail marks, finger impressions"],
    ["Nature","Usually SUICIDAL","Usually HOMICIDAL","ALWAYS homicidal"],
    ["Hyoid fracture","Rare (suicidal); C2 fracture in judicial","Hyoid fracture common","Hyoid fracture very common"],
    ["Face","Pale (judicial); congested (suicidal)","Congested, cyanosed, petechiae","Congested, petechiae, marks of struggle"],
    ["Petechial haemorrhage","May be present in suicidal","Present (conjunctiva, face)","Very prominent"],
  ];
  s.addTable(asph,{x:0.3,y:4.22,w:12.7,h:3.0,border:{type:"solid",pt:0.4,color:"1E293B"},fill:C.panel,color:C.white,fontFace:"Calibri",fontSize:9,rowH:0.43,colW:[2.2,3.3,3.6,3.6]});
}

// ── SLIDE 8: ANTIDOTES MASTER TABLE ─────────────────────────────
{
  let s=addSlide();
  hdr(s,"FMT — Toxicology: Poisons, Features & Antidotes",C.coral);
  const rows=[
    [{text:"POISON",options:{bold:true,color:C.coral}},{text:"MECHANISM",options:{bold:true,color:C.coral}},{text:"KEY CLINICAL FEATURES",options:{bold:true,color:C.coral}},{text:"ANTIDOTE / TREATMENT",options:{bold:true,color:C.coral}}],
    ["Organophosphorus\n(Malathion, Parathion)","Inhibits AChE → ACh accumulation at synapses","SLUDGE: Salivation, Lacrimation, Urination, Defecation, GI cramps, Emesis + Miosis, bradycardia, bronchospasm, seizures","Atropine (large doses IV) + Pralidoxime/PAM (within 24-48 hrs of poisoning)"],
    ["Arsenic (As)","Inhibits SH-containing enzymes; trivalent most toxic","Mees' lines (nails), rain-drop pigmentation, peripheral neuropathy, GI upset, garlic odour, keratosis (chronic)","BAL (Dimercaprol) IM; D-Penicillamine oral (chronic)"],
    ["Lead (Pb)","Inhibits ALA dehydratase → disrupts heme synthesis","Burton's line (blue-black gum line), basophilic stippling in RBC, wrist drop/foot drop, colic, microcytic anaemia","EDTA IV (acute); Succimer/DMSA oral; BAL for encephalopathy"],
    ["Mercury (Hg)","Renal tubular damage; binds SH groups; CNS toxin","Acrodynia (pink disease in children), tremor, gingivitis, metallic taste, renal failure, minamata disease (methylHg)","BAL (Dimercaprol); Succimer DMSA; supportive"],
    ["Dhatura/Belladonna\n(Atropine alkaloids)","Anticholinergic: blocks muscarinic receptors","Dry as bone, blind as bat, red as beet, mad as hatter, hot as hare; dilated pupils, tachycardia, urinary retention","Physostigmine (specific antidote); supportive cooling"],
    ["Opium/Morphine\n(Opioids)","μ-opioid receptor agonist; CNS & respiratory depression","Pinpoint pupils (miosis), respiratory depression, coma, bradycardia, constipation, needle tracks (chronic)","Naloxone IV/IM (specific antagonist); O2; supportive"],
    ["Cyanide (HCN)","Inhibits cytochrome c oxidase → histotoxic hypoxia; cells cannot use O2","Bitter almond smell, rapid onset, cherry red blood (venous), convulsions, coma, death in minutes","Amyl nitrite (inhale) → Sodium nitrite IV → Sodium thiosulfate IV"],
    ["Carbon Monoxide (CO)","Binds Hb 250× more than O2 → carboxyhemoglobin → tissue hypoxia","Cherry red discoloration of skin/mucosa, headache, nausea, confusion, coma; no cyanosis","100% O2 (high-flow face mask); Hyperbaric O2 if severe/pregnant"],
    ["Barbiturates","CNS depression via GABA-A potentiation","Respiratory depression, hypothermia, hypotension, coma, bullous skin lesions (barbiturate blisters)","No specific antidote; supportive; alkaline diuresis; haemodialysis"],
    ["Alcohol (Ethanol)","CNS depressant; GABA enhancement; Wernicke-Korsakoff","Breath odour, staggering, slurred speech, ataxia; Wernicke's encephalopathy (chronic); withdrawal seizures","Supportive; IV Thiamine (before glucose); Naltrexone (chronic)"],
    ["Paracetamol (overdose)","NAPQI metabolite → hepatocellular necrosis (dose >150 mg/kg)","Nausea/vomiting (phase 1) → apparent recovery → liver failure (phase 3); AST/ALT rise","N-acetyl cysteine (NAC) IV — most effective within 10 hrs; liver transplant if fulminant failure"],
    ["Benzodiazepines","GABA-A potentiation; CNS/respiratory depression","Sedation, respiratory depression, ataxia; rarely fatal alone; synergistic with alcohol","Flumazenil (specific receptor antagonist); supportive; monitor respiratory status"],
    ["Cannabis (THC)","CB1 receptor agonist; CNS effects","Euphoria, hunger (munchies), red eyes, paranoia, time distortion, amotivational syndrome (chronic)","No specific antidote; supportive; benzodiazepines for agitation/anxiety"],
  ];
  tbl(s,rows,0.3,0.82,12.7,6.55,[2.0,2.3,4.2,4.2],8.3);
}

// ── SLIDE 9: SEXUAL OFFENCES + IDENTIFICATION ────────────────────
{
  let s=addSlide();
  hdr(s,"FMT — Sexual Offences, Identification & Medical Negligence",C.purple);

  card(s,0.3,0.82,6.2,3.3,"SEXUAL OFFENCES — MEDICOLEGAL KEY FACTS",C.purple);
  const sf=[
    "Rape (IPC 375): Penetration without consent; 7 circumstances defined",
    "Age of consent: 18 yrs (below = statutory rape regardless of consent)",
    "Examination of victim: Only registered female doctor preferably; 2-doctor rule removed",
    "Two-finger test: BANNED by Supreme Court — do NOT perform or report",
    "Hymen: NOT proof of virginity; cannot certify virginity medically",
    "POCSO Act 2012: <18 yrs; mandatory reporting by any person with knowledge",
    "Semen detection: Acid phosphatase (presumptive) → DNA profiling (confirmatory)",
    "Virginity: Cannot be medically certified",
    "MLC report: Seal evidence; hand over chain of custody to police",
    "Dying declaration (Sec 32 IEA): Admissible in court; no oath required",
  ];
  s.addText(sf.map(x=>"• "+x).join("\n"),{x:0.4,y:1.23,w:6.0,h:2.8,fontSize:9.5,color:C.white,fontFace:"Calibri"});

  card(s,6.7,0.82,6.3,3.3,"IDENTIFICATION — AGE ESTIMATION",C.blue);
  const id=[
    [{text:"METHOD",options:{bold:true}},{text:"KEY INDICATOR",options:{bold:true}}],
    ["Dental eruption","Deciduous 6m-2.5 yrs; Permanent 6-25 yrs; Wisdom 17-25 yrs"],
    ["Ossification centres","Appear & fuse at specific ages; Medial clavicle LAST to fuse (25-31 yrs)"],
    ["Gustafson's method","6 dental changes: attrition, periodontosis, secondary dentine, cementum, root resorption, transparency"],
    ["Greulich & Pyle atlas","X-ray hand/wrist — compare with standard atlas (children)"],
    ["Radiological (long bone)","Epiphyseal fusion; growth plate closure for adolescents"],
    ["Spermatozoa","Present from ~14-15 yrs (puberty); used in sexual offence cases"],
    ["Scalp hair","Medulla index, pigmentation changes in elderly"],
  ];
  s.addTable(id,{x:6.7,y:1.23,w:6.3,h:2.8,border:{type:"solid",pt:0.4,color:"1E293B"},fill:C.panel,color:C.white,fontFace:"Calibri",fontSize:9,rowH:0.35,colW:[2.5,3.8]});

  card(s,0.3,4.25,12.7,3.1,"MEDICAL NEGLIGENCE — BOLAM TEST, CONSENT & KEY ACTS",C.coral);
  const neg=[
    [{text:"TOPIC",options:{bold:true,color:C.coral}},{text:"KEY FACT",options:{bold:true,color:C.coral}}],
    ["Bolam Test","Standard of care = what a reasonable body of medical opinion accepts as proper practice"],
    ["Consent types","Informed > Expressed > Implied; Emergency treated without consent (IPC Sec 92)"],
    ["Res ipsa loquitur","'The thing speaks for itself' — negligence self-evident (swab left inside patient)"],
    ["Brain death (Harvard 1968)","Unreceptive/unresponsive; no movements; no reflexes; no breathing; flat EEG × 2 readings, 24 hrs apart"],
    ["Consumer Protection Act","Paid medical services covered; govt hospital free services excluded"],
    ["Therapeutic privilege","Withholding info if disclosure harms patient — NOT accepted in Indian law"],
    ["Dying declaration","Sec 32 IEA; statement of dying person; admissible evidence; no oath; any person can record"],
  ];
  s.addTable(neg,{x:0.3,y:4.67,w:12.7,h:2.6,border:{type:"solid",pt:0.4,color:"1E293B"},fill:C.panel,color:C.white,fontFace:"Calibri",fontSize:9,rowH:0.33,colW:[2.8,9.9]});
}

// ── SLIDE 10: MNEMONICS ──────────────────────────────────────────
{
  let s=addSlide();
  hdr(s,"PSM + FMT — High-Yield Mnemonics & Quick Recalls",C.teal);

  const mnems=[
    {topic:"OP Poisoning (SLUDGE)",color:C.coral,mnem:"S-Salivation  L-Lacrimation  U-Urination  D-Defecation  G-GI cramps  E-Emesis",extra:"Also add: Miosis, Bradycardia, Bronchospasm | Antidote: Atropine + PAM"},
    {topic:"Bradford Hill 9 Criteria",color:C.teal,mnem:"\"SCSTBPCEN\": Strength, Consistency, Specificity, Temporality, Biologic gradient, Plausibility, Coherence, Experiment, Analogy",extra:"Temporality = MOST important (cause MUST precede effect)"},
    {topic:"Alma Ata 8 Elements (1978)",color:C.amber,mnem:"\"ENFMIEET\": Education, Nutrition, Food supply, MCH+FP, Immunization, Endemic control, Essential drugs, Treatment",extra:"PHC = cornerstone of health system; Health for All 2000 AD"},
    {topic:"Sensitivity vs Specificity",color:C.purple,mnem:"SnNout: High Sensitivity → rules OUT disease (use for screening)\nSpPin: High Specificity → rules IN disease (use for confirmation)",extra:"Se=TP/(TP+FN)  |  Sp=TN/(TN+FP)  |  PPV rises with higher prevalence"},
    {topic:"Dhatura Toxidrome",color:C.coral,mnem:"Dry as BONE • Blind as BAT • Red as BEET • Mad as HATTER • Hot as HARE • Full as FLASK (urinary retention)",extra:"Anticholinergic syndrome | Antidote = Physostigmine"},
    {topic:"Kwashiorkor vs Marasmus",color:C.green,mnem:"Kwashiorkor = K for 'Keda' (Oedema/swollen): EDEMA + Fatty liver + Flag sign + Moon face (after weaning, 1-3 yrs)",extra:"Marasmus = Baggy pants, old man face, wasting, NO oedema, <1 yr"},
    {topic:"Rigor Mortis Sequence",color:C.blue,mnem:"Head → Neck → Trunk → Upper limbs → Lower limbs (Nysten's Law — descends)",extra:"Onset 2-6 hrs | Complete 6-12 hrs | Resolves 24-48 hrs | Tropical: faster"},
    {topic:"Levels of Prevention",color:C.teal,mnem:"Primordial=prevent risk factors | Primary=prevent disease | Secondary=detect early | Tertiary=limit disability+rehab",extra:"Primordial added by Rose 1985; Leavell & Clark had 3 levels originally"},
    {topic:"Grievous Hurt (IPC 320) — 8 types",color:C.amber,mnem:"Emasculation • Loss of eye • Loss of ear • Loss of limb/joint • Fracture • Disfigurement (permanent) • Loss of teeth • Endangers life / >20 day incapacitation",extra:"IPC 319 = simple hurt | IPC 320 = grievous hurt (8 specific types)"},
    {topic:"GOBI-FFF (UNICEF strategy)",color:C.purple,mnem:"Growth monitoring • ORT • Breastfeeding • Immunization + Female education • Family planning • Food supplementation",extra:"UNICEF child survival strategy; complements UIP + RMNCH+A"},
    {topic:"Cyanide antidote sequence",color:C.coral,mnem:"Amyl nitrite (inhale, immediate) → Sodium nitrite IV → Sodium thiosulfate IV",extra:"Mechanism: form metHb that competes with cytochrome oxidase for cyanide"},
    {topic:"Cold chain (UIP vaccines)",color:C.green,mnem:"Vaccines stored at 2-8°C (refrigerator); OPV/Varicella at -20°C (freezer); Never freeze DPT/Hep B/TT",extra:"VVM (Vaccine Vial Monitor) — discard if inner square equals or darker than outer ring"},
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// ── SLIDE 11: EXAM STRATEGY ──────────────────────────────────────
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    {n:"01",color:C.teal,tip:"PSM MCQs: Numbers WIN. Memorize IMR, MMR, TFR, chlorine doses, water standards, population norms — they are direct MCQ sources every year."},
    {n:"02",color:C.amber,tip:"FMT MCQs: IPC sections + antidotes WIN. Know ALL antidotes cold. Learn at least 15 key IPC sections with their punishment."},
    {n:"03",color:C.coral,tip:"Long answers (10 marks): Use headings, subheadings, bullets, tables, diagrams. Never write a paragraph. Target 2-3 pages minimum."},
    {n:"04",color:C.purple,tip:"Short notes (5 marks): Template = Definition → Classification → Features → Management. Target 1 full page. Use a diagram wherever possible."},
    {n:"05",color:C.blue,tip:"Toxicology long answer: Source → Toxic dose → Mechanism → Acute features → Chronic features → Diagnosis → Antidote. Draw the SLUDGE mnemonic."},
    {n:"06",color:C.green,tip:"National programs: Know full form + target population + one unique fact for EVERY programme. That covers MCQs + short notes + essay parts."},
    {n:"07",color:C.amber,tip:"Biostatistics: Practice drawing the 2×2 table for sensitivity/specificity. Explain Type I & II errors with examples. These come as long answer."},
    {n:"08",color:C.teal,tip:"Day before exam: ONLY revise notes — no new topics. Sleep by 10 PM. Eat well. Reach exam hall 30 min early. Attempt ALL questions."},
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