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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"},
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    {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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// ══════════════════════════════════════════════════════════════
// COVER SLIDE
// ══════════════════════════════════════════════════════════════
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// ══════════════════════════════════════════════════════════════
// CATEGORY 1: HEALTH INFRASTRUCTURE (10 cards)
// ══════════════════════════════════════════════════════════════
flashcard(1, "Health Infrastructure",
  "Population served by a Sub-Centre (SC) in PLAINS?",
  "3,000 – 5,000",
  "Hilly/tribal areas: 1,500–3,000\nStaff: 1 ANM + 1 MPW(Male)\nFirst contact point with health SYSTEM (not a doctor)",
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flashcard(2, "Health Infrastructure",
  "Population served by a Primary Health Centre (PHC)?",
  "30,000 (plains)\n20,000 (hilly/tribal)",
  "Staff: 1 Medical Officer + 14 paramedical staff\n6 beds | OPD, delivery, family planning\nFirst contact point with a QUALIFIED DOCTOR",
  C.teal, "Health Infrastructure");

flashcard(3, "Health Infrastructure",
  "Population served by a Community Health Centre (CHC)?",
  "1,20,000 (plains)\n80,000 (hilly)",
  "30 beds | 4 specialists: Surgery, Medicine, OBG, Paediatrics\nIPHS = Indian Public Health Standards\nReferral unit for PHCs",
  C.teal, "Health Infrastructure");

flashcard(4, "Health Infrastructure",
  "FIRST contact point between community and health SYSTEM in India?",
  "Sub-Centre (SC)",
  "Common exam trap: PHC = first contact with a DOCTOR\nSub-Centre = first contact with the health SYSTEM\nANM at SC is the grassroots health worker",
  C.teal, "Health Infrastructure");

flashcard(5, "Health Infrastructure",
  "ASHA stands for? Her role?",
  "Accredited Social Health Activist",
  "Link between community and health system\nIncentive-based (not salaried)\nRoles: Facilitate JSY, immunisation, ANC, referrals\n1 ASHA per ~1000 population in rural areas",
  C.teal, "Health Infrastructure");

flashcard(6, "Health Infrastructure",
  "Alma Ata Declaration year & goal?",
  "1978\n'Health for All by 2000 AD'",
  "Held in Alma Ata (Kazakhstan, USSR)\nOrganised by WHO + UNICEF jointly\nPHC = cornerstone of achieving HFA\n8 elements: ENFMIEET mnemonic",
  C.teal, "Health Infrastructure");

flashcard(7, "Health Infrastructure",
  "8 essential elements of Primary Health Care\n(Alma Ata, 1978)?",
  "ENFMIEET",
  "E - Education about health\nN - Nutrition & food supply\nF - Safe water & sanitation\nM - MCH including Family Planning\nI - Immunization\nE - Endemic disease control\nE - Essential drugs\nT - Treatment of common diseases",
  C.teal, "Health Infrastructure");

flashcard(8, "Health Infrastructure",
  "Ayushman Bharat has 2 components. What are they?",
  "1. Health & Wellness Centres (HWC)\n2. PM-JAY",
  "HWC: Upgrade SCs & PHCs → comprehensive primary care\nPM-JAY: Rs 5 lakh/family/year for secondary + tertiary care\nTarget: Bottom 40% poor families (~10.74 crore families)\nCashless, paperless at empanelled hospitals",
  C.teal, "Health Infrastructure");

flashcard(9, "Health Infrastructure",
  "National Health Policy was released in which year?",
  "2017",
  "Key goals of NHP 2017:\n• Progressive achievement of Universal Health Coverage (UHC)\n• Increase health expenditure to 2.5% of GDP\n• Reduce IMR to 28; MMR to 100 by 2020\n• Life expectancy to 70 years by 2025",
  C.teal, "Health Infrastructure");

flashcard(10, "Health Infrastructure",
  "Which level of health facility has IPHS norms with\n4 specialist doctors and 30 beds?",
  "Community Health Centre (CHC)",
  "IPHS = Indian Public Health Standards\n4 specialists: Surgeon, Physician, OBG, Paediatrician\n30 beds minimum\nServes 1,20,000 population in plains\nFirst referral unit (FRU) for emergency obstetric care",
  C.teal, "Health Infrastructure");

// ══════════════════════════════════════════════════════════════
// CATEGORY 2: KEY NUMBERS & AMOUNTS (10 cards)
// ══════════════════════════════════════════════════════════════
flashcard(11, "Key Numbers",
  "Chlorine added to water for disinfection?",
  "0.5 mg/L",
  "Memory trick: 'Add 5, Keep 2'\nResidual chlorine after 1 hr contact = 0.2 mg/L\nContact time required = minimum 1 hour\nBreakpoint chlorination used in practice",
  C.amber, "Key Numbers");

flashcard(12, "Key Numbers",
  "Residual chlorine after 1 hour of contact?",
  "0.2 mg/L",
  "0.5 mg/L is ADDED → 0.2 mg/L REMAINS after disinfection\nThe difference (0.3 mg/L) is consumed killing pathogens\nE.coli in drinking water = 0 per 100 mL (WHO standard)",
  C.amber, "Key Numbers");

flashcard(13, "Key Numbers",
  "Nikshay Poshan Yojana provides how much\nper month to TB patients?",
  "Rs 500 per month",
  "Part of NTEP (National TB Elimination Programme)\nDirect Benefit Transfer (DBT) to patient's account\nThroughout duration of treatment\nDo NOT confuse with: JSY rural = Rs 1400 | JSY urban = Rs 1000",
  C.amber, "Key Numbers");

flashcard(14, "Key Numbers",
  "JSY cash incentive for BPL woman:\nRural vs Urban institutional delivery?",
  "Rural = Rs 1,400\nUrban = Rs 1,000",
  "JSY = Janani Suraksha Yojana\nAim: Promote institutional delivery to reduce MMR\nASHA gets additional incentive for facilitating delivery\nLow Performing States get higher incentives",
  C.amber, "Key Numbers");

flashcard(15, "Key Numbers",
  "IMR (Infant Mortality Rate) as per NFHS-5?",
  "35.2 per 1,000 live births",
  "NFHS-5 (2019-21) national figure\nFormula: Deaths <1 yr ÷ Live births × 1,000\nNMR (Neonatal <28 days) = 24.9 per 1000 LB\nU5MR (Under-5) = 41.9 per 1000 LB",
  C.amber, "Key Numbers");

flashcard(16, "Key Numbers",
  "MMR (Maternal Mortality Ratio) in India?\n(SRS 2018-20)",
  "97 per 1,00,000 live births",
  "Formula: Maternal deaths ÷ Live births × 1,00,000\nSDG target: Reduce MMR to <70 per 1,00,000 LB by 2030\nNHP 2017 target: MMR <100 by 2020\nMajor cause: Haemorrhage (most common)",
  C.amber, "Key Numbers");

flashcard(17, "Key Numbers",
  "Total Fertility Rate (TFR) as per NFHS-5?\nWhat is replacement level TFR?",
  "TFR = 2.0\nReplacement = 2.1",
  "TFR < 2.1 means population will eventually decline\nIndia TFR 2.0 is just below replacement level\nHighest TFR state: Bihar (3.0)\nLowest TFR state: Sikkim (1.1)\nFormula: Sum of all age-specific fertility rates",
  C.amber, "Key Numbers");

flashcard(18, "Key Numbers",
  "Per capita water requirement:\nUrban vs Rural India?",
  "Urban = 135 L/person/day\nRural = 40 L/person/day",
  "WHO recommends minimum 50 L/person/day for basic needs\nWater for drinking alone = ~2 L/day\nTDS limit: 500 mg/L (WHO acceptable); 1000 mg/L (max permissible)\nTurbidity: <1 NTU (WHO ideal)",
  C.amber, "Key Numbers");

flashcard(19, "Key Numbers",
  "PM-JAY (Ayushman Bharat) health coverage\nper family per year?",
  "Rs 5 lakh per family per year",
  "Secondary AND tertiary hospitalisation covered\nTarget: Bottom 40% poor families = ~10.74 crore families\nCashless and paperless at empanelled hospitals\nDo NOT confuse: PM-JAY = Rs 5 lakh | JSY rural = Rs 1400",
  C.amber, "Key Numbers");

flashcard(20, "Key Numbers",
  "Crude Birth Rate (CBR) and Crude Death Rate (CDR)\nin India (recent estimates)?",
  "CBR = 19.5\nCDR = 6.0\n(per 1,000 population)",
  "Natural Growth Rate = CBR − CDR = ~13.5 per 1000\nLife Expectancy: 69.7 yrs (M: 68.2 | F: 70.7)\nSex ratio (Census 2011): 943 females per 1000 males\nChild sex ratio (0-6 yrs): 919 per 1000 males",
  C.amber, "Key Numbers");

// ══════════════════════════════════════════════════════════════
// CATEGORY 3: STUDY DESIGNS & EPIDEMIOLOGY (10 cards)
// ══════════════════════════════════════════════════════════════
flashcard(21, "Study Designs",
  "Which study design BEST measures INCIDENCE\nof a disease?",
  "Cohort Study",
  "Cohort = follows exposed vs unexposed FORWARD in time (prospective)\nDirectly measures NEW CASES = incidence\nCalculates RELATIVE RISK (RR)\nCross-sectional = prevalence (NOT incidence)\nCase-control = retrospective; calculates ODDS RATIO (OR)",
  C.purple, "Study Designs");

flashcard(22, "Study Designs",
  "Case-control study: direction, measure & statistic?",
  "Retrospective\n(Effect → Cause)\nCalculates: Odds Ratio (OR)",
  "Starts with CASES (diseased) and CONTROLS (non-diseased)\nLooks BACKWARD for exposure\nGood for: RARE diseases, quick, cheap\nOR = (a×d) ÷ (b×c) from 2×2 table\nCannot calculate incidence or prevalence",
  C.purple, "Study Designs");

flashcard(23, "Study Designs",
  "Gold standard for establishing causation\nin clinical research?",
  "Randomized Controlled Trial (RCT)",
  "Random allocation to intervention vs control group\nBlinding: single (patient), double (patient+researcher), triple (+analyst)\nCalculates: Relative Risk Reduction (RRR), NNT\nHighest level of evidence for treatment\nLimitation: Expensive, time-consuming, ethical constraints",
  C.purple, "Study Designs");

flashcard(24, "Study Designs",
  "Cross-sectional study measures what?\nWhat is it used for?",
  "Measures PREVALENCE\n(snapshot in time)",
  "Studies disease burden at ONE point in time\nCannot determine cause and effect (no temporality)\nGood for: chronic diseases, health surveys\nNFHS and DLHS are national cross-sectional surveys\nAlso called: Prevalence study",
  C.purple, "Study Designs");

flashcard(25, "Study Designs",
  "The MOST important Bradford Hill criterion\nfor causation?",
  "TEMPORALITY",
  "Cause MUST precede effect — only MANDATORY criterion\nAll 9 criteria (SCSTBPCEN):\nStrength, Consistency, Specificity, Temporality,\nBiologic gradient, Plausibility, Coherence, Experiment, Analogy\nStrength = first listed but NOT most important",
  C.purple, "Study Designs");

flashcard(26, "Study Designs",
  "Sensitivity = ? What does high sensitivity mean?",
  "TP ÷ (TP+FN) × 100\nHigh = Rules OUT disease",
  "SnNout: High SENsitivity → rules out (negative test reliable)\nUsed for SCREENING tests (catch all cases)\nLow false NEGATIVES with high sensitivity\nSpecificity = TN÷(TN+FP)×100 → SpPin: rules IN disease\nPPV depends on PREVALENCE of disease",
  C.purple, "Study Designs");

flashcard(27, "Study Designs",
  "Relative Risk (RR) of 1.0 means?",
  "No association between\nexposure and disease",
  "RR = Incidence in exposed ÷ Incidence in unexposed\nRR >1 = positive association (risk factor)\nRR <1 = protective association\nRR = 1 = no association\nUsed in cohort studies; OR used in case-control",
  C.purple, "Study Designs");

flashcard(28, "Study Designs",
  "p-value < 0.05 means?",
  "Result is statistically SIGNIFICANT\n(less than 5% chance it's due to chance)",
  "p < 0.05: Reject null hypothesis\np < 0.01: Highly significant\nType I error (α): Reject TRUE null = false positive\nType II error (β): Accept FALSE null = false negative\n95% CI that does NOT include 1.0 (for RR/OR) = significant",
  C.purple, "Study Designs");

flashcard(29, "Study Designs",
  "Normal distribution: what % of data lies\nwithin ±2 SD of the mean?",
  "95.45% (approximately 95%)",
  "±1 SD = 68.27% of data\n±2 SD = 95.45% of data\n±3 SD = 99.73% of data\n95% CI uses ±1.96 SD (not exactly 2)\nSE = SD ÷ √N | 95% CI = Mean ± 1.96 × SE",
  C.purple, "Study Designs");

flashcard(30, "Study Designs",
  "Which test is used to compare\nproportions in categorical data?",
  "Chi-square test (χ²)",
  "Use chi-square for: categorical/nominal/ordinal data\nUnpaired t-test: compare means of 2 independent groups\nPaired t-test: compare means before & after in same group\nANOVA: compare means of 3 or more groups\nMann-Whitney U: non-parametric alternative to unpaired t-test",
  C.purple, "Study Designs");

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// CATEGORY 4: NATIONAL PROGRAMMES (10 cards)
// ══════════════════════════════════════════════════════════════
flashcard(31, "National Programs",
  "RBSK: Full form, target age group\nand the '4 Ds'?",
  "Rashtriya Bal Swasthya Karyakram\n0–18 years",
  "4 Ds: Defects at birth | Deficiencies | Diseases | Development delays\n(NOT deformities or disabilities)\nImplemented via Mobile Health Teams (MHTs)\n2 MHTs per block; cover schools + anganwadis\nFree treatment for conditions detected",
  C.green, "National Programs");

flashcard(32, "National Programs",
  "NTEP goal and key diagnostic tool?",
  "End TB by 2025\n(5 years ahead of SDG 2030)",
  "Diagnosis: CBNAAT / TrueNat (NAAT-based; preferred)\nTreatment: DOTS strategy; 4-drug regimen\nNikshay Poshan Yojana: Rs 500/month nutritional support\nMDR-TB: Bedaquiline-containing regimen\nNTEP replaced RNTCP in 2020",
  C.green, "National Programs");

flashcard(33, "National Programs",
  "UIP: How many vaccines are currently\nin the national immunization schedule?",
  "12 vaccines",
  "BCG, OPV, Hep B, IPV, Pentavalent, PCV,\nRotavirus, MR, JE, DPT booster, Td, Vitamin A\nCold chain: 2-8°C (refrigerator) for most vaccines\nOPV & Varicella = stored at -20°C (freezer)\nNEVER freeze: DPT, Hep B, TT, IPV",
  C.green, "National Programs");

flashcard(34, "National Programs",
  "Mission Indradhanush: Goal and target?",
  "90%+ full immunization\nfor left-out/drop-out children",
  "Launched 2014 by Government of India\nIntensified immunization drives\nTargets children <2 yrs and pregnant women\nIntensified Mission Indradhanush (IMI) 2.0, 3.0 followed\n7 vaccine-preventable diseases initially targeted",
  C.green, "National Programs");

flashcard(35, "National Programs",
  "PMSMA: What is it and when is\nthe service delivered?",
  "PM Surakshit Matritva Abhiyan\nFree ANC on 9th of every month",
  "Free antenatal care by specialist/OBG/MD\nMinimum package: BP, weight, abdominal exam, USG, CBC, urine\nTargets high-risk pregnancies for early detection\nLaunched 2016 under NHM\nComplementary to routine ANC at PHC",
  C.green, "National Programs");

flashcard(36, "National Programs",
  "WIFS programme: Target group\nand intervention?",
  "Weekly Iron Folic Acid Supplementation\nAdolescent girls 10–19 years",
  "IFA tablet given every MONDAY at school\nAlso includes biannual deworming (Albendazole)\nTarget: Reduce anaemia in adolescent girls\nAnemia prevalence in adolescent girls India = ~59% (NFHS-4)\nAlso extended to adolescent boys in some states",
  C.green, "National Programs");

flashcard(37, "National Programs",
  "NVBDCP integrates control of\nwhich diseases?",
  "Malaria, Dengue, Filaria,\nKala-azar, JE, Chikungunya",
  "Malaria treatment: ACT (Artemisinin Combination Therapy)\nFilariasis: MDA — DEC + Albendazole annually\nKala-azar: Miltefosine (oral); target elimination by 2023\nDengue: No specific antiviral; supportive treatment\nVector control: IRS, LLINs, larval source management",
  C.green, "National Programs");

flashcard(38, "National Programs",
  "MAA programme — full form and aim?",
  "Mothers' Absolute Affection\nPromote breastfeeding",
  "Exclusive breastfeeding for FIRST 6 MONTHS\nLaunched 2016 under NHM\nIncludes: Lactation Management Centres at district hospitals\nColostrum (first milk): must NOT be discarded\nBreastfeeding initiation: within 1 hour of birth (WHO)",
  C.green, "National Programs");

flashcard(39, "National Programs",
  "JSSK: What free services does it provide\nto pregnant women?",
  "Janani Shishu Suraksha Karyakram\nFree delivery + C-section + drugs\n+ diagnostics + blood + diet + transport",
  "ALL services FREE at government facilities\nCovers: Normal delivery, C-section, newborn care\nZero expense policy for pregnant women\nComplementary to JSY (JSY = cash incentive; JSSK = free services)\nLaunched 2011",
  C.green, "National Programs");

flashcard(40, "National Programs",
  "NHM stands for? Its 2 sub-missions?",
  "National Health Mission\nNRHM + NUHM",
  "NRHM = National Rural Health Mission (2005)\nNUHM = National Urban Health Mission (2013)\nKey features: ASHA workers, RKS, Untied Funds\nIPHS standards for facility quality\nFlexible pool financing to states\nASHA = Accredited Social Health Activist",
  C.green, "National Programs");

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