ezmedicationinput 0.1.43 → 0.1.44

package/dist/i18n.js

@@ -5,6 +5,10 @@ exports.registerSigLocalization = registerSigLocalization;
 exports.getRegisteredSigLocalizations = getRegisteredSigLocalizations;
 exports.resolveSigLocalization = resolveSigLocalization;
 exports.resolveSigTranslation = resolveSigTranslation;
+const advice_1 = require("./advice");
+const fhir_translations_1 = require("./fhir-translations");
+const maps_1 = require("./maps");
+const prn_1 = require("./prn");
 const types_1 = require("./types");
 const timing_summary_1 = require("./timing-summary");
 const REGISTERED_LOCALIZATIONS = new Map();
@@ -65,8 +69,8 @@ function resolveSigTranslation(locale, config) {
 function createThaiLocalization() {
     return {
         locale: "th",
-        formatShort: ({ internal }) => formatShortThai(internal),
-        formatLong: ({ internal, groupMealTimingsByRelation, includeTimesPerDaySummary }) => formatLongThai(internal, {
+        formatShort: ({ clause }) => formatShortThai(clause),
+        formatLong: ({ clause, groupMealTimingsByRelation, includeTimesPerDaySummary }) => formatLongThai(clause, {
             groupMealTimingsByRelation,
             includeTimesPerDaySummary
         })
@@ -135,6 +139,8 @@ const TH_TIMES_PER_DAY = {
     3: "วันละ 3 ครั้ง",
     4: "วันละ 4 ครั้ง"
 };
+const SLOWLY_QUALIFIER_CODE = "419443000";
+const EMPTY_STOMACH_QUALIFIER_CODE = "717154004";
 exports.THAI_SITE_TRANSLATIONS = {
     eye: "ตา",
     eyes: "ตา",
@@ -169,6 +175,13 @@ exports.THAI_SITE_TRANSLATIONS = {
     "left upper arm": "ต้นแขนซ้าย",
     "right upper arm": "ต้นแขนขวา",
     "bilateral arms": "แขนทั้งสองข้าง",
+    shoulder: "ไหล่",
+    shoulders: "ไหล่ทั้งสองข้าง",
+    "left shoulder": "ไหล่ซ้าย",
+    "right shoulder": "ไหล่ขวา",
+    elbow: "ข้อศอก",
+    "left elbow": "ข้อศอกซ้าย",
+    "right elbow": "ข้อศอกขวา",
     "right leg": "ขาขวา",
     "left leg": "ขาซ้าย",
     "both legs": "ขาทั้งสองข้าง",
@@ -177,6 +190,22 @@ exports.THAI_SITE_TRANSLATIONS = {
     "left lower leg": "ขาส่วนล่างซ้าย",
     "right lower leg": "ขาส่วนล่างขวา",
     "bilateral legs": "ขาทั้งสองข้าง",
+    knee: "เข่า",
+    "left knee": "เข่าซ้าย",
+    "right knee": "เข่าขวา",
+    "both knees": "เข่าทั้งสองข้าง",
+    "bilateral knees": "เข่าทั้งสองข้าง",
+    wrist: "ข้อมือ",
+    "left wrist": "ข้อมือซ้าย",
+    "right wrist": "ข้อมือขวา",
+    ankle: "ข้อเท้า",
+    "left ankle": "ข้อเท้าซ้าย",
+    "right ankle": "ข้อเท้าขวา",
+    "both ankles": "ข้อเท้าทั้งสองข้าง",
+    "bilateral ankles": "ข้อเท้าทั้งสองข้าง",
+    hip: "สะโพก",
+    "left hip": "สะโพกซ้าย",
+    "right hip": "สะโพกขวา",
     "right hand": "มือขวา",
     "left hand": "มือซ้าย",
     "both hands": "มือทั้งสองข้าง",
@@ -190,19 +219,53 @@ exports.THAI_SITE_TRANSLATIONS = {
     abdomen: "ช่องท้อง",
     abdominal: "ช่องท้อง",
     belly: "ท้อง",
+    "affected area": "บริเวณที่เป็น",
+    "affected site": "บริเวณที่เป็น",
+    "บริเวณที่เป็น": "บริเวณที่เป็น",
+    head: "ศีรษะ",
+    "left head": "ศีรษะซ้าย",
+    "left side of head": "ศีรษะซ้าย",
+    "right head": "ศีรษะขวา",
+    "right side of head": "ศีรษะขวา",
     back: "แผ่นหลัง",
+    chest: "ทรวงอก",
+    "chest wall": "ผนังทรวงอก",
+    breast: "เต้านม",
+    "left breast": "เต้านมซ้าย",
+    "right breast": "เต้านมขวา",
+    "both breasts": "เต้านมทั้งสองข้าง",
+    "bilateral breasts": "เต้านมทั้งสองข้าง",
+    axilla: "รักแร้",
+    axillae: "รักแร้ทั้งสองข้าง",
+    armpit: "รักแร้",
+    armpits: "รักแร้ทั้งสองข้าง",
+    groin: "ขาหนีบ",
     scalp: "หนังศีรษะ",
     face: "ใบหน้า",
     cheek: "แก้ม",
     cheeks: "แก้มทั้งสองข้าง",
     forehead: "หน้าผาก",
+    temple: "ขมับ",
+    "temple region": "ขมับ",
+    "temporal region": "ขมับ",
+    temples: "ขมับทั้งสองข้าง",
+    "left temple": "ขมับซ้าย",
+    "left temple region": "ขมับซ้าย",
+    "left temporal region": "ขมับซ้าย",
+    "right temple": "ขมับขวา",
+    "right temple region": "ขมับขวา",
+    "right temporal region": "ขมับขวา",
+    "both temples": "ขมับทั้งสองข้าง",
+    "bilateral temples": "ขมับทั้งสองข้าง",
     chin: "คาง",
     neck: "คอ",
+    eyelid: "เปลือกตา",
+    eyelids: "เปลือกตา",
+    lip: "ริมฝีปาก",
+    lips: "ริมฝีปาก",
     forearm: "ปลายแขน",
     "left forearm": "ปลายแขนซ้าย",
     "right forearm": "ปลายแขนขวา",
-    shoulder: "ไหล่",
-    shoulders: "ไหล่ทั้งสองข้าง",
     thigh: "ต้นขา",
     thighs: "ต้นขาทั้งสองข้าง",
     "left thigh": "ต้นขาซ้าย",
@@ -234,6 +297,28 @@ exports.THAI_SITE_TRANSLATIONS = {
     skin: "ผิวหนัง",
     hair: "เส้นผม"
 };
+const THAI_SITE_CODE_TRANSLATIONS = (() => {
+    var _a;
+    const translations = {};
+    for (const { names, definition } of maps_1.DEFAULT_BODY_SITE_SNOMED_SOURCE) {
+        const code = (_a = definition.coding) === null || _a === void 0 ? void 0 : _a.code;
+        if (!code || translations[code]) {
+            continue;
+        }
+        let translated;
+        for (const name of names) {
+            const candidate = exports.THAI_SITE_TRANSLATIONS[(0, maps_1.normalizeBodySiteKey)(name)];
+            if (candidate) {
+                translated = candidate;
+                break;
+            }
+        }
+        if (translated) {
+            translations[code] = translated;
+        }
+    }
+    return translations;
+})();
 const DEFAULT_THAI_ROUTE_GRAMMAR = { verb: "ใช้" };
 const THAI_ROUTE_GRAMMAR = {
     [types_1.RouteCode["Oral route"]]: { verb: "รับประทาน", routePhrase: "ทางปาก" },
@@ -299,26 +384,168 @@ const THAI_ROUTE_GRAMMAR = {
         sitePreposition: "ที่"
     }
 };
-function resolveRouteGrammarThai(internal) {
-    var _a, _b, _c;
-    if (internal.routeCode && THAI_ROUTE_GRAMMAR[internal.routeCode]) {
-        return (_a = THAI_ROUTE_GRAMMAR[internal.routeCode]) !== null && _a !== void 0 ? _a : DEFAULT_THAI_ROUTE_GRAMMAR;
+const THAI_METHOD_TEXT_VERBS = {
+    Apply: "ทา",
+    "Apply sunscreen": "ทากันแดด",
+    Dab: "แต้ม",
+    Drink: "รับประทาน",
+    Insert: "สอด",
+    Instill: "หยอด",
+    Massage: "นวด",
+    Reapply: "ทาซ้ำ",
+    "Reapply sunscreen": "ทากันแดดซ้ำ",
+    Rub: "ถู",
+    Spray: "พ่น",
+    Shampoo: "สระ",
+    Swallow: "รับประทาน",
+    Take: "รับประทาน",
+    "Use shampoo": "สระ",
+    Wash: "ล้าง"
+};
+const THAI_IMPLIED_OBJECT_VERBS = new Set([
+    "ทา",
+    "ทาซ้ำ",
+    "แต้ม",
+    "ถู",
+    "นวด",
+    "พ่น",
+    "หยอด",
+    "สอด",
+    "ล้าง",
+    "สระ"
+]);
+const THAI_SUPPRESSIBLE_ROUTE_VERBS = new Set([
+    "ทา",
+    "ทากันแดด",
+    "ทาซ้ำ",
+    "ทากันแดดซ้ำ",
+    "แต้ม",
+    "ถู",
+    "นวด",
+    "ล้าง",
+    "สระ"
+]);
+const THAI_SITE_FIRST_VERBS = new Set([
+    "ทา",
+    "ทากันแดด",
+    "ทาซ้ำ",
+    "ทากันแดดซ้ำ",
+    "แต้ม",
+    "ถู",
+    "นวด",
+    "ล้าง",
+    "สระ",
+    "พ่น"
+]);
+function resolveThaiMethodVerb(clause, grammar) {
+    var _a, _b, _c, _d, _e;
+    const translatedText = (0, fhir_translations_1.getPrimitiveTranslation)((_a = clause.method) === null || _a === void 0 ? void 0 : _a._text, "th");
+    if (translatedText) {
+        return translatedText;
+    }
+    const methodText = (_c = (_b = clause.method) === null || _b === void 0 ? void 0 : _b.text) === null || _c === void 0 ? void 0 : _c.trim();
+    if (methodText) {
+        const overridden = THAI_METHOD_TEXT_VERBS[methodText];
+        if (overridden) {
+            return overridden;
+        }
+    }
+    const translatedDisplay = (0, fhir_translations_1.getPrimitiveTranslation)((_e = (_d = clause.method) === null || _d === void 0 ? void 0 : _d.coding) === null || _e === void 0 ? void 0 : _e._display, "th");
+    if (translatedDisplay) {
+        return translatedDisplay;
+    }
+    return grammar.verb;
+}
+function joinThaiVerbAndBody(verb, body) {
+    const trimmedBody = body.trim();
+    if (!trimmedBody) {
+        return verb;
+    }
+    switch (verb) {
+        case "พ่น":
+            if (trimmedBody.startsWith("เข้า")) {
+                return `${verb}${trimmedBody}`;
+            }
+            break;
+        case "ทาซ้ำ":
+        case "ทากันแดดซ้ำ":
+        case "สระ":
+            if (trimmedBody.startsWith("ทุก") ||
+                trimmedBody.startsWith("วัน") ||
+                trimmedBody.startsWith("ก่อน") ||
+                trimmedBody.startsWith("หลัง")) {
+                return `${verb}${trimmedBody}`;
+            }
+            break;
+        default:
+            break;
+    }
+    return `${verb} ${trimmedBody}`;
+}
+function shouldUseGenericMedicationObjectThai(clause, verb, explicitDosePart) {
+    var _a;
+    if (explicitDosePart) {
+        return false;
+    }
+    if (THAI_IMPLIED_OBJECT_VERBS.has(verb)) {
+        return false;
+    }
+    switch ((_a = clause.route) === null || _a === void 0 ? void 0 : _a.code) {
+        case types_1.RouteCode["Topical route"]:
+        case types_1.RouteCode["Transdermal route"]:
+        case types_1.RouteCode["Nasal route"]:
+        case types_1.RouteCode["Ophthalmic route"]:
+        case types_1.RouteCode["Otic route"]:
+        case types_1.RouteCode["Per rectum"]:
+        case types_1.RouteCode["Per vagina"]:
+            return false;
+        default:
+            return true;
+    }
+}
+function shouldSuppressRoutePhraseThai(clause, verb, hasSite, explicitDosePart) {
+    var _a;
+    if (hasSite || explicitDosePart) {
+        return false;
+    }
+    if (!THAI_SUPPRESSIBLE_ROUTE_VERBS.has(verb)) {
+        return false;
+    }
+    switch ((_a = clause.route) === null || _a === void 0 ? void 0 : _a.code) {
+        case types_1.RouteCode["Topical route"]:
+        case types_1.RouteCode["Transdermal route"]:
+            return true;
+        default:
+            return false;
+    }
+}
+function scheduleOf(clause) {
+    var _a;
+    return (_a = clause.schedule) !== null && _a !== void 0 ? _a : {};
+}
+function resolveRouteGrammarThai(clause) {
+    var _a, _b, _c, _d, _e, _f;
+    const routeCode = (_a = clause.route) === null || _a === void 0 ? void 0 : _a.code;
+    if (routeCode && THAI_ROUTE_GRAMMAR[routeCode]) {
+        return (_b = THAI_ROUTE_GRAMMAR[routeCode]) !== null && _b !== void 0 ? _b : DEFAULT_THAI_ROUTE_GRAMMAR;
     }
-    const grammar = grammarFromRouteTextThai(internal.routeText);
+    const grammar = grammarFromRouteTextThai((_c = clause.route) === null || _c === void 0 ? void 0 : _c.text);
     if (grammar) {
         return grammar;
     }
-    if (((_b = internal.unit) === null || _b === void 0 ? void 0 : _b.trim().toLowerCase()) === "puff") {
-        return (_c = THAI_ROUTE_GRAMMAR[types_1.RouteCode["Respiratory tract route (qualifier value)"]]) !== null && _c !== void 0 ? _c : DEFAULT_THAI_ROUTE_GRAMMAR;
+    if (((_e = (_d = clause.dose) === null || _d === void 0 ? void 0 : _d.unit) === null || _e === void 0 ? void 0 : _e.trim().toLowerCase()) === "puff") {
+        return ((_f = THAI_ROUTE_GRAMMAR[types_1.RouteCode["Respiratory tract route (qualifier value)"]]) !== null && _f !== void 0 ? _f : DEFAULT_THAI_ROUTE_GRAMMAR);
     }
     return DEFAULT_THAI_ROUTE_GRAMMAR;
 }
 function grammarFromRouteTextThai(text) {
-    if (!text)
+    if (!text) {
         return undefined;
+    }
     const normalized = text.trim().toLowerCase();
-    if (!normalized)
+    if (!normalized) {
         return undefined;
+    }
     if (normalized.includes("mouth") || normalized.includes("oral")) {
         return THAI_ROUTE_GRAMMAR[types_1.RouteCode["Oral route"]];
     }
@@ -343,6 +570,12 @@ function grammarFromRouteTextThai(text) {
     if (normalized.includes("intravenous") || normalized === "iv") {
         return THAI_ROUTE_GRAMMAR[types_1.RouteCode["Intravenous route"]];
     }
+    if (normalized.includes("rectal") || normalized.includes("rectum")) {
+        return THAI_ROUTE_GRAMMAR[types_1.RouteCode["Per rectum"]];
+    }
+    if (normalized.includes("vagin")) {
+        return THAI_ROUTE_GRAMMAR[types_1.RouteCode["Per vagina"]];
+    }
     if (normalized.includes("nasal")) {
         return THAI_ROUTE_GRAMMAR[types_1.RouteCode["Nasal route"]];
     }
@@ -351,45 +584,75 @@ function grammarFromRouteTextThai(text) {
     }
     return undefined;
 }
-function formatDoseThaiShort(internal) {
-    if (internal.doseRange) {
-        const { low, high } = internal.doseRange;
-        const base = `${stripTrailingZero(low)}-${stripTrailingZero(high)}`;
-        if (internal.unit) {
-            return `${base} ${formatUnitThai(internal.unit, high, "short")}`;
+function formatDoseThaiShort(dose) {
+    if (!dose) {
+        return undefined;
+    }
+    if (dose.range) {
+        if (dose.range.low !== undefined && dose.range.high !== undefined) {
+            const base = `${stripTrailingZero(dose.range.low)}-${stripTrailingZero(dose.range.high)}`;
+            if (dose.unit) {
+                return `${base} ${formatUnitThai(dose.unit, dose.range.high, "short")}`;
+            }
+            return base;
+        }
+        if (dose.range.low !== undefined) {
+            const base = `>=${stripTrailingZero(dose.range.low)}`;
+            if (dose.unit) {
+                return `${base} ${formatUnitThai(dose.unit, dose.range.low, "short")}`;
+            }
+            return base;
+        }
+        if (dose.range.high !== undefined) {
+            const base = `<=${stripTrailingZero(dose.range.high)}`;
+            if (dose.unit) {
+                return `${base} ${formatUnitThai(dose.unit, dose.range.high, "short")}`;
+            }
+            return base;
         }
-        return base;
     }
-    if (internal.dose !== undefined) {
-        const amount = stripTrailingZero(internal.dose);
-        if (internal.unit) {
-            return `${amount} ${formatUnitThai(internal.unit, internal.dose, "short")}`;
+    if (dose.value !== undefined) {
+        if (dose.unit) {
+            return `${stripTrailingZero(dose.value)} ${formatUnitThai(dose.unit, dose.value, "short")}`;
         }
-        return amount;
+        return stripTrailingZero(dose.value);
     }
     return undefined;
 }
-function formatDoseThaiLong(internal) {
-    if (internal.doseRange) {
-        const { low, high } = internal.doseRange;
-        if (internal.unit) {
-            const unit = formatUnitThai(internal.unit, high, "long");
-            return `ครั้งละ ${stripTrailingZero(low)} ถึง ${stripTrailingZero(high)} ${unit}`;
+function formatDoseThaiLong(dose) {
+    if (!dose) {
+        return undefined;
+    }
+    if (dose.range) {
+        if (dose.range.low !== undefined && dose.range.high !== undefined) {
+            if (dose.unit) {
+                return `ครั้งละ ${stripTrailingZero(dose.range.low)} ถึง ${stripTrailingZero(dose.range.high)} ${formatUnitThai(dose.unit, dose.range.high, "long")}`;
+            }
+            return `ครั้งละ ${stripTrailingZero(dose.range.low)} ถึง ${stripTrailingZero(dose.range.high)}`;
+        }
+        if (dose.range.low !== undefined) {
+            if (dose.unit) {
+                return `ครั้งละ อย่างน้อย ${stripTrailingZero(dose.range.low)} ${formatUnitThai(dose.unit, dose.range.low, "long")}`;
+            }
+            return `ครั้งละ อย่างน้อย ${stripTrailingZero(dose.range.low)}`;
+        }
+        if (dose.range.high !== undefined) {
+            if (dose.unit) {
+                return `ครั้งละ ไม่เกิน ${stripTrailingZero(dose.range.high)} ${formatUnitThai(dose.unit, dose.range.high, "long")}`;
+            }
+            return `ครั้งละ ไม่เกิน ${stripTrailingZero(dose.range.high)}`;
         }
-        return `ครั้งละ ${stripTrailingZero(low)} ถึง ${stripTrailingZero(high)}`;
     }
-    if (internal.dose !== undefined) {
-        if (internal.unit) {
-            const unit = formatUnitThai(internal.unit, internal.dose, "long");
-            return `ครั้งละ ${stripTrailingZero(internal.dose)} ${unit}`;
+    if (dose.value !== undefined) {
+        if (dose.unit) {
+            return `ครั้งละ ${stripTrailingZero(dose.value)} ${formatUnitThai(dose.unit, dose.value, "long")}`;
         }
-        return `ครั้งละ ${stripTrailingZero(internal.dose)}`;
+        return `ครั้งละ ${stripTrailingZero(dose.value)}`;
     }
     return undefined;
 }
-function formatUnitThai(unit, value, style) {
+function formatUnitThai(unit, _value, style) {
     const lower = unit.toLowerCase();
-    const quantity = Math.abs(value);
     const mapping = {
         tab: { short: "เม็ด", long: "เม็ด" },
         tablet: { short: "เม็ด", long: "เม็ด" },
@@ -413,13 +676,16 @@ function formatUnitThai(unit, value, style) {
         suppositories: { short: "ยาเหน็บ", long: "ยาเหน็บ" }
     };
     const entry = mapping[lower];
-    if (entry) {
-        return style === "short" ? entry.short : entry.long;
-    }
-    return unit;
+    return entry ? entry[style] : unit;
 }
-function describeFrequencyThai(internal) {
-    const { frequency, frequencyMax, period, periodMax, periodUnit, timingCode } = internal;
+function describeFrequencyThai(schedule) {
+    var _a;
+    const frequency = schedule === null || schedule === void 0 ? void 0 : schedule.frequency;
+    const frequencyMax = schedule === null || schedule === void 0 ? void 0 : schedule.frequencyMax;
+    const period = schedule === null || schedule === void 0 ? void 0 : schedule.period;
+    const periodMax = schedule === null || schedule === void 0 ? void 0 : schedule.periodMax;
+    const periodUnit = schedule === null || schedule === void 0 ? void 0 : schedule.periodUnit;
+    const timingCode = schedule === null || schedule === void 0 ? void 0 : schedule.timingCode;
     if (frequency !== undefined &&
         frequencyMax !== undefined &&
         periodUnit === types_1.FhirPeriodUnit.Day &&
@@ -433,11 +699,13 @@ function describeFrequencyThai(internal) {
         return `วันละ ${stripTrailingZero(frequency)} ถึง ${stripTrailingZero(frequencyMax)} ครั้ง`;
     }
     if (frequency && periodUnit === types_1.FhirPeriodUnit.Day && (!period || period === 1)) {
-        const dailyText = TH_TIMES_PER_DAY[frequency];
-        if (dailyText) {
-            return dailyText;
+        return (_a = TH_TIMES_PER_DAY[frequency]) !== null && _a !== void 0 ? _a : `วันละ ${stripTrailingZero(frequency)} ครั้ง`;
+    }
+    if (periodUnit === types_1.FhirPeriodUnit.Minute && period) {
+        if (periodMax && periodMax !== period) {
+            return `ทุก ${stripTrailingZero(period)} ถึง ${stripTrailingZero(periodMax)} นาที`;
         }
-        return `วันละ ${stripTrailingZero(frequency)} ครั้ง`;
+        return `ทุก ${stripTrailingZero(period)} นาที`;
     }
     if (periodUnit === types_1.FhirPeriodUnit.Hour && period) {
         if (periodMax && periodMax !== period) {
@@ -472,6 +740,15 @@ function describeFrequencyThai(internal) {
         }
         return `ทุก ${stripTrailingZero(period)} เดือน`;
     }
+    if (periodUnit === types_1.FhirPeriodUnit.Year && period) {
+        if (period === 1 && (!periodMax || periodMax === 1)) {
+            return "ปีละครั้ง";
+        }
+        if (periodMax && periodMax !== period) {
+            return `ทุก ${stripTrailingZero(period)} ถึง ${stripTrailingZero(periodMax)} ปี`;
+        }
+        return `ทุก ${stripTrailingZero(period)} ปี`;
+    }
     if (timingCode) {
         const map = {
             BID: "วันละ 2 ครั้ง",
@@ -490,24 +767,44 @@ function describeFrequencyThai(internal) {
         }
     }
     if (frequency && periodUnit === undefined && period === undefined) {
-        if (frequency === 1)
+        if (frequency === 1) {
             return "ครั้งเดียว";
+        }
         return `${stripTrailingZero(frequency)} ครั้ง`;
     }
     return undefined;
 }
 function describeFrequencyCountThai(count) {
+    var _a;
+    if (!count || count <= 0) {
+        return undefined;
+    }
+    return (_a = TH_TIMES_PER_DAY[count]) !== null && _a !== void 0 ? _a : `วันละ ${stripTrailingZero(count)} ครั้ง`;
+}
+function describeStandaloneOccurrenceCountThai(schedule) {
+    var _a, _b, _c;
+    const count = schedule === null || schedule === void 0 ? void 0 : schedule.count;
     if (!count || count <= 0) {
         return undefined;
     }
-    const dailyText = TH_TIMES_PER_DAY[count];
-    if (dailyText) {
-        return dailyText;
+    if ((schedule === null || schedule === void 0 ? void 0 : schedule.frequency) !== undefined ||
+        (schedule === null || schedule === void 0 ? void 0 : schedule.frequencyMax) !== undefined ||
+        (schedule === null || schedule === void 0 ? void 0 : schedule.period) !== undefined ||
+        (schedule === null || schedule === void 0 ? void 0 : schedule.periodMax) !== undefined ||
+        (schedule === null || schedule === void 0 ? void 0 : schedule.periodUnit) !== undefined ||
+        ((_a = schedule === null || schedule === void 0 ? void 0 : schedule.dayOfWeek) === null || _a === void 0 ? void 0 : _a.length) ||
+        ((_b = schedule === null || schedule === void 0 ? void 0 : schedule.when) === null || _b === void 0 ? void 0 : _b.length) ||
+        ((_c = schedule === null || schedule === void 0 ? void 0 : schedule.timeOfDay) === null || _c === void 0 ? void 0 : _c.length) ||
+        (schedule === null || schedule === void 0 ? void 0 : schedule.duration) !== undefined ||
+        (schedule === null || schedule === void 0 ? void 0 : schedule.durationMax) !== undefined ||
+        (schedule === null || schedule === void 0 ? void 0 : schedule.durationUnit) !== undefined ||
+        (schedule === null || schedule === void 0 ? void 0 : schedule.timingCode)) {
+        return undefined;
     }
-    return `วันละ ${stripTrailingZero(count)} ครั้ง`;
+    return `${stripTrailingZero(count)} ครั้ง`;
 }
 function joinMealNamesThai(parts) {
-    if (parts.length === 0) {
+    if (!parts.length) {
         return "";
     }
     if (parts.length === 1) {
@@ -534,13 +831,15 @@ function summarizeMealTimingGroupThai(group) {
         dinner: "เย็น"
     };
     const meals = [];
-    for (let i = 0; i < group.meals.length; i += 1) {
-        meals.push(mealText[group.meals[i]]);
+    for (const meal of group.meals) {
+        meals.push(mealText[meal]);
     }
     return `${relationText[group.relation]}${joinMealNamesThai(meals)}`;
 }
-function collectWhenPhrasesThai(internal, options) {
-    if (!internal.when.length) {
+function collectWhenPhrasesThai(schedule, options) {
+    var _a;
+    const when = (_a = schedule === null || schedule === void 0 ? void 0 : schedule.when) !== null && _a !== void 0 ? _a : [];
+    if (!when.length) {
         return [];
     }
     const unique = [];
@@ -548,7 +847,7 @@ function collectWhenPhrasesThai(internal, options) {
     let hasSpecificAfter = false;
     let hasSpecificBefore = false;
     let hasSpecificWith = false;
-    for (const code of internal.when) {
+    for (const code of when) {
         if (!seen.has(code)) {
             seen.add(code);
             unique.push(code);
@@ -562,16 +861,13 @@ function collectWhenPhrasesThai(internal, options) {
                 code === types_1.EventTiming["Before Dinner"]) {
                 hasSpecificBefore = true;
             }
-            if (code === types_1.EventTiming.Breakfast ||
-                code === types_1.EventTiming.Lunch ||
-                code === types_1.EventTiming.Dinner) {
+            if (code === types_1.EventTiming.Breakfast || code === types_1.EventTiming.Lunch || code === types_1.EventTiming.Dinner) {
                 hasSpecificWith = true;
             }
         }
     }
     const filtered = [];
-    for (let i = 0; i < unique.length; i += 1) {
-        const code = unique[i];
+    for (const code of unique) {
         if (code === types_1.EventTiming["After Meal"] && hasSpecificAfter) {
             continue;
         }
@@ -584,19 +880,9 @@ function collectWhenPhrasesThai(internal, options) {
         filtered.push(code);
     }
     const mealGroup = (0, timing_summary_1.getMealTimingGroup)(filtered, options);
-    if (mealGroup) {
-        const groupedCodes = new Set(mealGroup.codes);
+    if (!mealGroup) {
         const phrases = [];
-        let insertedGroup = false;
-        for (let i = 0; i < filtered.length; i += 1) {
-            const code = filtered[i];
-            if (groupedCodes.has(code)) {
-                if (!insertedGroup) {
-                    phrases.push(summarizeMealTimingGroupThai(mealGroup));
-                    insertedGroup = true;
-                }
-                continue;
-            }
+        for (const code of filtered) {
             const text = WHEN_TEXT_THAI[code];
             if (text) {
                 phrases.push(text);
@@ -604,9 +890,18 @@ function collectWhenPhrasesThai(internal, options) {
         }
         return phrases;
     }
+    const groupedCodes = new Set(mealGroup.codes);
     const phrases = [];
-    for (let i = 0; i < filtered.length; i += 1) {
-        const text = WHEN_TEXT_THAI[filtered[i]];
+    let insertedGroup = false;
+    for (const code of filtered) {
+        if (groupedCodes.has(code)) {
+            if (!insertedGroup) {
+                phrases.push(summarizeMealTimingGroupThai(mealGroup));
+                insertedGroup = true;
+            }
+            continue;
+        }
+        const text = WHEN_TEXT_THAI[code];
         if (text) {
             phrases.push(text);
         }
@@ -635,39 +930,34 @@ function combineFrequencyAndEventsThai(frequency, events) {
     if (!events.length) {
         return { frequency };
     }
-    if (events.length === 1 && events[0] === "ก่อนนอน") {
-        if (frequency.includes("วันละ")) {
-            return { frequency: `${frequency} และ ${events[0]}` };
-        }
+    if (events.length === 1 && events[0] === "ก่อนนอน" && frequency.includes("วันละ")) {
+        return { frequency: `${frequency} และ ${events[0]}` };
     }
     return { frequency, event: joinWithAndThai(events) };
 }
-function isOralRouteThai(internal) {
-    var _a;
-    if (internal.routeCode === types_1.RouteCode["Oral route"]) {
+function isOralRouteThai(clause) {
+    var _a, _b, _c;
+    if (((_a = clause.route) === null || _a === void 0 ? void 0 : _a.code) === types_1.RouteCode["Oral route"]) {
         return true;
     }
-    const text = (_a = internal.routeText) === null || _a === void 0 ? void 0 : _a.trim().toLowerCase();
+    const text = (_c = (_b = clause.route) === null || _b === void 0 ? void 0 : _b.text) === null || _c === void 0 ? void 0 : _c.trim().toLowerCase();
     if (!text) {
         return false;
     }
-    return (text === "po" ||
-        text === "oral" ||
-        text.includes("mouth") ||
-        text.includes("per os"));
+    return text === "po" || text === "oral" || text.includes("mouth") || text.includes("per os");
 }
-function buildRoutePhraseThai(internal, grammar, hasSite) {
-    var _a;
-    if (grammar.verb === "รับประทาน" && isOralRouteThai(internal)) {
+function buildRoutePhraseThai(clause, grammar, hasSite) {
+    var _a, _b;
+    if (grammar.verb === "รับประทาน" && isOralRouteThai(clause)) {
         return undefined;
     }
     if (typeof grammar.routePhrase === "function") {
-        return grammar.routePhrase({ hasSite, internal });
+        return grammar.routePhrase({ hasSite, clause });
     }
     if (typeof grammar.routePhrase === "string") {
         return grammar.routePhrase;
     }
-    const text = (_a = internal.routeText) === null || _a === void 0 ? void 0 : _a.trim();
+    const text = (_b = (_a = clause.route) === null || _a === void 0 ? void 0 : _a.text) === null || _b === void 0 ? void 0 : _b.trim();
     if (!text) {
         return undefined;
     }
@@ -701,138 +991,261 @@ function buildRoutePhraseThai(internal, grammar, hasSite) {
     }
     return text;
 }
-function formatSiteThai(internal, grammar) {
-    var _a, _b;
-    const text = (_a = internal.siteText) === null || _a === void 0 ? void 0 : _a.trim();
-    if (!text) {
+function formatSiteThai(clause, grammar) {
+    var _a, _b, _c, _d, _e, _f, _g, _h, _j, _k, _l, _m, _o;
+    const text = ((_b = (_a = clause.site) === null || _a === void 0 ? void 0 : _a.text) === null || _b === void 0 ? void 0 : _b.trim()) || ((_e = (_d = (_c = clause.site) === null || _c === void 0 ? void 0 : _c.coding) === null || _d === void 0 ? void 0 : _d.display) === null || _e === void 0 ? void 0 : _e.trim());
+    const lower = text === null || text === void 0 ? void 0 : text.toLowerCase();
+    const codingCode = (_g = (_f = clause.site) === null || _f === void 0 ? void 0 : _f.coding) === null || _g === void 0 ? void 0 : _g.code;
+    const routeText = (_j = (_h = clause.route) === null || _h === void 0 ? void 0 : _h.text) === null || _j === void 0 ? void 0 : _j.trim().toLowerCase();
+    const isRectalRoute = ((_k = clause.route) === null || _k === void 0 ? void 0 : _k.code) === types_1.RouteCode["Per rectum"] ||
+        routeText === "rectum" ||
+        routeText === "rectal";
+    const isVaginalRoute = ((_l = clause.route) === null || _l === void 0 ? void 0 : _l.code) === types_1.RouteCode["Per vagina"] ||
+        routeText === "vagina" ||
+        routeText === "vaginal";
+    const isRectumSite = codingCode === "34402009" || lower === "rectum" || lower === "rectal";
+    const isVaginaSite = codingCode === "76784001" || lower === "vagina" || lower === "vaginal";
+    if (isRectalRoute &&
+        isRectumSite) {
         return undefined;
     }
-    const translated = translateSiteThai(text);
-    const preposition = (_b = grammar.sitePreposition) !== null && _b !== void 0 ? _b : "ที่";
+    if (isVaginalRoute &&
+        isVaginaSite) {
+        return undefined;
+    }
+    const translated = translateSiteThai(text, codingCode);
+    if (!translated) {
+        return undefined;
+    }
+    if (((_m = clause.route) === null || _m === void 0 ? void 0 : _m.code) === types_1.RouteCode["Nasal route"]) {
+        return `เข้า${translated}`;
+    }
+    const preposition = (_o = grammar.sitePreposition) !== null && _o !== void 0 ? _o : "ที่";
     const separator = /^[\u0E00-\u0E7F]/.test(translated) ? "" : " ";
     return `${preposition}${separator}${translated}`.trim();
 }
-function translateSiteThai(site) {
+function translateSiteThai(site, code) {
     var _a;
-    const normalized = site.trim().toLowerCase().replace(/\s+/g, " ");
+    if (code) {
+        const translatedByCode = THAI_SITE_CODE_TRANSLATIONS[code];
+        if (translatedByCode) {
+            return translatedByCode;
+        }
+    }
+    if (!site) {
+        return undefined;
+    }
+    const normalized = (0, maps_1.normalizeBodySiteKey)(site);
     if (!normalized) {
         return site;
     }
     return (_a = exports.THAI_SITE_TRANSLATIONS[normalized]) !== null && _a !== void 0 ? _a : site;
 }
-function describeDayOfWeekThai(internal) {
-    if (!internal.dayOfWeek.length) {
+function describeDayOfWeekThai(schedule) {
+    var _a;
+    const dayOfWeek = (_a = schedule === null || schedule === void 0 ? void 0 : schedule.dayOfWeek) !== null && _a !== void 0 ? _a : [];
+    if (!dayOfWeek.length) {
         return undefined;
     }
-    const days = internal.dayOfWeek
-        .map((d) => { var _a; return (_a = DAY_NAMES_THAI[d]) !== null && _a !== void 0 ? _a : undefined; })
-        .filter((d) => Boolean(d));
-    if (!days.length) {
+    const days = [];
+    for (const day of dayOfWeek) {
+        const text = DAY_NAMES_THAI[day];
+        if (text) {
+            days.push(text);
+        }
+    }
+    return days.length ? `ใน${joinWithAndThai(days)}` : undefined;
+}
+function formatDurationShortThai(schedule) {
+    if (schedule.duration === undefined || !schedule.durationUnit) {
         return undefined;
     }
-    return `ใน${joinWithAndThai(days)}`;
+    const base = stripTrailingZero(schedule.duration);
+    const qualifier = schedule.durationMax !== undefined && schedule.durationMax !== schedule.duration
+        ? `${base}-${stripTrailingZero(schedule.durationMax)}`
+        : base;
+    return `x${qualifier}${schedule.durationUnit}`;
 }
-function formatAsNeededThai(internal) {
-    var _a, _b;
-    if (!internal.asNeeded) {
+function describeDurationThai(schedule) {
+    if (!schedule || schedule.duration === undefined || !schedule.durationUnit) {
+        return undefined;
+    }
+    const unit = schedule.durationUnit;
+    const label = () => {
+        switch (unit) {
+            case types_1.FhirPeriodUnit.Minute:
+                return "นาที";
+            case types_1.FhirPeriodUnit.Hour:
+                return "ชั่วโมง";
+            case types_1.FhirPeriodUnit.Day:
+                return "วัน";
+            case types_1.FhirPeriodUnit.Week:
+                return "สัปดาห์";
+            case types_1.FhirPeriodUnit.Month:
+                return "เดือน";
+            case types_1.FhirPeriodUnit.Year:
+                return "ปี";
+            default:
+                return unit;
+        }
+    };
+    if (schedule.durationMax !== undefined && schedule.durationMax !== schedule.duration) {
+        return `เป็นเวลา ${stripTrailingZero(schedule.duration)} ถึง ${stripTrailingZero(schedule.durationMax)} ${label()}`;
+    }
+    return `เป็นเวลา ${stripTrailingZero(schedule.duration)} ${label()}`;
+}
+function formatAsNeededThai(clause) {
+    var _a, _b, _c, _d, _e, _f, _g, _h, _j, _k, _l;
+    if (!((_a = clause.prn) === null || _a === void 0 ? void 0 : _a.enabled)) {
         return undefined;
     }
-    if (internal.asNeededReason) {
-        const translation = (_b = (_a = internal.asNeededReasonCoding) === null || _a === void 0 ? void 0 : _a.i18n) === null || _b === void 0 ? void 0 : _b.th;
-        return `ใช้เมื่อจำเป็นสำหรับ ${translation || internal.asNeededReason}`;
+    if ((_b = clause.prn.reasons) === null || _b === void 0 ? void 0 : _b.length) {
+        const translatedReasons = [];
+        for (const reason of clause.prn.reasons) {
+            let text = (_c = reason.text) !== null && _c !== void 0 ? _c : (_d = reason.coding) === null || _d === void 0 ? void 0 : _d.display;
+            const coding = reason.coding;
+            if (coding === null || coding === void 0 ? void 0 : coding.code) {
+                const definition = (0, maps_1.findPrnReasonDefinitionByCoding)((_e = coding.system) !== null && _e !== void 0 ? _e : "http://snomed.info/sct", coding.code);
+                text = (_g = (_f = definition === null || definition === void 0 ? void 0 : definition.i18n) === null || _f === void 0 ? void 0 : _f.th) !== null && _g !== void 0 ? _g : text;
+            }
+            translatedReasons.push({ text, coding: reason.coding });
+        }
+        const joined = (0, prn_1.getPreferredCanonicalPrnReasonText)(undefined, translatedReasons, "หรือ");
+        if (joined) {
+            return `ใช้เมื่อจำเป็นสำหรับ ${joined}`;
+        }
+    }
+    let translation;
+    const coding = (_h = clause.prn.reason) === null || _h === void 0 ? void 0 : _h.coding;
+    if (coding === null || coding === void 0 ? void 0 : coding.code) {
+        const definition = (0, maps_1.findPrnReasonDefinitionByCoding)((_j = coding.system) !== null && _j !== void 0 ? _j : "http://snomed.info/sct", coding.code);
+        translation = (_k = definition === null || definition === void 0 ? void 0 : definition.i18n) === null || _k === void 0 ? void 0 : _k.th;
+    }
+    const reason = (_l = translation !== null && translation !== void 0 ? translation : (0, prn_1.getPreferredCanonicalPrnReasonText)(clause.prn.reason, clause.prn.reasons, "หรือ")) !== null && _l !== void 0 ? _l : coding === null || coding === void 0 ? void 0 : coding.display;
+    if (reason) {
+        return `ใช้เมื่อจำเป็นสำหรับ ${reason}`;
     }
     return "ใช้เมื่อจำเป็น";
 }
-function formatShortThai(internal) {
-    var _a;
+function formatShortThai(clause) {
+    var _a, _b, _c, _d, _e, _f;
+    const schedule = scheduleOf(clause);
     const parts = [];
-    const dose = formatDoseThaiShort(internal);
+    const dose = formatDoseThaiShort(clause.dose);
     if (dose) {
         parts.push(dose);
     }
-    if (internal.routeCode) {
-        const short = ROUTE_SHORT[internal.routeCode];
+    if ((_a = clause.route) === null || _a === void 0 ? void 0 : _a.code) {
+        const short = ROUTE_SHORT[clause.route.code];
         if (short) {
             parts.push(short);
         }
-        else if (internal.routeText) {
-            parts.push(internal.routeText);
+        else if (clause.route.text) {
+            parts.push(clause.route.text);
         }
     }
-    else if (internal.routeText) {
-        parts.push(internal.routeText);
+    else if ((_b = clause.route) === null || _b === void 0 ? void 0 : _b.text) {
+        parts.push(clause.route.text);
     }
-    const timing = describeFrequencyThai(internal);
+    const timing = describeFrequencyThai(schedule);
     if (timing) {
         parts.push(timing);
     }
-    else if (internal.timingCode) {
-        parts.push(internal.timingCode);
+    else if (schedule.timingCode) {
+        parts.push(schedule.timingCode);
     }
-    else if (internal.period && internal.periodUnit) {
-        const base = stripTrailingZero(internal.period);
-        const qualifier = internal.periodMax && internal.periodMax !== internal.period
-            ? `${base}-${stripTrailingZero(internal.periodMax)}`
+    else if (schedule.period && schedule.periodUnit) {
+        const base = stripTrailingZero(schedule.period);
+        const qualifier = schedule.periodMax && schedule.periodMax !== schedule.period
+            ? `${base}-${stripTrailingZero(schedule.periodMax)}`
             : base;
-        parts.push(`Q${qualifier}${internal.periodUnit.toUpperCase()}`);
+        parts.push(`Q${qualifier}${schedule.periodUnit.toUpperCase()}`);
+    }
+    const events = collectWhenPhrasesThai(schedule);
+    if (events.length) {
+        parts.push(events.join(" "));
     }
-    if (internal.when.length) {
-        const events = collectWhenPhrasesThai(internal);
-        if (events.length) {
-            parts.push(events.join(" "));
+    if ((_c = schedule.timeOfDay) === null || _c === void 0 ? void 0 : _c.length) {
+        const times = [];
+        for (const time of schedule.timeOfDay) {
+            times.push(time.slice(0, 5));
         }
+        parts.push(times.join(","));
     }
-    if ((_a = internal.timeOfDay) === null || _a === void 0 ? void 0 : _a.length) {
-        const times = internal.timeOfDay.map((t) => t.slice(0, 5)).join(",");
-        parts.push(times);
+    if ((_d = schedule.dayOfWeek) === null || _d === void 0 ? void 0 : _d.length) {
+        const days = [];
+        for (const day of schedule.dayOfWeek) {
+            days.push((_f = (_e = DAY_NAMES_THAI[day]) === null || _e === void 0 ? void 0 : _e.replace(/^วัน/, "")) !== null && _f !== void 0 ? _f : day);
+        }
+        parts.push(days.join(","));
     }
-    if (internal.dayOfWeek.length) {
-        const days = internal.dayOfWeek
-            .map((d) => { var _a, _b; return (_b = (_a = DAY_NAMES_THAI[d]) === null || _a === void 0 ? void 0 : _a.replace(/^วัน/, "")) !== null && _b !== void 0 ? _b : d; })
-            .join(",");
-        parts.push(days);
+    if (schedule.count !== undefined) {
+        parts.push(`x${stripTrailingZero(schedule.count)}`);
     }
-    if (internal.count !== undefined) {
-        parts.push(`x${stripTrailingZero(internal.count)}`);
+    const durationShort = formatDurationShortThai(schedule);
+    if (durationShort) {
+        parts.push(durationShort);
     }
-    const asNeeded = formatAsNeededThai(internal);
+    const asNeeded = formatAsNeededThai(clause);
     if (asNeeded) {
         parts.push(asNeeded);
     }
     return parts.filter(Boolean).join(" ");
 }
-function formatLongThai(internal, options) {
+function formatLongThai(clause, options) {
     var _a, _b, _c;
-    const grammar = resolveRouteGrammarThai(internal);
-    const dosePart = (_a = formatDoseThaiLong(internal)) !== null && _a !== void 0 ? _a : "ยา";
-    const sitePart = formatSiteThai(internal, grammar);
-    const routePart = buildRoutePhraseThai(internal, grammar, Boolean(sitePart));
-    const frequencyPart = (_b = describeFrequencyThai(internal)) !== null && _b !== void 0 ? _b : describeFrequencyCountThai((0, timing_summary_1.inferDailyOccurrenceCount)(internal, options));
-    const eventParts = collectWhenPhrasesThai(internal, options);
-    if ((_c = internal.timeOfDay) === null || _c === void 0 ? void 0 : _c.length) {
+    const schedule = scheduleOf(clause);
+    const grammar = resolveRouteGrammarThai(clause);
+    const verb = resolveThaiMethodVerb(clause, grammar);
+    const explicitDosePart = formatDoseThaiLong(clause.dose);
+    const sitePart = formatSiteThai(clause, grammar);
+    const dosePart = shouldUseGenericMedicationObjectThai(clause, verb, explicitDosePart)
+        ? explicitDosePart !== null && explicitDosePart !== void 0 ? explicitDosePart : "ยา"
+        : explicitDosePart;
+    const routePart = shouldSuppressRoutePhraseThai(clause, verb, Boolean(sitePart), explicitDosePart)
+        ? undefined
+        : buildRoutePhraseThai(clause, grammar, Boolean(sitePart));
+    const standaloneOccurrenceCount = describeStandaloneOccurrenceCountThai(schedule);
+    const frequencyPart = (_b = (_a = describeFrequencyThai(schedule)) !== null && _a !== void 0 ? _a : standaloneOccurrenceCount) !== null && _b !== void 0 ? _b : describeFrequencyCountThai((0, timing_summary_1.inferDailyOccurrenceCount)(schedule, options));
+    const eventParts = collectWhenPhrasesThai(schedule, options);
+    if ((_c = schedule.timeOfDay) === null || _c === void 0 ? void 0 : _c.length) {
         const timeStrings = [];
-        for (const time of internal.timeOfDay) {
+        for (const time of schedule.timeOfDay) {
             const parts = time.split(":");
-            const h = parseInt(parts[0], 10);
-            const m = parseInt(parts[1], 10);
-            const displayM = m < 10 ? `0${m}` : `${m}`;
-            const displayH = h < 10 ? `0${h}` : `${h}`;
-            timeStrings.push(`${displayH}:${displayM}`);
+            const hours = Number(parts[0]);
+            const minutes = Number(parts[1]);
+            if (!Number.isFinite(hours) || !Number.isFinite(minutes)) {
+                continue;
+            }
+            const displayMinutes = minutes < 10 ? `0${minutes}` : `${minutes}`;
+            const displayHours = hours < 10 ? `0${hours}` : `${hours}`;
+            timeStrings.push(`${displayHours}:${displayMinutes}`);
         }
-        if (timeStrings.length > 0) {
+        if (timeStrings.length) {
             eventParts.push(`เวลา ${timeStrings.join(", ")}`);
         }
     }
     const timing = combineFrequencyAndEventsThai(frequencyPart, eventParts);
-    const dayPart = describeDayOfWeekThai(internal);
-    const countPart = internal.count !== undefined
-        ? `จำนวน ${stripTrailingZero(internal.count)} ครั้ง`
+    const dayPart = describeDayOfWeekThai(schedule);
+    const countPart = schedule.count !== undefined && !standaloneOccurrenceCount
+        ? `จำนวน ${stripTrailingZero(schedule.count)} ครั้ง`
         : undefined;
-    const asNeeded = formatAsNeededThai(internal);
-    const segments = [dosePart];
+    const durationPart = describeDurationThai(schedule);
+    const asNeeded = formatAsNeededThai(clause);
+    const segments = [];
+    if (dosePart) {
+        segments.push(dosePart);
+    }
     if (routePart) {
         segments.push(routePart);
     }
+    const siteFirst = Boolean(sitePart) &&
+        THAI_SITE_FIRST_VERBS.has(verb) &&
+        explicitDosePart === undefined &&
+        routePart === undefined;
+    if (siteFirst && sitePart) {
+        segments.push(sitePart);
+    }
     if (timing.frequency) {
         segments.push(timing.frequency);
     }
@@ -845,50 +1258,79 @@ function formatLongThai(internal, options) {
     if (countPart) {
         segments.push(countPart);
     }
+    if (durationPart) {
+        segments.push(durationPart);
+    }
     if (asNeeded) {
         segments.push(asNeeded);
     }
-    if (sitePart) {
+    if (!siteFirst && sitePart) {
         segments.push(sitePart);
     }
     const body = segments.filter(Boolean).join(" ").replace(/\s+/g, " ").trim();
+    const instructionPhrases = [];
+    const instructionText = formatAdditionalInstructionsThai(clause);
+    if (instructionText) {
+        instructionPhrases.push(instructionText);
+    }
+    const patientInstruction = formatPatientInstructionSentence(clause.patientInstruction);
+    if (patientInstruction) {
+        instructionPhrases.push(patientInstruction);
+    }
+    const trailingInstructionText = instructionPhrases.join(" ").trim() || undefined;
+    const baseSentence = `${joinThaiVerbAndBody(verb, body)}.`;
     if (!body) {
-        const instructionText = formatAdditionalInstructionsThai(internal);
-        if (!instructionText) {
-            return `${grammar.verb}.`;
-        }
-        return `${grammar.verb}. ${instructionText}`.trim();
+        return trailingInstructionText ? `${baseSentence} ${trailingInstructionText}` : baseSentence;
     }
-    const instructionText = formatAdditionalInstructionsThai(internal);
-    const baseSentence = `${grammar.verb} ${body}.`;
-    return instructionText ? `${baseSentence} ${instructionText}` : baseSentence;
+    return trailingInstructionText ? `${baseSentence} ${trailingInstructionText}` : baseSentence;
 }
-function formatAdditionalInstructionsThai(internal) {
-    var _a;
-    if (!((_a = internal.additionalInstructions) === null || _a === void 0 ? void 0 : _a.length)) {
+function formatAdditionalInstructionsThai(clause) {
+    var _a, _b, _c, _d, _e, _f, _g, _h, _j, _k;
+    const instructions = (_a = clause.additionalInstructions) !== null && _a !== void 0 ? _a : [];
+    if (!instructions.length) {
         return undefined;
     }
-    const phrases = internal.additionalInstructions
-        .map((instruction) => {
-        var _a, _b, _c;
-        const translation = (_b = (_a = instruction.coding) === null || _a === void 0 ? void 0 : _a.i18n) === null || _b === void 0 ? void 0 : _b.th;
-        if (translation)
-            return translation;
-        const original = instruction.text || ((_c = instruction.coding) === null || _c === void 0 ? void 0 : _c.display);
-        if (!original)
-            return undefined;
-        return original.trim();
-    })
-        .filter((text) => Boolean(text))
-        .map((text) => text.trim())
-        .filter((text) => text.length > 0);
+    const phrases = [];
+    const grammar = resolveRouteGrammarThai(clause);
+    const verb = resolveThaiMethodVerb(clause, grammar);
+    for (const instruction of instructions) {
+        if (((_b = instruction.coding) === null || _b === void 0 ? void 0 : _b.code) === SLOWLY_QUALIFIER_CODE) {
+            const contextual = verb ? `${verb}ช้าๆ` : "ช้าๆ";
+            phrases.push(contextual);
+            continue;
+        }
+        if (((_c = instruction.coding) === null || _c === void 0 ? void 0 : _c.code) === EMPTY_STOMACH_QUALIFIER_CODE ||
+            ((_d = instruction.frames) === null || _d === void 0 ? void 0 : _d.some((frame) => frame.relation === types_1.AdviceRelation.On &&
+                frame.args.some((arg) => arg.role === types_1.AdviceArgumentRole.MealState &&
+                    arg.conceptId === "empty_stomach")))) {
+            phrases.push("ขณะท้องว่าง");
+            continue;
+        }
+        let text = (_e = instruction.text) !== null && _e !== void 0 ? _e : (_f = instruction.coding) === null || _f === void 0 ? void 0 : _f.display;
+        if ((_g = instruction.coding) === null || _g === void 0 ? void 0 : _g.code) {
+            const definition = (0, advice_1.findAdditionalInstructionDefinitionByCoding)((_h = instruction.coding.system) !== null && _h !== void 0 ? _h : "http://snomed.info/sct", instruction.coding.code);
+            text = (_k = (_j = definition === null || definition === void 0 ? void 0 : definition.i18n) === null || _j === void 0 ? void 0 : _j.th) !== null && _k !== void 0 ? _k : text;
+        }
+        if (!text) {
+            continue;
+        }
+        const trimmed = text.trim();
+        if (trimmed) {
+            phrases.push(trimmed);
+        }
+    }
     if (!phrases.length) {
         return undefined;
     }
-    return phrases
-        .map((phrase) => (/[.!?]$/.test(phrase) ? phrase : `${phrase}.`))
-        .join(" ")
-        .trim();
+    return phrases.map((phrase) => (/[.!?]$/.test(phrase) ? phrase : `${phrase}.`)).join(" ").trim();
+}
+function formatPatientInstructionSentence(text) {
+    const trimmed = text === null || text === void 0 ? void 0 : text.trim();
+    if (!trimmed) {
+        return undefined;
+    }
+    const sentence = /^[.!?]$/.test(trimmed.slice(-1)) ? trimmed : `${trimmed}.`;
+    return sentence.charAt(0).toUpperCase() + sentence.slice(1);
 }
 function stripTrailingZero(value) {
     const text = value.toString();