ls /home/daytona/workspace/ 2>/dev/null || echo "workspace empty or doesn't exis…

mkdir -p /home/daytona/workspace/aws-presentation && echo "created"

~/aws-presentation/build.js

const pptxgen = require("pptxgenjs");
const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Alcohol Withdrawal Management";
pres.author = "Clinical Pharmacology Teaching";

// ── COLOUR PALETTE ──────────────────────────────────────────────
const NAVY   = "0D1B2A";   // dominant background
const TEAL   = "1B7F79";   // accent bars / section headers
const AMBER  = "E8A838";   // highlight / key facts
const WHITE  = "FFFFFF";
const LGRAY  = "E8EDF2";   // card fill
const DGRAY  = "2C3E50";   // body text on light bg
const RED    = "C0392B";   // danger / warning
const GREEN  = "1E8449";   // safe / mild

// ── HELPERS ─────────────────────────────────────────────────────
function addBg(slide, color) {
  slide.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 5.625, fill: { color } });
}

function addAccentBar(slide, color = TEAL) {
  slide.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.08, fill: { color } });
  slide.addShape(pres.shapes.RECTANGLE, { x: 0, y: 5.545, w: 10, h: 0.08, fill: { color } });
}

function sectionTitle(slide, text, sub) {
  addBg(slide, NAVY);
  // centre accent line
  slide.addShape(pres.shapes.RECTANGLE, { x: 3.5, y: 2.65, w: 3, h: 0.06, fill: { color: AMBER } });
  slide.addText(text, {
    x: 0.5, y: 1.9, w: 9, h: 1,
    fontSize: 40, bold: true, color: WHITE, align: "center", fontFace: "Calibri"
  });
  if (sub) slide.addText(sub, {
    x: 1, y: 2.9, w: 8, h: 0.6,
    fontSize: 18, color: TEAL, align: "center", fontFace: "Calibri", italic: true
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 1 — TITLE
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addBg(s, NAVY);
  // bold teal sidebar
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 0.18, h: 5.625, fill: { color: TEAL } });
  // amber accent
  s.addShape(pres.shapes.RECTANGLE, { x: 0.5, y: 3.5, w: 5.5, h: 0.07, fill: { color: AMBER } });

  s.addText("ALCOHOL WITHDRAWAL", {
    x: 0.5, y: 0.8, w: 9, h: 1,
    fontSize: 44, bold: true, color: WHITE, fontFace: "Calibri", charSpacing: 2
  });
  s.addText("MANAGEMENT", {
    x: 0.5, y: 1.75, w: 9, h: 0.9,
    fontSize: 44, bold: true, color: AMBER, fontFace: "Calibri", charSpacing: 2
  });
  s.addText("A Comprehensive Clinical Teaching Module", {
    x: 0.5, y: 2.85, w: 8, h: 0.55,
    fontSize: 17, color: LGRAY, fontFace: "Calibri", italic: true
  });
  s.addText([
    { text: "Pathophysiology  •  ", options: {} },
    { text: "CIWA-Ar Assessment  •  ", options: {} },
    { text: "Pharmacotherapy  •  ", options: {} },
    { text: "Complications  •  ", options: {} },
    { text: "Pharmacist Role", options: {} }
  ], {
    x: 0.5, y: 3.75, w: 9, h: 0.5,
    fontSize: 12, color: "8ABFD4", fontFace: "Calibri"
  });
  s.addText("Maudsley Prescribing Guidelines, 15e  |  ROSEN's Emergency Medicine  |  Goldman-Cecil Medicine", {
    x: 0.5, y: 5.2, w: 9, h: 0.3,
    fontSize: 9, color: "5A7A8A", fontFace: "Calibri"
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 2 — OVERVIEW / AGENDA
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addBg(s, LGRAY);
  addAccentBar(s);

  s.addText("What We Will Cover", {
    x: 0.5, y: 0.15, w: 9, h: 0.55,
    fontSize: 26, bold: true, color: NAVY, fontFace: "Calibri"
  });

  const topics = [
    ["01", "Epidemiology & Overview",       "Who gets AWS and why it matters"],
    ["02", "Pathophysiology",               "GABA / NMDA imbalance explained"],
    ["03", "Clinical Features & Timeline",  "What you will see and when"],
    ["04", "CIWA-Ar Scoring",               "Quantifying severity objectively"],
    ["05", "Pharmacotherapy",               "Benzodiazepines, thiamine, adjuncts"],
    ["06", "Delirium Tremens",              "The most dangerous complication"],
    ["07", "Wernicke-Korsakoff",            "Thiamine deficiency spectrum"],
    ["08", "Drug Therapy Problems",         "Pharmacist interventions"],
    ["09", "Discharge & Counseling",        "Preventing relapse & complications"],
  ];

  const cols = [[0], [1,2,3,4], [5,6,7,8]];
  const positions = [
    { x: 0.3, y: 0.85 },
    { x: 0.3, y: 0.85 },
    { x: 3.5, y: 0.85 },
    { x: 6.7, y: 0.85 },
  ];

  let col = 0;
  const xStarts = [0.3, 3.45, 6.6];
  const yStart = 0.85;
  topics.forEach((t, i) => {
    const c = i < 3 ? 0 : i < 6 ? 1 : 2;
    const row = i % 3;
    const x = xStarts[c];
    const y = yStart + row * 1.45;

    s.addShape(pres.shapes.RECTANGLE, {
      x, y, w: 3.0, h: 1.3,
      fill: { color: WHITE },
      shadow: { type: "outer", color: "AAAAAA", blur: 5, offset: 2, angle: 135, opacity: 0.18 }
    });
    s.addShape(pres.shapes.RECTANGLE, { x, y, w: 0.55, h: 1.3, fill: { color: TEAL } });
    s.addText(t[0], {
      x, y: y + 0.38, w: 0.55, h: 0.55,
      fontSize: 16, bold: true, color: WHITE, align: "center", fontFace: "Calibri"
    });
    s.addText(t[1], {
      x: x + 0.62, y: y + 0.12, w: 2.3, h: 0.5,
      fontSize: 11, bold: true, color: NAVY, fontFace: "Calibri"
    });
    s.addText(t[2], {
      x: x + 0.62, y: y + 0.6, w: 2.3, h: 0.55,
      fontSize: 9.5, color: "556070", fontFace: "Calibri", italic: true
    });
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 3 — SECTION DIVIDER: PATHOPHYSIOLOGY
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  sectionTitle(s, "PATHOPHYSIOLOGY", "Why does alcohol withdrawal cause seizures?");
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 4 — GABA/NMDA MECHANISM
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addBg(s, WHITE);
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.55, fill: { color: NAVY } });
  s.addText("Mechanism of Alcohol Withdrawal", {
    x: 0.3, y: 0.05, w: 9.4, h: 0.45,
    fontSize: 20, bold: true, color: WHITE, fontFace: "Calibri"
  });

  // Three state boxes
  const states = [
    {
      title: "CHRONIC ALCOHOL USE",
      color: "1A5276",
      items: [
        "↑ GABA-A receptor activity (inhibition)",
        "Alcohol potentiates GABA → brain adapts",
        "Down-regulates GABA-A receptors",
        "↓ NMDA receptor sensitivity (excitation suppressed)",
        "Brain compensates: UP-regulates NMDA receptors",
      ]
    },
    {
      title: "ABRUPT CESSATION",
      color: RED,
      items: [
        "GABA inhibition suddenly drops",
        "Down-regulated GABA-A can't compensate",
        "NMDA excitatory receptors now unmasked",
        "Net result: BRAIN HYPEREXCITABILITY",
        "Unopposed sympathetic drive",
      ]
    },
    {
      title: "CLINICAL RESULT",
      color: TEAL,
      items: [
        "Tremors (earliest — 6-8h)",
        "Seizures (peak 12-24h)",
        "Hallucinations (12-36h)",
        "Autonomic instability",
        "Delirium Tremens (48-72h+)",
      ]
    }
  ];

  states.forEach((st, i) => {
    const x = 0.18 + i * 3.28;
    s.addShape(pres.shapes.RECTANGLE, { x, y: 0.7, w: 3.1, h: 0.42, fill: { color: st.color } });
    s.addText(st.title, {
      x, y: 0.72, w: 3.1, h: 0.38,
      fontSize: 11, bold: true, color: WHITE, align: "center", fontFace: "Calibri"
    });
    st.items.forEach((item, j) => {
      s.addText([
        { text: "▸  ", options: { color: st.color, bold: true } },
        { text: item, options: { color: DGRAY } }
      ], {
        x: x + 0.1, y: 1.2 + j * 0.75, w: 2.95, h: 0.65,
        fontSize: 11, fontFace: "Calibri"
      });
    });
    // Arrow between boxes
    if (i < 2) {
      s.addText("→", {
        x: x + 3.08, y: 1.5, w: 0.25, h: 0.5,
        fontSize: 22, bold: true, color: AMBER, align: "center"
      });
    }
  });

  s.addShape(pres.shapes.RECTANGLE, { x: 0.18, y: 5.15, w: 9.64, h: 0.35, fill: { color: LGRAY } });
  s.addText("Key principle: Benzodiazepines restore GABA-ergic tone → suppress the hyperexcitable state", {
    x: 0.3, y: 5.18, w: 9.4, h: 0.28,
    fontSize: 10.5, italic: true, color: NAVY, fontFace: "Calibri"
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 5 — CLINICAL TIMELINE
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addBg(s, NAVY);
  s.addText("Clinical Timeline of Alcohol Withdrawal", {
    x: 0.4, y: 0.12, w: 9.2, h: 0.52,
    fontSize: 22, bold: true, color: WHITE, fontFace: "Calibri"
  });
  s.addShape(pres.shapes.RECTANGLE, { x: 0.4, y: 0.66, w: 9.2, h: 0.05, fill: { color: AMBER } });

  // Timeline axis
  s.addShape(pres.shapes.RECTANGLE, { x: 0.5, y: 3.1, w: 9, h: 0.06, fill: { color: AMBER } });
  s.addText("LAST DRINK →", { x: 0.5, y: 3.22, w: 2, h: 0.3, fontSize: 9, color: AMBER, fontFace: "Calibri" });
  s.addText("TIME", { x: 8.5, y: 3.22, w: 1, h: 0.3, fontSize: 9, color: AMBER, fontFace: "Calibri" });

  const events = [
    { h: "6-8h",   label: "Tremor\nAnxiety\nDiaphoresis", x: 1.0,  color: GREEN,  danger: false },
    { h: "12-24h", label: "SEIZURES\n(Tonic-Clonic)\nPeak risk", x: 3.0, color: AMBER,  danger: true  },
    { h: "12-36h", label: "Hallucinations\n(Visual/Auditory)", x: 5.1, color: "E67E22", danger: false },
    { h: "48-72h+",label: "DELIRIUM\nTREMENS", x: 7.2,  color: RED,    danger: true  },
  ];

  events.forEach(ev => {
    // pole
    s.addShape(pres.shapes.RECTANGLE, { x: ev.x + 0.55, y: 1.0, w: 0.05, h: 2.1, fill: { color: ev.color } });
    // top flag
    s.addShape(pres.shapes.RECTANGLE, {
      x: ev.x, y: ev.danger ? 0.75 : 0.75, w: 1.2, h: 1.0,
      fill: { color: ev.color }, shadow: { type: "outer", color: "000000", blur: 4, offset: 2, angle: 135, opacity: 0.25 }
    });
    s.addText(ev.h, {
      x: ev.x + 0.03, y: 0.78, w: 1.14, h: 0.26,
      fontSize: 10, bold: true, color: WHITE, align: "center", fontFace: "Calibri"
    });
    s.addText(ev.label, {
      x: ev.x + 0.03, y: 1.04, w: 1.14, h: 0.66,
      fontSize: 8.5, color: WHITE, align: "center", fontFace: "Calibri"
    });
    // dot on axis
    s.addShape(pres.shapes.OVAL, {
      x: ev.x + 0.48, y: 3.03, w: 0.19, h: 0.19, fill: { color: ev.color }
    });
  });

  // Bottom key facts
  const facts = [
    "90% of patients have 1-6 GTC seizures",
    "60% of seizures cluster within 6 hours",
    "~30% of AWS patients progress to delirium tremens",
    "Delirium tremens mortality: 1-5% (untreated: up to 15%)",
  ];
  facts.forEach((f, i) => {
    s.addText([
      { text: "◆  ", options: { color: AMBER, bold: true } },
      { text: f, options: { color: WHITE } }
    ], {
      x: 0.5 + (i % 2) * 4.7,
      y: 3.6 + Math.floor(i / 2) * 0.5,
      w: 4.5, h: 0.42,
      fontSize: 11, fontFace: "Calibri"
    });
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 6 — CIWA-Ar SCORING
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addBg(s, WHITE);
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.55, fill: { color: TEAL } });
  s.addText("CIWA-Ar: Clinical Institute Withdrawal Assessment for Alcohol (Revised)", {
    x: 0.3, y: 0.05, w: 9.4, h: 0.45,
    fontSize: 16, bold: true, color: WHITE, fontFace: "Calibri"
  });

  // Left: 10 items
  s.addText("10 Assessed Parameters", {
    x: 0.3, y: 0.65, w: 4.5, h: 0.38,
    fontSize: 14, bold: true, color: NAVY, fontFace: "Calibri"
  });

  const items = [
    "1. Nausea / Vomiting",
    "2. Tremor",
    "3. Paroxysmal Sweats",
    "4. Anxiety",
    "5. Agitation",
    "6. Tactile Disturbances",
    "7. Auditory Disturbances",
    "8. Visual Disturbances",
    "9. Headache / Fullness in Head",
    "10. Orientation / Clouding of Sensorium",
  ];
  items.forEach((item, i) => {
    s.addText(item, {
      x: 0.3, y: 1.1 + i * 0.41,
      w: 4.4, h: 0.37,
      fontSize: 11, color: DGRAY, fontFace: "Calibri",
      bullet: { type: "number" }
    });
  });

  // Right: severity table
  s.addText("Severity & Action", {
    x: 5.2, y: 0.65, w: 4.5, h: 0.38,
    fontSize: 14, bold: true, color: NAVY, fontFace: "Calibri"
  });

  const rows = [
    { score: "≤ 8",    sev: "Mild",     action: "Monitor; no BZD needed",                  col: GREEN },
    { score: "9-14",   sev: "Moderate", action: "Symptomatic BZD; close monitoring",         col: AMBER },
    { score: "15-19",  sev: "Severe",   action: "Chlordiazepoxide taper; hospitalise",       col: "E67E22" },
    { score: "≥ 20",   sev: "Critical", action: "IV BZD; consider ICU; monitor DT risk",     col: RED },
  ];
  rows.forEach((r, i) => {
    const y = 1.12 + i * 1.02;
    s.addShape(pres.shapes.RECTANGLE, { x: 5.15, y, w: 4.6, h: 0.92, fill: { color: LGRAY } });
    s.addShape(pres.shapes.RECTANGLE, { x: 5.15, y, w: 0.85, h: 0.92, fill: { color: r.col } });
    s.addText(r.score, { x: 5.15, y: y + 0.14, w: 0.85, h: 0.6, fontSize: 14, bold: true, color: WHITE, align: "center", fontFace: "Calibri" });
    s.addText(r.sev, { x: 6.08, y: y + 0.06, w: 3.6, h: 0.34, fontSize: 12, bold: true, color: DGRAY, fontFace: "Calibri" });
    s.addText(r.action, { x: 6.08, y: y + 0.44, w: 3.6, h: 0.38, fontSize: 9.5, color: "55667A", fontFace: "Calibri" });
  });

  s.addText("Max score = 67  |  Each item scored 0-7  |  Complete in ~5 minutes  |  Score every 4-8h during detox", {
    x: 0.3, y: 5.25, w: 9.4, h: 0.3,
    fontSize: 9.5, color: TEAL, italic: true, fontFace: "Calibri"
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 7 — SECTION DIVIDER: PHARMACOTHERAPY
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  sectionTitle(s, "PHARMACOTHERAPY", "Benzodiazepines, Thiamine & Adjuncts");
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 8 — BENZODIAZEPINES (First-Line)
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addBg(s, WHITE);
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.55, fill: { color: NAVY } });
  s.addText("Benzodiazepines — First-Line Treatment for AWS", {
    x: 0.3, y: 0.07, w: 9.4, h: 0.42,
    fontSize: 18, bold: true, color: WHITE, fontFace: "Calibri"
  });

  // Why BZDs?
  s.addShape(pres.shapes.RECTANGLE, { x: 0.25, y: 0.65, w: 9.5, h: 0.34, fill: { color: LGRAY } });
  s.addText("Why Benzodiazepines? Cross-tolerance with alcohol → restore GABA-A inhibition → suppress neuronal hyperexcitability & raise seizure threshold", {
    x: 0.35, y: 0.67, w: 9.3, h: 0.3, fontSize: 10.5, color: DGRAY, italic: true, fontFace: "Calibri"
  });

  const drugs = [
    {
      name: "Chlordiazepoxide",
      type: "Long-acting (gold standard for detox)",
      dose: "Starting dose = alcohol units/day (mg QID)\ne.g. 20 units → 20mg QID, then taper over 5-7 days",
      pros: ["Low dependence potential", "Self-tapering via active metabolites", "Preferred in most centres (NICE)"],
      cons: ["Avoid in liver failure (use oxazepam/lorazepam)", "Long half-life risk in elderly"],
      color: TEAL,
    },
    {
      name: "Diazepam",
      type: "Long-acting (used for acute seizures / step-down)",
      dose: "5-10mg orally TID-QID, tapering\nIV 5-10mg for acute seizure control",
      pros: ["Rapid onset IV", "Effective for acute control", "Step-down from chlordiazepoxide"],
      cons: ["Higher abuse potential", "Accumulates in liver disease"],
      color: "1A5276",
    },
    {
      name: "Lorazepam",
      type: "Short-acting (acute seizure use only)",
      dose: "IV 2mg SOS for active seizure\nRepeat q5-10min if needed",
      pros: ["Only BZD proven to ↓ seizure recurrence (NNT=5)", "Safe in liver disease", "Predictable IM absorption"],
      cons: ["Does not self-taper", "Not suitable for full detox course"],
      color: AMBER,
    },
  ];

  drugs.forEach((d, i) => {
    const x = 0.22 + i * 3.26;
    s.addShape(pres.shapes.RECTANGLE, { x, y: 1.1, w: 3.1, h: 4.35, fill: { color: LGRAY } });
    s.addShape(pres.shapes.RECTANGLE, { x, y: 1.1, w: 3.1, h: 0.52, fill: { color: d.color } });
    s.addText(d.name, { x: x + 0.1, y: 1.13, w: 2.9, h: 0.28, fontSize: 12, bold: true, color: WHITE, fontFace: "Calibri" });
    s.addText(d.type, { x: x + 0.1, y: 1.38, w: 2.9, h: 0.22, fontSize: 8.5, color: WHITE, fontFace: "Calibri", italic: true });

    s.addText("DOSE:", { x: x + 0.1, y: 1.72, w: 0.6, h: 0.22, fontSize: 9, bold: true, color: d.color, fontFace: "Calibri" });
    s.addText(d.dose, { x: x + 0.1, y: 1.93, w: 2.9, h: 0.7, fontSize: 9, color: DGRAY, fontFace: "Calibri" });

    s.addText("✓ Advantages:", { x: x + 0.1, y: 2.72, w: 2.9, h: 0.25, fontSize: 9.5, bold: true, color: GREEN, fontFace: "Calibri" });
    d.pros.forEach((p, j) => {
      s.addText("• " + p, { x: x + 0.1, y: 2.98 + j * 0.3, w: 2.9, h: 0.28, fontSize: 8.5, color: DGRAY, fontFace: "Calibri" });
    });

    s.addText("⚠ Cautions:", { x: x + 0.1, y: 3.95, w: 2.9, h: 0.25, fontSize: 9.5, bold: true, color: RED, fontFace: "Calibri" });
    d.cons.forEach((c, j) => {
      s.addText("• " + c, { x: x + 0.1, y: 4.2 + j * 0.3, w: 2.9, h: 0.28, fontSize: 8.5, color: DGRAY, fontFace: "Calibri" });
    });
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 9 — THIAMINE & ADJUNCT THERAPY
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addBg(s, WHITE);
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.55, fill: { color: TEAL } });
  s.addText("Thiamine & Adjunct Pharmacotherapy", {
    x: 0.3, y: 0.08, w: 9.4, h: 0.42,
    fontSize: 20, bold: true, color: WHITE, fontFace: "Calibri"
  });

  // THIAMINE BOX (big)
  s.addShape(pres.shapes.RECTANGLE, { x: 0.25, y: 0.68, w: 5.8, h: 3.0, fill: { color: LGRAY } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0.25, y: 0.68, w: 5.8, h: 0.45, fill: { color: "8B4513" } });
  s.addText("⭐ THIAMINE (Vitamin B1) — MANDATORY IN ALL CASES", {
    x: 0.35, y: 0.71, w: 5.6, h: 0.38,
    fontSize: 11, bold: true, color: WHITE, fontFace: "Calibri"
  });

  const thi = [
    ["Why?", "Alcoholics are thiamine-deficient: poor diet + impaired GI absorption + hepatic storage depletion"],
    ["Critical rule:", "Give thiamine BEFORE or WITH glucose/dextrose — glucose load in deficient patient precipitates Wernicke's Encephalopathy"],
    ["Inpatient dose:", "100-200mg IV/IM OD (Pabrinex or thiamine injection); 200mg IV used in this case"],
    ["Discharge:", "100mg oral BD x 14 days minimum; longer if malnourished"],
    ["Prevents:", "Wernicke's Encephalopathy → Korsakoff Syndrome (irreversible amnesia)"],
  ];
  thi.forEach((row, i) => {
    s.addText(row[0], {
      x: 0.35, y: 1.2 + i * 0.47, w: 1.1, h: 0.38,
      fontSize: 9.5, bold: true, color: "8B4513", fontFace: "Calibri"
    });
    s.addText(row[1], {
      x: 1.5, y: 1.2 + i * 0.47, w: 4.4, h: 0.38,
      fontSize: 9.5, color: DGRAY, fontFace: "Calibri"
    });
  });

  // Right column: adjuncts
  const adjuncts = [
    {
      drug: "Sodium Valproate",
      use: "Seizure prophylaxis (esp. if pre-existing epilepsy)",
      dose: "200mg BD-TID",
      note: "Not first-line for AWS alone but useful for comorbid epilepsy"
    },
    {
      drug: "Levetiracetam",
      use: "Add-on anticonvulsant in complex cases",
      dose: "500mg IV/oral BD",
      note: "Used when seizure risk is high; taper once withdrawal phase passes"
    },
    {
      drug: "Pantoprazole",
      use: "Gastric protection (alcohol erosions, GERD)",
      dose: "40mg IV/oral OD",
      note: "Step down to oral once tolerating food"
    },
    {
      drug: "B-Complex",
      use: "Replenish B2, B6, B12, folate — all depleted",
      dose: "1-0-1 orally",
      note: "Continue for weeks; supports neurological recovery"
    },
  ];

  adjuncts.forEach((a, i) => {
    const y = 0.68 + i * 1.15;
    s.addShape(pres.shapes.RECTANGLE, { x: 6.25, y, w: 3.5, h: 1.05, fill: { color: LGRAY } });
    s.addShape(pres.shapes.RECTANGLE, { x: 6.25, y, w: 0.1, h: 1.05, fill: { color: TEAL } });
    s.addText(a.drug, { x: 6.42, y: y + 0.04, w: 3.2, h: 0.3, fontSize: 11, bold: true, color: NAVY, fontFace: "Calibri" });
    s.addText(a.use + " — " + a.dose, { x: 6.42, y: y + 0.33, w: 3.2, h: 0.3, fontSize: 9, color: DGRAY, fontFace: "Calibri" });
    s.addText(a.note, { x: 6.42, y: y + 0.66, w: 3.2, h: 0.3, fontSize: 8.5, color: "667788", fontFace: "Calibri", italic: true });
  });

  s.addShape(pres.shapes.RECTANGLE, { x: 0.25, y: 3.77, w: 5.8, h: 0.55, fill: { color: "FFF3CD" } });
  s.addText("⚠  CARDINAL RULE: Thiamine → THEN glucose. Never glucose before thiamine in a suspected deficient patient.", {
    x: 0.35, y: 3.79, w: 5.6, h: 0.44,
    fontSize: 10, bold: true, color: RED, fontFace: "Calibri"
  });

  // Electrolytes reminder
  s.addShape(pres.shapes.RECTANGLE, { x: 0.25, y: 4.4, w: 9.5, h: 0.96, fill: { color: LGRAY } });
  s.addText("Electrolyte Correction (Do Not Forget):", {
    x: 0.4, y: 4.44, w: 4, h: 0.28, fontSize: 11, bold: true, color: NAVY, fontFace: "Calibri"
  });
  const electros = [
    "Potassium (K⁺): Hypokalemia (common; lowers seizure threshold) → Oral/IV KCl",
    "Magnesium: Deficiency causes refractory hypokalemia → IV MgSO₄",
    "Glucose: Monitor for hypoglycemia (especially in liver disease)",
    "Sodium: Hyponatremia can mimic/precipitate seizures",
  ];
  electros.forEach((e, i) => {
    s.addText("• " + e, {
      x: 0.4 + (i % 2) * 4.7,
      y: 4.75 + Math.floor(i / 2) * 0.28,
      w: 4.55, h: 0.26,
      fontSize: 9, color: DGRAY, fontFace: "Calibri"
    });
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 10 — DELIRIUM TREMENS
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addBg(s, NAVY);
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.55, fill: { color: RED } });
  s.addText("⚠  DELIRIUM TREMENS — The Most Dangerous Complication", {
    x: 0.3, y: 0.07, w: 9.4, h: 0.42,
    fontSize: 17, bold: true, color: WHITE, fontFace: "Calibri"
  });

  // Key facts banner
  s.addShape(pres.shapes.RECTANGLE, { x: 0.25, y: 0.68, w: 9.5, h: 0.5, fill: { color: "1A1A2E" } });
  s.addText("Onset: 48-72h after last drink  |  Occurs in ~30% of AWS  |  Untreated mortality: up to 15%  |  Treated mortality: 1-5%", {
    x: 0.35, y: 0.72, w: 9.3, h: 0.38,
    fontSize: 11, color: AMBER, align: "center", fontFace: "Calibri", bold: true
  });

  // Features + Management side by side
  // Features
  s.addShape(pres.shapes.RECTANGLE, { x: 0.25, y: 1.28, w: 4.5, h: 0.36, fill: { color: RED } });
  s.addText("Clinical Features", { x: 0.35, y: 1.3, w: 4.3, h: 0.3, fontSize: 13, bold: true, color: WHITE, fontFace: "Calibri" });
  const features = [
    "Disorientation and confusion",
    "Agitation / combativeness",
    "Fever (>38.5°C)",
    "Profuse diaphoresis",
    "Tachycardia (HR >100)",
    "Hypertension",
    "Vivid visual hallucinations",
    "Autonomic instability",
    "Risk of status epilepticus",
  ];
  features.forEach((f, i) => {
    s.addText([
      { text: "✕  ", options: { color: RED, bold: true } },
      { text: f, options: { color: WHITE } }
    ], { x: 0.35, y: 1.72 + i * 0.37, w: 4.3, h: 0.34, fontSize: 10.5, fontFace: "Calibri" });
  });

  // Management
  s.addShape(pres.shapes.RECTANGLE, { x: 5.0, y: 1.28, w: 4.75, h: 0.36, fill: { color: TEAL } });
  s.addText("Management", { x: 5.1, y: 1.3, w: 4.5, h: 0.3, fontSize: 13, bold: true, color: WHITE, fontFace: "Calibri" });
  const mgmt = [
    ["ICU Admission", "Continuous monitoring essential"],
    ["IV BZD loading", "Diazepam 10mg IV q10min until calm; or lorazepam 2-4mg IV"],
    ["Thiamine IV", "200mg IV BEFORE any glucose — non-negotiable"],
    ["IV Fluids", "Rehydration + electrolyte correction (K⁺, Mg²⁺)"],
    ["Phenobarbital", "BZD-refractory cases — adjunct anticonvulsant"],
    ["Antipsychotics", "Haloperidol for agitation (not for seizures)"],
    ["Airway", "Intubation if repeated IV boluses needed or GCS falls"],
    ["Treat triggers", "Infection, pain, metabolic — common precipitants"],
  ];
  mgmt.forEach((m, i) => {
    s.addText(m[0] + ":", { x: 5.1, y: 1.72 + i * 0.37, w: 1.5, h: 0.34, fontSize: 9.5, bold: true, color: AMBER, fontFace: "Calibri" });
    s.addText(m[1], { x: 6.65, y: 1.72 + i * 0.37, w: 3.0, h: 0.34, fontSize: 9.5, color: WHITE, fontFace: "Calibri" });
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 11 — WERNICKE-KORSAKOFF
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addBg(s, WHITE);
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.55, fill: { color: "8B4513" } });
  s.addText("Wernicke-Korsakoff Syndrome — Thiamine Deficiency Spectrum", {
    x: 0.3, y: 0.07, w: 9.4, h: 0.42,
    fontSize: 17, bold: true, color: WHITE, fontFace: "Calibri"
  });

  // Two columns: Wernicke | Korsakoff
  const sides = [
    {
      title: "WERNICKE'S ENCEPHALOPATHY",
      subtitle: "Acute — Reversible if treated early",
      color: AMBER,
      items: [
        "Classic triad (present in <20%!):",
        "  → Ophthalmoplegia / Nystagmus",
        "  → Ataxia",
        "  → Confusion / Altered consciousness",
        "",
        "Broader symptoms to watch for:",
        "  → Hypothermia, Hypotension",
        "  → Memory disturbance",
        "  → Peripheral neuropathy",
        "",
        "Treatment: 200-500mg thiamine IV TID x 3 days",
        "Reversible with prompt treatment",
      ]
    },
    {
      title: "KORSAKOFF SYNDROME",
      subtitle: "Chronic — Often irreversible",
      color: RED,
      items: [
        "Develops from untreated Wernicke's",
        "Classic features:",
        "  → Severe anterograde amnesia",
        "  → Retrograde amnesia",
        "  → Confabulation (fabricated memories)",
        "  → Personality change",
        "  → Relatively preserved intelligence",
        "",
        "Damage: mammillary bodies + thalamus",
        "80% have persistent deficits",
        "Prevention is the ONLY effective strategy",
      ]
    }
  ];

  sides.forEach((side, i) => {
    const x = 0.25 + i * 4.9;
    s.addShape(pres.shapes.RECTANGLE, { x, y: 0.65, w: 4.6, h: 4.75, fill: { color: LGRAY } });
    s.addShape(pres.shapes.RECTANGLE, { x, y: 0.65, w: 4.6, h: 0.75, fill: { color: side.color } });
    s.addText(side.title, { x: x + 0.1, y: 0.68, w: 4.4, h: 0.38, fontSize: 12, bold: true, color: WHITE, fontFace: "Calibri" });
    s.addText(side.subtitle, { x: x + 0.1, y: 1.02, w: 4.4, h: 0.3, fontSize: 9.5, color: WHITE, italic: true, fontFace: "Calibri" });
    side.items.forEach((item, j) => {
      if (item === "") return;
      s.addText(item, {
        x: x + 0.12, y: 1.5 + j * 0.32, w: 4.35, h: 0.3,
        fontSize: 10, color: DGRAY, fontFace: "Calibri",
        bold: item.endsWith(":") || item.startsWith("Treatment")
      });
    });
  });

  // Bottom prevention rule
  s.addShape(pres.shapes.RECTANGLE, { x: 0.25, y: 5.22, w: 9.5, h: 0.3, fill: { color: "FFF3CD" } });
  s.addText("Prevention = Prophylactic IV/IM Thiamine in ALL hospitalised alcohol-dependent patients before any glucose administration", {
    x: 0.35, y: 5.24, w: 9.3, h: 0.24,
    fontSize: 9.5, bold: true, color: RED, fontFace: "Calibri"
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 12 — DRUG THERAPY PROBLEMS (Pharmacist Interventions)
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addBg(s, WHITE);
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.55, fill: { color: NAVY } });
  s.addText("Drug Therapy Problems — Pharmacist Interventions", {
    x: 0.3, y: 0.07, w: 9.4, h: 0.42,
    fontSize: 18, bold: true, color: WHITE, fontFace: "Calibri"
  });

  const dtps = [
    { no: "1", type: "ADR Prevention", prob: "Thiamine–glucose sequencing", action: "Confirm thiamine given BEFORE dextrose; educate nurses on MAR", col: TEAL },
    { no: "2", type: "Needs Drug Therapy", prob: "Hypokalemia untreated (K 3.13)", action: "Recommend KCl supplementation; add MgSO₄ to prevent refractory hypokalemia", col: RED },
    { no: "3", type: "ADR / Monitoring", prob: "Elevated lipase (188 U/L)", action: "Alert physician re: pancreatitis; monitor trend; counsel on alcohol", col: AMBER },
    { no: "4", type: "Dosing / Monitoring", prob: "No CIWA-Ar score documented", action: "Recommend CIWA-Ar q4-8h; adjust BZD dose to objective score", col: "1A5276" },
    { no: "5", type: "Unnecessary Drug?", prob: "Levetiracetam role unclear", action: "Clarify if pre-existing epilepsy separate from AWS; formalize epilepsy plan", col: "6C3483" },
    { no: "6", type: "Route / Omission", prob: "IV PPI not stepped to oral; not on discharge Rx", action: "Step down to oral pantoprazole by Day 2-3; verify discharge omission intentional", col: "117A65" },
  ];

  dtps.forEach((d, i) => {
    const x = 0.18 + (i % 2) * 4.92;
    const y = 0.68 + Math.floor(i / 2) * 1.6;
    s.addShape(pres.shapes.RECTANGLE, {
      x, y, w: 4.7, h: 1.48,
      fill: { color: WHITE },
      shadow: { type: "outer", color: "AAAAAA", blur: 4, offset: 1, angle: 135, opacity: 0.15 }
    });
    s.addShape(pres.shapes.RECTANGLE, { x, y, w: 0.52, h: 1.48, fill: { color: d.col } });
    s.addText(d.no, { x, y: y + 0.48, w: 0.52, h: 0.5, fontSize: 18, bold: true, color: WHITE, align: "center", fontFace: "Calibri" });
    s.addText(d.type, { x: x + 0.6, y: y + 0.08, w: 4.0, h: 0.28, fontSize: 10, bold: true, color: d.col, fontFace: "Calibri" });
    s.addText("Problem: " + d.prob, { x: x + 0.6, y: y + 0.38, w: 4.0, h: 0.38, fontSize: 9.5, color: DGRAY, fontFace: "Calibri" });
    s.addText("Action: " + d.action, { x: x + 0.6, y: y + 0.76, w: 4.0, h: 0.58, fontSize: 9, color: "445566", fontFace: "Calibri", italic: true });
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 13 — DISCHARGE & COUNSELING
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addBg(s, WHITE);
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.55, fill: { color: TEAL } });
  s.addText("Discharge Medications & Patient Counseling", {
    x: 0.3, y: 0.07, w: 9.4, h: 0.42,
    fontSize: 20, bold: true, color: WHITE, fontFace: "Calibri"
  });

  // Discharge meds table
  s.addText("Discharge Prescription (x14 days)", {
    x: 0.3, y: 0.65, w: 5.5, h: 0.32,
    fontSize: 13, bold: true, color: NAVY, fontFace: "Calibri"
  });
  const meds = [
    ["Drug", "Dose", "Schedule", "Purpose"],
    ["T. Thiamine", "100mg", "1–0–1", "Rebuild B1 stores; prevent WE recurrence"],
    ["T. Diazepam", "5mg", "0–0–2", "Continued gradual detox / nocte seizure prophylaxis"],
    ["T. Sodium Valproate", "200mg", "2–0–2", "Anticonvulsant maintenance (epilepsy + AWS)"],
    ["B-Complex Tablet", "—", "1–0–1", "Replenish B2, B6, B12, folate"],
  ];
  const colW = [1.9, 0.7, 0.8, 2.3];
  const colX = [0.3, 2.22, 2.95, 3.78];
  meds.forEach((row, ri) => {
    const y = 1.02 + ri * 0.45;
    const bg = ri === 0 ? NAVY : ri % 2 === 0 ? LGRAY : WHITE;
    s.addShape(pres.shapes.RECTANGLE, { x: 0.3, y, w: 5.78, h: 0.43, fill: { color: bg } });
    row.forEach((cell, ci) => {
      s.addText(cell, {
        x: colX[ci] + 0.05, y: y + 0.05, w: colW[ci] - 0.1, h: 0.34,
        fontSize: ri === 0 ? 10 : 9.5,
        bold: ri === 0 || ci === 0,
        color: ri === 0 ? WHITE : DGRAY,
        fontFace: "Calibri"
      });
    });
  });

  // Counseling points
  s.addText("Key Patient Counseling Points", {
    x: 6.35, y: 0.65, w: 3.4, h: 0.32,
    fontSize: 13, bold: true, color: NAVY, fontFace: "Calibri"
  });
  const counsel = [
    ["🚫", "No alcohol", "Even one drink can restart the cycle — relapse triggers seizures"],
    ["💊", "Adherence", "Complete full 14-day course; do not stop valproate suddenly"],
    ["🍳", "With food", "Take valproate with meals to reduce nausea"],
    ["⚠", "Diazepam", "Nocte only; no extra doses; extremely dangerous with alcohol"],
    ["🔁", "Follow-up", "Repeat LFTs, serum K, lipase in 2 weeks"],
    ["🏥", "Return if:", "Shaking, confusion, hallucinations, severe abdominal pain"],
    ["🧠", "Referral", "De-addiction psychiatry; structured support program"],
  ];
  counsel.forEach((c, i) => {
    s.addShape(pres.shapes.RECTANGLE, { x: 6.3, y: 1.02 + i * 0.61, w: 3.45, h: 0.55, fill: { color: i % 2 === 0 ? LGRAY : WHITE } });
    s.addText(c[0], { x: 6.33, y: 1.07 + i * 0.61, w: 0.35, h: 0.4, fontSize: 14, align: "center" });
    s.addText(c[1] + ": ", { x: 6.72, y: 1.07 + i * 0.61, w: 0.75, h: 0.2, fontSize: 9, bold: true, color: NAVY, fontFace: "Calibri" });
    s.addText(c[2], { x: 6.72, y: 1.27 + i * 0.61, w: 2.9, h: 0.26, fontSize: 8.5, color: DGRAY, fontFace: "Calibri" });
  });

  // Warning signs row
  s.addShape(pres.shapes.RECTANGLE, { x: 0.3, y: 5.0, w: 9.4, h: 0.5, fill: { color: "FFF3CD" } });
  s.addText("⚠  Warn patient: Stopping alcohol suddenly at home WITHOUT medical supervision is dangerous — advise supervised detox program", {
    x: 0.4, y: 5.03, w: 9.2, h: 0.42,
    fontSize: 10, bold: true, color: RED, fontFace: "Calibri"
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 14 — SUMMARY / KEY TAKEAWAYS
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addBg(s, NAVY);
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.08, fill: { color: AMBER } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 5.545, w: 10, h: 0.08, fill: { color: AMBER } });

  s.addText("10 KEY TAKEAWAYS", {
    x: 0.5, y: 0.18, w: 9, h: 0.52,
    fontSize: 28, bold: true, color: WHITE, align: "center", fontFace: "Calibri", charSpacing: 3
  });
  s.addShape(pres.shapes.RECTANGLE, { x: 3.0, y: 0.72, w: 4, h: 0.06, fill: { color: AMBER } });

  const takes = [
    ["01", "AWS seizures peak 12-24h after last drink (up to 48h)"],
    ["02", "Mechanism: GABA-A down-regulation + NMDA up-regulation → hyperexcitability"],
    ["03", "CIWA-Ar score every 4-8h guides benzodiazepine dosing — use it"],
    ["04", "Chlordiazepoxide = gold standard for detox; Lorazepam IV for acute seizures (NNT=5)"],
    ["05", "THIAMINE BEFORE GLUCOSE — non-negotiable rule; prevents Wernicke's"],
    ["06", "Hypokalemia + Hypomagnesemia → lower seizure threshold — correct both"],
    ["07", "Delirium tremens onset 48-72h; mortality up to 15% untreated — escalate early"],
    ["08", "GGT is the most sensitive enzyme marker for chronic alcohol use"],
    ["09", "Pharmacist: identify DTPs (untreated hypokalemia, CIWA-Ar omission, sequencing)"],
    ["10", "Discharge counseling + de-addiction referral = essential to prevent relapse"],
  ];

  takes.forEach((t, i) => {
    const col = i < 5 ? 0 : 1;
    const row = i % 5;
    const x = 0.3 + col * 4.9;
    const y = 0.88 + row * 0.88;
    s.addShape(pres.shapes.RECTANGLE, { x, y, w: 4.6, h: 0.78, fill: { color: "0A2540" } });
    s.addShape(pres.shapes.RECTANGLE, { x, y, w: 0.48, h: 0.78, fill: { color: AMBER } });
    s.addText(t[0], { x, y: y + 0.17, w: 0.48, h: 0.44, fontSize: 14, bold: true, color: NAVY, align: "center", fontFace: "Calibri" });
    s.addText(t[1], { x: x + 0.55, y: y + 0.1, w: 3.97, h: 0.58, fontSize: 10, color: WHITE, fontFace: "Calibri" });
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// WRITE FILE
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
pres.writeFile({ fileName: "/home/daytona/workspace/aws-presentation/Alcohol_Withdrawal_Management.pptx" })
  .then(() => console.log("DONE"))
  .catch(e => { console.error("ERROR", e); process.exit(1); });

cd /home/daytona/workspace/aws-presentation && node build.js 2>&1

ls -lh /home/daytona/workspace/aws-presentation/Alcohol_Withdrawal_Management.pp…