ls /home/daytona/workspace/ 2>/dev/null || echo "workspace empty or not found"

mkdir -p /home/daytona/workspace/criminal-abortion-ppt

~/criminal-abortion-ppt/create_ppt.js

const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = 'LAYOUT_16x9';
pres.title = 'Criminal Abortion & MTP Act';
pres.author = 'Forensic Medicine - MBBS Final Year';

// Color palette
const DARK_BG = "1A1A2E";
const ACCENT = "E94560";
const LIGHT_BLUE = "16213E";
const CARD_BG = "0F3460";
const WHITE = "FFFFFF";
const LIGHT_GRAY = "E8E8E8";
const YELLOW_ACC = "FFD700";
const GREEN_ACC = "00C896";
const ORANGE_ACC = "FF6B35";
const SECTION_BG = "0D1B2A";

// ── helpers ──────────────────────────────────────────────────────────────────
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}

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}

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function tableSlide(title, tableData, colWidths) {
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// ── SLIDE 1: Title ────────────────────────────────────────────────────────────
titleSlide("Criminal Abortion &\nMTP Act 1971 (Amendment 2021)", "A Case-Based Forensic Medicine Discussion");

// ── SLIDE 2: Clinical Scenario ────────────────────────────────────────────────
{
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}

// ── SLIDE 3: Outline ──────────────────────────────────────────────────────────
{
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    ["01", "Definition & Classification of Abortion", ACCENT],
    ["02", "Medico-Legal Duties of the Doctor", GREEN_ACC],
    ["03", "Methods Used for Criminal Abortion", ORANGE_ACC],
    ["04", "Complications of Criminal Abortion", YELLOW_ACC],
    ["05", "MTP Act 1971 & Amendment Act 2021", "00BFFF"],
    ["06", "Summary & Key Points", "CC99FF"],
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}

// ══════════════════════════════════════════════════════════════════════════════
// SECTION 1: ABORTION - DEFINITIONS & CLASSIFICATION
// ══════════════════════════════════════════════════════════════════════════════
sectionDivider("Section 1", "Definition & Classification of Abortion");

// Slide 5: Medical & Legal Definitions
twoColumnSlide(
  "Definition of Abortion",
  "Medical Definition",
  [
    "Spontaneous or induced expulsion of products of conception before viability (before 28 weeks)",
    "Premature labor: delivery after 28 weeks up to 40th week",
    "Abortion = 1st trimester",
    "Miscarriage = 2nd trimester",
    "Premature labor = 3rd trimester",
  ],
  "Legal Definition",
  [
    "Expulsion of products of conception at ANY period prior to full term",
    "Products: ovum, embryo or fetus",
    "Law makes NO distinction between abortion, miscarriage & premature labor",
    "All three terms are synonymous legally",
  ]
);

// Slide 6: Terminology
contentSlide("Terminology - Products of Conception", [
  "Ovum → product of conception between 7–10 days of gestation",
  "Embryo → after 10 days until end of 9th week of gestation",
  "Fetus → more than 9 weeks of intrauterine life until birth",
  "Abortus → any product (or all products) of an abortion",
  "Viability → ability of fetus to survive outside uterus (traditionally 28 weeks; now ~22–24 weeks with NICU support)",
  "Quick child → fetus that has quickened (movement felt ~16–20 weeks); relevant in IPC Sec 315-316",
]);

// Slide 7: Classification
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  });
  const cats = [
    { label: "1. Natural / Spontaneous", items: ["Spontaneous (natural causes before 28 weeks)", "Accidental"], color: GREEN_ACC },
    { label: "2. Artificial / Induced", items: ["Justifiable (Legal)", "Criminal (Unlawful)"], color: ACCENT },
    { label: "3. Clinical Types", items: ["Threatened, Inevitable, Incomplete, Complete", "Missed, Septic, Habitual/Recurrent"], color: YELLOW_ACC },
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// Slide 8: Clinical types detail
contentSlide("Clinical Types of Abortion", [
  "Threatened: Vaginal bleeding + closed cervical os + mild pain | Conservative management",
  "Inevitable: Severe pain + dilated cervix + increased uterine contractions | Cannot be prevented",
  "Incomplete: Partial expulsion of POC | Retention of placenta → continuous bleeding | Needs surgical evacuation + ergometrine",
  "Complete: All POC expelled completely | Uterus well-contracted | Cervix closed",
  "Missed: Fetus dies in utero, retained >8 weeks | Brown discharge | Products become carneous mole / blood mole",
  "Septic: Infected abortion | Fever, uterine tenderness, foul-smelling discharge | May cause septicemia",
  "Habitual/Recurrent: ≥3 consecutive spontaneous abortions",
  "Criminal: Induced unlawfully without any therapeutic indication",
]);

// Slide 9: Natural vs Criminal Abortion Table
tableSlide("Natural vs Criminal Abortion", [
  [
    { text: "Feature", options: { bold: true, color: YELLOW_ACC, fill: { color: "1a2a4a" }, fontSize: 13 } },
    { text: "Natural Abortion", options: { bold: true, color: GREEN_ACC, fill: { color: "1a2a4a" }, fontSize: 13 } },
    { text: "Criminal Abortion", options: { bold: true, color: ACCENT, fill: { color: "1a2a4a" }, fontSize: 13 } },
  ],
  [
    { text: "Person affected", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 12 } },
    { text: "Any woman; predisposing disease", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 12 } },
    { text: "Usually unmarried woman or widow", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 12 } },
  ],
  [
    { text: "Infection", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 12 } },
    { text: "Rare", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 12 } },
    { text: "Frequent", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 12 } },
  ],
  [
    { text: "Abdominal violence marks", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 12 } },
    { text: "Absent", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 12 } },
    { text: "May be present", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 12 } },
  ],
  [
    { text: "Genital injuries", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 12 } },
    { text: "Absent", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 12 } },
    { text: "Present (lacerations, perforations)", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 12 } },
  ],
  [
    { text: "Toxic drug effects", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 12 } },
    { text: "Absent", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 12 } },
    { text: "Present (abortifacients)", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 12 } },
  ],
  [
    { text: "Foreign bodies in genital tract", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 12 } },
    { text: "Absent", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 12 } },
    { text: "May be found", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 12 } },
  ],
  [
    { text: "Fetal wounds", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 12 } },
    { text: "Absent", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 12 } },
    { text: "Present", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 12 } },
  ],
], [2.5, 3.2, 3.7]);

// ══════════════════════════════════════════════════════════════════════════════
// SECTION 2: CRIMINAL ABORTION - DEFINITION & CONTEXT
// ══════════════════════════════════════════════════════════════════════════════
sectionDivider("Criminal Abortion", "Definition, Context & Legal Provisions");

// Slide 11: Definition of Criminal Abortion
contentSlide("Criminal Abortion — Definition", [
  "Induced destruction or expulsion of the fetus from the womb of the mother UNLAWFULLY",
  "Performed WITHOUT any therapeutic indication",
  "Done by any person — qualified or unqualified — outside legal framework",
  "IPC SECTIONS (now under BNS 2023):",
  "  → Sec 88 BNS (formerly IPC 312): Causing miscarriage | Imprisonment up to 3 years + fine",
  "  → Sec 89 BNS (formerly IPC 313): Without woman's consent | Up to 10 years + fine up to ₹2 lakh",
  "  → Sec 90 BNS (formerly IPC 314): Causing woman's death | Up to 10 years imprisonment + fine",
  "  → Sec 91 BNS (formerly IPC 315): Preventing live birth | Up to 10 years imprisonment or fine or both",
  "  → Sec 92 BNS (formerly IPC 316): Causing death of quick unborn child | Culpable homicide | Up to 10 years",
]);

// Slide 12: Who performs criminal abortions & Why
twoColumnSlide(
  "Criminal Abortion — Context",
  "Who Seeks It",
  [
    "Widows who wish to remarry",
    "Unmarried girls — social stigma, pregnancy from illicit intercourse",
    "Married middle-class women — family limitation",
    "Sex-determination abortions — to avoid female child",
    "Victims of rape or incest",
    "Women without access to legal abortion services",
  ],
  "Types of Abortionists",
  [
    "Expert / Medically qualified professional",
    "Semi-skilled: midwives, nurses, chemists",
    "Unskilled: dais, quacks",
    "Usually done in 2nd–3rd month of pregnancy",
    "Investigated when woman dies or police are informed",
    "Unregistered abortionists = highest risk to woman",
  ]
);

// ══════════════════════════════════════════════════════════════════════════════
// SECTION 3: MEDICO-LEGAL DUTIES
// ══════════════════════════════════════════════════════════════════════════════
sectionDivider("Section 2", "Medico-Legal Duties of the Doctor");

// Slide 14: Overview card
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    ["2. Clinical Care", "Treat to the best of ability — patient's life takes PRIORITY over legal issues"],
    ["3. History Taking", "Gather information about manner/circumstances of abortion; record systemic & genital findings"],
    ["4. Confidentiality", "Information is a professional secret — doctor-patient privilege applies"],
    ["5. Caution in Mx", "Do NOT perform treatment that could lead to criminal charges in own surgery/clinic"],
    ["6. Inform Police", "If patient is seriously ill — inform police (medico-legal case)"],
  ];
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}

// Slide 15: Duties continued - Dying declaration, Death, Reporting
contentSlide("Medico-Legal Duties — Continued", [
  "7. Dying Declaration: If death is IMMINENT → arrange for dying declaration by informing the nearest magistrate",
  "8. Dying Deposition: Magistrate records the statement on oath if death is likely",
  "9. Do NOT issue Death Certificate: If the patient dies — REFUSE to issue death certificate; report to police",
  "10. Post-mortem: Report to police who will arrange medico-legal post-mortem examination",
  "11. Colleague notification: If treating in patient's house, inform a professional colleague about the case",
  "12. Court attendance: May be required to give expert evidence in court",
  "13. Maintain Confidentiality: Do not disclose patient identity to anyone except authorized persons",
  "14. Medico-legal report: Prepare a detailed medico-legal report of all findings",
]);

// Slide 16: Doctor's duties flow
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// ══════════════════════════════════════════════════════════════════════════════
// SECTION 4: METHODS OF CRIMINAL ABORTION
// ══════════════════════════════════════════════════════════════════════════════
sectionDivider("Section 3", "Methods Used for Criminal Abortion");

// Slide 18: Overview of methods
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// Slide 19: General Mechanical Violence
contentSlide("Method I: General Mechanical Violence", [
  "Acts directly on the uterus OR indirectly by promoting pelvic congestion",
  "1. Severe abdominal pressure: blows, kicks, tight lacing, jumping",
  "2. Violent exercise: riding, cycling, jumping from height, jolting on rough roads, lifting heavy weights",
  "3. Cupping (Desi method): Lighted wick placed over hypogastric area → brass mug inverted → traction causes placental separation | Used in advanced pregnancy",
  "4. Application of leeches to pudenda, perineum and inner thighs",
  "5. Alternating very hot and very cold baths",
  "6. Powerful purgatives (castor oil, magnesium sulphate) — cause reflex uterine contractions",
  "NOTE: These methods are often ineffective at early gestation but cause significant harm to the woman",
]);

// Slide 20: Local Mechanical (Instrumental) Methods
contentSlide("Method I: Local Mechanical (Instrumental)", [
  "Instruments introduced into the cervix to rupture membranes / dislodge implantation",
  "Abortion stick: Hard root/twig/stick inserted through cervical os",
  "Catheter: Rubber catheter introduced into uterine cavity",
  "Uterine sound: Metal rod used to perforate membranes",
  "Curette / spoon: Scraping the uterine wall",
  "Bougie or graduated dilator: To dilate cervix",
  "Knitting needles, bicycle spokes: Used by unskilled abortionists — highly dangerous",
  "Laminaria tent: Dried seaweed inserted to slowly dilate cervix",
  "Higginson's syringe: Injecting fluid (water, soap solution, disinfectant) into uterus",
  "DANGER: These can cause uterine perforation, hemorrhage, air embolism, sepsis",
]);

// Slide 21: Abortifacient Drugs - Systemic
contentSlide("Method II: Abortifacient Drugs — Systemic", [
  "Act via: (a) Direct uterine stimulation OR (b) Causing general toxicity to the pregnant woman",
  "Ergot (Ergometrine): Causes sustained uterine contractions; most commonly misused",
  "Quinine: Large doses cause uterine contractions (rarely effective alone)",
  "Castor oil + Quinine combination: Traditional method; ineffective but harmful",
  "Ecbolics: Pituitary extracts (oxytocin) injected — uterine stimulant",
  "Prostaglandins (Misoprostol/PGF2α): Highly effective uterotonic; used illicitly",
  "Mifepristone (RU-486): Anti-progesterone; used illegally outside medical supervision",
  "Hormonal preparations: Oral estrogen in large doses",
  "Diuretics, purgatives: Indirect — reflex contractions",
  "Heavy metal salts: Lead, mercury compounds — toxic to mother AND fetus",
]);

// Slide 22: Abortifacient Drugs - Local
contentSlide("Method II: Abortifacient Drugs — Local Application", [
  "Applied locally to the vagina, cervix or uterus to cause irritation/contraction",
  "Paste of quinine or ergot introduced into vagina",
  "Potassium permanganate tablets inserted into vagina: Causes severe chemical burns, ulceration, hemorrhage",
  "Lead plasters: Applied locally",
  "Strong irritants: Turpentine oil, mustard oil, crude carbolic acid",
  "Slippery elm bark: Introduced into cervix; expands on absorbing moisture → dilates cervix",
  "Bleaching powder: Corrosive local effect",
  "Phenol / Lysol douches: Highly corrosive; can cause fatal systemic absorption",
  "DANGER: All local agents risk severe chemical burns, infection, perforation",
  "KEY FORENSIC FINDING: Chemical burns in vagina/cervix suggest local abortifacient use",
]);

// Slide 23: Surgical/Instrumental Methods (Legal & Illegal)
contentSlide("Method III: Surgical Methods (Also Used Criminally)", [
  "These are also the LEGAL methods of MTP — used illegally by unqualified persons:",
  "1. Dilatation & Curettage (D&C): Cervical dilation + uterine curettage — risk of perforation if done blindly",
  "2. Vacuum Aspiration (Suction Evacuation): 6–12 weeks gestation | Safer method | Used in licensed facilities",
  "3. D&E (Dilatation & Evacuation): For 13–20 weeks gestation",
  "4. Intra-amniotic injection: Prostaglandin F2α (25 mg) or hypertonic saline in 2nd trimester",
  "5. Cervical dilation + Oxytocin drip: To induce uterine contractions",
  "6. Hysterotomy: Surgical opening of uterus; used when other methods fail",
  "FORENSIC NOTE: Same methods — criminal when done by unqualified persons outside approved places",
]);

// ══════════════════════════════════════════════════════════════════════════════
// SECTION 5: COMPLICATIONS
// ══════════════════════════════════════════════════════════════════════════════
sectionDivider("Section 4", "Complications of Criminal Abortion");

// Slide 25: Immediate complications
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// Slide 26: Hemorrhage details
contentSlide("Complication 1: Hemorrhage", [
  "Most immediate and life-threatening complication",
  "Primary hemorrhage: During procedure — vessel injury, uterine perforation",
  "Secondary hemorrhage: Retained products of conception (RPOC) → bleeding 1–2 weeks later",
  "Mechanism: RPOC prevent uterine contraction → continued bleeding from placental sinuses",
  "Clinical features: PV bleeding (often profuse), pallor, tachycardia, hypotension → hemorrhagic shock",
  "In our case scenario: PV bleeding after criminal abortion → PRIMARY + possible secondary hemorrhage",
  "Management: IV access, fluid resuscitation, blood transfusion, surgical evacuation (D&C), Ergometrine/Oxytocin",
  "Forensic significance: Severity of hemorrhage correlates with degree of uterine trauma",
]);

// Slide 27: Sepsis & Infection
contentSlide("Complication 2: Sepsis & Infection", [
  "Second most common cause of death after criminal abortion",
  "Sources of infection: Unsterile instruments, use of contaminated foreign bodies (abortion sticks, catheters)",
  "Common organisms: E. coli, Klebsiella, Clostridium perfringens (gas gangrene), Bacteroides, Streptococcus",
  "Ascending infection: Endometritis → Salpingitis → Pelvic peritonitis → Generalized peritonitis → Septicemia",
  "Clinical features: Fever, chills, uterine tenderness, foul-smelling discharge, peritonism",
  "Clostridium perfringens: Gas gangrene of uterus — rapid tissue destruction, high mortality",
  "Septicemic shock: Hypotension, multiorgan failure — can be fatal within hours",
  "Management: IV broad-spectrum antibiotics, surgical debridement, ICU care, hysterectomy if needed",
]);

// Slide 28: Uterine Perforation & Air Embolism
twoColumnSlide(
  "Complication 3 & 4: Perforation & Air Embolism",
  "Uterine Perforation",
  [
    "Common with blind instrumental methods",
    "Can perforate fundus, body, lower segment, or cervix",
    "May injure bowel, bladder, ureters, blood vessels",
    "Fig 30.1 (Parikh): Fetus lying in abdomen after perforation — small intestine pulled out mistaking for POC",
    "Diagnosis: acute abdomen, pain, bleeding, peritonism",
    "Management: Laparotomy, repair or hysterectomy",
  ],
  "Air Embolism",
  [
    "Air introduced via cervix (Higginson syringe, douche)",
    "Lethal dose: minimum 100 mL in humans",
    "Air enters uterine sinuses → pulmonary vasculature → right heart failure",
    "Death can occur within minutes",
    "PM finding: frothy blood in right heart, air in pulmonary vessels",
    "PM diagnosis: submerge heart in water before incising — air bubbles confirm",
  ]
);

// Slide 29: Drug toxicity & other complications
contentSlide("Complication 5: Drug Toxicity (Abortifacients)", [
  "Ergot poisoning: Ergotism → peripheral vasoconstriction, gangrene of fingers/toes, convulsions",
  "Quinine toxicity: Tinnitus, deafness, blurred vision, hypoglycemia, cardiac arrhythmias",
  "KMnO4 (Potassium permanganate): Corrosive burns of vagina/cervix → scarring, stricture",
  "Lead/Mercury salts: Nephrotoxicity, hepatotoxicity, neurotoxicity",
  "Misoprostol overdose: Hypertonic uterine contractions → uterine rupture",
  "Phenol/Carbolic acid douche: Systemic absorption → renal failure, dark urine (carbolurea), convulsions, death",
  "Lysol poisoning: Corrosive mucous membrane damage, hemolysis, renal failure",
  "Castor oil: Large doses → severe GI upset, dehydration",
  "FORENSIC TIP: Urine analysis, blood levels, and PM toxicology samples are essential",
]);

// Slide 30: Long-term & Forensic significance
twoColumnSlide(
  "Long-Term Complications & Forensic Significance",
  "Long-Term Complications",
  [
    "Asherman syndrome: Intrauterine adhesions → secondary amenorrhea, infertility",
    "Cervical incompetence: Habitual abortion in subsequent pregnancies",
    "Tubal factor infertility: PID → hydrosalpinx, tubal block",
    "Chronic pelvic pain",
    "Psychological trauma: Depression, PTSD",
    "Ectopic pregnancy risk: Post-PID tubal damage",
  ],
  "Forensic Significance",
  [
    "PM findings: Perforations, lacerations, RPOC, chemical burns, foreign bodies",
    "Histology: Chorionic villi in cervix/vagina confirm abortion",
    "Toxicology: Drug residues in urine, blood, stomach contents",
    "Foreign bodies: Instruments, cotton, sticks in uterine cavity",
    "Culture: Organism identification links to abortionist",
    "Bleeding patterns help time the event",
  ]
);

// ══════════════════════════════════════════════════════════════════════════════
// SECTION 6: MTP ACT 1971
// ══════════════════════════════════════════════════════════════════════════════
sectionDivider("Section 5", "Medical Termination of Pregnancy Act 1971");

// Slide 32: Background
contentSlide("MTP Act 1971 — Background & Aims", [
  "Enacted: Medical Termination of Pregnancy Act, 1971 (Act No. 34 of 1971)",
  "Came into force: 1 April 1972",
  "OBJECTIVE: To reduce maternal morbidity and mortality from UNSAFE / illegal abortions",
  "ALSO AIM: To provide safe, legal and accessible abortion services",
  "Before 1971: All abortions (except to save life) were illegal under IPC Sec 312",
  "Amended: 2002, 2003, and 2021 (Amendment Act)",
  "Scope: Applies to whole of India except Jammu & Kashmir (initially)",
  "Philosophy: Women-centric, protective, confidential",
]);

// Slide 33: Grounds for MTP
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    { num: "4", name: "Humanitarian", desc: "Pregnancy alleged to be caused by RAPE — mental anguish presumed", examples: "No need to prove rape or lodge FIR; woman's statement sufficient", color: GREEN_ACC },
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// Slide 34: Gestational limits (original 1971)
contentSlide("MTP Act 1971 — Gestational Limits & RMP Qualification", [
  "GESTATIONAL LIMITS (Original 1971):",
  "  → Up to 12 weeks: Single RMP opinion sufficient",
  "  → 12–20 weeks: Two RMP opinions required",
  "  → Beyond 20 weeks: ONLY to save mother's life (no gestational limit)",
  "QUALIFICATION OF RMP:",
  "  → PG degree/diploma in Obstetrics & Gynecology, OR",
  "  → Assisted in performing ≥25 MTP cases, OR",
  "  → 6 months house surgency in OBG at recognized hospital, OR",
  "  → Doctors registered before 1971: 3 years practice in OBG",
  "  → Doctors registered after 1971: 1 year practice in OBG",
]);

// Slide 35: Place, Consent, Confidentiality
contentSlide("MTP Act — Place, Consent & Confidentiality", [
  "PLACE FOR MTP (Section 4):",
  "  → Government hospitals, OR",
  "  → Hospitals approved/certified by Government | Private clinics need License from Chief Medical Officer",
  "  → Must have: aseptic environment, emergency resuscitation, blood transfusion, post-procedure care",
  "CONSENT:",
  "  → Adult woman (≥18 yrs): Only HER OWN written consent required",
  "  → Minor (<18 yrs) or mentally ill: Consent of GUARDIAN required",
  "  → Husband's consent: NOT legally required",
  "  → Abortion cannot be done on husband's request if woman is unwilling",
  "CONFIDENTIALITY:",
  "  → Admission register is a SECRET DOCUMENT — not to be disclosed",
  "  → No need for woman to prove her age or rape allegation",
]);

// ══════════════════════════════════════════════════════════════════════════════
// SECTION 7: MTP AMENDMENT ACT 2021
// ══════════════════════════════════════════════════════════════════════════════
sectionDivider("Section 5B", "MTP Amendment Act 2021\nKey Changes & Provisions");

// Slide 37: Key changes overview
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// Slide 38: Special Categories for 24-week extension
contentSlide("2021 Amendment — Special Categories (Up to 24 Weeks)", [
  "The following categories of women can now terminate pregnancy up to 24 weeks (requires 2 RMP opinions):",
  "1. Survivors of sexual assault or rape (including marital rape)",
  "2. Minors (under 18 years of age)",
  "3. Change of marital status during pregnancy (widowhood / divorce)",
  "4. Women with physical disabilities (≥40% disability as per Rights of Persons with Disabilities Act 2016)",
  "5. Mentally ill women (including mental retardation)",
  "6. Fetal malformation incompatible with life or would be seriously handicapping",
  "7. Women in humanitarian/disaster settings or emergency situations",
  "8. Multi-parity in adverse social/economic circumstances",
  "IMPORTANT: No gestational limit for fetal anomalies (subject to Medical Board approval)",
]);

// Slide 39: Medical Board
contentSlide("2021 Amendment — Medical Board Provisions", [
  "Mandatory for ALL terminations beyond 24 weeks where fetal anomalies are present",
  "COMPOSITION of Medical Board:",
  "  → Gynecologist (Obstetrics & Gynecology specialist)",
  "  → Radiologist or Sonologist",
  "  → Pediatrician",
  "  → Other members as notified by State Government",
  "FUNCTION: Allow or deny termination of pregnancy beyond 24 weeks",
  "TIMEFRAME: Board must give its opinion within 3 days of woman's application",
  "LOCATION: Established by State Governments at approved facilities",
  "Landmark court cases: Supreme Court allowed 14-year-old rape victim to terminate ~30-week pregnancy",
  "NOTE: Even after Medical Board approval, RMP still needs to certify safety for the woman",
]);

// Slide 40: Comparison Table - 1971 vs 2021
tableSlide("MTP Act 1971 vs Amendment Act 2021 — Comparison", [
  [
    { text: "Parameter", options: { bold: true, color: YELLOW_ACC, fill: { color: "1a2a4a" }, fontSize: 12 } },
    { text: "Original MTP Act 1971", options: { bold: true, color: ORANGE_ACC, fill: { color: "1a2a4a" }, fontSize: 12 } },
    { text: "Amendment Act 2021", options: { bold: true, color: GREEN_ACC, fill: { color: "1a2a4a" }, fontSize: 12 } },
  ],
  [
    { text: "Upper gestational limit", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "20 weeks", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "24 weeks (special cat.) / No limit (fetal anomalies)", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
  ],
  [
    { text: "1 RMP opinion needed", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
    { text: "Up to 12 weeks", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
    { text: "Up to 20 weeks", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
  ],
  [
    { text: "2 RMP opinions needed", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "12–20 weeks", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "20–24 weeks (special categories)", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
  ],
  [
    { text: "Contraceptive failure", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
    { text: "Married women only", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
    { text: "Married AND unmarried women", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
  ],
  [
    { text: "Privacy/Confidentiality", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "Implied", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "Explicit Sec 5A — violation punishable", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
  ],
  [
    { text: "Medical Board", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
    { text: "Not present", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
    { text: "Mandatory for >24 weeks fetal anomalies", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
  ],
  [
    { text: "Women's autonomy", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "Limited to married women", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "Extended to ALL women regardless of marital status", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
  ],
], [2.8, 3.0, 3.6]);

// Slide 41: Emergency provisions & Confidentiality
contentSlide("MTP Act — Emergency Provisions & Key Rules", [
  "EMERGENCY PROVISIONS (Section 5):",
  "  → In an emergency: Pregnancy can be terminated by a SINGLE doctor",
  "  → Even without required training/qualification",
  "  → Even after 20 weeks (or now 24 weeks)",
  "  → Even in a private hospital that is NOT recognized",
  "  → No need to consult a second doctor",
  "REPORTING REQUIREMENT: All MTP cases to be reported to CMO; records maintained in secret register",
  "GOOD FAITH PROTECTION (Section 8): No legal action against RMP who acts in good faith",
  "BNS 2023 (replacing IPC): Criminal abortion now under Sections 88–92 BNS",
  "PCPNDT ACT LINKAGE: MTP Act must NOT be used for sex-selective abortion (punishable separately)",
]);

// ══════════════════════════════════════════════════════════════════════════════
// SECTION 8: DIAGNOSIS OF CRIMINAL ABORTION (PM & LIVING)
// ══════════════════════════════════════════════════════════════════════════════
sectionDivider("Section 6", "Diagnosis of Criminal Abortion");

// Slide 43: Diagnosis in living
contentSlide("Diagnosis of Criminal Abortion — In the Living", [
  "History: Amenorrhea + recent interference + PV bleeding + abdominal pain",
  "GENERAL EXAMINATION: Signs of hemorrhage, shock, pallor, tachycardia; toxic/febrile state (sepsis)",
  "ABDOMINAL EXAMINATION: Signs of peritonitis (rigid abdomen, guarding, tenderness); marks of violence",
  "VAGINAL EXAMINATION (requires permission/MLC documentation):",
  "  → Cervical lacerations, dilatation of cervix",
  "  → Injury marks inside vagina (chemical burns, bruises)",
  "  → Foreign bodies: sticks, catheter remnants, slippery elm bark",
  "  → Foul-smelling discharge, pus",
  "INVESTIGATION: CBC (anemia, leukocytosis), USG pelvis (RPOC, free fluid), blood culture, urine culture, toxicology screen",
  "β-hCG: Elevated → confirms recent pregnancy",
]);

// Slide 44: Post-Mortem Diagnosis
contentSlide("Diagnosis of Criminal Abortion — Post-Mortem", [
  "External examination: Marks of violence on abdomen; injection marks on arms (ergotamine/oxytocin)",
  "Genital examination: Cervical lacerations, vaginal burns (chemical), foreign bodies",
  "Uterine examination: Size confirms gestation; perforation sites; retained POC",
  "Histology of uterus: Chorionic villi, decidual tissue → confirms intrauterine pregnancy",
  "Air embolism: Heart examined submerged in water → air bubbles confirm diagnosis",
  "Toxicology samples: Gastric contents, liver, kidney, urine, blood for abortifacient drugs",
  "Culture: Clostridium, Bacteroides from uterus in septic cases",
  "Fabricated abortion: Woman presents animal fetus | Precipitin test (species-specific) confirms",
  "IMPORTANT: Histological identification of chorionic villi is GOLD STANDARD for confirming abortion",
]);

// Slide 45: IPC/BNS sections reference
tableSlide("Legal Sections — Criminal Abortion (IPC → BNS 2023)", [
  [
    { text: "IPC Section", options: { bold: true, color: YELLOW_ACC, fill: { color: "1a2a4a" }, fontSize: 12 } },
    { text: "BNS 2023", options: { bold: true, color: YELLOW_ACC, fill: { color: "1a2a4a" }, fontSize: 12 } },
    { text: "Offence", options: { bold: true, color: YELLOW_ACC, fill: { color: "1a2a4a" }, fontSize: 12 } },
    { text: "Punishment", options: { bold: true, color: YELLOW_ACC, fill: { color: "1a2a4a" }, fontSize: 12 } },
  ],
  [
    { text: "Sec 312", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "Sec 88", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "Causing miscarriage (with woman's consent)", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "3 years imprisonment + fine", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
  ],
  [
    { text: "Sec 313", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
    { text: "Sec 89", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
    { text: "Causing miscarriage WITHOUT woman's consent", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
    { text: "Up to 10 years + fine up to ₹2 lakh", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
  ],
  [
    { text: "Sec 314", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "Sec 90", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "Death caused by act intended to cause miscarriage", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "Up to 10 years + fine", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
  ],
  [
    { text: "Sec 315", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
    { text: "Sec 91", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
    { text: "Act to prevent live birth or cause death after birth", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
    { text: "Up to 10 years or fine or both", options: { color: WHITE, fill: { color: "0d1b2a" }, fontSize: 11 } },
  ],
  [
    { text: "Sec 316", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "Sec 92", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "Causing death of quick unborn child (Culpable homicide)", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
    { text: "Up to 10 years imprisonment", options: { color: WHITE, fill: { color: CARD_BG }, fontSize: 11 } },
  ],
], [1.5, 1.5, 3.7, 2.7]);

// ══════════════════════════════════════════════════════════════════════════════
// SECTION 9: CASE ANALYSIS
// ══════════════════════════════════════════════════════════════════════════════
sectionDivider("Back to the Case", "Applying Knowledge to the Scenario");

// Slide 47: Case Analysis
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    { step: "INVESTIGATE", text: "CBC, coagulation, USG pelvis, blood culture, urine, β-hCG, toxicology screen", color: YELLOW_ACC },
    { step: "LEGAL DUTY", text: "Inform police if serious (MLC)\nIf death imminent → inform magistrate for dying declaration", color: GREEN_ACC },
    { step: "CONFIDENTIALITY", text: "Do NOT disclose patient identity\nMaintain professional secrecy as per Section 5A MTP Act", color: "00BFFF" },
    { step: "POST-DISCHARGE", text: "Refuse to issue death certificate if she dies\nReport to police; attend court as expert witness if required", color: "CC99FF" },
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// Slide 48: Quick Recall Summary
contentSlide("Summary — High-Yield Points for Exam", [
  "1. Criminal abortion = induced expulsion of fetus UNLAWFULLY without therapeutic indication",
  "2. Most common immediate complication = Hemorrhage; most common cause of death = Sepsis",
  "3. Air embolism: from Higginson syringe; lethal dose 100 mL; detected by submerging heart in water at PM",
  "4. Potassium permanganate tablets: cause severe chemical burns of vagina/cervix — important forensic finding",
  "5. Medico-legal duties: document, treat, maintain confidentiality, inform police (if serious), dying declaration, refuse death certificate",
  "6. MTP Act 1971: Original limits 12 weeks (1 doctor), 12–20 weeks (2 doctors)",
  "7. MTP Amendment 2021: Key changes — upper limit to 24 weeks (special categories), unmarried women included, Medical Board for >24 weeks, privacy clause",
  "8. Special categories for 24 weeks: rape survivors, minors, disabled, mentally ill, fetal anomaly",
  "9. Fabricated abortion: Precipitin test confirms species of fetus",
  "10. Histological finding of chorionic villi = GOLD STANDARD for confirming abortion",
]);

// Slide 49: QUICK MCQ Review
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    ["Q2", "Most dangerous method for air embolism in criminal abortion?", "Higginson syringe / douche", ORANGE_ACC],
    ["Q3", "Gold standard for confirming abortion at PM?", "Histology showing chorionic villi", YELLOW_ACC],
    ["Q4", "Upper gestational limit for special categories post-2021?", "24 weeks", GREEN_ACC],
    ["Q5", "Consent requirement for adult woman seeking MTP?", "Only her OWN written consent; husband not required", "00BFFF"],
  ];
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// Slide 50: Thank You / References
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    "1. P C Dikshit — Textbook of Forensic Medicine and Toxicology",
    "2. The Essentials of Forensic Medicine & Toxicology — 36th Edition (2026), Karmakar",
    "3. Parikh's Textbook of Medical Jurisprudence, Forensic Medicine & Toxicology",
    "4. The Medical Termination of Pregnancy Act, 1971 (Act No. 34 of 1971)",
    "5. The MTP (Amendment) Act, 2021 — came into force 25 March 2021",
    "6. Bharatiya Nyaya Sanhita (BNS) 2023 — Sections 88–92",
  ];
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// Write file
const outPath = "/home/daytona/workspace/criminal-abortion-ppt/Criminal_Abortion_MTP_Act.pptx";
pres.writeFile({ fileName: outPath }).then(() => {
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});

cd /home/daytona/workspace/criminal-abortion-ppt && node create_ppt.js 2>&1

cd /home/daytona/workspace/criminal-abortion-ppt && python -m markitdown Crimina…

python3 -c " import zipfile, os pptx = '/home/daytona/workspace/criminal-abortio…

ls -lh /home/daytona/workspace/criminal-abortion-ppt/

cd /home/daytona/workspace/criminal-abortion-ppt && node create_ppt.js 2>&1