Tuberculosis (TB) Treatment Guidelines

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pres.layout = "LAYOUT_16x9";
pres.title = "Tuberculosis Treatment Guidelines";
pres.author = "Orris Medical";

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// ══════════════════════════════════════════════════════════════
// SLIDE 1: Title
// ══════════════════════════════════════════════════════════════
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  s.addText("🫁", { x: 7.2, y: 0.7, w: 2.5, h: 2.3, fontSize: 54, align: "center", valign: "middle" });

  s.addText("TUBERCULOSIS", {
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  s.addText("TREATMENT GUIDELINES", {
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// ══════════════════════════════════════════════════════════════
// SLIDE 2: Overview / Classification
// ══════════════════════════════════════════════════════════════
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    { title: "Drug-Resistant TB", sub: "MDR / pre-XDR / XDR", icon: "⚠️", col: C.red },
    { title: "Special Populations", sub: "HIV, Pregnancy, Pediatric, CNS", icon: "👥", col: C.green },
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// ══════════════════════════════════════════════════════════════
// SLIDE 3: DS-TB Standard 6-month Regimen
// ══════════════════════════════════════════════════════════════
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// ══════════════════════════════════════════════════════════════
// SLIDE 4: DS-TB Regimen Options (table)
// ══════════════════════════════════════════════════════════════
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    ["3", "HRZE 3×/wk DOT × 8 wks", "HR 3×/wk DOT × 18 wks", "Caution: HIV or cavitary disease"],
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// ══════════════════════════════════════════════════════════════
// SLIDE 5: NEW 4-month Regimen
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    "Non-inferior to 6-month regimen for drug-susceptible pulmonary TB",
    "For adults & adolescents (age ≥12 yrs, weight ≥40 kg)",
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// ══════════════════════════════════════════════════════════════
// SLIDE 6: Latent TB (LTBI) Treatment
// ══════════════════════════════════════════════════════════════
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    { name: "4R", detail: "Rifampin daily × 4 months", dur: "4 mo", col: C.green, note: "Good alternative; good tolerability" },
    { name: "3HR", detail: "INH + Rifampin daily × 3 months", dur: "3 mo", col: C.accent, note: "Short course option" },
    { name: "6H", detail: "Isoniazid daily × 6 months", dur: "6 mo", col: C.orange, note: "Not for HIV+ or children" },
    { name: "9H", detail: "Isoniazid daily × 9 months", dur: "9 mo", col: "9B59B6", note: "Preferred in pregnancy (high risk)" },
    { name: "1HP", detail: "INH + Rifapentine daily × 1 month", dur: "1 mo", col: C.accent2, note: "HIV+ adults ≥13 yrs only" },
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// ══════════════════════════════════════════════════════════════
// SLIDE 7: Drug-Resistant TB
// ══════════════════════════════════════════════════════════════
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    { label: "MDR-TB", info: "Resistant to INH + RIF\nBPaL or BPaLM regimen\nAll-oral × 6 months", col: C.red },
    { label: "XDR-TB / pre-XDR", info: "MDR + fluoroquinolone/injectable\nBPaL regimen (FDA-approved)\nBedaquiline + Pretomanid + Linezolid", col: "8E1A1A" },
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  const drugs = [
    { name: "Bedaquiline", info: "Blocks ATP synthase\nQT prolongation — ECG monitoring required" },
    { name: "Pretomanid", info: "Nitroimidazooxazine\nQT prolongation — ECG required; liver enzyme monitoring" },
    { name: "Linezolid", info: "Protein synthesis inhibition\nPeripheral neuropathy (>60% had interruptions), myelosuppression" },
  ];

  drugs.forEach((d, i) => {
    const x = 0.3 + i * 3.2;
    s.addShape(pres.ShapeType.rect, {
      x, y: 3.55, w: 3.0, h: 1.6,
      fill: { color: "1A0A0A" }, line: { color: "884444", width: 1 },
    });
    s.addText(d.name, {
      x: x + 0.1, y: 3.6, w: 2.8, h: 0.35,
      fontSize: 11, bold: true, color: C.red,
    });
    s.addText(d.info, {
      x: x + 0.1, y: 3.95, w: 2.8, h: 1.1,
      fontSize: 9, color: C.lightGray,
    });
  });

  addSlideLabel(s, "Drug-Resistant TB");
}

// ══════════════════════════════════════════════════════════════
// SLIDE 8: Key Drug Adverse Effects
// ══════════════════════════════════════════════════════════════
{
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  s.background = { color: "F4F8FB" };
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  s.addText("KEY DRUG ADVERSE EFFECTS & MONITORING", {
    x: 0.4, y: 0, w: 9.4, h: 0.75,
    fontSize: 17, bold: true, color: C.accent, valign: "middle", margin: 0,
  });

  const drugs = [
    { name: "Isoniazid (INH)", ae: "Hepatotoxicity (5-33%)\nPeripheral neuropathy\nDrug-induced lupus", mon: "LFTs in high-risk\nPyridoxine (B6) to prevent neuropathy", col: C.orange },
    { name: "Rifampicin (RIF)", ae: "Hepatotoxicity\nOrange body fluids\nDrug interactions (CYP inducer)", mon: "LFTs\nReview concomitant medications", col: C.accent },
    { name: "Pyrazinamide (PZA)", ae: "Hepatotoxicity\nHyperuricemia\nGout", mon: "LFTs\nUric acid levels", col: C.green },
    { name: "Ethambutol (EMB)", ae: "Optic neuritis\n(dose-related)\nColor vision loss", mon: "Monthly visual acuity\nand color vision tests", col: C.accent2 },
    { name: "Bedaquiline", ae: "QT prolongation\nHepatotoxicity\nNausea", mon: "Baseline + monthly ECG\nLFTs", col: C.red },
    { name: "Linezolid", ae: "Peripheral neuropathy\nMyelosuppression\nSerotonin syndrome", mon: "CBC regularly\nNeurological assessment", col: "8E44AD" },
  ];

  drugs.forEach((d, i) => {
    const col = i % 3;
    const row = Math.floor(i / 3);
    const x = 0.28 + col * 3.2;
    const y = 0.85 + row * 1.95;
    s.addShape(pres.ShapeType.rect, {
      x, y, w: 3.0, h: 1.75,
      fill: { color: C.white }, line: { color: d.col, width: 2 },
    });
    s.addShape(pres.ShapeType.rect, {
      x, y, w: 3.0, h: 0.38,
      fill: { color: d.col }, line: { type: "none" },
    });
    s.addText(d.name, {
      x: x + 0.08, y, w: 2.9, h: 0.38,
      fontSize: 10, bold: true, color: C.white, valign: "middle", margin: 3,
    });
    s.addText("⚠ AE:", {
      x: x + 0.08, y: y + 0.42, w: 0.5, h: 0.28,
      fontSize: 8, bold: true, color: C.red,
    });
    s.addText(d.ae, {
      x: x + 0.08, y: y + 0.42, w: 2.85, h: 0.7,
      fontSize: 8.5, color: C.textDark, margin: [0, 0, 0, 30],
    });
    s.addText("● Monitor:", {
      x: x + 0.08, y: y + 1.13, w: 0.9, h: 0.22,
      fontSize: 7.5, bold: true, color: "556B8A",
    });
    s.addText(d.mon, {
      x: x + 0.08, y: y + 1.13, w: 2.85, h: 0.55,
      fontSize: 8, color: "556B8A", margin: [0, 0, 0, 55], italic: true,
    });
  });

  s.addText("STOP ALL ANTI-TB DRUGS if:  AST > 5× ULN  OR  Bilirubin > 3 mg/dL", {
    x: 0.25, y: 5.08, w: 9.5, h: 0.28,
    fontSize: 9, bold: true, color: C.red, align: "center",
  });

  addSlideLabel(s, "Adverse Effects");
}

// ══════════════════════════════════════════════════════════════
// SLIDE 9: Special Populations — HIV
// ══════════════════════════════════════════════════════════════
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  const s = pres.addSlide();
  s.background = { color: C.darkBg };

  s.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: 10, h: 0.75,
    fill: { color: "0A1C2E" }, line: { type: "none" },
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  s.addText("SPECIAL POPULATIONS  |  HIV Co-Infection", {
    x: 0.3, y: 0, w: 9.4, h: 0.75,
    fontSize: 16, bold: true, color: C.accent, valign: "middle", margin: 0,
  });

  const pts = [
    { icon: "📊", title: "Epidemiology", body: "HIV is the strongest known risk factor for TB.\nHIV+ patients are 20-30× more likely to develop TB.\nAlways test for HIV in new TB diagnosis." },
    { icon: "💊", title: "Treatment Regimen", body: "Same HRZE 2-month + HR 4-month regimen.\nDrug interactions: Rifampin (CYP inducer) — prefer efavirenz-based ART.\nMay need regimen adjustment based on ART choice." },
    { icon: "⏱", title: "ART Timing", body: "Start ART within 2-8 weeks of TB treatment.\nException: TB meningitis — delay ART to 8 weeks.\nEarlier ART reduces AIDS progression but may increase IRIS." },
    { icon: "⚠️", title: "IRIS (Immune Reconstitution)", body: "Paradoxical worsening after ART initiation.\nMore common in HIV patients.\nUsually self-limiting; NSAIDs/steroids for severe cases." },
  ];

  pts.forEach((pt, i) => {
    const x = 0.3 + (i % 2) * 4.8;
    const y = 0.9 + Math.floor(i / 2) * 2.15;
    s.addShape(pres.ShapeType.rect, {
      x, y, w: 4.5, h: 1.95,
      fill: { color: "1E4A6E" }, line: { color: C.accent2, width: 1.5 },
    });
    s.addText(pt.icon + "  " + pt.title, {
      x: x + 0.15, y: y + 0.1, w: 4.2, h: 0.4,
      fontSize: 12, bold: true, color: C.accent2,
    });
    s.addText(pt.body, {
      x: x + 0.15, y: y + 0.52, w: 4.2, h: 1.35,
      fontSize: 9.5, color: C.lightGray,
    });
  });

  addSlideLabel(s, "Special Populations");
}

// ══════════════════════════════════════════════════════════════
// SLIDE 10: Core Principles
// ══════════════════════════════════════════════════════════════
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  s.background = { color: "F4F8FB" };
  addSectionBadge(s);

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    fill: { color: C.darkBg }, line: { type: "none" },
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  s.addText("CORE PRINCIPLES OF TB TREATMENT", {
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    fontSize: 17, bold: true, color: C.accent, valign: "middle", margin: 0,
  });

  const principles = [
    { num: "1", title: "Combination Therapy Always", body: "Never give monotherapy. Resistant mutants exist at ~1/10⁵. Two-drug resistance probability: ~1/10¹⁰." },
    { num: "2", title: "Direct Observed Therapy (DOT)", body: "Mandatory for twice/thrice weekly regimens. Critical for adherence and preventing resistance." },
    { num: "3", title: "Drug Susceptibility Testing (DST)", body: "Modify therapy as soon as DST results available. Tailors treatment to resistance profile." },
    { num: "4", title: "Reportable Disease", body: "Notify public health within 24 hours (US and most countries). Enables contact tracing." },
    { num: "5", title: "Negative Pressure Isolation", body: "Required for hospitalized patients with suspected active pulmonary TB. Prevents airborne transmission." },
    { num: "6", title: "Fixed-Dose Combinations", body: "Use FDC tablets when available. Optimizes adherence, prevents inadvertent monotherapy." },
  ];

  principles.forEach((p, i) => {
    const x = 0.28 + (i % 2) * 4.85;
    const y = 0.85 + Math.floor(i / 2) * 1.48;
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      x, y, w: 4.5, h: 1.3,
      fill: { color: C.white }, line: { color: C.lightGray, width: 1 },
      shadow: { type: "outer", color: "AABBCC", blur: 5, offset: 2, angle: 45, opacity: 0.15 },
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    // Number circle
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      x, y: y + 0.2, w: 0.55, h: 0.55,
      fill: { color: C.darkBg }, line: { type: "none" },
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    s.addText(p.num, {
      x, y: y + 0.2, w: 0.55, h: 0.55,
      fontSize: 13, bold: true, color: C.accent, align: "center", valign: "middle", margin: 0,
    });
    s.addText(p.title, {
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      fontSize: 11, bold: true, color: C.darkBg,
    });
    s.addText(p.body, {
      x: x + 0.65, y: y + 0.5, w: 3.75, h: 0.7,
      fontSize: 8.5, color: "445566",
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  addSlideLabel(s, "Core Principles");
}

// ══════════════════════════════════════════════════════════════
// SLIDE 11: Key Takeaways / Summary
// ══════════════════════════════════════════════════════════════
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  s.background = { color: C.darkBg };

  s.addShape(pres.ShapeType.rect, {
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    fill: { color: C.accent }, line: { type: "none" },
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  s.addShape(pres.ShapeType.rect, {
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  const takeaways = [
    { col: C.accent2, text: "Standard DS-TB: HRZE × 2 months → HR × 4 months (6 months total)" },
    { col: C.accent,  text: "New 4-month regimen (RPT+MOX+INH+PZA) now recommended for eligible adults (2025)" },
    { col: C.green,   text: "LTBI: Prefer short courses — 3HP (3 months weekly INH+RPT) or 4R (4 months rifampin)" },
    { col: C.red,     text: "MDR/XDR-TB: All-oral BPaL (Bedaquiline+Pretomanid+Linezolid) × 6 months" },
    { col: C.orange,  text: "HIV+TB: Same TB regimen; start ART within 2-8 weeks; watch for IRIS" },
    { col: "9B59B6",  text: "ALWAYS use combination therapy. DOT is key. Report within 24 hours." },
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  s.addText("Source: ATS/CDC/ERS/IDSA 2025 Guidelines (PMID: 40693952) | WHO TB Guidelines | Katzung 16th Ed | Murray & Nadel | Tintinalli", {
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    fontSize: 7, color: "667788", italic: true, align: "center",
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// ── Write file ──────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/tb-treatment-ppt/TB_Treatment_Guidelines.pptx" })
  .then(() => console.log("DONE: TB_Treatment_Guidelines.pptx"))
  .catch(e => { console.error(e); process.exit(1); });