Guillain-Barre syndrome rehabilitation physiotherapy

mkdir -p /home/daytona/workspace/gbs-rehab-ppt && ls /home/daytona/workspace/gbs…

~/gbs-rehab-ppt/gbs_rehab.js

const pptxgen = require("pptxgenjs");
const { execSync } = require("child_process");

// Fetch all 5 images in parallel
const imageUrls = [
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_dd524c501db31e1fb1646f3dfc56be3328bce5179ef6a686f74588d8de88a195.jpg",  // pelvic bridging exercise
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_e0cbef3a92e6bef044f9b3f34e1e76753b14297a486ac7ee2ba5696a3dc8e0d9.jpg",  // Achilles stretching
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_ff33cc60fbe7431a2c352ea3085c8ec25c885081bac130f2b70faa12743399c8.jpg",  // chronic motor deficits
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_60a6ca2d41197bf5ee33d1c54758ad76ae6b406b84a8448274d18254b28978c5.jpg",  // wheelchair → standing recovery
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_3fc0b5f32487a3ddb44fdfcd0ab805e4dda970c46b4410fc976276f4e2166f98.jpg",  // early rehab exercises
];

console.log("Fetching images...");
const images = JSON.parse(
  execSync(
    `node /home/daytona/skills/shared/scripts/fetch_images.js ${imageUrls.map(u => `"${u}"`).join(" ")}`
  ).toString()
);
console.log("Images fetched:", images.map(i => i.error || "OK"));

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.author = "Rehab Medicine";
pres.title = "Guillain–Barré Syndrome: Rehabilitation";

// ─── COLOR PALETTE ───────────────────────────────────────────────
const DARK_BG   = "0D1B2A";  // deep navy (dominant ~65%)
const TEAL      = "1B8A8F";  // medical teal (accent)
const LIGHT_BG  = "F0F4F8";  // off-white for content slides
const WHITE     = "FFFFFF";
const ACCENT    = "E8A838";  // warm amber highlight
const TEXT_DARK = "1A2333";
const SUBTEXT   = "4A6080";

// ─── HELPER ──────────────────────────────────────────────────────
function addAccentBar(slide, color = TEAL) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 5.2, w: 10, h: 0.08, fill: { color }, line: { color } });
}

function addSlideNumber(slide, n) {
  slide.addText(`${n} / 5`, {
    x: 8.8, y: 5.25, w: 1.1, h: 0.3,
    fontSize: 9, color: SUBTEXT, align: "right"
  });
}

// ─── SLIDE 1: TITLE SLIDE ────────────────────────────────────────
const s1 = pres.addSlide();

// Full dark background
s1.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: DARK_BG }, line: { color: DARK_BG } });

// Teal accent left bar
s1.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.12, h: 5.625, fill: { color: TEAL }, line: { color: TEAL } });

// Amber accent line
s1.addShape(pres.ShapeType.rect, { x: 0.12, y: 2.6, w: 5.5, h: 0.05, fill: { color: ACCENT }, line: { color: ACCENT } });

// Title
s1.addText("Guillain–Barré Syndrome", {
  x: 0.4, y: 0.6, w: 8, h: 1.0,
  fontSize: 36, bold: true, color: WHITE, fontFace: "Calibri Light",
  charSpacing: 1
});

// Subtitle
s1.addText("Rehabilitation: Principles & Practice", {
  x: 0.4, y: 1.65, w: 7, h: 0.55,
  fontSize: 20, color: ACCENT, fontFace: "Calibri", bold: false
});

// Tagline
s1.addText("From ICU to Independence", {
  x: 0.4, y: 2.3, w: 6, h: 0.35,
  fontSize: 13, color: "8FB3CC", fontFace: "Calibri", italic: true
});

// Key stat box
s1.addShape(pres.ShapeType.rect, { x: 0.4, y: 3.0, w: 4.2, h: 1.8, fill: { color: "132238" }, line: { color: TEAL, pt: 1 } });
s1.addText([
  { text: "~20–30%", options: { fontSize: 28, bold: true, color: ACCENT, breakLine: true } },
  { text: "require mechanical ventilation", options: { fontSize: 11, color: "A8BFCC", breakLine: true } },
  { text: "~80%", options: { fontSize: 20, bold: true, color: WHITE, breakLine: true } },
  { text: "walk independently within 6 months", options: { fontSize: 11, color: "A8BFCC" } }
], { x: 0.5, y: 3.05, w: 4.0, h: 1.65, valign: "middle" });

// Image (recovery photo)
if (images[3] && !images[3].error) {
  s1.addImage({ data: images[3].base64, x: 5.2, y: 1.5, w: 4.5, h: 3.5 });
  // image caption
  s1.addShape(pres.ShapeType.rect, { x: 5.2, y: 4.8, w: 4.5, h: 0.35, fill: { color: "0A1520", transparency: 20 }, line: { color: "0A1520" } });
  s1.addText("Wheelchair → Full recovery at 3 months (post-GBS)", {
    x: 5.2, y: 4.82, w: 4.5, h: 0.3, fontSize: 7.5, color: "8FB3CC", align: "center"
  });
}

// Footer
s1.addText("Bradley & Daroff's Neurology in Clinical Practice | GBS Rehabilitation Series", {
  x: 0.4, y: 5.3, w: 9, h: 0.2, fontSize: 7.5, color: "4A6080", align: "left"
});

// ─── SLIDE 2: OVERVIEW OF GBS & REHABILITATION RATIONALE ─────────
const s2 = pres.addSlide();
s2.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: LIGHT_BG }, line: { color: LIGHT_BG } });

// Header band
s2.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.85, fill: { color: DARK_BG }, line: { color: DARK_BG } });
s2.addShape(pres.ShapeType.rect, { x: 0, y: 0.85, w: 10, h: 0.05, fill: { color: TEAL }, line: { color: TEAL } });
s2.addText("Overview of GBS & Rehabilitation Rationale", {
  x: 0.3, y: 0.1, w: 9, h: 0.65, fontSize: 22, bold: true, color: WHITE, fontFace: "Calibri Light"
});

// Left column: What is GBS
s2.addShape(pres.ShapeType.rect, { x: 0.25, y: 1.1, w: 4.5, h: 4.2, fill: { color: WHITE }, line: { color: "D0DCE8", pt: 1 } });
s2.addShape(pres.ShapeType.rect, { x: 0.25, y: 1.1, w: 4.5, h: 0.38, fill: { color: TEAL }, line: { color: TEAL } });
s2.addText("What is GBS?", { x: 0.3, y: 1.12, w: 4.4, h: 0.32, fontSize: 13, bold: true, color: WHITE });

s2.addText([
  { text: "• Acute immune-mediated polyradiculoneuropathy", options: { bullet: false, breakLine: true } },
  { text: "• Ascending flaccid paralysis + areflexia", options: { breakLine: true } },
  { text: "• Triggered by: Campylobacter jejuni, CMV, EBV, Zika", options: { breakLine: true } },
  { text: "• Incidence: 1.8 / 100,000/year (↑ with age)", options: { breakLine: true } },
  { text: "• Males > Females (1.5:1)", options: { breakLine: true } },
  { text: "", options: { breakLine: true } },
  { text: "Subtypes:", options: { bold: true, color: TEAL, breakLine: true } },
  { text: "AIDP  •  AMAN  •  AMSAN  •  MFS", options: { breakLine: true } },
  { text: "", options: { breakLine: true } },
  { text: "Why Rehabilitation?", options: { bold: true, color: TEAL, breakLine: true } },
  { text: "Motor weakness, deconditioning & disability require structured inpatient rehab from the acute phase through community re-integration.", options: {} }
], {
  x: 0.35, y: 1.55, w: 4.3, h: 3.65,
  fontSize: 10.5, color: TEXT_DARK, fontFace: "Calibri", lineSpacingMultiple: 1.3
});

// Right column: Phases of Recovery
s2.addShape(pres.ShapeType.rect, { x: 5.0, y: 1.1, w: 4.75, h: 4.2, fill: { color: WHITE }, line: { color: "D0DCE8", pt: 1 } });
s2.addShape(pres.ShapeType.rect, { x: 5.0, y: 1.1, w: 4.75, h: 0.38, fill: { color: "1A5F7A" }, line: { color: "1A5F7A" } });
s2.addText("Phases of Rehabilitation", { x: 5.05, y: 1.12, w: 4.65, h: 0.32, fontSize: 13, bold: true, color: WHITE });

const phases = [
  ["Phase 1", "Acute / ICU", "Respiratory care, positioning, DVT prophylaxis, passive ROM"],
  ["Phase 2", "Sub-acute Inpatient", "Active-assistive exercises, ADL training, swallowing therapy"],
  ["Phase 3", "Outpatient / Community", "Strengthening, gait retraining, fatigue management"],
];
phases.forEach(([num, name, desc], i) => {
  const y = 1.6 + i * 1.2;
  s2.addShape(pres.ShapeType.rect, { x: 5.1, y, w: 0.55, h: 0.55, fill: { color: ACCENT }, line: { color: ACCENT } });
  s2.addText(num, { x: 5.1, y, w: 0.55, h: 0.55, fontSize: 10, bold: true, color: DARK_BG, align: "center", valign: "middle" });
  s2.addText(name, { x: 5.75, y: y + 0.02, w: 3.9, h: 0.28, fontSize: 11, bold: true, color: DARK_BG });
  s2.addText(desc, { x: 5.75, y: y + 0.3, w: 3.9, h: 0.65, fontSize: 9.5, color: SUBTEXT, lineSpacingMultiple: 1.25 });
});

addAccentBar(s2);
addSlideNumber(s2, 2);

// ─── SLIDE 3: ACUTE PHASE REHABILITATION (ICU & WARD) ────────────
const s3 = pres.addSlide();
s3.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: LIGHT_BG }, line: { color: LIGHT_BG } });

// Header
s3.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.85, fill: { color: DARK_BG }, line: { color: DARK_BG } });
s3.addShape(pres.ShapeType.rect, { x: 0, y: 0.85, w: 10, h: 0.05, fill: { color: ACCENT }, line: { color: ACCENT } });
s3.addText("Acute Phase Rehabilitation", {
  x: 0.3, y: 0.1, w: 7, h: 0.65, fontSize: 22, bold: true, color: WHITE, fontFace: "Calibri Light"
});
s3.addText("ICU & Acute Ward", { x: 7.1, y: 0.22, w: 2.7, h: 0.4, fontSize: 12, color: ACCENT, align: "right", italic: true });

// Image (early rehab exercises in hospital)
if (images[4] && !images[4].error) {
  s3.addImage({ data: images[4].base64, x: 5.4, y: 1.0, w: 4.35, h: 3.35 });
  s3.addShape(pres.ShapeType.rect, { x: 5.4, y: 4.2, w: 4.35, h: 0.3, fill: { color: "B8C8D8", transparency: 30 }, line: { color: "B8C8D8" } });
  s3.addText("Early UE rehab exercise — bedridden to active movement", {
    x: 5.4, y: 4.22, w: 4.35, h: 0.26, fontSize: 7.5, color: TEXT_DARK, align: "center"
  });
}

// Left content cards
const acuteItems = [
  { icon: "🫁", heading: "Respiratory", text: "Monitoring FVC (<20 mL/kg = intubation threshold)\nChest physiotherapy, suction, NIV weaning" },
  { icon: "🤲", heading: "Positioning & Skin", text: "2-hourly turns, pressure-relieving mattress\nSplinting to prevent foot-drop & contractures" },
  { icon: "💉", heading: "Medical Management", text: "IVIG (0.4 g/kg × 5 days) or Plasmapheresis (5 exchanges)\nPain: gabapentin/pregabalin; DVT prophylaxis (LMWH)" },
  { icon: "🦵", heading: "Passive ROM", text: "Gentle passive range-of-motion all joints\nPrevent muscle shortening & joint stiffness" },
];
acuteItems.forEach((item, i) => {
  const y = 1.05 + i * 1.05;
  s3.addShape(pres.ShapeType.rect, { x: 0.2, y, w: 5.0, h: 0.95, fill: { color: WHITE }, line: { color: "D0DCE8", pt: 1 } });
  s3.addShape(pres.ShapeType.rect, { x: 0.2, y, w: 0.06, h: 0.95, fill: { color: i % 2 === 0 ? TEAL : ACCENT }, line: { color: i % 2 === 0 ? TEAL : ACCENT } });
  s3.addText(item.icon + " " + item.heading, { x: 0.32, y: y + 0.06, w: 4.7, h: 0.28, fontSize: 11, bold: true, color: DARK_BG });
  s3.addText(item.text, { x: 0.32, y: y + 0.34, w: 4.7, h: 0.52, fontSize: 9, color: SUBTEXT, lineSpacingMultiple: 1.2 });
});

addAccentBar(s3);
addSlideNumber(s3, 3);

// ─── SLIDE 4: SUB-ACUTE & OUTPATIENT REHABILITATION ──────────────
const s4 = pres.addSlide();
s4.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: LIGHT_BG }, line: { color: LIGHT_BG } });

s4.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.85, fill: { color: DARK_BG }, line: { color: DARK_BG } });
s4.addShape(pres.ShapeType.rect, { x: 0, y: 0.85, w: 10, h: 0.05, fill: { color: TEAL }, line: { color: TEAL } });
s4.addText("Sub-Acute & Outpatient Rehabilitation", {
  x: 0.3, y: 0.1, w: 9, h: 0.65, fontSize: 22, bold: true, color: WHITE, fontFace: "Calibri Light"
});

// Two-column layout
// LEFT: Physiotherapy
s4.addShape(pres.ShapeType.rect, { x: 0.2, y: 1.05, w: 4.55, h: 4.25, fill: { color: WHITE }, line: { color: "D0DCE8", pt: 1 } });
s4.addShape(pres.ShapeType.rect, { x: 0.2, y: 1.05, w: 4.55, h: 0.4, fill: { color: TEAL }, line: { color: TEAL } });
s4.addText("🏃 Physiotherapy", { x: 0.3, y: 1.07, w: 4.35, h: 0.34, fontSize: 12.5, bold: true, color: WHITE });

s4.addText([
  { text: "Active-Assistive → Progressive Resistive Exercises", options: { bold: true, breakLine: true } },
  { text: "• Pelvic bridging, leg lifts, upper-limb strengthening", options: { breakLine: true } },
  { text: "• Hydrotherapy (buoyancy reduces effort)", options: { breakLine: true } },
  { text: "", options: { breakLine: true } },
  { text: "Gait Re-training", options: { bold: true, breakLine: true } },
  { text: "• Parallel bars → walker → unaided", options: { breakLine: true } },
  { text: "• Balance training, proprioception exercises", options: { breakLine: true } },
  { text: "", options: { breakLine: true } },
  { text: "Stretching & Flexibility", options: { bold: true, breakLine: true } },
  { text: "• Achilles tendon stretching", options: { breakLine: true } },
  { text: "• Prevent contractures and foot-drop", options: { breakLine: true } },
  { text: "", options: { breakLine: true } },
  { text: "Fatigue Management", options: { bold: true, breakLine: true } },
  { text: "• Energy conservation strategies", options: { breakLine: true } },
  { text: "• Graded exercise — avoid overwork weakness", options: {} },
], { x: 0.3, y: 1.52, w: 4.35, h: 3.65, fontSize: 9.5, color: TEXT_DARK, lineSpacingMultiple: 1.25 });

// RIGHT: OT + Images
s4.addShape(pres.ShapeType.rect, { x: 4.95, y: 1.05, w: 4.8, h: 2.0, fill: { color: WHITE }, line: { color: "D0DCE8", pt: 1 } });
s4.addShape(pres.ShapeType.rect, { x: 4.95, y: 1.05, w: 4.8, h: 0.4, fill: { color: "1A5F7A" }, line: { color: "1A5F7A" } });
s4.addText("🖐 Occupational Therapy & MDT", { x: 5.05, y: 1.07, w: 4.6, h: 0.34, fontSize: 12.5, bold: true, color: WHITE });
s4.addText([
  { text: "• ADL retraining: dressing, feeding, bathing", options: { breakLine: true } },
  { text: "• Assistive devices: splints, orthotics, adaptive equipment", options: { breakLine: true } },
  { text: "• Speech & swallowing therapy (if bulbar involvement)", options: { breakLine: true } },
  { text: "• Psychosocial support & depression screening", options: { breakLine: true } },
  { text: "• Community re-integration & vocational counselling", options: {} },
], { x: 5.05, y: 1.52, w: 4.6, h: 1.45, fontSize: 9.5, color: TEXT_DARK, lineSpacingMultiple: 1.3 });

// Images for slide 4
if (images[0] && !images[0].error) {
  s4.addImage({ data: images[0].base64, x: 4.95, y: 3.15, w: 2.3, h: 2.05 });
  s4.addText("Pelvic bridging exercise", {
    x: 4.95, y: 5.0, w: 2.3, h: 0.2, fontSize: 7, color: SUBTEXT, align: "center"
  });
}
if (images[1] && !images[1].error) {
  s4.addImage({ data: images[1].base64, x: 7.35, y: 3.15, w: 2.4, h: 2.05 });
  s4.addText("Achilles tendon stretching", {
    x: 7.35, y: 5.0, w: 2.4, h: 0.2, fontSize: 7, color: SUBTEXT, align: "center"
  });
}

addAccentBar(s4);
addSlideNumber(s4, 4);

// ─── SLIDE 5: OUTCOMES, PROGNOSIS & KEY PEARLS ───────────────────
const s5 = pres.addSlide();
s5.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: DARK_BG }, line: { color: DARK_BG } });

// Teal top band
s5.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.85, fill: { color: "0A3045" }, line: { color: "0A3045" } });
s5.addShape(pres.ShapeType.rect, { x: 0, y: 0.85, w: 10, h: 0.05, fill: { color: ACCENT }, line: { color: ACCENT } });
s5.addText("Outcomes, Prognosis & Rehabilitation Pearls", {
  x: 0.3, y: 0.1, w: 9, h: 0.65, fontSize: 20, bold: true, color: WHITE, fontFace: "Calibri Light"
});

// Outcome stat boxes row
const stats = [
  { val: "~80%", label: "walk independently\nby 6 months" },
  { val: "5–10%", label: "permanent\ndisability" },
  { val: "1–5%", label: "mortality\n(modern care)" },
  { val: "3–5%", label: "relapse as CIDP" },
];
stats.forEach((s, i) => {
  const x = 0.2 + i * 2.4;
  s5.addShape(pres.ShapeType.rect, { x, y: 1.0, w: 2.2, h: 1.25, fill: { color: "132238" }, line: { color: TEAL, pt: 1 } });
  s5.addText(s.val, { x: x + 0.05, y: 1.05, w: 2.1, h: 0.55, fontSize: 22, bold: true, color: ACCENT, align: "center" });
  s5.addText(s.label, { x: x + 0.05, y: 1.6, w: 2.1, h: 0.55, fontSize: 9, color: "8FB3CC", align: "center", lineSpacingMultiple: 1.2 });
});

// Poor prognosis factors
s5.addShape(pres.ShapeType.rect, { x: 0.2, y: 2.4, w: 5.5, h: 2.9, fill: { color: "0F2030" }, line: { color: "1E4060", pt: 1 } });
s5.addShape(pres.ShapeType.rect, { x: 0.2, y: 2.4, w: 5.5, h: 0.36, fill: { color: "C0392B" }, line: { color: "C0392B" } });
s5.addText("⚠ Poor Prognosis Indicators", { x: 0.3, y: 2.42, w: 5.3, h: 0.3, fontSize: 11.5, bold: true, color: WHITE });
s5.addText([
  { text: "• Age >60 years", options: { breakLine: true } },
  { text: "• Rapid onset (<7 days to nadir)", options: { breakLine: true } },
  { text: "• Severe quadriplegia requiring ventilation", options: { breakLine: true } },
  { text: "• Axonal subtype (AMAN/AMSAN)", options: { breakLine: true } },
  { text: "• Preceding Campylobacter jejuni infection", options: { breakLine: true } },
  { text: "• Persistent severe pain (>1 year in ~30%)", options: {} }
], { x: 0.3, y: 2.83, w: 5.3, h: 2.35, fontSize: 10, color: "A8BFCC", lineSpacingMultiple: 1.35 });

// Key Rehab Pearls
s5.addShape(pres.ShapeType.rect, { x: 5.9, y: 2.4, w: 3.9, h: 2.9, fill: { color: "0F2030" }, line: { color: "1E4060", pt: 1 } });
s5.addShape(pres.ShapeType.rect, { x: 5.9, y: 2.4, w: 3.9, h: 0.36, fill: { color: TEAL }, line: { color: TEAL } });
s5.addText("✅ Key Rehab Pearls", { x: 6.0, y: 2.42, w: 3.7, h: 0.3, fontSize: 11.5, bold: true, color: WHITE });
s5.addText([
  { text: "• Start rehab early — even in ICU", options: { breakLine: true } },
  { text: "• Avoid overwork weakness", options: { breakLine: true } },
  { text: "• MDT approach (PT, OT, SLT, psychology)", options: { breakLine: true } },
  { text: "• Pain management is essential", options: { breakLine: true } },
  { text: "• Monitor autonomic instability", options: { breakLine: true } },
  { text: "• Psychosocial support for anxiety/depression", options: {} }
], { x: 6.0, y: 2.83, w: 3.7, h: 2.35, fontSize: 9.5, color: "A8BFCC", lineSpacingMultiple: 1.35 });

// Chronic deficits image
if (images[2] && !images[2].error) {
  s5.addImage({ data: images[2].base64, x: 5.9, y: 1.0, w: 3.9, h: 1.3 });
  s5.addText("Chronic motor deficits — MRC grade 3 UL / grade 2 LL at 5 years", {
    x: 5.9, y: 2.2, w: 3.9, h: 0.18, fontSize: 7, color: "6080A0", align: "center"
  });
}

// Footer
s5.addText("Source: Bradley & Daroff's Neurology in Clinical Practice; Miller's Anesthesia; Robbins & Kumar Pathology", {
  x: 0.2, y: 5.38, w: 9.6, h: 0.2, fontSize: 7, color: "4A6080", align: "left"
});

// ─── SAVE ─────────────────────────────────────────────────────────
const outPath = "/home/daytona/workspace/gbs-rehab-ppt/GBS_Rehabilitation.pptx";
pres.writeFile({ fileName: outPath }).then(() => {
  console.log("✅ Saved:", outPath);
}).catch(err => {
  console.error("❌ Error:", err);
  process.exit(1);
});

cd /home/daytona/workspace/gbs-rehab-ppt && node gbs_rehab.js 2>&1