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

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Asthma Management";
pres.author = "Medical Education";

// ─── Color Palette ───────────────────────────────────────────────────────────
const C = {
  deepBlue:   "0D3B66",  // dominant dark
  skyBlue:    "1A78C2",  // supporting mid
  lightBlue:  "D6EAF8",  // soft fill / card bg
  accent:     "F4A261",  // warm amber accent
  white:      "FFFFFF",
  lightGray:  "EAF0FB",
  darkText:   "1C2B3A",
  midText:    "3A5068",
  subtle:     "6B8CAE",
};

// ─── HELPERS ─────────────────────────────────────────────────────────────────

function addHeader(slide, title, subtitle) {
  // Full-width dark header bar
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: "100%", h: 1.1,
    fill: { color: C.deepBlue },
    line: { color: C.deepBlue },
  });
  // Accent stripe
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 1.05, w: "100%", h: 0.06,
    fill: { color: C.accent },
    line: { color: C.accent },
  });
  slide.addText(title, {
    x: 0.4, y: 0.1, w: 8.5, h: 0.65,
    fontSize: 26, bold: true, color: C.white,
    fontFace: "Calibri", valign: "middle",
  });
  if (subtitle) {
    slide.addText(subtitle, {
      x: 0.4, y: 0.72, w: 8.5, h: 0.35,
      fontSize: 13, color: C.accent,
      fontFace: "Calibri", valign: "middle",
    });
  }
}

function addFooter(slide, pageNum) {
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 5.45, w: "100%", h: 0.18,
    fill: { color: C.deepBlue }, line: { color: C.deepBlue },
  });
  slide.addText("Asthma Management  |  Evidence-Based Clinical Guide", {
    x: 0.3, y: 5.45, w: 8.5, h: 0.18,
    fontSize: 8, color: C.subtle, fontFace: "Calibri",
  });
  slide.addText(`${pageNum}`, {
    x: 9.5, y: 5.45, w: 0.4, h: 0.18,
    fontSize: 8, color: C.white, fontFace: "Calibri", align: "right",
  });
}

function addBullets(slide, items, opts = {}) {
  const { x=0.4, y=1.3, w=9.2, h=3.9, fontSize=15, color=C.darkText } = opts;
  const textArr = items.map((item, i) => ({
    text: item,
    options: {
      bullet: { type: "bullet", characterCode: "25B6", indent: 16 },
      breakLine: i < items.length - 1,
      fontSize, color, fontFace: "Calibri",
      paraSpaceAfter: 6,
    },
  }));
  slide.addText(textArr, { x, y, w, h, valign: "top" });
}

function card(slide, x, y, w, h, title, lines, titleColor=C.deepBlue, bgColor=C.lightGray) {
  slide.addShape(pres.ShapeType.roundRect, {
    x, y, w, h,
    fill: { color: bgColor },
    line: { color: C.skyBlue, pt: 1.2 },
    rectRadius: 0.12,
  });
  slide.addText(title, {
    x: x + 0.12, y: y + 0.07, w: w - 0.24, h: 0.38,
    fontSize: 13, bold: true, color: titleColor,
    fontFace: "Calibri",
  });
  const lineArr = lines.map((l, i) => ({
    text: l,
    options: {
      bullet: { type: "bullet" },
      breakLine: i < lines.length - 1,
      fontSize: 12, color: C.darkText, fontFace: "Calibri",
      paraSpaceAfter: 4,
    },
  }));
  slide.addText(lineArr, {
    x: x + 0.12, y: y + 0.48, w: w - 0.24, h: h - 0.55,
    valign: "top",
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  // Background gradient bands
  sl.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: "100%", h: "100%",
    fill: { color: C.deepBlue }, line: { color: C.deepBlue },
  });
  sl.addShape(pres.ShapeType.rect, {
    x: 6.5, y: 0, w: 3.5, h: "100%",
    fill: { color: "0E4D8A" }, line: { color: "0E4D8A" },
  });
  // Large accent stripe
  sl.addShape(pres.ShapeType.rect, {
    x: 0, y: 3.8, w: 6.4, h: 0.08,
    fill: { color: C.accent }, line: { color: C.accent },
  });
  // Decorative circle
  sl.addShape(pres.ShapeType.ellipse, {
    x: 7.2, y: 0.6, w: 2.2, h: 2.2,
    fill: { color: "ffffff", transparency: 88 },
    line: { color: "ffffff", transparency: 70, pt: 1.5 },
  });
  sl.addShape(pres.ShapeType.ellipse, {
    x: 7.6, y: 1.0, w: 1.4, h: 1.4,
    fill: { color: C.accent, transparency: 30 },
    line: { color: C.accent },
  });

  sl.addText("ASTHMA", {
    x: 0.5, y: 1.0, w: 6, h: 1.1,
    fontSize: 58, bold: true, color: C.white,
    fontFace: "Calibri", charSpacing: 6,
  });
  sl.addText("MANAGEMENT", {
    x: 0.5, y: 1.95, w: 6, h: 0.9,
    fontSize: 42, bold: true, color: C.accent,
    fontFace: "Calibri", charSpacing: 3,
  });
  sl.addText("A Comprehensive Clinical Guide", {
    x: 0.5, y: 2.95, w: 6, h: 0.5,
    fontSize: 18, color: C.lightBlue, fontFace: "Calibri", italic: true,
  });
  sl.addText("Evidence-Based Approach to Diagnosis, Classification & Treatment", {
    x: 0.5, y: 3.98, w: 6, h: 0.5,
    fontSize: 13, color: "8AAFC8", fontFace: "Calibri",
  });
  sl.addText("Sources: Washington Manual of Medical Therapeutics • Murray & Nadel's Textbook of Respiratory Medicine • Textbook of Family Medicine", {
    x: 0.5, y: 5.15, w: 9.2, h: 0.35,
    fontSize: 8, color: "5D8AAD", fontFace: "Calibri",
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 2 — OVERVIEW / AGENDA
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.white}, line:{color:C.white} });
  addHeader(sl, "Overview", "What we will cover");
  addFooter(sl, 2);

  const topics = [
    ["01", "Definition & Pathophysiology",    "Airway inflammation, bronchospasm, remodeling"],
    ["02", "Diagnosis & Classification",       "Symptoms, spirometry, severity grading"],
    ["03", "Long-Term Management",             "Stepwise pharmacotherapy & controller therapy"],
    ["04", "Acute Exacerbation Management",    "Emergency & hospital-based treatment"],
    ["05", "Monitoring & Special Populations", "Pregnancy, pediatrics, follow-up goals"],
  ];

  topics.forEach(([num, heading, sub], i) => {
    const y = 1.25 + i * 0.83;
    sl.addShape(pres.ShapeType.rect, {
      x: 0.35, y, w: 9.3, h: 0.72,
      fill: { color: i % 2 === 0 ? C.lightGray : "F0F7FF" },
      line: { color: C.skyBlue, pt: 0.5 },
    });
    sl.addShape(pres.ShapeType.rect, {
      x: 0.35, y, w: 0.55, h: 0.72,
      fill: { color: C.skyBlue }, line: { color: C.skyBlue },
    });
    sl.addText(num, {
      x: 0.35, y: y + 0.16, w: 0.55, h: 0.4,
      fontSize: 14, bold: true, color: C.white, align: "center", fontFace: "Calibri",
    });
    sl.addText(heading, {
      x: 1.05, y: y + 0.06, w: 5.5, h: 0.35,
      fontSize: 14, bold: true, color: C.deepBlue, fontFace: "Calibri",
    });
    sl.addText(sub, {
      x: 1.05, y: y + 0.38, w: 8.4, h: 0.28,
      fontSize: 11, color: C.midText, fontFace: "Calibri",
    });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 3 — DEFINITION & PATHOPHYSIOLOGY
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.white}, line:{color:C.white} });
  addHeader(sl, "Definition & Pathophysiology", "What happens in asthma?");
  addFooter(sl, 3);

  card(sl, 0.3, 1.25, 4.5, 2.1, "Definition",
    ["Chronic inflammatory airway disease", "Reversible airflow obstruction", "Airway hyperresponsiveness to triggers", "Symptoms: wheezing, cough, chest tightness, dyspnea"],
    C.deepBlue, C.lightGray
  );

  card(sl, 5.0, 1.25, 4.7, 2.1, "Pathophysiology",
    ["Mast cell & eosinophil-driven inflammation", "Th2 cytokines (IL-4, IL-5, IL-13)", "Goblet cell hyperplasia → mucus hypersecretion", "Airway smooth muscle hypertrophy & remodeling"],
    C.deepBlue, "F0F7FF"
  );

  card(sl, 0.3, 3.5, 9.4, 1.85, "Key Triggers",
    ["Respiratory viruses (rhinovirus — most common exacerbation trigger)", "Allergens: dust mites, pollen, animal dander, mold", "Air pollutants, smoke, exercise, cold air", "NSAIDs/aspirin, β-blockers (in susceptible individuals)", "Occupational sensitizers, emotional stress"],
    C.accent, C.lightBlue
  );
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 4 — DIAGNOSIS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.white}, line:{color:C.white} });
  addHeader(sl, "Diagnosis", "Clinical features & spirometry");
  addFooter(sl, 4);

  // Left column – clinical
  sl.addText("Clinical Features", { x:0.35, y:1.25, w:4.5, h:0.38, fontSize:15, bold:true, color:C.skyBlue, fontFace:"Calibri" });
  addBullets(sl, [
    "Episodic or recurrent wheezing",
    "Dyspnea, chest tightness",
    "Dry cough (especially nocturnal)",
    "Symptoms worse with exercise, cold air, allergens",
    "Symptoms variable and often reversible",
    "Personal/family history of atopy or eczema",
  ], { x:0.35, y:1.65, w:4.5, h:3.5, fontSize:13 });

  // Right column – spirometry
  sl.addShape(pres.ShapeType.rect, { x:5.1, y:1.2, w:4.6, h:4.1, fill:{color:C.lightGray}, line:{color:C.skyBlue, pt:1} });
  sl.addText("Spirometry & Objective Testing", { x:5.2, y:1.28, w:4.3, h:0.4, fontSize:14, bold:true, color:C.deepBlue, fontFace:"Calibri" });
  
  const spiro = [
    ["FEV\u2081/FVC", "< 0.70 confirms obstruction"],
    ["Reversibility", "\u226512% AND \u2265200 mL \u2191FEV\u2081 post-bronchodilator"],
    ["Bronchoprovocation", "Methacholine challenge if baseline normal"],
    ["Peak Flow", "Diurnal variability >10% supports diagnosis"],
    ["FeNO", ">40 ppb suggests eosinophilic airway inflammation"],
  ];
  spiro.forEach(([label, val], i) => {
    const y = 1.78 + i * 0.65;
    sl.addShape(pres.ShapeType.rect, { x:5.2, y, w:1.4, h:0.52, fill:{color:C.skyBlue}, line:{color:C.skyBlue} });
    sl.addText(label, { x:5.2, y: y+0.08, w:1.4, h:0.38, fontSize:11, bold:true, color:C.white, align:"center", fontFace:"Calibri" });
    sl.addText(val, { x:6.7, y: y+0.06, w:2.9, h:0.44, fontSize:11, color:C.darkText, fontFace:"Calibri", valign:"middle" });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 5 — CLASSIFICATION
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.white}, line:{color:C.white} });
  addHeader(sl, "Classification of Asthma Severity", "NAEPP Guidelines — ≥12 years of age");
  addFooter(sl, 5);

  const headers = ["Component", "Intermittent", "Mild Persistent", "Moderate Persistent", "Severe Persistent"];
  const rows = [
    ["Symptoms", "≤2 days/week", ">2 d/wk, not daily", "Daily", "Throughout the day"],
    ["Night awakenings", "≤2×/month", "3–4×/month", ">1×/week", "Often nightly"],
    ["SABA use", "≤2 d/wk", ">2 d/wk, not daily", "Daily", "Several times/day"],
    ["Activity limitation", "None", "Minor", "Some", "Extreme"],
    ["FEV\u2081 % predicted", ">80%", ">80%", "60–80%", "<60%"],
    ["Recommended step", "Step 1", "Step 2", "Step 3", "Step 4–5"],
  ];
  const colW = [2.0, 1.85, 1.85, 1.85, 1.85];
  const colX = [0.3, 2.3, 4.15, 6.0, 7.85];
  const headerColors = [C.deepBlue, "1565C0", "1976D2", "1A78C2", "1A8A9B"];

  // Headers
  headers.forEach((h, i) => {
    sl.addShape(pres.ShapeType.rect, { x:colX[i], y:1.2, w:colW[i]-0.04, h:0.5, fill:{color:headerColors[i]}, line:{color:C.deepBlue} });
    sl.addText(h, { x:colX[i], y:1.2, w:colW[i]-0.04, h:0.5, fontSize:11, bold:true, color:C.white, align:"center", fontFace:"Calibri", valign:"middle" });
  });

  // Rows
  rows.forEach((row, ri) => {
    const y = 1.72 + ri * 0.61;
    const bg = ri % 2 === 0 ? C.lightGray : C.white;
    row.forEach((cell, ci) => {
      sl.addShape(pres.ShapeType.rect, { x:colX[ci], y, w:colW[ci]-0.04, h:0.58, fill:{color:ci===0 ? C.lightBlue : bg}, line:{color:"C5D8EB"} });
      sl.addText(cell, { x:colX[ci]+0.05, y, w:colW[ci]-0.09, h:0.58, fontSize: ci===0 ? 11 : 11, bold:ci===0, color:C.darkText, fontFace:"Calibri", valign:"middle", align: ci===0 ? "left" : "center" });
    });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 6 — STEPWISE LONG-TERM MANAGEMENT (image slide)
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.white}, line:{color:C.white} });
  addHeader(sl, "Stepwise Long-Term Management", "2021 Asthma Management Continuum");
  addFooter(sl, 6);

  // Fetch the stepwise image
  const imgUrl = "https://cdn.orris.care/cdss_images/GLGCA_4567551_1766519263906_cef1591b-1cc1-40a2-9a0c-94dd0647fc05_729150ca-35ec-4041-9fdd-a9051cbf609c.png";
  let imgData = null;
  try {
    const result = execSync(`node /home/daytona/skills/shared/scripts/fetch_images.js "${imgUrl}"`).toString();
    const parsed = JSON.parse(result);
    if (parsed[0] && !parsed[0].error) imgData = parsed[0].base64;
  } catch(e) { console.error("Image fetch failed:", e.message); }

  if (imgData) {
    sl.addImage({ data: imgData, x: 0.4, y: 1.18, w: 9.2, h: 4.2 });
  } else {
    sl.addText("Stepwise Management Continuum diagram", { x:0.4, y:1.3, w:9.2, h:4, fontSize:18, color:C.midText, align:"center" });
  }
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 7 — PHARMACOTHERAPY STEPS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.white}, line:{color:C.white} });
  addHeader(sl, "Pharmacotherapy — Steps 1–6", "Controller & reliever medications");
  addFooter(sl, 7);

  const steps = [
    { step:"Step 1", drug:"PRN SABA",            bg:"EBF5FB", tx:C.deepBlue },
    { step:"Step 2", drug:"Low-dose ICS + PRN SABA",  bg:"D6EAF8", tx:C.deepBlue },
    { step:"Step 3", drug:"Low-dose ICS/LABA",        bg:"AED6F1", tx:C.deepBlue },
    { step:"Step 4", drug:"Med/High ICS/LABA",         bg:"5DADE2", tx:C.white    },
    { step:"Step 5", drug:"High ICS/LABA + Consider biologics", bg:"2E86C1", tx:C.white },
    { step:"Step 6", drug:"Oral corticosteroids (lowest dose)", bg:C.deepBlue, tx:C.white },
  ];

  const boxW = 1.5;
  const startX = 0.3;
  steps.forEach(({step, drug, bg, tx}, i) => {
    const x = startX + i * 1.58;
    // Trapezoid approximation using rect with different heights
    const h = 1.3 + i * 0.35;
    const y = 5.5 - h;
    sl.addShape(pres.ShapeType.rect, {
      x, y, w: boxW, h,
      fill: { color: bg }, line: { color: C.skyBlue, pt: 0.8 },
    });
    sl.addText(step, {
      x, y: y + 0.1, w: boxW, h: 0.35,
      fontSize: 11, bold: true, color: tx, align: "center", fontFace: "Calibri",
    });
    sl.addText(drug, {
      x: x + 0.05, y: y + 0.42, w: boxW - 0.1, h: h - 0.5,
      fontSize: 10, color: tx, align: "center", fontFace: "Calibri", valign: "middle",
    });
  });

  // Arrow showing escalation
  sl.addShape(pres.ShapeType.rect, {
    x: 0.3, y: 5.5, w: 9.2, h: 0.06,
    fill: { color: C.accent }, line: { color: C.accent },
  });
  sl.addText("▶  Escalate if not controlled   |   ◀  Step down when stable for ≥3 months   |   Reassess at every visit", {
    x: 0.3, y: 5.58, w: 9.2, h: 0.3,
    fontSize: 10, color: C.midText, align: "center", fontFace: "Calibri",
  });

  // Note row
  sl.addText("ICS = Inhaled Corticosteroid  •  LABA = Long-Acting β₂-Agonist  •  SABA = Short-Acting β₂-Agonist  •  All steps: Education + trigger avoidance", {
    x: 0.3, y: 5.15, w: 9.4, h: 0.28,
    fontSize: 9, color: C.subtle, fontFace: "Calibri", italic: true,
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 8 — CONTROLLER MEDICATIONS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.white}, line:{color:C.white} });
  addHeader(sl, "Controller Medications", "Long-term pharmacological agents");
  addFooter(sl, 8);

  const meds = [
    { name:"Inhaled Corticosteroids (ICS)", detail:"Cornerstone of therapy. Reduce airway inflammation.\nExamples: fluticasone, budesonide, beclomethasone.\nLow-dose for mild, high-dose for severe persistent asthma.", col:C.deepBlue },
    { name:"Long-Acting β₂-Agonists (LABA)", detail:"Never use as monotherapy. Add to ICS for Steps 3–5.\nExamples: salmeterol, formoterol.\nImprove FEV\u2081 and reduce exacerbations.", col:C.skyBlue },
    { name:"Leukotriene Receptor Antagonists", detail:"Second-line alternative or add-on.\nExamples: montelukast, zafirlukast.\nUseful in aspirin-sensitive asthma & allergic rhinitis.", col:"1A8A9B" },
    { name:"Biologics (Severe Asthma)", detail:"Step 5 add-on. Target specific inflammatory pathways.\nomalizumab (anti-IgE), mepolizumab/benralizumab (anti-IL-5),\ndupilumab (anti-IL-4/IL-13).", col:"7D3C98" },
    { name:"Tiotropium (LAMA)", detail:"Add-on for ≥12 yrs at Step 4–5.\nImproves lung function in severe uncontrolled asthma.", col:C.accent },
  ];

  meds.forEach(({name, detail, col}, i) => {
    const x = i < 3 ? 0.3 : 3.6 + (i-3)*3.5;
    const y = i < 3 ? 1.2 + i * 1.42 : 1.2;
    const w = i < 3 ? 3.1 : 3.3;
    const h = i < 3 ? 1.3 : 3.0;

    if(i < 3) {
      // Left column: 3 stacked cards
      sl.addShape(pres.ShapeType.roundRect, { x, y, w, h, fill:{color:C.lightGray}, line:{color:col, pt:2}, rectRadius:0.1 });
      sl.addShape(pres.ShapeType.rect, { x, y, w:0.12, h, fill:{color:col}, line:{color:col} });
      sl.addText(name, { x:x+0.18, y:y+0.07, w:w-0.24, h:0.35, fontSize:12, bold:true, color:col, fontFace:"Calibri" });
      sl.addText(detail, { x:x+0.18, y:y+0.42, w:w-0.24, h:h-0.5, fontSize:10, color:C.darkText, fontFace:"Calibri" });
    } else {
      // Right column: 2 tall cards
      sl.addShape(pres.ShapeType.roundRect, { x, y, w, h, fill:{color:C.lightGray}, line:{color:col, pt:2}, rectRadius:0.1 });
      sl.addShape(pres.ShapeType.rect, { x, y, w:0.12, h, fill:{color:col}, line:{color:col} });
      sl.addText(name, { x:x+0.18, y:y+0.07, w:w-0.24, h:0.35, fontSize:12, bold:true, color:col, fontFace:"Calibri" });
      sl.addText(detail, { x:x+0.18, y:y+0.42, w:w-0.24, h:h-0.5, fontSize:10, color:C.darkText, fontFace:"Calibri" });
    }
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 9 — ACUTE EXACERBATION MANAGEMENT
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.white}, line:{color:C.white} });
  addHeader(sl, "Management of Acute Exacerbations", "Emergency & hospital-based approach");
  addFooter(sl, 9);

  // Severity assessment box
  sl.addShape(pres.ShapeType.roundRect, { x:0.3, y:1.2, w:4.4, h:4.0, fill:{color:C.lightGray}, line:{color:C.skyBlue, pt:1}, rectRadius:0.12 });
  sl.addText("Initial Assessment", { x:0.4, y:1.27, w:4.2, h:0.38, fontSize:14, bold:true, color:C.deepBlue, fontFace:"Calibri" });
  const assess = [
    "Severity: mild/moderate/severe/near-fatal",
    "Oximetry, SpO₂, peak expiratory flow (PEF)",
    "Use of accessory muscles, ability to speak",
    "ABG if PCO₂ normalizes without improvement → impending respiratory failure",
    "Chest X-ray if pneumothorax suspected",
    "High-risk features: prior ICU admission, recent OCS use, poor adherence",
  ];
  addBullets(sl, assess, { x:0.4, y:1.67, w:4.2, h:3.4, fontSize:12 });

  // Treatment
  sl.addShape(pres.ShapeType.roundRect, { x:5.0, y:1.2, w:4.7, h:4.0, fill:{color:"F0F7FF"}, line:{color:C.accent, pt:1.5}, rectRadius:0.12 });
  sl.addText("Treatment Protocol", { x:5.1, y:1.27, w:4.4, h:0.38, fontSize:14, bold:true, color:C.accent, fontFace:"Calibri" });

  const treatments = [
    ["Mild–Moderate", "Albuterol 2–6 puffs MDI q20min × 3, or 2.5 mg nebulized"],
    ["Severe",        "Albuterol 2.5–5 mg + Ipratropium 0.5 mg q20min via nebulizer"],
    ["Systemic CS",   "Prednisone 40–60 mg/day (oral = IV if equivalent dose). Prompt administration is key."],
    ["Refractory",    "IV Magnesium 2 g over 20 min. Heliox-driven nebulization (70:30 He:O₂)."],
    ["Admission",     "Fails SABA after 30–60 min, PEF <70% baseline, SpO₂ <90%"],
    ["Discharge",     "Prednisone 40 mg/day × 5–7 days + Initiate/increase ICS"],
  ];
  treatments.forEach(([label, val], i) => {
    const y = 1.7 + i * 0.57;
    sl.addShape(pres.ShapeType.rect, { x:5.1, y, w:1.4, h:0.5, fill:{color:C.accent}, line:{color:C.accent} });
    sl.addText(label, { x:5.1, y, w:1.4, h:0.5, fontSize:10, bold:true, color:C.white, align:"center", fontFace:"Calibri", valign:"middle" });
    sl.addText(val, { x:6.6, y: y+0.02, w:3.0, h:0.48, fontSize:9.5, color:C.darkText, fontFace:"Calibri", valign:"middle" });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 10 — MONITORING & SPECIAL POPULATIONS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.white}, line:{color:C.white} });
  addHeader(sl, "Monitoring & Special Populations", "Follow-up, control goals, pregnancy & children");
  addFooter(sl, 10);

  card(sl, 0.3, 1.2, 4.4, 2.1, "Monitoring Goals",
    ["Reassess control at every visit", "Spirometry or PEF monitoring", "Check inhaler technique & adherence", "Review trigger avoidance & action plan", "Sputum eosinophils in severe asthma", "Step down if well-controlled ≥3 months"],
    C.deepBlue
  );
  card(sl, 5.05, 1.2, 4.65, 2.1, "Well-Controlled Asthma Criteria",
    ["Symptoms ≤2 days/week", "Nighttime awakenings ≤2×/month", "No limitation of normal activity", "SABA use ≤2 days/week", "FEV\u2081 or PEF ≥80% predicted", "No exacerbations in past year"],
    C.skyBlue, "F0F7FF"
  );
  card(sl, 0.3, 3.45, 4.4, 2.1, "Pregnancy",
    ["Uncontrolled asthma → greater risk than medications", "Continue ICS — budesonide preferred (most data)", "SABA safe for acute relief", "Maintain SpO\u2082 ≥95%", "Monitor lung function each trimester"],
    "7D3C98", C.lightGray
  );
  card(sl, 5.05, 3.45, 4.65, 2.1, "Pediatrics",
    ["Children 0–4 yrs: intermittent ICS or daily low-dose ICS", "Children 5–11 yrs: same stepwise approach, lower ICS doses", "LABAs can be added at Step 3 (≥5 yrs)", "Spacers/VHCs recommended for all inhaled therapies", "Regular assessment of growth with ICS use"],
    C.accent, C.lightBlue
  );
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 11 — KEY TAKEAWAYS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x:0, y:0, w:"100%", h:"100%", fill:{color:C.deepBlue}, line:{color:C.deepBlue} });
  sl.addShape(pres.ShapeType.rect, { x:0, y:4.9, w:"100%", h:0.08, fill:{color:C.accent}, line:{color:C.accent} });

  sl.addText("Key Takeaways", {
    x:0.5, y:0.15, w:9, h:0.7,
    fontSize:30, bold:true, color:C.white, fontFace:"Calibri", charSpacing:2,
  });

  const points = [
    ["ICS is the cornerstone",    "Every persistent asthma patient should be on inhaled corticosteroids."],
    ["Stepwise approach",         "Escalate therapy based on severity; step down when stable for 3+ months."],
    ["Treat exacerbations early", "Prompt bronchodilators + systemic steroids limit morbidity."],
    ["Patient education",         "Trigger avoidance, inhaler technique, and written action plans are essential."],
    ["Biologics for refractory",  "Anti-IgE, anti-IL-5, anti-IL-4/13 agents for Step 5 severe asthma."],
    ["Monitor & reassess",        "Spirometry, control scores, adherence review at every visit."],
  ];

  points.forEach(([title, desc], i) => {
    const col = i < 3 ? 0 : 1;
    const row = i % 3;
    const x = 0.35 + col * 4.85;
    const y = 1.05 + row * 1.25;
    sl.addShape(pres.ShapeType.roundRect, { x, y, w:4.6, h:1.1, fill:{color:"ffffff", transparency:88}, line:{color:C.accent, pt:1}, rectRadius:0.1 });
    sl.addShape(pres.ShapeType.rect, { x, y, w:0.1, h:1.1, fill:{color:C.accent}, line:{color:C.accent} });
    sl.addText(title, { x:x+0.18, y:y+0.1, w:4.3, h:0.35, fontSize:13, bold:true, color:C.accent, fontFace:"Calibri" });
    sl.addText(desc,  { x:x+0.18, y:y+0.48, w:4.3, h:0.55, fontSize:11, color:"D6EAF8", fontFace:"Calibri" });
  });

  sl.addText("Sources: Washington Manual of Medical Therapeutics • Murray & Nadel's Respiratory Medicine • Textbook of Family Medicine (Rakel)", {
    x:0.4, y:5.02, w:9.2, h:0.28,
    fontSize:8, color:"5D8AAD", fontFace:"Calibri",
  });
}

// ─── WRITE FILE ───────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/asthma-management-ppt/Asthma_Management.pptx" })
  .then(() => console.log("SUCCESS: /home/daytona/workspace/asthma-management-ppt/Asthma_Management.pptx"))
  .catch(e => { console.error("FAILED:", e); process.exit(1); });