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

// ── Download images ────────────────────────────────────────────────────────────
const imageUrls = [
  // Clinical presentations composite (tinea capitis, pedis, corporis, cruris, onychomycosis)
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_11d7cf4e49fce6a7701eab40f3667102048917d9e2a96afa56c488595c72c1a3.jpg",
  // Another clinical composite (onychomycosis, candidiasis, pityriasis versicolor)
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_f083aeddbc9f8ce48b590fc2c18dcade267ac0d53be15a0bfea54a019da04e86.jpg",
  // AmphoB mechanism
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_9cba238b28ddb695bf76b8ea05f85765cda3dfd04d149f32c7dd0a713338bfdd.jpg",
  // Onychomycosis + moccasin tinea pedis
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_09e97cadc35b1880d65c4adff710ff8b61ac4193a97f64d9638444f48042aec7.jpg",
];

let images = [];
try {
  const cmd = `node /home/daytona/skills/shared/scripts/fetch_images.js ${imageUrls.map(u => `"${u}"`).join(" ")}`;
  images = JSON.parse(execSync(cmd, { maxBuffer: 50 * 1024 * 1024 }).toString());
} catch (e) {
  console.error("Image fetch error:", e.message);
  images = imageUrls.map(() => ({ base64: null, error: "fetch failed" }));
}

// ── Helpers ────────────────────────────────────────────────────────────────────
const DARK_BG   = "0D1B2A";   // deep navy
const MID_BG    = "1B2E45";   // medium navy panel
const ACCENT1   = "00B4D8";   // cyan accent
const ACCENT2   = "90E0EF";   // light cyan
const GREEN     = "52B788";   // teal-green
const GOLD      = "FFD166";   // amber highlight
const WHITE     = "FFFFFF";
const LIGHT_TXT = "CAF0F8";
const MUTED     = "8ECAE6";

function addBg(slide, color = DARK_BG) {
  slide.addShape("rect", { x: 0, y: 0, w: "100%", h: "100%", fill: { color } });
}

function sectionBanner(slide, text, y = 0, h = 0.55) {
  slide.addShape("rect", { x: 0, y, w: "100%", h, fill: { color: ACCENT1 } });
  slide.addText(text, {
    x: 0.3, y: y + 0.04, w: 9.4, h: h - 0.08,
    fontSize: 14, bold: true, color: DARK_BG, fontFace: "Calibri", valign: "middle",
    margin: 0
  });
}

function addBullets(slide, items, x, y, w, h, opts = {}) {
  const defaults = { fontSize: 11, color: WHITE, fontFace: "Calibri", bold: false };
  const o = { ...defaults, ...opts };
  slide.addText(
    items.map((item, i) => ({
      text: item,
      options: { bullet: { type: "bullet" }, breakLine: i < items.length - 1, ...o }
    })),
    { x, y, w, h, valign: "top" }
  );
}

// ══════════════════════════════════════════════════════════════════════════════
const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Drugs for Treatment of Mycosis of Skin and Its Derivatives";

// ── SLIDE 1 — Title ────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  addBg(s, DARK_BG);
  // decorative top stripe
  s.addShape("rect", { x: 0, y: 0, w: "100%", h: 0.08, fill: { color: ACCENT1 } });
  // vertical accent bar
  s.addShape("rect", { x: 0.35, y: 0.7, w: 0.08, h: 4.2, fill: { color: ACCENT1 } });
  // title
  s.addText("Drugs for Treatment of", {
    x: 0.65, y: 0.9, w: 8.7, h: 0.75,
    fontSize: 30, bold: true, color: ACCENT2, fontFace: "Calibri",
  });
  s.addText("Mycosis of Skin and Its Derivatives", {
    x: 0.65, y: 1.55, w: 8.7, h: 0.8,
    fontSize: 28, bold: true, color: WHITE, fontFace: "Calibri",
  });
  s.addText("Superficial & Cutaneous Fungal Infections | Pharmacology", {
    x: 0.65, y: 2.55, w: 8, h: 0.45,
    fontSize: 15, color: MUTED, fontFace: "Calibri", italic: true,
  });
  // decorative pill tags
  ["Topical Antifungals", "Systemic Antifungals", "Dermatophytosis", "Candidiasis"].forEach((tag, i) => {
    s.addShape("roundRect", {
      x: 0.65 + i * 2.25, y: 3.6, w: 2.1, h: 0.38,
      fill: { color: MID_BG }, line: { color: ACCENT1, width: 1 }, rectRadius: 0.12
    });
    s.addText(tag, {
      x: 0.65 + i * 2.25, y: 3.6, w: 2.1, h: 0.38,
      fontSize: 9.5, color: ACCENT2, fontFace: "Calibri", align: "center", valign: "middle",
    });
  });
  s.addText("Sources: Fitzpatrick's Dermatology 9e | Dermatology 5e | Medical Microbiology 9e | Harrison's 22e", {
    x: 0.65, y: 4.9, w: 9.0, h: 0.3,
    fontSize: 7.5, color: MUTED, fontFace: "Calibri",
  });
  s.addShape("rect", { x: 0, y: 5.325, w: "100%", h: 0.3, fill: { color: MID_BG } });
  s.addText("Pharmacology of Cutaneous Mycosis | 2026", {
    x: 0, y: 5.325, w: "100%", h: 0.3,
    fontSize: 9, color: ACCENT2, align: "center", valign: "middle", fontFace: "Calibri",
  });
}

// ── SLIDE 2 — Overview & Classification ───────────────────────────────────────
{
  const s = pres.addSlide();
  addBg(s, DARK_BG);
  sectionBanner(s, "Classification of Skin Mycoses");
  s.addText("What are Skin Mycoses?", {
    x: 0.3, y: 0.65, w: 9.4, h: 0.45,
    fontSize: 18, bold: true, color: WHITE, fontFace: "Calibri",
  });
  s.addText(
    "Mycoses of the skin and its derivatives (hair, nails) are fungal infections of the keratinized layers of the integument. " +
    "They are classified by depth and causative organism.",
    { x: 0.3, y: 1.1, w: 9.4, h: 0.55, fontSize: 11, color: LIGHT_TXT, fontFace: "Calibri" }
  );

  // 3 cards
  const cards = [
    {
      title: "Superficial / Cutaneous", color: GREEN,
      items: [
        "Dermatophytoses (tinea spp.)",
        "Tinea versicolor (Malassezia)",
        "Cutaneous candidiasis",
        "Affects stratum corneum, hair & nails",
      ]
    },
    {
      title: "Subcutaneous", color: GOLD,
      items: [
        "Sporotrichosis",
        "Chromoblastomycosis",
        "Mycetoma",
        "Invades dermis & subcutaneous tissue",
      ]
    },
    {
      title: "Systemic (with cutaneous signs)", color: ACCENT1,
      items: [
        "Histoplasmosis",
        "Coccidioidomycosis",
        "Cryptococcosis (skin lesions)",
        "Requires systemic antifungal therapy",
      ]
    },
  ];
  cards.forEach((card, i) => {
    const cx = 0.25 + i * 3.3;
    s.addShape("roundRect", {
      x: cx, y: 1.75, w: 3.1, h: 2.8,
      fill: { color: MID_BG }, line: { color: card.color, width: 2 }, rectRadius: 0.15
    });
    s.addShape("rect", { x: cx, y: 1.75, w: 3.1, h: 0.42, fill: { color: card.color }, rectRadius: 0.1 });
    s.addText(card.title, {
      x: cx + 0.1, y: 1.75, w: 2.9, h: 0.42,
      fontSize: 10.5, bold: true, color: DARK_BG, fontFace: "Calibri", valign: "middle", margin: 0,
    });
    addBullets(s, card.items, cx + 0.15, 2.22, 2.8, 2.2, { fontSize: 10, color: LIGHT_TXT });
  });

  s.addShape("rect", { x: 0, y: 5.325, w: "100%", h: 0.3, fill: { color: MID_BG } });
  s.addText("Focus: Treatment of superficial/cutaneous mycoses — dermatophytoses, candidiasis, pityriasis versicolor", {
    x: 0, y: 5.325, w: "100%", h: 0.3,
    fontSize: 8, color: ACCENT2, align: "center", valign: "middle", fontFace: "Calibri",
  });
}

// ── SLIDE 3 — Clinical Images ─────────────────────────────────────────────────
{
  const s = pres.addSlide();
  addBg(s, DARK_BG);
  sectionBanner(s, "Clinical Presentations of Cutaneous Mycoses");
  s.addText("Dermatophytoses — Tinea Species", {
    x: 0.3, y: 0.65, w: 9.4, h: 0.4, fontSize: 16, bold: true, color: WHITE, fontFace: "Calibri",
  });

  if (images[0] && images[0].base64) {
    s.addImage({ data: images[0].base64, x: 0.3, y: 1.15, w: 5.0, h: 3.5 });
  }

  const tineaTypes = [
    ["Tinea Capitis", "Scalp ringworm; hair shaft involvement; treated with oral antifungals (griseofulvin, terbinafine)"],
    ["Tinea Pedis", "Athlete's foot; most common dermatophytosis; topical or oral terbinafine/azoles"],
    ["Tinea Corporis", "Annular 'ringworm' plaque; topical allylamines or imidazoles"],
    ["Tinea Cruris", "Groin; topical antifungals; oral for recalcitrant cases"],
    ["Tinea Unguium", "Onychomycosis; nail involvement; requires prolonged oral therapy"],
  ];
  tineaTypes.forEach(([name, desc], i) => {
    s.addShape("roundRect", {
      x: 5.6, y: 1.15 + i * 0.72, w: 4.05, h: 0.65,
      fill: { color: MID_BG }, line: { color: ACCENT1, width: 0.5 }, rectRadius: 0.1
    });
    s.addText(name, {
      x: 5.7, y: 1.17 + i * 0.72, w: 3.85, h: 0.25,
      fontSize: 10, bold: true, color: ACCENT2, fontFace: "Calibri", margin: 0,
    });
    s.addText(desc, {
      x: 5.7, y: 1.38 + i * 0.72, w: 3.85, h: 0.35,
      fontSize: 8.5, color: LIGHT_TXT, fontFace: "Calibri", margin: 0,
    });
  });
  s.addShape("rect", { x: 0, y: 5.325, w: "100%", h: 0.3, fill: { color: MID_BG } });
  s.addText("Fitzpatrick's Dermatology 9e, Ch. 160 | Dermatology 5e, Ch. 77", {
    x: 0, y: 5.325, w: "100%", h: 0.3,
    fontSize: 8, color: MUTED, align: "center", valign: "middle", fontFace: "Calibri",
  });
}

// ── SLIDE 4 — Clinical Images 2 (Candida / Pityriasis) ────────────────────────
{
  const s = pres.addSlide();
  addBg(s, DARK_BG);
  sectionBanner(s, "Other Cutaneous Mycoses");
  s.addText("Candidiasis & Pityriasis Versicolor", {
    x: 0.3, y: 0.65, w: 9.4, h: 0.4, fontSize: 16, bold: true, color: WHITE, fontFace: "Calibri",
  });
  if (images[1] && images[1].base64) {
    s.addImage({ data: images[1].base64, x: 0.3, y: 1.1, w: 4.7, h: 3.7 });
  }
  const items2 = [
    { title: "Cutaneous Candidiasis", color: GREEN,
      lines: ["Caused by Candida spp. (C. albicans)", "Intertriginous areas, skin folds", "Treatment: topical imidazoles (clotrimazole, miconazole)", "Oral fluconazole for widespread/recurrent cases"] },
    { title: "Pityriasis Versicolor", color: GOLD,
      lines: ["Caused by Malassezia furfur", "Hypopigmented/hyperpigmented macules on trunk", "Treatment: topical selenium sulfide, zinc pyrithione, ketoconazole shampoo", "Oral itraconazole or fluconazole for extensive cases"] },
  ];
  items2.forEach((item, i) => {
    s.addShape("roundRect", {
      x: 5.25, y: 1.1 + i * 2.0, w: 4.4, h: 1.85,
      fill: { color: MID_BG }, line: { color: item.color, width: 2 }, rectRadius: 0.15,
    });
    s.addText(item.title, {
      x: 5.35, y: 1.15 + i * 2.0, w: 4.1, h: 0.35,
      fontSize: 12, bold: true, color: item.color, fontFace: "Calibri", margin: 0,
    });
    addBullets(s, item.lines, 5.35, 1.5 + i * 2.0, 4.1, 1.3, { fontSize: 9.5, color: LIGHT_TXT });
  });
  s.addShape("rect", { x: 0, y: 5.325, w: "100%", h: 0.3, fill: { color: MID_BG } });
  s.addText("Dermatology 5e | Fitzpatrick's Dermatology 9e", {
    x: 0, y: 5.325, w: "100%", h: 0.3,
    fontSize: 8, color: MUTED, align: "center", valign: "middle", fontFace: "Calibri",
  });
}

// ── SLIDE 5 — Mechanism of Action Overview ────────────────────────────────────
{
  const s = pres.addSlide();
  addBg(s, DARK_BG);
  sectionBanner(s, "Mechanisms of Action of Antifungal Drugs");
  s.addText("Target Sites in the Fungal Cell", {
    x: 0.3, y: 0.65, w: 9.4, h: 0.4, fontSize: 16, bold: true, color: WHITE, fontFace: "Calibri",
  });

  if (images[2] && images[2].base64) {
    s.addImage({ data: images[2].base64, x: 0.3, y: 1.1, w: 4.2, h: 3.3 });
    s.addText("Amphotericin B binds ergosterol → transmembrane pore formation → cell death", {
      x: 0.3, y: 4.42, w: 4.2, h: 0.4,
      fontSize: 8.5, color: MUTED, fontFace: "Calibri", italic: true, align: "center",
    });
  }

  const mechs = [
    { drug: "Allylamines (Terbinafine, Naftifine)", mech: "Inhibit squalene epoxidase → ↓ ergosterol synthesis + squalene accumulation", color: ACCENT1 },
    { drug: "Azoles (Imidazoles & Triazoles)", mech: "Inhibit lanosterol 14α-demethylase (CYP450) → ↓ ergosterol → disrupted membrane", color: GOLD },
    { drug: "Polyenes (Amphotericin B, Nystatin)", mech: "Bind ergosterol directly → pore formation → ion leakage → cell death", color: GREEN },
    { drug: "Griseofulvin", mech: "Inhibits fungal microtubule polymerization → arrests mitosis in metaphase", color: MUTED },
    { drug: "Ciclopirox", mech: "Chelates metal ions → inhibits metal-dependent enzymes; disrupts cell membrane", color: ACCENT2 },
    { drug: "Echinocandins (Caspofungin)", mech: "Inhibit β-1,3-glucan synthase → ↓ cell wall synthesis (not first-line for skin)", color: "#E07A5F" },
  ];
  mechs.forEach((m, i) => {
    const col = i < 3 ? 4.75 : 4.75;
    const row = i % 3;
    const xOff = i < 3 ? 4.7 : 7.2;  // we fit in 2 columns on right side only if needed
    // Put all 6 in single column on right
    s.addShape("rect", { x: 4.7, y: 1.1 + i * 0.72, w: 5.0, h: 0.65, fill: { color: MID_BG } });
    s.addShape("rect", { x: 4.7, y: 1.1 + i * 0.72, w: 0.06, h: 0.65, fill: { color: m.color } });
    s.addText(m.drug, {
      x: 4.85, y: 1.12 + i * 0.72, w: 4.7, h: 0.25,
      fontSize: 9.5, bold: true, color: m.color, fontFace: "Calibri", margin: 0,
    });
    s.addText(m.mech, {
      x: 4.85, y: 1.33 + i * 0.72, w: 4.7, h: 0.35,
      fontSize: 8.5, color: LIGHT_TXT, fontFace: "Calibri", margin: 0,
    });
  });
  s.addShape("rect", { x: 0, y: 5.325, w: "100%", h: 0.3, fill: { color: MID_BG } });
  s.addText("Medical Microbiology 9e, Table 61.1 | Dermatology 5e, Fig. 127.9", {
    x: 0, y: 5.325, w: "100%", h: 0.3,
    fontSize: 8, color: MUTED, align: "center", valign: "middle", fontFace: "Calibri",
  });
}

// ── SLIDE 6 — Topical Antifungals ─────────────────────────────────────────────
{
  const s = pres.addSlide();
  addBg(s, DARK_BG);
  sectionBanner(s, "Topical Antifungal Agents");
  s.addText("First-line for localized superficial infections", {
    x: 0.3, y: 0.65, w: 9.4, h: 0.35, fontSize: 14, color: LIGHT_TXT, fontFace: "Calibri", italic: true,
  });

  const topicals = [
    { class: "Allylamines", color: ACCENT1,
      agents: "Terbinafine 1%, Naftifine 1%",
      indications: "Tinea pedis, corporis, cruris; apply 1–2× daily × 1–4 wks",
      notes: "Fungicidal; superior cure rates vs imidazoles for dermatophytes" },
    { class: "Imidazoles", color: GOLD,
      agents: "Clotrimazole, Miconazole, Ketoconazole, Econazole, Oxiconazole",
      indications: "Tinea spp., cutaneous candidiasis, pityriasis versicolor",
      notes: "Fungistatic; broad-spectrum including Candida & Malassezia; OTC available" },
    { class: "Benzylamines", color: GREEN,
      agents: "Butenafine 1%",
      indications: "Tinea pedis, corporis, cruris; once-daily dosing available",
      notes: "Similar to allylamines; inhibits squalene epoxidase" },
    { class: "Hydroxypyridones", color: MUTED,
      agents: "Ciclopirox 0.77% cream, 8% nail lacquer",
      indications: "Dermatophytoses, candidiasis, onychomycosis (nail lacquer)",
      notes: "Broad-spectrum; metal chelation MOA; nail lacquer for mild onychomycosis" },
    { class: "Polyenes (topical)", color: ACCENT2,
      agents: "Nystatin cream, powder",
      indications: "Cutaneous candidiasis, intertrigo",
      notes: "Fungicidal vs Candida; NOT active against dermatophytes" },
    { class: "Others", color: "#E07A5F",
      agents: "Tolnaftate 1%, Selenium sulfide 2.5%, Zinc pyrithione",
      indications: "Tinea pedis/corporis (tolnaftate); pityriasis versicolor (selenium sulfide)",
      notes: "Tolnaftate: OTC; selenium sulfide/ketoconazole shampoo as body wash for PV" },
  ];

  topicals.forEach((row, i) => {
    const y = 1.1 + i * 0.73;
    s.addShape("rect", { x: 0.2, y, w: 9.6, h: 0.66, fill: { color: i % 2 === 0 ? MID_BG : "152338" } });
    s.addShape("rect", { x: 0.2, y, w: 0.06, h: 0.66, fill: { color: row.color } });
    s.addText(row.class, {
      x: 0.35, y: y + 0.04, w: 1.5, h: 0.25,
      fontSize: 9.5, bold: true, color: row.color, fontFace: "Calibri", margin: 0,
    });
    s.addText(row.agents, {
      x: 0.35, y: y + 0.31, w: 1.6, h: 0.28,
      fontSize: 8, color: LIGHT_TXT, fontFace: "Calibri", margin: 0,
    });
    s.addText(row.indications, {
      x: 1.95, y: y + 0.04, w: 4.0, h: 0.55,
      fontSize: 8.5, color: LIGHT_TXT, fontFace: "Calibri", margin: 0,
    });
    s.addText(row.notes, {
      x: 6.0, y: y + 0.04, w: 3.7, h: 0.55,
      fontSize: 8, color: MUTED, fontFace: "Calibri", italic: true, margin: 0,
    });
  });

  // Column headers
  const headers = ["Class", "Agents", "Indications / Dosing", "Notes"];
  const hx = [0.35, 1.95, 1.95, 6.0];
  const hw = [1.5, 1.5, 4.0, 3.7];
  headers.forEach((h, i) => {
    s.addText(h, {
      x: hx[i], y: 0.98, w: hw[i] + (i === 1 ? 2.2 : 0), h: 0.25,
      fontSize: 8, bold: true, color: ACCENT1, fontFace: "Calibri", margin: 0,
      underline: true,
    });
  });

  s.addShape("rect", { x: 0, y: 5.325, w: "100%", h: 0.3, fill: { color: MID_BG } });
  s.addText("Dermatology 5e, Tables 127.12 & 127.13 | Fitzpatrick's 9e, Tables 160-10 & 160-11", {
    x: 0, y: 5.325, w: "100%", h: 0.3,
    fontSize: 8, color: MUTED, align: "center", valign: "middle", fontFace: "Calibri",
  });
}

// ── SLIDE 7 — Oral Systemic Antifungals ───────────────────────────────────────
{
  const s = pres.addSlide();
  addBg(s, DARK_BG);
  sectionBanner(s, "Systemic (Oral) Antifungal Agents for Skin Mycoses");
  s.addText("Indicated for: hair/nail infections, widespread disease, immunocompromise, topical failure", {
    x: 0.3, y: 0.65, w: 9.4, h: 0.35, fontSize: 11, color: MUTED, fontFace: "Calibri", italic: true,
  });

  const drugs = [
    { drug: "Terbinafine", class: "Allylamine", mech: "Squalene epoxidase inhibitor", dose: "250 mg/day oral", indications: "Onychomycosis (fingernail 6 wks, toenail 12 wks); tinea capitis", se: "GI upset, hepatotoxicity (rare), taste disturbance", color: ACCENT1 },
    { drug: "Itraconazole", class: "Triazole", mech: "Lanosterol 14α-demethylase inhibitor", dose: "200 mg/day or pulse 200 mg BID × 1 wk/month", indications: "Onychomycosis (pulse therapy), widespread dermatophytosis, PV, candidiasis", se: "Hepatotoxicity, negative inotropy, drug interactions (CYP3A4)", color: GOLD },
    { drug: "Fluconazole", class: "Triazole", mech: "Lanosterol 14α-demethylase inhibitor", dose: "150–300 mg/week for tinea; 50 mg/day", indications: "Candidiasis (skin, mucosal), tinea capitis/corporis, PV (less efficacious vs dermatophytes)", se: "Nausea, headache, rare hepatotoxicity; QT prolongation at high doses", color: GREEN },
    { drug: "Griseofulvin", class: "Antimitotic", mech: "Inhibits fungal microtubule assembly", dose: "Microsize 500–1000 mg/day; ultramicrosize 375–500 mg/day (with fatty meal)", indications: "Tinea capitis (drug of choice in children), tinea corporis", se: "Photosensitivity, GI, headache; CYP inducer; contraindicated in porphyria", color: MUTED },
    { drug: "Ketoconazole (systemic)", class: "Imidazole", mech: "Lanosterol 14α-demethylase inhibitor", dose: "200–400 mg/day (RESTRICTED USE)", indications: "Reserved for refractory cases; shampoo/cream used topically for PV", se: "Hepatotoxicity, adrenal suppression, QT prolongation; many drug interactions", color: "#E07A5F" },
  ];

  drugs.forEach((d, i) => {
    const y = 1.08 + i * 0.87;
    s.addShape("roundRect", {
      x: 0.2, y, w: 9.6, h: 0.8,
      fill: { color: MID_BG }, line: { color: d.color, width: 0.8 }, rectRadius: 0.1,
    });
    // Drug name badge
    s.addShape("roundRect", {
      x: 0.25, y: y + 0.08, w: 1.55, h: 0.65,
      fill: { color: d.color }, rectRadius: 0.08,
    });
    s.addText(d.drug, {
      x: 0.25, y: y + 0.08, w: 1.55, h: 0.35,
      fontSize: 11, bold: true, color: DARK_BG, fontFace: "Calibri", align: "center", valign: "bottom", margin: 0,
    });
    s.addText(d.class, {
      x: 0.25, y: y + 0.43, w: 1.55, h: 0.25,
      fontSize: 8.5, color: DARK_BG, fontFace: "Calibri", align: "center", valign: "top", margin: 0,
    });
    // Mechanism
    s.addText("⚙ " + d.mech, {
      x: 1.95, y: y + 0.05, w: 2.4, h: 0.3,
      fontSize: 8.5, color: ACCENT2, fontFace: "Calibri", margin: 0,
    });
    // Dose
    s.addText("💊 " + d.dose, {
      x: 1.95, y: y + 0.38, w: 2.4, h: 0.35,
      fontSize: 8, color: LIGHT_TXT, fontFace: "Calibri", margin: 0,
    });
    // Indications
    s.addText(d.indications, {
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}

// ── SLIDE 8 — Onychomycosis Deep-Dive ─────────────────────────────────────────
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    { header: "Oral Itraconazole (Pulse)", color: GOLD,
      lines: ["200 mg BID × 1 week/month", "Fingernails: 2 pulses; Toenails: 3 pulses", "Broad spectrum; useful for non-dermatophyte molds", "CYP3A4 interactions; negative inotrope"] },
    { header: "Topical (Adjunct / Mild cases)", color: GREEN,
      lines: ["Ciclopirox 8% lacquer (Penlac) — apply daily × ≥48 weeks", "Efinaconazole 10% solution (Jublia) — once daily", "Tavaborole 5% solution (Kerydin) — once daily", "Lower cure rates; no systemic effects"] },
    { header: "Griseofulvin (Historical / Pediatric)", color: MUTED,
      lines: ["4–6 months for fingernails; 6+ months for toenails", "No longer commonly used for onychomycosis", "Used for tinea capitis in children when terbinafine unavailable"] },
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// ── SLIDE 9 — Tinea Capitis Deep-Dive ─────────────────────────────────────────
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  sectionBanner(s, "Treatment of Tinea Capitis (Scalp Ringworm)");
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    { drug: "Terbinafine", detail: "< 20 kg: 62.5 mg/day\n20–40 kg: 125 mg/day\n> 40 kg: 250 mg/day\n4–6 weeks; preferred for T. tonsurans infections", color: ACCENT1 },
    { drug: "Itraconazole", detail: "5 mg/kg/day × 4–6 weeks OR\n5 mg/kg/day pulse 1 wk/month × 2–3 months\nBetter for M. canis infections", color: GREEN },
    { drug: "Fluconazole", detail: "6 mg/kg/day × 3–6 weeks\nAlternative option; good safety profile in children\nActive against M. canis & T. tonsurans", color: MUTED },
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  s.addText("Adjunct: Selenium sulfide 1–2.5% or ketoconazole 2% shampoo (2×/week) to reduce spore shedding", {
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    fontSize: 8.5, color: ACCENT2, align: "center", valign: "middle", fontFace: "Calibri",
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    fontSize: 8, color: MUTED, align: "center", valign: "middle", fontFace: "Calibri",
  });
}

// ── SLIDE 10 — Drug Comparison Table ─────────────────────────────────────────
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  sectionBanner(s, "Antifungal Drug Comparison — Quick Reference");

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    { label: "Class", x: 1.7, w: 1.2 },
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    { label: "Spectrum", x: 5.7, w: 1.8 },
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    ["Naftifine", "Allylamine", "T", "Squalene epoxidase", "Dermatophytes", "Local irritation", ACCENT1],
    ["Clotrimazole", "Imidazole", "T", "14α-demethylase", "Dermatophytes, Candida, Malassezia", "Local irritation", GOLD],
    ["Miconazole", "Imidazole", "T / IV", "14α-demethylase", "Dermatophytes, Candida", "Local burning", GOLD],
    ["Ketoconazole", "Imidazole", "T / O", "14α-demethylase", "Broad (dermatophytes, yeast)", "Hepatotox, adrenal suppression", GOLD],
    ["Itraconazole", "Triazole", "O / IV", "14α-demethylase", "Broad including molds", "Hepatotox, ↓ cardiac contractility", GOLD],
    ["Fluconazole", "Triazole", "O / IV", "14α-demethylase", "Candida, limited dermatophytes", "Nausea, QT prolongation", GOLD],
    ["Griseofulvin", "Antimitotic", "O", "Microtubules", "Dermatophytes ONLY", "Photosensitivity, CYP inducer", MUTED],
    ["Ciclopirox", "Hydroxypyridone", "T", "Metal chelation", "Broad (dermatophytes, Candida)", "Local irritation", GREEN],
    ["Nystatin", "Polyene", "T", "Ergosterol binding", "Candida ONLY (topical)", "Local irritation", ACCENT2],
    ["Amphotericin B", "Polyene", "IV", "Ergosterol pore", "Broad, systemic mycoses", "Nephrotoxicity, infusion reactions", "#E07A5F"],
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// ── SLIDE 11 — Treatment Algorithm ───────────────────────────────────────────
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  addBg(s, DARK_BG);
  sectionBanner(s, "Treatment Algorithm — Selecting the Right Antifungal");

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  ];
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    { label: "Hair / Nail\ninvolvement", x: 3.8, y: 1.5, color: GOLD },
    { label: "Candidiasis /\nPityriasis versicolor", x: 7.1, y: 1.5, color: ACCENT2 },
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      { label: "Topical imidazole\n(clotrimazole, miconazole × 2–4 wk)", color: GOLD },
      { label: "If widespread/failed:\nOral terbinafine or itraconazole", color: MUTED },
    ],
    [
      { label: "Tinea capitis:\nOral griseofulvin or terbinafine\n(4–12 weeks)", color: GOLD },
      { label: "Onychomycosis:\nOral terbinafine (6–12 wks)\nor itraconazole pulse therapy", color: ACCENT1 },
      { label: "Topical ciclopirox lacquer\nfor mild onychomycosis\nor adjunct therapy", color: GREEN },
    ],
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      { label: "Topical: nystatin, clotrimazole\nfor candidiasis", color: ACCENT2 },
      { label: "Topical: ketoconazole/selenium\nsulfide for pityriasis versicolor", color: GOLD },
      { label: "Extensive/recurrent:\nOral fluconazole or itraconazole", color: ACCENT1 },
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// ── SLIDE 12 — Special Considerations ────────────────────────────────────────
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  sectionBanner(s, "Special Considerations & Contraindications");

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        "Topical azoles: generally safe (minimal absorption)",
        "Griseofulvin: CONTRAINDICATED (teratogenic)",
        "Itraconazole: Avoid (cardiac concerns, teratogenic in animals)",
        "Fluconazole: Avoid high-dose systemic use (teratogenic risk)",
        "Terbinafine: Limited data; use with caution",
        "Nystatin topical: Safe (not absorbed)",
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    { title: "Pediatrics", color: ACCENT2, icon: "👶",
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        "Griseofulvin: First-line for tinea capitis in young children",
        "Terbinafine: Weight-based dosing for tinea capitis (>2 yrs)",
        "Fluconazole: Safe alternative in children",
        "Topical antifungals: Generally safe for children",
        "Monitor for hepatotoxicity with systemic agents",
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    { title: "Drug Interactions", color: GOLD, icon: "⚗",
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        "Azoles inhibit CYP3A4 → ↑ levels of statins, warfarin, cyclosporine",
        "Itraconazole: Contraindicated with cisapride, pimozide, quinidine",
        "Ketoconazole: CYP3A4 inhibitor; many serious interactions",
        "Griseofulvin: CYP INDUCER → ↓ warfarin, OCPs",
        "Terbinafine: CYP2D6 inhibitor (mild interactions)",
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    { title: "Immunocompromised / Renal/Hepatic", color: "#E07A5F", icon: "⚠",
      items: [
        "Dose-adjust fluconazole in renal impairment",
        "Avoid itraconazole in significant hepatic disease",
        "Terbinafine: contraindicated in liver disease (LFTs required)",
        "Immunocompromised: may require systemic therapy for localized infections",
        "Consider resistance in recurrent/refractory cases",
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// ── SLIDE 13 — Summary ────────────────────────────────────────────────────────
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    ["2", "Hair (tinea capitis) → Always oral. Griseofulvin (children) or terbinafine. 4–12 weeks minimum.", GOLD],
    ["3", "Nail (onychomycosis) → Oral terbinafine (first-line) or itraconazole pulse. Prolonged therapy (6–12 weeks+).", GREEN],
    ["4", "Candidiasis → Topical nystatin or clotrimazole; oral fluconazole for recurrent/widespread cases.", ACCENT2],
    ["5", "Pityriasis versicolor → Topical selenium sulfide or ketoconazole shampoo; oral azoles for extensive disease.", MUTED],
    ["6", "Drug interactions: Azoles inhibit CYP3A4. Griseofulvin induces CYP enzymes. Monitor LFTs with systemic agents.", "#E07A5F"],
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// ── Write file ─────────────────────────────────────────────────────────────────
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