mkdir -p /home/daytona/workspace/dengue-pptx && ls /home/daytona/workspace/dengu…

~/dengue-pptx/dengue.js

const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.author = "Medical Presentation";
pres.title = "Dengue – A Clinical Overview";

// ─── COLOUR PALETTE ──────────────────────────────────────────────────────────
const C = {
  navy:    "0D2137",   // dominant dark background
  teal:    "00A896",   // primary accent
  amber:   "F4A261",   // warning / highlight
  red:     "E63946",   // danger / severe
  white:   "FFFFFF",
  offWhite:"F0F4F8",
  lightGray:"B0BEC5",
  darkText:"1A2E42",
};

// ─── HELPERS ─────────────────────────────────────────────────────────────────
function darkSlide(slide) {
  slide.background = { color: C.navy };
}
function lightSlide(slide) {
  slide.background = { color: C.offWhite };
}
function accentBar(slide, color = C.teal) {
  // left vertical accent bar
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: 0.12, h: 5.625, fill: { color: color }, line: { color: color },
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}
function slideTitle(slide, text, color = C.white) {
  slide.addText(text, {
    x: 0.28, y: 0.2, w: 9.4, h: 0.7,
    fontSize: 26, bold: true, color: color, fontFace: "Calibri",
    align: "left", valign: "middle", margin: 0,
  });
  // underline rule
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    x: 0.28, y: 0.95, w: 9.4, h: 0.04, fill: { color: C.teal }, line: { color: C.teal },
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}

// ─── SLIDE 1 · TITLE ─────────────────────────────────────────────────────────
{
  const sl = pres.addSlide();
  darkSlide(sl);
  // Bold left accent strip
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.5, h: 5.625, fill: { color: C.teal }, line: { color: C.teal } });
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  sl.addText("DENGUE", {
    x: 0.8, y: 1.1, w: 8.4, h: 1.4,
    fontSize: 60, bold: true, color: C.teal, fontFace: "Calibri",
    align: "center", charSpacing: 8,
  });
  sl.addText("A Clinical Overview for Healthcare Professionals", {
    x: 0.8, y: 2.6, w: 8.4, h: 0.6,
    fontSize: 20, color: C.white, fontFace: "Calibri", align: "center", italic: true,
  });
  sl.addText("Flavivirus · Aedes-borne · Global Burden", {
    x: 0.8, y: 3.3, w: 8.4, h: 0.45,
    fontSize: 15, color: C.lightGray, fontFace: "Calibri", align: "center",
  });
  sl.addShape(pres.ShapeType.rect, { x: 2.5, y: 3.9, w: 5, h: 0.06, fill: { color: C.amber }, line: { color: C.amber } });
  sl.addText("Sources: Harrison's 22E · Rosen's Emergency Medicine · Red Book 2021 · Robbins & Kumar Pathology", {
    x: 0.8, y: 4.9, w: 8.4, h: 0.4,
    fontSize: 9, color: C.lightGray, fontFace: "Calibri", align: "center",
  });
}

// ─── SLIDE 2 · EPIDEMIOLOGY ──────────────────────────────────────────────────
{
  const sl = pres.addSlide();
  darkSlide(sl);
  accentBar(sl);
  slideTitle(sl, "Epidemiology & Global Burden");

  const stats = [
    { num: "400 M", label: "Estimated infections per year" },
    { num: "100 M", label: "Symptomatic cases annually" },
    { num: "40,000", label: "Deaths from severe dengue/year" },
    { num: "3 B+",  label: "People at risk worldwide" },
  ];
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  const startX = 0.4;
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      x, y: 1.2, w: boxW, h: boxH,
      fill: { color: "112840" }, line: { color: C.teal, pt: 1.5 },
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    });
    sl.addText(s.num, {
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      fontSize: 28, bold: true, color: C.amber, fontFace: "Calibri", align: "center",
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    sl.addText(s.label, {
      x: x + 0.05, y: 2.0, w: boxW - 0.1, h: 0.6,
      fontSize: 11, color: C.white, fontFace: "Calibri", align: "center", wrap: true,
    });
  });

  const bullets = [
    "Endemic in >100 countries across tropical & subtropical regions",
    "Most cases in Southeast Asia, Western Pacific, Central & South America",
    "Leading cause of febrile illness in returned travellers from the Caribbean & South Asia",
    "Higher rates in adolescents/young adults; severe disease in infants, pregnant women, & patients with chronic disease",
    "Wolbachia-infected Aedes mosquito release reduces cases by 95-97% (novel control strategy)",
  ];
  sl.addText(bullets.map((b, i) => ({ text: b, options: { bullet: { indent: 10 }, breakLine: i < bullets.length - 1, color: i === bullets.length - 1 ? C.amber : C.white } })), {
    x: 0.28, y: 2.9, w: 9.5, h: 2.5, fontSize: 13, fontFace: "Calibri",
  });
}

// ─── SLIDE 3 · VIROLOGY & PATHOGENESIS ──────────────────────────────────────
{
  const sl = pres.addSlide();
  lightSlide(sl);
  accentBar(sl, C.navy);
  slideTitle(sl, "Virology & Pathogenesis", C.darkText);

  // Left column
  sl.addShape(pres.ShapeType.roundRect, {
    x: 0.28, y: 1.15, w: 4.5, h: 4.2,
    fill: { color: C.navy }, line: { color: C.navy }, rectRadius: 0.1,
  });
  sl.addText("THE VIRUS", {
    x: 0.38, y: 1.25, w: 4.3, h: 0.5,
    fontSize: 14, bold: true, color: C.teal, fontFace: "Calibri", align: "center", charSpacing: 3,
  });
  const virusPoints = [
    "Flavivirus family — single-stranded positive-sense RNA",
    "4 serotypes: DENV-1, DENV-2, DENV-3, DENV-4",
    "Infection with one serotype gives lifelong serotype-specific immunity",
    "Cross-protective immunity against other serotypes lasts only 1-3 years",
    "Aedes aegypti is the primary vector; A. albopictus is secondary",
    "Humans are the main amplifying host",
  ];
  sl.addText(virusPoints.map((t, i) => ({ text: t, options: { bullet: { indent: 8 }, breakLine: i < virusPoints.length - 1 } })), {
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    fontSize: 12, color: C.white, fontFace: "Calibri",
  });

  // Right column
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    x: 5.02, y: 1.15, w: 4.7, h: 4.2,
    fill: { color: "FFF8F0" }, line: { color: C.amber, pt: 1.5 }, rectRadius: 0.1,
  });
  sl.addText("PATHOGENESIS", {
    x: 5.12, y: 1.25, w: 4.5, h: 0.5,
    fontSize: 14, bold: true, color: C.darkText, fontFace: "Calibri", align: "center", charSpacing: 3,
  });
  const pathPoints = [
    "Antibody-Dependent Enhancement (ADE): Cross-reactive antibodies from prior infection enhance viral uptake into macrophages via Fc receptors",
    "Second heterologous serotype infection → dramatically increased viral replication → cytokine storm",
    "DENV-2 most likely to cause severe disease",
    "Massive endothelial activation → plasma leakage → haemoconcentration, ascites, pleural effusion",
    "Thrombocytopenia: platelet destruction + impaired production",
    "Severe dengue also in infants with maternal anti-dengue antibodies (consistent with ADE)",
  ];
  sl.addText(pathPoints.map((t, i) => ({ text: t, options: { bullet: { indent: 8 }, breakLine: i < pathPoints.length - 1 } })), {
    x: 5.12, y: 1.85, w: 4.4, h: 3.3,
    fontSize: 11.5, color: C.darkText, fontFace: "Calibri",
  });
}

// ─── SLIDE 4 · TRANSMISSION & INCUBATION ────────────────────────────────────
{
  const sl = pres.addSlide();
  darkSlide(sl);
  accentBar(sl, C.amber);
  slideTitle(sl, "Transmission & Incubation Period");

  const items = [
    { icon: "🦟", title: "Primary vector", body: "Aedes aegypti (peridomestic) — bites mainly during the day" },
    { icon: "🌊", title: "Secondary vector", body: "Aedes albopictus (tiger mosquito) and Aedes polynesiensis" },
    { icon: "👶", title: "Vertical transmission", body: "Rate ~20%; higher if maternal infection occurs near delivery" },
    { icon: "🩸", title: "Rare routes", body: "Blood / organ transfusion, needlestick, breastfeeding, sexual transmission" },
    { icon: "⏱️", title: "Extrinsic incubation", body: "8–12 days in mosquito (then infectious for life)" },
    { icon: "👤", title: "Intrinsic incubation", body: "3–14 days in humans before symptom onset" },
    { icon: "🔄", title: "Viremic window", body: "1-2 days pre-symptoms through ~7 days of illness (both symptomatic & asymptomatic)" },
    { icon: "💧", title: "Risk factor", body: "Peridomestic water storage, lack of screens/AC, crowding, poor sanitation" },
  ];

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  const boxW = 4.55, boxH = 1.0, gapX = 0.35, gapY = 0.18;
  items.forEach((item, i) => {
    const col = i % cols;
    const row = Math.floor(i / cols);
    const x = 0.28 + col * (boxW + gapX);
    const y = 1.1 + row * (boxH + gapY);
    sl.addShape(pres.ShapeType.roundRect, {
      x, y, w: boxW, h: boxH,
      fill: { color: "112840" }, line: { color: C.teal, pt: 1 }, rectRadius: 0.07,
    });
    sl.addText([
      { text: item.icon + "  ", options: { fontSize: 16 } },
      { text: item.title + "  ", options: { fontSize: 13, bold: true, color: C.amber } },
      { text: item.body, options: { fontSize: 12, color: C.white } },
    ], { x: x + 0.1, y: y + 0.12, w: boxW - 0.2, h: boxH - 0.2, valign: "middle", fontFace: "Calibri" });
  });
}

// ─── SLIDE 5 · CLINICAL CLASSIFICATION (WHO 2009) ────────────────────────────
{
  const sl = pres.addSlide();
  lightSlide(sl);
  accentBar(sl, C.navy);
  slideTitle(sl, "WHO 2009 Clinical Classification", C.darkText);

  const cols = [
    {
      title: "Dengue WITHOUT\nWarning Signs",
      color: C.teal,
      textColor: C.white,
      bg: C.navy,
      items: [
        "Fever + ≥2 of the following:",
        "• Nausea / vomiting",
        "• Rash",
        "• Aches & pains",
        "• Leukopenia",
        "• Positive tourniquet test",
        "",
        "Usually self-limited; managed as outpatient with close follow-up",
      ],
    },
    {
      title: "Dengue WITH\nWarning Signs",
      color: C.amber,
      textColor: C.darkText,
      bg: "FFF3DC",
      items: [
        "Dengue criteria + any of:",
        "• Abdominal pain or tenderness",
        "• Persistent vomiting",
        "• Clinical fluid accumulation (ascites, effusion)",
        "• Mucosal bleeding",
        "• Lethargy / restlessness",
        "• Liver enlargement >2 cm",
        "Hospital admission recommended",
      ],
    },
    {
      title: "SEVERE Dengue",
      color: C.red,
      textColor: C.white,
      bg: "2D0A0F",
      items: [
        "At least ONE of:",
        "• Severe plasma leakage → shock",
        "• Fluid accumulation + respiratory distress",
        "• Severe bleeding (clinician-assessed)",
        "• Severe organ involvement:",
        "  – AST/ALT ≥1000 IU/L",
        "  – Impaired consciousness",
        "  – Heart / organ failure",
        "ICU admission required",
      ],
    },
  ];

  const colW = 2.95, colH = 4.1, startX = 0.28, gapC = 0.29;
  cols.forEach((col, i) => {
    const x = startX + i * (colW + gapC);
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      x, y: 1.15, w: colW, h: colH,
      fill: { color: col.bg }, line: { color: col.color, pt: 2 }, rectRadius: 0.1,
    });
    sl.addShape(pres.ShapeType.roundRect, {
      x, y: 1.15, w: colW, h: 0.65,
      fill: { color: col.color }, line: { color: col.color }, rectRadius: 0.1,
    });
    sl.addText(col.title, {
      x, y: 1.18, w: colW, h: 0.58,
      fontSize: 12, bold: true, color: col.textColor === C.white ? C.white : C.darkText,
      fontFace: "Calibri", align: "center", valign: "middle",
    });
    sl.addText(col.items.map((t, j) => ({ text: t, options: { breakLine: j < col.items.length - 1, color: col.textColor === C.darkText ? C.darkText : C.white, bold: j === 0 } })), {
      x: x + 0.1, y: 1.88, w: colW - 0.2, h: 3.3,
      fontSize: 11.5, fontFace: "Calibri",
    });
  });
}

// ─── SLIDE 6 · CLINICAL PHASES ───────────────────────────────────────────────
{
  const sl = pres.addSlide();
  darkSlide(sl);
  accentBar(sl);
  slideTitle(sl, "Disease Phases & Clinical Course");

  const phases = [
    {
      name: "FEBRILE PHASE",
      days: "Days 1-7",
      color: C.amber,
      points: [
        "Abrupt onset fever 39-40°C",
        "Retro-orbital pain, severe myalgias ('breakbone fever')",
        "Facial erythema, injected oropharynx",
        "Macular / maculopapular rash",
        "Leukopenia, petechiae",
        "Headache prominent",
      ],
    },
    {
      name: "CRITICAL PHASE",
      days: "Days 3-7 (defervescence)",
      color: C.red,
      points: [
        "Plasma leakage peaks (24-48 hr window)",
        "Hemoconcentration (rising haematocrit)",
        "Rapid platelet count decline",
        "Pleural effusion, ascites",
        "Risk of hypovolaemic shock (DSS)",
        "Warning signs must be actively sought",
      ],
    },
    {
      name: "RECOVERY PHASE",
      days: "Days 7-10",
      color: C.teal,
      points: [
        "Gradual haemodynamic stabilisation",
        "Fluid reabsorption from third spaces",
        "Risk of fluid overload if IV fluids continued",
        "Platelet count rises",
        "Bradycardia may be present",
        "Generalised pruritus common",
      ],
    },
  ];

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  phases.forEach((p, i) => {
    const x = startX + i * (bW + gap);
    sl.addShape(pres.ShapeType.roundRect, {
      x, y: 1.15, w: bW, h: bH,
      fill: { color: "112840" }, line: { color: p.color, pt: 2 }, rectRadius: 0.1,
    });
    // header band
    sl.addShape(pres.ShapeType.rect, {
      x, y: 1.15, w: bW, h: 0.6,
      fill: { color: p.color }, line: { color: p.color },
    });
    sl.addText(p.name, { x, y: 1.15, w: bW, h: 0.35, fontSize: 13, bold: true, color: C.white, fontFace: "Calibri", align: "center", valign: "middle" });
    sl.addText(p.days, { x, y: 1.48, w: bW, h: 0.28, fontSize: 11, color: C.white, fontFace: "Calibri", align: "center", valign: "middle", italic: true });
    sl.addText(p.points.map((t, j) => ({ text: t, options: { bullet: { indent: 8 }, breakLine: j < p.points.length - 1 } })), {
      x: x + 0.1, y: 1.82, w: bW - 0.2, h: 3.1,
      fontSize: 12, color: C.white, fontFace: "Calibri",
    });
  });
}

// ─── SLIDE 7 · DIAGNOSIS ────────────────────────────────────────────────────
{
  const sl = pres.addSlide();
  lightSlide(sl);
  accentBar(sl, C.navy);
  slideTitle(sl, "Diagnostic Approach", C.darkText);

  // Table header
  const tX = 0.28, tY = 1.12;
  const colWidths = [2.2, 2.5, 2.5, 2.5];
  const headers = ["Test", "Best Timing", "Sensitivity", "Notes"];
  headers.forEach((h, i) => {
    const x = tX + colWidths.slice(0, i).reduce((a, b) => a + b, 0);
    sl.addShape(pres.ShapeType.rect, {
      x, y: tY, w: colWidths[i], h: 0.45,
      fill: { color: C.navy }, line: { color: C.navy },
    });
    sl.addText(h, { x, y: tY, w: colWidths[i], h: 0.45, fontSize: 13, bold: true, color: C.white, fontFace: "Calibri", align: "center", valign: "middle" });
  });

  const rows = [
    ["RT-PCR", "Days 1-7 (febrile)", "High (gold standard)", "Detects RNA; most sensitive early"],
    ["NS1 Antigen EIA", "Days 1-10 (febrile)", "High early; declines after day 5", "Can combine with IgM for ≥90% detection"],
    ["Anti-dengue IgM", "From day 3-5", "99% by day 10", "Cross-reacts with Zika; peaks at 2 wks"],
    ["Anti-dengue IgG", "Convalescent / past", "Lifelong elevation", "4-fold rise confirms acute infection; may be false + with other flavivirus vaccines"],
    ["CBC", "Throughout illness", "Non-specific", "Leukopenia, thrombocytopenia, haemoconcentration (rising Hct)"],
    ["LFTs", "If severe suspected", "Non-specific", "AST/ALT ≥1000 IU/L = severe dengue criterion"],
  ];
  rows.forEach((row, ri) => {
    const bg = ri % 2 === 0 ? "EBF4F6" : C.white;
    row.forEach((cell, ci) => {
      const x = tX + colWidths.slice(0, ci).reduce((a, b) => a + b, 0);
      sl.addShape(pres.ShapeType.rect, {
        x, y: tY + 0.45 + ri * 0.55, w: colWidths[ci], h: 0.55,
        fill: { color: bg }, line: { color: C.lightGray, pt: 0.5 },
      });
      sl.addText(cell, {
        x: x + 0.05, y: tY + 0.45 + ri * 0.55, w: colWidths[ci] - 0.1, h: 0.55,
        fontSize: 11, color: C.darkText, fontFace: "Calibri", valign: "middle", wrap: true,
      });
    });
  });

  sl.addText("Note: NS1 + IgM on a single specimen collected within first 10 days identifies ≥90% of both primary and secondary cases.", {
    x: 0.28, y: 4.9, w: 9.4, h: 0.4,
    fontSize: 11, italic: true, color: C.teal, fontFace: "Calibri",
  });
}

// ─── SLIDE 8 · MANAGEMENT ───────────────────────────────────────────────────
{
  const sl = pres.addSlide();
  darkSlide(sl);
  accentBar(sl);
  slideTitle(sl, "Clinical Management");

  const tiers = [
    {
      label: "GROUP A — Outpatient",
      labelColor: C.teal,
      bg: "0D2F4A",
      border: C.teal,
      items: [
        "Dengue without warning signs, tolerating oral fluids",
        "Rest, oral hydration (ORS / water / coconut water)",
        "Paracetamol for fever — max 4 g/day",
        "AVOID: Aspirin, NSAIDs, ibuprofen (bleeding risk)",
        "Monitor for warning signs at defervescence",
      ],
    },
    {
      label: "GROUP B — Inpatient Monitoring",
      labelColor: C.amber,
      bg: "2D1F00",
      border: C.amber,
      items: [
        "Dengue WITH warning signs OR high-risk patient",
        "IV crystalloid fluid replacement (NS / Ringer's lactate)",
        "Titrate IV fluids by clinical response & haematocrit",
        "Strict fluid balance; urine output monitoring",
        "Serial CBC every 6-12 hrs; watch platelet trend",
        "Blood products if active bleeding occurs",
      ],
    },
    {
      label: "GROUP C — ICU",
      labelColor: C.red,
      bg: "2D0A0F",
      border: C.red,
      items: [
        "Severe dengue (shock, organ failure, severe bleeding)",
        "Rapid IV fluid resuscitation to reverse shock",
        "Haemodynamic monitoring; vasopressors if refractory shock",
        "Platelet transfusion for severe bleeding / <10,000",
        "Mechanical ventilation for respiratory failure",
        "Early recognition reduces CFR from 5-10% to <1%",
      ],
    },
  ];

  const bW = 2.9, bH = 3.9, startX = 0.28, gapB = 0.27;
  tiers.forEach((t, i) => {
    const x = startX + i * (bW + gapB);
    sl.addShape(pres.ShapeType.roundRect, {
      x, y: 1.15, w: bW, h: bH,
      fill: { color: t.bg }, line: { color: t.border, pt: 2 }, rectRadius: 0.1,
    });
    sl.addText(t.label, {
      x: x + 0.1, y: 1.18, w: bW - 0.2, h: 0.5,
      fontSize: 12.5, bold: true, color: t.labelColor, fontFace: "Calibri", valign: "middle",
    });
    sl.addShape(pres.ShapeType.rect, {
      x: x + 0.1, y: 1.7, w: bW - 0.2, h: 0.03,
      fill: { color: t.border }, line: { color: t.border },
    });
    sl.addText(t.items.map((it, j) => ({ text: it, options: { bullet: { indent: 8 }, breakLine: j < t.items.length - 1 } })), {
      x: x + 0.1, y: 1.78, w: bW - 0.2, h: 3.1,
      fontSize: 11.5, color: C.white, fontFace: "Calibri",
    });
  });
}

// ─── SLIDE 9 · DIFFERENTIAL DIAGNOSIS ───────────────────────────────────────
{
  const sl = pres.addSlide();
  lightSlide(sl);
  accentBar(sl, C.navy);
  slideTitle(sl, "Differential Diagnosis", C.darkText);

  const diffs = [
    { name: "Zika Virus", points: ["Same Aedes vector", "Conjunctivitis prominent", "Milder febrile illness", "Linked to microcephaly in pregnancy"] },
    { name: "Chikungunya", points: ["Aedes-borne arbovirus", "Debilitating arthralgia", "Rash common", "Less severe systemic illness"] },
    { name: "Malaria", points: ["Plasmodium spp.", "Cyclical fever pattern", "Splenomegaly", "Blood smear / RDT confirms"] },
    { name: "Rickettsial Infections", points: ["Tick-borne / flea-borne", "Eschar may be present", "Doxycycline responsive", "Petechial rash evolves"] },
    { name: "Leptospirosis", points: ["Water / soil exposure", "Conjunctival suffusion", "Renal involvement", "Serology / culture confirms"] },
    { name: "Measles", points: ["Co-endemic regions", "Koplik spots", "Cough, coryza, conjunctivitis", "Vaccination history key"] },
  ];

  const cW = 2.85, cH = 1.92, sX = 0.28, gap = 0.22;
  diffs.forEach((d, i) => {
    const col = i % 3;
    const row = Math.floor(i / 3);
    const x = sX + col * (cW + gap);
    const y = 1.12 + row * (cH + 0.18);
    sl.addShape(pres.ShapeType.roundRect, {
      x, y, w: cW, h: cH,
      fill: { color: "EBF4F6" }, line: { color: C.navy, pt: 1.5 }, rectRadius: 0.08,
    });
    sl.addShape(pres.ShapeType.rect, {
      x, y, w: cW, h: 0.38,
      fill: { color: C.navy }, line: { color: C.navy },
    });
    sl.addText(d.name, { x, y, w: cW, h: 0.38, fontSize: 13, bold: true, color: C.white, fontFace: "Calibri", align: "center", valign: "middle" });
    sl.addText(d.points.map((p, j) => ({ text: p, options: { bullet: { indent: 6 }, breakLine: j < d.points.length - 1 } })), {
      x: x + 0.1, y: y + 0.42, w: cW - 0.2, h: cH - 0.5,
      fontSize: 11, color: C.darkText, fontFace: "Calibri",
    });
  });
}

// ─── SLIDE 10 · VACCINE & PREVENTION ─────────────────────────────────────────
{
  const sl = pres.addSlide();
  darkSlide(sl);
  accentBar(sl, C.teal);
  slideTitle(sl, "Prevention, Vector Control & Vaccines");

  // Left: prevention
  sl.addShape(pres.ShapeType.roundRect, {
    x: 0.28, y: 1.15, w: 4.55, h: 4.15,
    fill: { color: "112840" }, line: { color: C.teal, pt: 1.5 }, rectRadius: 0.1,
  });
  sl.addText("PREVENTION & VECTOR CONTROL", {
    x: 0.38, y: 1.22, w: 4.35, h: 0.45,
    fontSize: 13, bold: true, color: C.teal, fontFace: "Calibri", align: "center",
  });
  const prevPoints = [
    "Eliminate standing water (flower pots, tyres, containers)",
    "Use insecticide-treated bed nets / window screens",
    "Personal protection: long sleeves, DEET repellents",
    "Community-level mosquito surveillance & fogging",
    "Wolbachia-infected Aedes release — reduces transmission by 95-97%",
    "No direct human-to-human transmission; mosquito control is key",
  ];
  sl.addText(prevPoints.map((t, i) => ({ text: t, options: { bullet: { indent: 8 }, breakLine: i < prevPoints.length - 1 } })), {
    x: 0.38, y: 1.75, w: 4.25, h: 3.4,
    fontSize: 12, color: C.white, fontFace: "Calibri",
  });

  // Right: vaccines
  sl.addShape(pres.ShapeType.roundRect, {
    x: 5.07, y: 1.15, w: 4.65, h: 4.15,
    fill: { color: "112840" }, line: { color: C.amber, pt: 1.5 }, rectRadius: 0.1,
  });
  sl.addText("DENGUE VACCINES", {
    x: 5.17, y: 1.22, w: 4.45, h: 0.45,
    fontSize: 13, bold: true, color: C.amber, fontFace: "Calibri", align: "center",
  });
  const vaccPoints = [
    "Dengvaxia (CYD-TDV): WHO-approved; tetravalent live recombinant",
    "Recommended ONLY for seropositive individuals (≥9 years)",
    "Risk of severe dengue in seronegative recipients (ADE mechanism)",
    "Qdenga (TAK-003): live attenuated tetravalent; approved in EU/Indonesia",
    "Can be given regardless of prior dengue serostatus",
    "Fear remains that vaccines might potentiate more severe disease in some settings",
  ];
  sl.addText(vaccPoints.map((t, i) => ({ text: t, options: { bullet: { indent: 8 }, breakLine: i < vaccPoints.length - 1 } })), {
    x: 5.17, y: 1.75, w: 4.35, h: 3.4,
    fontSize: 12, color: C.white, fontFace: "Calibri",
  });
}

// ─── SLIDE 11 · SPECIAL POPULATIONS ─────────────────────────────────────────
{
  const sl = pres.addSlide();
  lightSlide(sl);
  accentBar(sl, C.red);
  slideTitle(sl, "Special Populations & High-Risk Groups", C.darkText);

  const groups = [
    {
      title: "Pregnant Women",
      color: C.red,
      bg: "FDE8EA",
      points: [
        "Higher risk of severe dengue",
        "Vertical transmission rate ~20% (higher near delivery)",
        "Risk of preterm labour, low birth weight",
        "Neonatal dengue: thrombocytopenia, hepatitis",
        "Avoid NSAIDs; careful fluid management to prevent overload",
      ],
    },
    {
      title: "Infants",
      color: C.amber,
      bg: "FFF3DC",
      points: [
        "Maternal anti-dengue IgG crosses placenta",
        "ADE mechanism → severe dengue in primary infection",
        "Fever without source — always consider dengue in endemic areas",
        "May not localise pain; watch for irritability, poor feeding",
        "Lower threshold for admission",
      ],
    },
    {
      title: "Chronic Disease Patients",
      color: C.teal,
      bg: "E0F7F4",
      points: [
        "Higher severity: asthma, sickle cell anaemia, diabetes, heart disease",
        "DM: hyperglycaemia complicates fluid management",
        "Sickle cell: vaso-occlusive crisis can co-exist",
        "Immunocompromised: prolonged viremia; atypical presentation",
        "Review all co-medications for NSAID / anticoagulant use",
      ],
    },
  ];

  const bW = 2.9, bH = 3.9, sX = 0.28, gap = 0.27;
  groups.forEach((g, i) => {
    const x = sX + i * (bW + gap);
    sl.addShape(pres.ShapeType.roundRect, {
      x, y: 1.12, w: bW, h: bH,
      fill: { color: g.bg }, line: { color: g.color, pt: 2 }, rectRadius: 0.1,
    });
    sl.addShape(pres.ShapeType.rect, {
      x, y: 1.12, w: bW, h: 0.5,
      fill: { color: g.color }, line: { color: g.color },
    });
    sl.addText(g.title, { x, y: 1.12, w: bW, h: 0.5, fontSize: 14, bold: true, color: C.white, fontFace: "Calibri", align: "center", valign: "middle" });
    sl.addText(g.points.map((p, j) => ({ text: p, options: { bullet: { indent: 8 }, breakLine: j < g.points.length - 1 } })), {
      x: x + 0.1, y: 1.68, w: bW - 0.2, h: 3.2,
      fontSize: 12, color: C.darkText, fontFace: "Calibri",
    });
  });
}

// ─── SLIDE 12 · SUMMARY & KEY TAKEAWAYS ─────────────────────────────────────
{
  const sl = pres.addSlide();
  darkSlide(sl);
  // Gradient-like effect with multiple rects
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.navy }, line: { color: C.navy } });
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 4.8, w: 10, h: 0.825, fill: { color: C.teal }, line: { color: C.teal } });
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.12, fill: { color: C.teal }, line: { color: C.teal } });

  sl.addText("KEY TAKEAWAYS", {
    x: 0.5, y: 0.2, w: 9, h: 0.6,
    fontSize: 28, bold: true, color: C.amber, fontFace: "Calibri", align: "center", charSpacing: 4,
  });

  const takeaways = [
    { num: "01", text: "Dengue = 4 flavivirus serotypes (DENV 1-4); Aedes aegypti is the primary vector; affects 400 million/year" },
    { num: "02", text: "Second heterologous infection (ADE) drives severe dengue; DENV-2 most implicated" },
    { num: "03", text: "WHO 2009 classification: Dengue ± warning signs / Severe dengue — guides triage & admission decisions" },
    { num: "04", text: "Critical phase (defervescence, days 3-7): plasma leakage window — act on warning signs immediately" },
    { num: "05", text: "Diagnosis: RT-PCR or NS1 antigen (days 1-7) + IgM (days 3-5 onwards); combine for ≥90% sensitivity" },
    { num: "06", text: "Treatment is supportive; AVOID aspirin/NSAIDs; IV fluids titrated carefully to prevent overload" },
    { num: "07", text: "Vaccines: Dengvaxia for seropositive ≥9 yrs; Qdenga regardless of serostatus — screen before vaccinating" },
  ];

  takeaways.forEach((tk, i) => {
    const y = 0.95 + i * 0.52;
    sl.addShape(pres.ShapeType.roundRect, {
      x: 0.25, y, w: 0.55, h: 0.42,
      fill: { color: C.teal }, line: { color: C.teal }, rectRadius: 0.05,
    });
    sl.addText(tk.num, { x: 0.25, y, w: 0.55, h: 0.42, fontSize: 13, bold: true, color: C.navy, fontFace: "Calibri", align: "center", valign: "middle" });
    sl.addText(tk.text, {
      x: 0.9, y: y + 0.02, w: 8.9, h: 0.42,
      fontSize: 12, color: C.white, fontFace: "Calibri", valign: "middle",
    });
  });

  sl.addText("Sources: Harrison's Principles of Internal Medicine 22E | Rosen's Emergency Medicine | Red Book 2021 | Robbins & Kumar Pathology | Andrews' Dermatology", {
    x: 0.3, y: 4.85, w: 9.4, h: 0.4,
    fontSize: 9, color: C.navy, fontFace: "Calibri", align: "center", bold: true,
  });
}

// ─── WRITE FILE ──────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/dengue-pptx/Dengue_Clinical_Overview.pptx" })
  .then(() => console.log("SUCCESS: Dengue_Clinical_Overview.pptx written"))
  .catch(err => { console.error("ERROR:", err); process.exit(1); });

cd /home/daytona/workspace/dengue-pptx && node dengue.js 2>&1

ls -lh /home/daytona/workspace/dengue-pptx/Dengue_Clinical_Overview.pptx