mkdir -p /home/daytona/workspace/itp-presentation && ls /home/daytona/workspace/…

~/itp-presentation/itp.js

const pptxgen = require("pptxgenjs");
const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Immune Thrombocytopenia in Children";

// ─── COLOR PALETTE ───────────────────────────────────────────────
const DARK_BG   = "0D1B2A";   // deep navy — dominant (~65 %)
const MID_NAVY  = "1B3A5C";   // mid-navy accent panels
const ACCENT    = "4FC3F7";   // sky-blue accent lines/icons
const GOLD      = "F4A261";   // warm amber for headings/highlights
const LIGHT_TXT = "E8F4FD";   // near-white body text
const MUTED     = "A8C8E8";   // muted blue for secondary text
const WHITE     = "FFFFFF";
const RED       = "E63946";   // danger / alert colour

// ─── REUSABLE HELPERS ────────────────────────────────────────────
function navySlide() {
  const slide = pres.addSlide();
  slide.background = { color: DARK_BG };
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}

function accentBar(slide, y = 0) {
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function sectionLabel(slide, label, y = 0.15) {
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}

function slideTitle(slide, text, y = 0.5) {
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function divider(slide, y) {
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}

// bullet helper – returns a rich-text object
function bullet(text, indent = 0, sub = false) {
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      fontSize: sub ? 13 : 14.5,
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      breakLine: true
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}

function infoBox(slide, x, y, w, h, title, lines, titleColor = GOLD) {
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  // box title
  slide.addText(title, { x: x + 0.12, y: y + 0.1, w: w - 0.24, h: 0.3, fontSize: 12, bold: true, color: titleColor, margin: 0 });
  // box content
  slide.addText(lines, { x: x + 0.12, y: y + 0.42, w: w - 0.24, h: h - 0.52, fontSize: 12, color: LIGHT_TXT, valign: "top", margin: 0 });
}

// ═══════════════════════════════════════════════════════════════
//  SLIDE 1 — TITLE
// ═══════════════════════════════════════════════════════════════
{
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  // side stripe
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0.12, w: 0.18, h: 5.505, fill: { color: GOLD } });

  // big title
  s.addText("Immune\nThrombocytopenia", {
    x: 0.5, y: 0.55, w: 9, h: 2.2,
    fontSize: 46, bold: true, color: WHITE, align: "left", lineSpacingMultiple: 1.1
  });
  s.addText("in Children", {
    x: 0.5, y: 2.55, w: 9, h: 0.85,
    fontSize: 36, bold: false, color: ACCENT, align: "left", italic: true
  });

  // subtitle strip
  s.addShape(pres.ShapeType.rect, { x: 0.5, y: 3.55, w: 9, h: 0.05, fill: { color: GOLD } });
  s.addText("Definition  •  Pathogenesis  •  Clinical Features  •  Management", {
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    fontSize: 14, color: MUTED, align: "left", charSpacing: 1
  });

  // bottom note
  s.addShape(pres.ShapeType.rect, { x: 0, y: 5.3, w: 10, h: 0.325, fill: { color: MID_NAVY } });
  s.addText("Pediatric Hematology  |  2026", {
    x: 0.5, y: 5.32, w: 9, h: 0.28,
    fontSize: 11, color: MUTED, align: "left"
  });
}

// ═══════════════════════════════════════════════════════════════
//  SLIDE 2 — OVERVIEW / AGENDA
// ═══════════════════════════════════════════════════════════════
{
  const s = navySlide();
  accentBar(s);
  sectionLabel(s, "Presentation Outline");
  slideTitle(s, "Topics Covered");
  divider(s, 1.22);

  const topics = [
    ["01", "Definition & Classification", "What is ITP? Primary vs secondary, acute vs chronic"],
    ["02", "Epidemiology", "Incidence, age distribution, sex ratio in children"],
    ["03", "Pathogenesis", "Autoantibodies, T-cell destruction, megakaryocyte dysfunction"],
    ["04", "Clinical Features", "Bleeding manifestations, petechiae, purpura, exam findings"],
    ["05", "Diagnosis", "Lab workup, peripheral smear, exclusion criteria"],
    ["06", "Management", "Observation, corticosteroids, IVIG, anti-D, splenectomy"],
  ];

  topics.forEach(([num, title, sub], i) => {
    const col = i < 3 ? 0 : 1;
    const row = i % 3;
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    const y = 1.4 + row * 1.3;
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    s.addText(title, { x: x + 0.7, y: y + 0.08, w: 3.75, h: 0.45, fontSize: 13, bold: true, color: GOLD, margin: 0 });
    s.addText(sub, { x: x + 0.12, y: y + 0.56, w: 4.35, h: 0.48, fontSize: 11, color: MUTED, margin: 0 });
  });
}

// ═══════════════════════════════════════════════════════════════
//  SLIDE 3 — DEFINITION
// ═══════════════════════════════════════════════════════════════
{
  const s = navySlide();
  accentBar(s);
  sectionLabel(s, "Definition & Classification");
  slideTitle(s, "What is Immune Thrombocytopenia?");
  divider(s, 1.22);

  // Definition box
  s.addShape(pres.ShapeType.rect, { x: 0.45, y: 1.35, w: 9.1, h: 1.15, fill: { color: MID_NAVY }, line: { color: GOLD, width: 1.5 } });
  s.addText([
    { text: "ITP ", options: { bold: true, color: GOLD } },
    { text: "is an acquired autoimmune condition characterized by isolated thrombocytopenia (platelet count ", options: { color: LIGHT_TXT } },
    { text: "<100 × 10⁹/L", options: { bold: true, color: ACCENT } },
    { text: ") with a normal bone marrow and the absence of other causes of thrombocytopenia. Previously called ", options: { color: LIGHT_TXT } },
    { text: "idiopathic thrombocytopenic purpura", options: { italic: true, color: MUTED } },
    { text: ", renamed in 2009 to reflect better disease understanding.", options: { color: LIGHT_TXT } },
  ], { x: 0.65, y: 1.42, w: 8.7, h: 1.0, fontSize: 14, valign: "middle" });

  // Two columns: types + chronicity
  infoBox(s, 0.45, 2.65, 4.35, 2.65, "Types of ITP",
    "PRIMARY ITP\nNo identifiable underlying cause.\nAutoantibodies to platelet membrane\nglycoprotein antigens (mainly GpIIb/IIIa,\nGpIb/IX) → destruction + impaired\nproduction\n\nSECONDARY ITP\nAssociated with viral infections, SLE,\nlymphoma, HIV, HCV, medications");

  infoBox(s, 5.0, 2.65, 4.55, 2.65, "Chronicity Classification",
    "NEWLY DIAGNOSED\n< 3 months since diagnosis\n\nPERSISTENT\n3 – 12 months since diagnosis\n\nCHRONIC\n> 12 months since diagnosis\n\nSEVERE ITP\nPlatelet count < 20,000/µL");
}

// ═══════════════════════════════════════════════════════════════
//  SLIDE 4 — EPIDEMIOLOGY
// ═══════════════════════════════════════════════════════════════
{
  const s = navySlide();
  accentBar(s);
  sectionLabel(s, "Epidemiology");
  slideTitle(s, "Who Gets ITP?");
  divider(s, 1.22);

  const stats = [
    { val: "4–8", unit: "per 100,000", label: "Annual incidence\nin children" },
    { val: "2–6", unit: "years", label: "Peak age of\nonset in children" },
    { val: "1:1", unit: "M : F", label: "Equal sex ratio\nin childhood ITP" },
    { val: "80%", unit: "of cases", label: "Spontaneous\nremission rate" },
  ];

  stats.forEach(({ val, unit, label }, i) => {
    const x = 0.45 + i * 2.35;
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    s.addText(unit, { x, y: 2.35, w: 2.2, h: 0.35, fontSize: 12, color: ACCENT, align: "center", margin: 0 });
    s.addShape(pres.ShapeType.rect, { x: x + 0.35, y: 2.72, w: 1.5, h: 0.04, fill: { color: ACCENT } });
    s.addText(label, { x, y: 2.82, w: 2.2, h: 0.65, fontSize: 12, color: MUTED, align: "center", margin: 0 });
  });

  // bullets below
  s.addText([
    bullet("Bimodal age distribution: peaks at 1–5 years (childhood) and >60 years (adults)"),
    bullet("Childhood acute ITP commonly follows a viral illness by 1–3 weeks (post-infectious)"),
    bullet("Chronic ITP (>12 months) is primarily an adult disease, 3× more common in women"),
    bullet("Acute form has >90% rate of spontaneous remission; morbidity/mortality low"),
  ], { x: 0.55, y: 3.75, w: 9.0, h: 1.6, valign: "top", margin: 0 });
}

// ═══════════════════════════════════════════════════════════════
//  SLIDE 5 — PATHOGENESIS
// ═══════════════════════════════════════════════════════════════
{
  const s = navySlide();
  accentBar(s);
  sectionLabel(s, "Pathogenesis");
  slideTitle(s, "How Does ITP Develop?");
  divider(s, 1.22);

  // Step-by-step flow
  const steps = [
    { num: "1", title: "Trigger", body: "Viral infection or unknown antigen stimulus (post-viral in 70% of childhood cases)" },
    { num: "2", title: "Autoantibody Formation", body: "B-cells produce IgG autoantibodies targeting platelet membrane glycoproteins (GpIIb/IIIa, GpIb/IX)" },
    { num: "3", title: "Platelet Destruction", body: "Antibody-coated platelets removed by macrophages & cytotoxic T-cells in the reticuloendothelial system (mainly spleen & liver)" },
    { num: "4", title: "Impaired Production", body: "Megakaryocyte dysfunction — same autoantibodies impair megakaryocyte maturation → reduced platelet production despite normal bone marrow" },
  ];

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    s.addShape(pres.ShapeType.ellipse, { x: 0.45, y: y + 0.12, w: 0.52, h: 0.52, fill: { color: GOLD } });
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    s.addText(title, { x: 1.1, y, w: 3.5, h: 0.38, fontSize: 14, bold: true, color: GOLD, margin: 0 });
    s.addText(body, { x: 1.1, y: y + 0.38, w: 8.4, h: 0.58, fontSize: 12.5, color: LIGHT_TXT, margin: 0 });
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  });
}

// ═══════════════════════════════════════════════════════════════
//  SLIDE 6 — PATHOGENESIS (MECHANISM DETAIL)
// ═══════════════════════════════════════════════════════════════
{
  const s = navySlide();
  accentBar(s);
  sectionLabel(s, "Pathogenesis – Mechanism Detail");
  slideTitle(s, "Dual Mechanism of Thrombocytopenia");
  divider(s, 1.22);

  // Left column
  infoBox(s, 0.45, 1.38, 4.55, 3.8, "Increased Destruction",
    "• IgG autoantibodies (anti-GpIIb/IIIa most common) coat platelet surface\n\n• Fc receptor-mediated phagocytosis by splenic macrophages\n\n• Cytotoxic T-lymphocytes directly lyse platelets\n\n• Spleen is both the major site of autoantibody production AND platelet destruction\n\n• Thrombopoietin (TPO) levels paradoxically normal/low despite thrombocytopenia → megakaryocyte insensitivity");

  // Right column
  infoBox(s, 5.2, 1.38, 4.35, 3.8, "Impaired Production",
    "• Autoantibodies cross-react with megakaryocyte surface antigens\n\n• Inhibit megakaryocyte maturation & proplatelet formation\n\n• Bone marrow shows NORMAL or INCREASED megakaryocytes (functional defect, not numerical)\n\n• T-cell-mediated suppression of thrombopoiesis\n\n• Net result: circulating platelets are young & functional (hence bleeding < expected for count)", RED);
}

// ═══════════════════════════════════════════════════════════════
//  SLIDE 7 — CLINICAL FEATURES
// ═══════════════════════════════════════════════════════════════
{
  const s = navySlide();
  accentBar(s);
  sectionLabel(s, "Clinical Features");
  slideTitle(s, "Presentation in Children");
  divider(s, 1.22);

  // Feature cards in a 3x2 grid
  const cards = [
    { icon: "●", title: "Onset", body: "Sudden, abrupt onset\nTypically within 1–3 weeks\nafter viral illness" },
    { icon: "●", title: "Petechiae", body: "Pin-point non-blanching\nred/purple spots on skin\nMost common finding" },
    { icon: "●", title: "Purpura & Ecchymoses", body: "Bruising without significant\ntrauma; purpuric patches on\nskin and mucous membranes" },
    { icon: "●", title: "Mucosal Bleeding", body: "Epistaxis, gingival bleeding,\noral bullae; prolonged bleeding\nfrom minor wounds" },
    { icon: "●", title: "Absent Organomegaly", body: "Spleen palpable in <10%\nGross splenomegaly → consider\nalternative diagnosis" },
    { icon: "●", title: "Rare Serious Events", body: "Intracranial haemorrhage: <1%\nbut most feared complication;\nurinary/GI bleeding uncommon" },
  ];

  cards.forEach(({ title, body }, i) => {
    const col = i % 3;
    const row = Math.floor(i / 3);
    const x = 0.45 + col * 3.1;
    const y = 1.4 + row * 2.0;
    s.addShape(pres.ShapeType.rect, { x, y, w: 2.9, h: 1.8, fill: { color: MID_NAVY }, line: { color: (row === 0 ? ACCENT : GOLD), width: 1 } });
    s.addShape(pres.ShapeType.rect, { x, y, w: 2.9, h: 0.38, fill: { color: (row === 0 ? ACCENT : GOLD) } });
    s.addText(title, { x: x + 0.1, y: y + 0.04, w: 2.7, h: 0.3, fontSize: 12, bold: true, color: DARK_BG, margin: 0 });
    s.addText(body, { x: x + 0.1, y: y + 0.44, w: 2.7, h: 1.28, fontSize: 12, color: LIGHT_TXT, valign: "top", margin: 0 });
  });
}

// ═══════════════════════════════════════════════════════════════
//  SLIDE 8 — DIAGNOSIS
// ═══════════════════════════════════════════════════════════════
{
  const s = navySlide();
  accentBar(s);
  sectionLabel(s, "Diagnosis");
  slideTitle(s, "Diagnosing ITP — Diagnosis of Exclusion");
  divider(s, 1.22);

  // Left — workup
  s.addText("Laboratory Workup", { x: 0.45, y: 1.38, w: 4.5, h: 0.35, fontSize: 14, bold: true, color: GOLD, margin: 0 });
  s.addText([
    bullet("CBC: isolated thrombocytopenia; platelets <100 × 10⁹/L"),
    bullet("Peripheral blood smear: large/young platelets, rule out fragmented RBCs"),
    bullet("Coagulation studies: PT, aPTT — NORMAL in ITP"),
    bullet("Bone marrow biopsy: only if atypical features; shows normal/↑ megakaryocytes"),
    bullet("ANA, anti-dsDNA if SLE suspected"),
    bullet("HIV, HCV, H. pylori serology (secondary ITP workup"),
    bullet("Direct Coombs test: if concern for Evans syndrome"),
  ], { x: 0.45, y: 1.78, w: 4.65, h: 3.5, valign: "top", margin: 0 });

  // Right — differential diagnosis box
  s.addText("Differential Diagnosis", { x: 5.4, y: 1.38, w: 4.15, h: 0.35, fontSize: 14, bold: true, color: RED, margin: 0 });
  const ddx = [
    "Gestational/drug-induced thrombocytopenia",
    "Thrombotic thrombocytopenic purpura (TTP)",
    "Hemolytic-uremic syndrome (HUS)",
    "Leukemia / lymphoma",
    "Aplastic anemia",
    "Congenital thrombocytopenias",
    "Bone marrow failure syndromes",
    "Hypersplenism / portal hypertension",
    "Vitamin B12 or folate deficiency",
    "Disseminated intravascular coagulation (DIC)",
  ];
  ddx.forEach((d, i) => {
    s.addText("▸ " + d, {
      x: 5.4, y: 1.8 + i * 0.34, w: 4.15, h: 0.32,
      fontSize: 12, color: i % 2 === 0 ? LIGHT_TXT : MUTED, margin: 0
    });
  });
}

// ═══════════════════════════════════════════════════════════════
//  SLIDE 9 — MANAGEMENT (OVERVIEW)
// ═══════════════════════════════════════════════════════════════
{
  const s = navySlide();
  accentBar(s);
  sectionLabel(s, "Management");
  slideTitle(s, "Treatment Approach in Children");
  divider(s, 1.22);

  // Key principle box
  s.addShape(pres.ShapeType.rect, { x: 0.45, y: 1.35, w: 9.1, h: 0.8, fill: { color: MID_NAVY }, line: { color: GOLD, width: 1.5 } });
  s.addText([
    { text: "Key Principle: ", options: { bold: true, color: GOLD } },
    { text: "Childhood ITP is usually self-limiting. ", options: { color: LIGHT_TXT } },
    { text: "Manage based on BLEEDING SEVERITY, not platelet count alone.", options: { bold: true, color: ACCENT } },
    { text: " Most newly diagnosed children with only cutaneous bleeding can be observed without medication even when platelets <20,000/µL.", options: { color: LIGHT_TXT } },
  ], { x: 0.65, y: 1.42, w: 8.7, h: 0.65, fontSize: 13, valign: "middle" });

  // Three-tier treatment table
  const tiers = [
    {
      label: "TIER 1 — Observation",
      color: ACCENT,
      items: [
        "Mild bleeding: skin manifestations only (petechiae, bruising)",
        "Platelet count > 20,000/µL with no bleeding symptoms",
        "Regular monitoring; activity restrictions (avoid contact sports)",
        "Treat infections that may have triggered ITP",
      ]
    },
    {
      label: "TIER 2 — Medical Therapy (First-Line)",
      color: GOLD,
      items: [
        "PREDNISONE: 1–2 mg/kg/day PO × 2–4 weeks",
        "IVIG: 1 g/kg IV (one dose); use when rapid platelet rise needed",
        "ANTI-D IMMUNOGLOBULIN: for Rh(D)-positive non-splenectomized children",
        "Indications: mucous membrane bleeding, platelet <10,000/µL, need for surgery",
      ]
    },
    {
      label: "TIER 3 — Second-Line Therapy",
      color: RED,
      items: [
        "RITUXIMAB: anti-CD20 monoclonal antibody (375 mg/m²/week × 4)",
        "TPO RECEPTOR AGONISTS: eltrombopag, romiplostim (stimulate production)",
        "SPLENECTOMY: reserved for chronic refractory ITP; avoid < 5 years",
        "Response rates: splenectomy ~87%, TPO-RA ~66%, rituximab ~62%",
      ]
    },
  ];

  tiers.forEach(({ label, color, items }, i) => {
    const y = 2.3 + i * 1.1;
    s.addShape(pres.ShapeType.rect, { x: 0.45, y, w: 9.1, h: 0.3, fill: { color } });
    s.addText(label, { x: 0.55, y: y + 0.03, w: 9.0, h: 0.24, fontSize: 12, bold: true, color: DARK_BG, margin: 0 });
    items.forEach((item, j) => {
      s.addText("  •  " + item, {
        x: 0.55, y: y + 0.33 + j * 0.175, w: 9.0, h: 0.17,
        fontSize: 11, color: LIGHT_TXT, margin: 0
      });
    });
  });
}

// ═══════════════════════════════════════════════════════════════
//  SLIDE 10 — MANAGEMENT DETAIL: MEDICATIONS
// ═══════════════════════════════════════════════════════════════
{
  const s = navySlide();
  accentBar(s);
  sectionLabel(s, "Management – Pharmacotherapy");
  slideTitle(s, "Drug Treatments in Detail");
  divider(s, 1.22);

  const drugs = [
    {
      name: "Corticosteroids",
      dose: "Prednisone 1–2 mg/kg/day; Dexamethasone 0.6 mg/kg/day × 4 days",
      mech: "Reduce autoantibody production; inhibit macrophage Fc-receptor function",
      note: "First-line; response in 2/3 within 1–3 weeks; taper to avoid side effects"
    },
    {
      name: "IVIG",
      dose: "1 g/kg IV as single dose (may repeat)",
      mech: "Fc-receptor blockade on macrophages → reduced platelet clearance",
      note: "Fastest response (24–72 h); use before surgery or active bleeding"
    },
    {
      name: "Anti-D Immunoglobulin",
      dose: "75 µg/kg IV",
      mech: "Rh(D)+ RBCs coated → compete with platelets for Fc-receptor clearance",
      note: "Only in Rh(D)+ non-splenectomized; risk of hemolysis — monitor Hb"
    },
    {
      name: "Rituximab",
      dose: "375 mg/m²/week × 4 doses",
      mech: "Anti-CD20 depletes B-lymphocytes → reduces autoantibody production",
      note: "Second-line; response ~62%; risk of hypogammaglobulinaemia"
    },
    {
      name: "TPO Receptor Agonists",
      dose: "Eltrombopag (oral); Romiplostim (SC weekly)",
      mech: "Stimulate megakaryocyte proliferation → increased platelet production",
      note: "Slow onset (days–weeks); second/third-line; used for refractory chronic ITP"
    },
  ];

  drugs.forEach(({ name, dose, mech, note }, i) => {
    const y = 1.38 + i * 0.84;
    s.addShape(pres.ShapeType.rect, { x: 0.45, y, w: 9.1, h: 0.76, fill: { color: MID_NAVY }, line: { color: i % 2 === 0 ? ACCENT : GOLD, width: 0.8 } });
    s.addText(name, { x: 0.6, y: y + 0.06, w: 2.0, h: 0.28, fontSize: 13, bold: true, color: GOLD, margin: 0 });
    s.addText("Dose: " + dose, { x: 2.65, y: y + 0.04, w: 6.8, h: 0.22, fontSize: 10.5, color: MUTED, margin: 0 });
    s.addText("Mechanism: " + mech, { x: 2.65, y: y + 0.25, w: 6.8, h: 0.22, fontSize: 10.5, color: LIGHT_TXT, margin: 0 });
    s.addText("Note: " + note, { x: 2.65, y: y + 0.47, w: 6.8, h: 0.22, fontSize: 10.5, color: ACCENT, margin: 0 });
  });
}

// ═══════════════════════════════════════════════════════════════
//  SLIDE 11 — EMERGENCY / PLATELET THRESHOLDS
// ═══════════════════════════════════════════════════════════════
{
  const s = navySlide();
  accentBar(s);
  sectionLabel(s, "Management – Clinical Thresholds");
  slideTitle(s, "Platelet Thresholds & Action Points");
  divider(s, 1.22);

  const thresholds = [
    { count: ">50,000", color: "2E7D32", action: "Observation", detail: "Rarely associated with clinical sequelae; safe for most procedures" },
    { count: "30,000–50,000", color: "F9A825", action: "Monitor closely", detail: "Variable risk; consider treatment if symptomatic or high-risk lifestyle" },
    { count: "20,000–30,000", color: "E65100", action: "Consider treatment", detail: "Initiate glucocorticoids if symptomatic mucous membrane bleeding or active lifestyle" },
    { count: "<20,000", color: "B71C1C", action: "Treat / Admit", detail: "Hospitalization for assessment; IVIG + steroids; hematology consult" },
    { count: "<10,000", color: "880E4F", action: "IVIG + Steroids", detail: "High risk of spontaneous bleeding; dual therapy; platelet transfusion for active severe hemorrhage" },
  ];

  thresholds.forEach(({ count, color, action, detail }, i) => {
    const y = 1.38 + i * 0.82;
    s.addShape(pres.ShapeType.rect, { x: 0.45, y, w: 2.4, h: 0.72, fill: { color } });
    s.addText(count + "\n/µL", { x: 0.45, y, w: 2.4, h: 0.72, fontSize: 14, bold: true, color: WHITE, align: "center", valign: "middle", margin: 0 });
    s.addShape(pres.ShapeType.rect, { x: 3.0, y: y + 0.05, w: 1.8, h: 0.62, fill: { color: MID_NAVY }, line: { color, width: 1.2 } });
    s.addText(action, { x: 3.0, y: y + 0.05, w: 1.8, h: 0.62, fontSize: 12, bold: true, color: GOLD, align: "center", valign: "middle", margin: 0 });
    s.addText(detail, { x: 5.0, y: y + 0.08, w: 4.55, h: 0.6, fontSize: 12.5, color: LIGHT_TXT, valign: "middle", margin: 0 });
  });

  // Special procedure note
  s.addShape(pres.ShapeType.rect, { x: 0.45, y: 5.52, w: 9.1, h: 0.0, fill: { color: ACCENT } });
}

// ═══════════════════════════════════════════════════════════════
//  SLIDE 12 — PROGNOSIS & SUMMARY
// ═══════════════════════════════════════════════════════════════
{
  const s = navySlide();
  accentBar(s);
  sectionLabel(s, "Prognosis & Key Takeaways");
  slideTitle(s, "Outcomes & Summary");
  divider(s, 1.22);

  // Prognosis boxes
  infoBox(s, 0.45, 1.38, 4.4, 2.25, "Prognosis in Children",
    "> 90% of children achieve spontaneous remission\n\n80% complete resolution within 6–12 months\n\nIntracranial haemorrhage: <1% — most feared complication\n\nMortality is rare; quality-of-life impact significant during acute phase\n\nChronic ITP develops in 10–20% of children");

  infoBox(s, 5.05, 1.38, 4.5, 2.25, "When to Refer to Haematology",
    "• Uncertainty about diagnosis\n• Platelet count < 20,000/µL at presentation\n• No close follow-up available\n• Failure to respond to first-line therapy\n• Chronic ITP (> 12 months)\n• Before any surgical procedure\n• Life-threatening bleeding", RED);

  // Key takeaways
  s.addText("Key Takeaways", { x: 0.45, y: 3.78, w: 9.1, h: 0.38, fontSize: 16, bold: true, color: GOLD, margin: 0 });
  s.addText([
    bullet("ITP in children is usually acute, self-limiting, and follows a viral illness"),
    bullet("Pathogenesis: anti-platelet IgG autoantibodies → destruction + impaired production"),
    bullet("Diagnosis is one of exclusion — rule out other causes of thrombocytopenia"),
    bullet("Treat based on bleeding severity, NOT platelet count alone"),
    bullet("First-line: observation / corticosteroids / IVIG; second-line: rituximab, TPO-RAs, splenectomy"),
  ], { x: 0.55, y: 4.18, w: 9.0, h: 1.35, valign: "top", margin: 0 });
}

// ─── WRITE FILE ──────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/itp-presentation/ITP_in_Children.pptx" })
  .then(() => console.log("DONE: ITP_in_Children.pptx"))
  .catch(err => { console.error(err); process.exit(1); });

cd /home/daytona/workspace/itp-presentation && node itp.js 2>&1

ls -lh /home/daytona/workspace/itp-presentation/ITP_in_Children.pptx