"""
Build a simple, hand-made-looking PPTX for the Cutaneous Signs of Bioterrorism seminar.
Design philosophy:
- White/off-white background
- Simple bold headings, plain body text (Calibri / Arial)
- Thin coloured accent line under heading (not full gradient background)
- Minimal shapes -- just text and simple rectangles
- No shadows, no gradients, no flashy effects
- Numbered bullets drawn as plain text
- Consistent but human-feeling layout
"""

from pptx import Presentation
from pptx.util import Inches, Pt, Emu
from pptx.dml.color import RGBColor
from pptx.enum.text import PP_ALIGN
from pptx.util import Inches, Pt
from pptx.oxml.ns import qn
from lxml import etree
import copy

# ── colour palette ──────────────────────────────────────────────────────────
DARK       = RGBColor(0x1A, 0x1A, 0x2E)   # near-black navy
ACCENT     = RGBColor(0x8B, 0x00, 0x00)   # dark red  (medical / serious)
LIGHT_BG   = RGBColor(0xFF, 0xFF, 0xFF)   # white slide BG
SECTION_BG = RGBColor(0x8B, 0x00, 0x00)   # section-divider BG
BOX_BG     = RGBColor(0xF5, 0xF0, 0xF0)   # very light warm grey for content boxes
HEADING_FG = RGBColor(0xFF, 0xFF, 0xFF)   # white text on red header strip
BODY_FG    = RGBColor(0x1A, 0x1A, 0x1A)   # near-black body text
MUTED      = RGBColor(0x55, 0x55, 0x55)   # muted grey for subheadings

# ── slide size (16:9) ───────────────────────────────────────────────────────
W = Inches(13.33)
H = Inches(7.5)

prs = Presentation()
prs.slide_width  = W
prs.slide_height = H

BLANK = prs.slide_layouts[6]   # truly blank

# ── helper utilities ─────────────────────────────────────────────────────────

def set_bg(slide, rgb=None):
    """Set solid background colour (default white)."""
    rgb = rgb or LIGHT_BG
    bg = slide.background
    fill = bg.fill
    fill.solid()
    fill.fore_color.rgb = rgb


def add_rect(slide, x, y, w, h, fill_rgb=None, line_rgb=None, line_width=None):
    shape = slide.shapes.add_shape(
        1,  # MSO_SHAPE_TYPE.RECTANGLE
        x, y, w, h
    )
    if fill_rgb:
        shape.fill.solid()
        shape.fill.fore_color.rgb = fill_rgb
    else:
        shape.fill.background()
    if line_rgb:
        shape.line.color.rgb = line_rgb
        if line_width:
            shape.line.width = line_width
    else:
        shape.line.fill.background()
    return shape


def add_textbox(slide, x, y, w, h, text, font_size=18, bold=False,
                color=None, align=PP_ALIGN.LEFT, wrap=True, italic=False):
    txBox = slide.shapes.add_textbox(x, y, w, h)
    tf = txBox.text_frame
    tf.word_wrap = wrap
    p = tf.paragraphs[0]
    p.alignment = align
    run = p.add_run()
    run.text = text
    run.font.size = Pt(font_size)
    run.font.bold = bold
    run.font.italic = italic
    run.font.color.rgb = color or BODY_FG
    run.font.name = "Calibri"
    return txBox


def add_multiline_textbox(slide, x, y, w, h, lines, font_size=14,
                          bold=False, color=None, align=PP_ALIGN.LEFT,
                          line_spacing_pt=None):
    """lines = list of (text, bold, size, color)  OR  list of str"""
    txBox = slide.shapes.add_textbox(x, y, w, h)
    tf = txBox.text_frame
    tf.word_wrap = True

    first = True
    for item in lines:
        if isinstance(item, str):
            txt, b, sz, c = item, bold, font_size, color or BODY_FG
        else:
            txt, b, sz, c = item

        if first:
            para = tf.paragraphs[0]
            first = False
        else:
            para = tf.add_paragraph()
        para.alignment = align
        if line_spacing_pt:
            para.space_after = Pt(line_spacing_pt)
        run = para.add_run()
        run.text = txt
        run.font.size = Pt(sz)
        run.font.bold = b
        run.font.name = "Calibri"
        run.font.color.rgb = c
    return txBox


def header_strip(slide, section_tag, subtitle=""):
    """Red strip at top with white section tag + subtitle."""
    # Red banner
    add_rect(slide, Inches(0), Inches(0), W, Inches(1.1), fill_rgb=ACCENT)
    # Section tag (left)
    add_textbox(slide,
                Inches(0.35), Inches(0.05),
                Inches(9), Inches(0.9),
                section_tag,
                font_size=22, bold=True,
                color=HEADING_FG, align=PP_ALIGN.LEFT)
    if subtitle:
        add_textbox(slide,
                    Inches(0.35), Inches(0.6),
                    Inches(12), Inches(0.5),
                    subtitle,
                    font_size=13, bold=False,
                    color=RGBColor(0xFF, 0xCC, 0xCC), align=PP_ALIGN.LEFT)


def page_number(slide, num):
    add_textbox(slide,
                Inches(12.5), Inches(7.1),
                Inches(0.7), Inches(0.3),
                str(num),
                font_size=11, bold=False,
                color=MUTED, align=PP_ALIGN.RIGHT)


def bullet_lines(slide, x, y, w, h, items, font_size=14):
    """Render a list of bullet strings into a textbox with bullet chars."""
    lines = []
    for it in items:
        lines.append(("• " + it, False, font_size, BODY_FG))
    add_multiline_textbox(slide, x, y, w, h, lines,
                          font_size=font_size, line_spacing_pt=2)


def section_divider(slide, title, subtitle=""):
    """Full-bleed dark-red section cover slide."""
    add_rect(slide, 0, 0, W, H, fill_rgb=ACCENT)
    # thin white decorative line
    add_rect(slide, Inches(0.6), Inches(3.4), Inches(12), Pt(2),
             fill_rgb=RGBColor(0xFF, 0xFF, 0xFF))
    add_textbox(slide,
                Inches(0.6), Inches(2.2),
                Inches(12), Inches(1.2),
                title,
                font_size=40, bold=True,
                color=HEADING_FG, align=PP_ALIGN.LEFT)
    if subtitle:
        add_textbox(slide,
                    Inches(0.6), Inches(3.6),
                    Inches(12), Inches(0.8),
                    subtitle,
                    font_size=20, bold=False,
                    color=RGBColor(0xFF, 0xCC, 0xCC), align=PP_ALIGN.LEFT)


def pill_box(slide, x, y, w, h, text, font_size=13):
    """Rounded rectangle with light background for category boxes."""
    shape = slide.shapes.add_shape(
        5,   # ROUNDED_RECTANGLE
        x, y, w, h
    )
    shape.fill.solid()
    shape.fill.fore_color.rgb = BOX_BG
    shape.line.color.rgb = ACCENT
    shape.line.width = Pt(1)
    tf = shape.text_frame
    tf.word_wrap = True
    para = tf.paragraphs[0]
    para.alignment = PP_ALIGN.LEFT
    run = para.add_run()
    run.text = text
    run.font.size = Pt(font_size)
    run.font.name = "Calibri"
    run.font.color.rgb = BODY_FG


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 1 – TITLE SLIDE
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)

# Full-width red top band
add_rect(sl, 0, 0, W, Inches(1.6), fill_rgb=ACCENT)
add_textbox(sl, Inches(0.5), Inches(0.25), Inches(12), Inches(0.9),
            "SEMINAR", font_size=14, bold=True,
            color=RGBColor(0xFF, 0xCC, 0xCC), align=PP_ALIGN.LEFT)

# Main title
add_textbox(sl, Inches(0.5), Inches(1.8), Inches(12), Inches(1.2),
            "Cutaneous Signs of Bioterrorism",
            font_size=38, bold=True, color=DARK, align=PP_ALIGN.LEFT)
add_textbox(sl, Inches(0.5), Inches(3.0), Inches(12), Inches(0.7),
            "What the Dermatologist Must Know",
            font_size=20, bold=False, color=MUTED, align=PP_ALIGN.LEFT)

# Thin accent rule
add_rect(sl, Inches(0.5), Inches(3.75), Inches(5), Pt(2),
         fill_rgb=ACCENT)

# Presenter / Moderator boxes – simple, side by side
pill_box(sl, Inches(0.5), Inches(4.1), Inches(3.6), Inches(1.2),
         "PRESENTER\nDr Meenal Goyal", font_size=14)
pill_box(sl, Inches(4.4), Inches(4.1), Inches(3.6), Inches(1.2),
         "MODERATOR\nDr Shruti Gupta", font_size=14)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 2 – OVERVIEW / TABLE OF CONTENTS
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "OVERVIEW", "Outline of the seminar")

topics = [
    ("1", "Introduction to bioterrorism & the skin"),
    ("2", "Smallpox  –  Variola virus"),
    ("3", "Anthrax  –  Bacillus anthracis"),
    ("4", "Botulism  –  Clostridium botulinum"),
    ("5", "Tularemia  –  Francisella tularensis"),
    ("6", "Plague  –  Yersinia pestis"),
    ("7", "Viral Haemorrhagic Fevers  –  Ebola, Marburg, Lassa, Junin"),
    ("8", "Summary, comparison table & conclusion"),
]

col1 = topics[:4]
col2 = topics[4:]

def toc_col(slide, items, cx, cy):
    for num, lbl in items:
        # Number circle rendered as bold text in accent colour
        add_textbox(slide, cx, cy, Inches(0.5), Inches(0.55),
                    num, font_size=16, bold=True, color=ACCENT)
        add_textbox(slide, cx + Inches(0.5), cy, Inches(5.4), Inches(0.55),
                    lbl, font_size=14, bold=False, color=BODY_FG)
        # thin separator line
        add_rect(slide, cx, cy + Inches(0.5), Inches(5.8), Pt(1),
                 fill_rgb=RGBColor(0xDD, 0xDD, 0xDD))
        cy += Inches(0.62)

toc_col(sl, col1, Inches(0.5), Inches(1.3))
toc_col(sl, col2, Inches(6.9), Inches(1.3))
page_number(sl, 1)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 3 – INTRODUCTION (1)
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "INTRODUCTION", "Why bioterrorism matters to the dermatologist")

bullets = [
    "Biologic warfare = intentional use of microorganisms or toxins to produce death or disease in humans, animals or plants",
    "Most illnesses from biologic agents have a cutaneous component – the skin is a valuable marker for early diagnosis",
    "The dermatologist is often first to recognise the index case from skin findings",
    "If in doubt, contact the health department or CDC: being over-cautious harms no one; being under-cautious is a grave error",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.8), bullets, font_size=17)
page_number(sl, 2)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 4 – INTRODUCTION (2)  CDC Category A
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "INTRODUCTION", "CDC Category A: six highest-risk agents")

add_textbox(sl, Inches(0.5), Inches(1.25), Inches(12.3), Inches(0.5),
            "Category A agents pose the greatest risk: easy production & spread, high person-to-person transmission, high lethality and major psychosocial impact.",
            font_size=14, color=MUTED)

agents = ["Smallpox", "Anthrax", "Botulism", "Tularemia", "Plague", "Viral Haemorrhagic Fevers"]
cols = 3
box_w = Inches(3.8)
box_h = Inches(0.85)
gap_x = Inches(0.45)
gap_y = Inches(0.3)
start_x = Inches(0.5)
start_y = Inches(2.0)

for idx, ag in enumerate(agents):
    col = idx % cols
    row = idx // cols
    bx = start_x + col * (box_w + gap_x)
    by = start_y + row * (box_h + gap_y)
    pill_box(sl, bx, by, box_w, box_h, ag, font_size=16)

add_textbox(sl, Inches(0.5), Inches(6.0), Inches(12), Inches(0.5),
            "Category B and C agents are second- and third-highest priority.",
            font_size=13, color=MUTED, italic=True)
page_number(sl, 3)


# ════════════════════════════════════════════════════════════════════════════
#   SECTION DIVIDER: SMALLPOX
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
section_divider(sl, "SMALLPOX", "Variola virus")


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 5 – Smallpox: agent & epidemiology
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "SMALLPOX  |  VARIOLA VIRUS", "Agent & epidemiology")

bullets = [
    "Caused by variola, an Orthopoxvirus (DNA virus replicating in host-cell cytoplasm); relatives include cowpox, vaccinia & monkeypox",
    "WHO regards smallpox as humankind's deadliest disease; killed ~half a billion people even in the 20th century",
    "Last natural case: Somalia 1977; WHO declared eradication in 1980",
    "Stocks retained only at CDC (Atlanta) and Novosibirsk (Russia): a theoretical risk of re-emergence remains",
    "Spread mainly by respiratory droplets; weaponised virus would spread by aerosolisation",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.5), bullets, font_size=16)
page_number(sl, 4)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 6 – Smallpox: three clinical stages
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "SMALLPOX  |  VARIOLA VIRUS", "Three clinical stages")

stages = [
    ("Incubation", "12-14 days (range 7-17); patient feels well and is non-infectious"),
    ("Prodrome",   "Sudden high fever (102-105°F), severe headache, backache, malaise; toxic & prostrate, then oropharyngeal enanthem appears"),
    ("Eruptive stage", "Patient becomes infectious; lasts until all scabs separate (~20-25 days)\nLesions evolve slowly over 14-18 days: macules → papules → vesicles → umbilicated vesicles → pustules → crusted scabs\nHistorical case-fatality 1-3%; much higher in unvaccinated"),
]

y = Inches(1.3)
for title, body in stages:
    add_textbox(sl, Inches(0.5), y, Inches(12.3), Inches(0.35),
                title, font_size=15, bold=True, color=ACCENT)
    y += Inches(0.35)
    add_multiline_textbox(sl, Inches(0.7), y, Inches(12.1), Inches(0.8),
                          [body], font_size=14)
    add_rect(sl, Inches(0.5), y + Inches(0.8), Inches(12.3), Pt(1),
             fill_rgb=RGBColor(0xDD, 0xDD, 0xDD))
    y += Inches(1.0)

page_number(sl, 5)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 7 – Smallpox: hallmark diagnostic clue
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "SMALLPOX  |  VARIOLA VIRUS", "The hallmark diagnostic clue")

# Key callout box
add_rect(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(0.9),
         fill_rgb=BOX_BG, line_rgb=ACCENT, line_width=Pt(1.5))
add_textbox(sl, Inches(0.7), Inches(1.35), Inches(12.1), Inches(0.8),
            "In any one body region, ALL lesions are in the SAME stage  (synchronous).",
            font_size=17, bold=True, color=ACCENT)

bullets = [
    "Lesions are deep-seated, firm, globose – \"pearls of pus\"",
    "Acral predominance: face, palms & soles (involves palms/soles)",
    "Contrast chickenpox: asynchronous \"dewdrops on a rose petal\", central/truncal, spares palms & soles",
    "~90% present as ordinary type; haemorrhagic & malignant (flat) types carry >95% mortality",
]
bullet_lines(sl, Inches(0.5), Inches(2.4), Inches(12.3), Inches(3.5), bullets, font_size=15)

add_textbox(sl, Inches(0.5), Inches(6.3), Inches(12.3), Inches(0.4),
            "Figure: Classic exanthem of variola major – uniform pustules, more prominent on acral surfaces.",
            font_size=11, color=MUTED, italic=True)
page_number(sl, 6)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 8 – Smallpox: diagnosis & differential
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "SMALLPOX  |  VARIOLA VIRUS", "Diagnosis & differential")

bullets = [
    "Confirmation: PCR, direct fluorescent antibody (DFA), immunohistochemistry & in-situ hybridisation differentiate poxvirus from herpesvirus",
    "Classic \"brick- or dumbbell-shaped\" cytoplasmic virions on electron microscopy",
    "Chief differential is chickenpox; use the CDC acute vesicular/pustular rash algorithm",
    "Other differentials: disseminated HSV/zoster, monkeypox, impetigo, drug eruptions, erythema multiforme",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.0), bullets, font_size=16)

add_textbox(sl, Inches(0.5), Inches(6.4), Inches(12.3), Inches(0.4),
            "Figure: \"Pearls of pus\" – firm, deep-seated, globose, opalescent papules and pustules.",
            font_size=11, color=MUTED, italic=True)
page_number(sl, 7)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 9 – Smallpox: vaccination & treatment
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "SMALLPOX  |  VARIOLA VIRUS", "Vaccination & treatment")

bullets = [
    "Vaccine (live vaccinia) is the most successful immunisation ever devised; post-exposure vaccination within 3-5 days can prevent or attenuate disease",
    "Contraindicated in: pregnancy, immunocompromise, cardiac disease & atopic dermatitis (risk of eczema vaccinatum)",
    "Skin complications: eczema vaccinatum, progressive vaccinia, generalised vaccinia, vaccinia keratitis – treat with vaccinia immune globulin",
    "Treatment: supportive care + antibiotics for secondary infection; cidofovir / brincidofovir show promise (no approved antiviral)",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.5), bullets, font_size=16)

add_textbox(sl, Inches(0.5), Inches(6.4), Inches(12.3), Inches(0.4),
            "Figure: Eczema vaccinatum – a potentially fatal complication of vaccination in atopic patients.",
            font_size=11, color=MUTED, italic=True)
page_number(sl, 8)


# ════════════════════════════════════════════════════════════════════════════
#   SECTION DIVIDER: ANTHRAX
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
section_divider(sl, "ANTHRAX", "Bacillus anthracis")


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 10 – Anthrax: agent & background
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "ANTHRAX  |  BACILLUS ANTHRACIS", "Agent & background")

bullets = [
    "Aerobic, gram-positive, spore-forming rod; one of the oldest diseases known",
    "Spores are 1-2 µm, survive in soil for decades and are easily aerosolised & inhaled",
    "Naturally associated with domesticated ruminants (sheep, cattle, goats); \"Woolsorter disease\" from inhaling spores",
    "First bioterrorism agent used in the US: 2001 anthrax letter attacks (22 cases, 5 deaths)",
    "Three forms of disease: cutaneous (most common, 95%), inhalational (most lethal), gastrointestinal",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.5), bullets, font_size=16)
page_number(sl, 9)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 11 – Anthrax: evolution of the lesion
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "ANTHRAX  |  BACILLUS ANTHRACIS", "Evolution of the cutaneous lesion")

# Arrow-flow boxes
steps = [
    "Painless papule\n(like arthropod bite)",
    "Vesicles /\nedematous plaque",
    "Painless ulcer with\ncentral BLACK ESCHAR",
    "Regional lymphadenitis,\nmalaise, fever",
]
bw = Inches(2.8)
bh = Inches(1.1)
gap = Inches(0.25)
sx = Inches(0.5)
sy = Inches(1.5)
for i, step in enumerate(steps):
    pill_box(sl, sx + i*(bw+gap), sy, bw, bh, step, font_size=14)
    if i < len(steps)-1:
        add_textbox(sl, sx + i*(bw+gap) + bw + Inches(0.02), sy + Inches(0.3),
                    Inches(0.23), Inches(0.5),
                    "→", font_size=22, bold=True, color=ACCENT)

add_textbox(sl, Inches(0.5), Inches(2.85), Inches(12.3), Inches(0.5),
            "Lesions look pustular (\"malignant pustule\") but contain NO pus; histology shows oedema & necrosis with no inflammatory infiltrate.",
            font_size=14, color=MUTED, italic=True)

bullet_note = "• The word \"anthrax\" derives from the Greek for coal – referring to the characteristic black eschar"
add_textbox(sl, Inches(0.5), Inches(3.5), Inches(12.3), Inches(0.5),
            bullet_note, font_size=14, color=BODY_FG)

add_textbox(sl, Inches(0.5), Inches(6.4), Inches(12.3), Inches(0.4),
            "Figure: Cutaneous anthrax – central black eschar surrounded by a red rim.",
            font_size=11, color=MUTED, italic=True)
page_number(sl, 10)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 12 – Anthrax: diagnosis & treatment
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "ANTHRAX  |  BACILLUS ANTHRACIS", "Diagnosis & treatment")

bullets = [
    "Toxin-mediated disease: antibiotics kill bacteria but do NOT reverse already-produced toxin",
    "Diagnosis: Gram stain, culture, PCR of exudate/blood; biopsy for histopathology & immunohistochemistry",
    "Inhalational anthrax: flu-like onset progressing rapidly; widened mediastinum without pneumonia is characteristic",
    "Treatment: fluoroquinolone (e.g. ciprofloxacin) or doxycycline first-line, even in pregnancy/children; add antitoxin (raxibacumab) or immune globulin for systemic disease",
    "Untreated cutaneous anthrax: ~20% mortality; not transmitted person-to-person",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.5), bullets, font_size=16)
page_number(sl, 11)


# ════════════════════════════════════════════════════════════════════════════
#   SECTION DIVIDER: BOTULISM
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
section_divider(sl, "BOTULISM", "Clostridium botulinum")


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 13 – Botulism: agent & relevance
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "BOTULISM  |  CLOSTRIDIUM BOTULINUM", "Agent & relevance")

bullets = [
    "Neurotoxin from Clostridium botulinum – anaerobic, gram-positive bacilli forming extremely hardy spores",
    "Considered an ideal bioweapon; aerosolisation of toxin is the most likely method of release",
    "Six clinical syndromes: food-borne, infant, wound, adult intestinal toxaemia, inhalational & iatrogenic",
    "Botulinum toxin is the most toxic substance known; 1 gram could kill over 1 million people if dispersed as aerosol",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.5), bullets, font_size=16)
page_number(sl, 12)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 14 – Botulism: features, diagnosis & treatment
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "BOTULISM  |  CLOSTRIDIUM BOTULINUM", "Features, diagnosis & treatment")

bullets = [
    "Toxin absorbed via mucosa or wound; produces symmetric, descending flaccid paralysis with cranial-nerve dysfunction",
    "Afebrile, normal mental status, no sensory deficits; facial nerve palsy, dilated pupils, dry oral mucosa",
    "Diagnosis: mouse bioassay is standard; also real-time PCR (good for wound), mass spectrometry & ELISA",
    "Treatment: heptavalent botulinum antitoxin (HBAT) neutralises free circulating toxin; mechanical ventilation as needed",
    "No direct skin rash – diagnosis rests on the characteristic descending paralysis pattern",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.5), bullets, font_size=15)
page_number(sl, 13)


# ════════════════════════════════════════════════════════════════════════════
#   SECTION DIVIDER: TULAREMIA
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
section_divider(sl, "TULAREMIA", "Francisella tularensis")


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 15 – Tularemia: agent & background
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "TULAREMIA  |  FRANCISELLA TULARENSIS", "Agent & background")

bullets = [
    "Francisella tularensis – aerobic, intracellular, gram-negative coccobacillus; does not form spores but survives for weeks",
    "\"Rabbit fever\" / \"deerfly fever\"; commonest vectors today are ticks",
    "Transmitted by contact with infected animal tissue, ingestion of contaminated water/meat, or inhalation of aerosols",
    "US maintained it as a biologic weapon until 1970; aerosol release would cause pleuropneumonitis",
    "No recorded use in a bioterror attack; not transmitted person-to-person",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.5), bullets, font_size=16)
page_number(sl, 14)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 16 – Tularemia: cutaneous features & management
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "TULAREMIA  |  FRANCISELLA TULARENSIS", "Cutaneous features & management")

bullets = [
    "Seven syndromes; ulceroglandular is commonest & most relevant to dermatology",
    "Tender/pruritic papule at inoculation site (2-5 days) → sharply demarcated ulcer with yellowish exudate → may form a black eschar + regional lymphadenopathy",
    "\"Tularemids\": secondary eruptions – erythema nodosum, erythema multiforme, Sweet syndrome",
    "Diagnosis: serology (most frequent); also culture, PCR, DFA; histology shows granulomatous response",
    "Treatment: streptomycin or gentamicin; doxycycline/cipro in mass-casualty settings; no current vaccine",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.3), bullets, font_size=15)
add_textbox(sl, Inches(0.5), Inches(6.4), Inches(12.3), Inches(0.4),
            "Figure: Sharply demarcated tularemia ulcer at inoculation site; may evolve into a black eschar.",
            font_size=11, color=MUTED, italic=True)
page_number(sl, 15)


# ════════════════════════════════════════════════════════════════════════════
#   SECTION DIVIDER: PLAGUE
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
section_divider(sl, "PLAGUE", "Yersinia pestis")


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 17 – Plague: agent & background
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "PLAGUE  |  YERSINIA PESTIS", "Agent & background")

bullets = [
    "Yersinia pestis – aerobic, gram-negative coccobacillus with \"safety-pin\" bipolar staining (Enterobacteriaceae)",
    "~200 million deaths through history; high mortality & panic make it a feared bioweapon",
    "WWII: Japanese units dropped plague-infected fleas on Chinese populations",
    "Usually transmitted by flea bite or handling infected animals; three forms – bubonic, pneumonic, primary septicaemic",
    "As a bioweapon it would be aerosolised → primary pneumonic plague (rare in US – should raise suspicion of bioterrorism)",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.5), bullets, font_size=16)
page_number(sl, 16)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 18 – Plague: clinical forms & cutaneous signs
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "PLAGUE  |  YERSINIA PESTIS", "Clinical forms & cutaneous signs")

forms = [
    ("BUBONIC",    "Skin pustule at bite site → painful, tender, enlarged nodes = \"buboes\"; commonest form"),
    ("SEPTICAEMIC","Cyanosis, petechiae, purpura, ecchymoses & acral gangrene – the \"Black Death\"; DIC"),
    ("PNEUMONIC",  "Follows spread or aerosol exposure; rapidly fatal, most likely bioweapon form"),
]
y = Inches(1.4)
for form, desc in forms:
    add_textbox(sl, Inches(0.5), y, Inches(2.4), Inches(0.7),
                form, font_size=14, bold=True, color=ACCENT)
    add_textbox(sl, Inches(2.9), y, Inches(10.0), Inches(0.7),
                desc, font_size=14, color=BODY_FG)
    add_rect(sl, Inches(0.5), y + Inches(0.7), Inches(12.3), Pt(1),
             fill_rgb=RGBColor(0xDD, 0xDD, 0xDD))
    y += Inches(0.9)

add_textbox(sl, Inches(0.5), y + Inches(0.1), Inches(12.3), Inches(0.35),
            "Diagnosis & treatment", font_size=14, bold=True, color=DARK)
bullets2 = [
    "Diagnosis: culture/stain of bubo aspirate, blood or sputum; DFA, serology, PCR; rapid F1-antigen test in 15 min",
    "Treatment: isolate ≥72 h; streptomycin/gentamicin (doxycycline in mass casualty)",
    "Prophylaxis: 7-day doxycycline for asymptomatic close contacts; vaccine discontinued",
]
bullet_lines(sl, Inches(0.5), y + Inches(0.5), Inches(12.3), Inches(2.0), bullets2, font_size=14)
page_number(sl, 17)


# ════════════════════════════════════════════════════════════════════════════
#   SECTION DIVIDER: VHF
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
section_divider(sl, "VIRAL HAEMORRHAGIC FEVERS", "Filoviridae, Flaviviridae, Bunyaviridae, Arenaviridae")


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 19 – VHF: agents & background
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "VIRAL HAEMORRHAGIC FEVERS", "Agents & background")

bullets = [
    ">25 viruses from four families – Filoviridae, Flaviviridae, Bunyaviridae & Arenaviridae",
    "Weaponised by the former Soviet Union: Marburg, Ebola, Lassa, Junin & Machupo",
    "West-Africa Ebola outbreak (2014) declared a Public Health Emergency of International Concern by WHO",
    "Discussion focuses on the two filoviruses – Ebola and Marburg",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.0), bullets, font_size=17)
page_number(sl, 18)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 20 – VHF: clinical features
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "VIRAL HAEMORRHAGIC FEVERS", "Clinical features")

bullets = [
    "Multiorgan syndrome leading to haematologic collapse: acute high fever, malaise, fatigue, myalgia, diarrhoea, headache",
    "Bleeding under skin, from organs or orifices – petechiae, epistaxis, haematemesis, puncture-site & gum bleeding; may progress to DIC",
    "A non-pruritic morbilliform eruption appears ~5 days after onset; begins on the trunk, may become haemorrhagic",
    "Typical case-fatality: Ebola 50-90%; Marburg 25-80%",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.5), bullets, font_size=16)
page_number(sl, 19)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 21 – VHF: diagnosis & treatment
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "VIRAL HAEMORRHAGIC FEVERS", "Diagnosis & treatment")

bullets = [
    "Handling specimens is hazardous – tissues/fluids readily transmit infection",
    "Diagnosis: viral culture, RT-PCR, antigen-capture ELISA & IgM ELISA; skin biopsy with immunohistochemistry detects Ebola",
    "Treatment: strict infection control, aggressive fluid & electrolyte repletion, supportive care",
    "Ribavirin has some benefit for Arenaviridae & Bunyaviridae; no proven antiviral for Ebola/Marburg",
    "Experimental: ZMapp antibody cocktail; rVSV-ZEBOV vaccine licensed for Ebola",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.5), bullets, font_size=15)
page_number(sl, 20)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 22 – SUMMARY: six agents at a glance
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "SUMMARY", "The six Category A agents at a glance")

summary_items = [
    ("Smallpox  (Variola virus)",       "Synchronous vesiculopustular rash, acral, \"pearls of pus\""),
    ("Anthrax  (B. anthracis)",         "Painless papule → ulcer with black eschar"),
    ("Botulism  (C. botulinum toxin)",  "Descending flaccid paralysis; facial palsy, dry mucosa"),
    ("Tularemia  (F. tularensis)",      "Ulceroglandular: ulcer + eschar + lymphadenopathy"),
    ("Plague  (Y. pestis)",             "Buboes; petechiae, purpura & acral gangrene (Black Death)"),
    ("VHF  (Ebola / Marburg)",          "Petechiae, purpura & haemorrhage; morbilliform rash"),
]

y = Inches(1.3)
for agent, clue in summary_items:
    add_textbox(sl, Inches(0.5), y, Inches(4.5), Inches(0.52),
                agent, font_size=14, bold=True, color=ACCENT)
    add_textbox(sl, Inches(5.0), y, Inches(8.0), Inches(0.52),
                clue, font_size=14, bold=False, color=BODY_FG)
    add_rect(sl, Inches(0.5), y + Inches(0.52), Inches(12.3), Pt(1),
             fill_rgb=RGBColor(0xDD, 0xDD, 0xDD))
    y += Inches(0.72)

page_number(sl, 21)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 23-24 – SUMMARY TABLE (text-based since original had images)
# ════════════════════════════════════════════════════════════════════════════
for part_num, part_label in [(23, "1/2"), (24, "2/2")]:
    sl = prs.slides.add_slide(BLANK)
    set_bg(sl)
    header_strip(sl, "SUMMARY TABLE", f"CDC Category A agents – comparison ({part_label})")

    add_textbox(sl, Inches(0.5), Inches(1.4), Inches(12.3), Inches(5.0),
                "Refer to CDC Table 52-1: Category A biologic agents\n\n"
                "The original slide contains a detailed comparison table covering agent, route, incubation, "
                "cutaneous features, diagnosis and treatment for all six Category A agents.\n\n"
                "Source: CDC – Table 52-1, Category A biologic agents.",
                font_size=15, color=BODY_FG)
    page_number(sl, 22 if part_num == 23 else 23)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 25 – CONCLUSION
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
header_strip(sl, "CONCLUSION", "Key take-home messages")

bullets = [
    "The skin is a valuable early marker of a bioterrorism event – dermatologists have a pivotal front-line role",
    "Know the hallmark cutaneous clue for each agent: synchronous acral rash (smallpox), black eschar (anthrax, tularemia), buboes & acral gangrene (plague), haemorrhage/purpura (VHF), descending paralysis (botulism)",
    "Early recognition, correct sampling and prompt antibiotics/antitoxin & isolation save lives",
    "When in doubt, notify public health / CDC promptly – over-caution is safe, under-caution is a grave error",
]
bullet_lines(sl, Inches(0.5), Inches(1.3), Inches(12.3), Inches(5.5), bullets, font_size=16)
page_number(sl, 24)


# ════════════════════════════════════════════════════════════════════════════
#   SLIDE 26 – THANK YOU
# ════════════════════════════════════════════════════════════════════════════
sl = prs.slides.add_slide(BLANK)
set_bg(sl)
add_rect(sl, 0, 0, W, H, fill_rgb=ACCENT)
add_rect(sl, Inches(0.5), Inches(3.45), Inches(12), Pt(2),
         fill_rgb=RGBColor(0xFF, 0xFF, 0xFF))
add_textbox(sl, Inches(0.5), Inches(2.3), Inches(12), Inches(1.1),
            "Thank You",
            font_size=52, bold=True, color=HEADING_FG, align=PP_ALIGN.CENTER)
add_textbox(sl, Inches(0.5), Inches(3.7), Inches(12), Inches(0.7),
            "Questions & Discussion",
            font_size=22, bold=False,
            color=RGBColor(0xFF, 0xCC, 0xCC), align=PP_ALIGN.CENTER)


# ── SAVE ────────────────────────────────────────────────────────────────────
out_path = "/tmp/workspace/bioterrorism-simple/Cutaneous_Signs_Bioterrorism_Simple.pptx"
prs.save(out_path)
print(f"Saved: {out_path}")
print(f"Slides: {len(prs.slides)}")
EOF