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

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Drugs for Peptic Ulcer Disease";
pres.author = "Medical Education";

// ─── Colour palette ──────────────────────────────────────────────────────────
const BG       = "0D1B2A";  // deep navy  (dominant)
const ACCENT   = "E85D04";  // vivid orange
const CARD_BG  = "1B2E42";  // slightly lighter navy card
const WHITE    = "FFFFFF";
const GOLD     = "FFB703";
const TEAL     = "2EC4B6";
const GREY_LT  = "C9D6E3";
const SUBTITLE_C = "8AAFC8";

// ─── Helper: slide background ─────────────────────────────────────────────────
function navyBg(slide) {
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: "100%", h: "100%", fill: { color: BG }, line: { color: BG }
  });
}

// ─── Helper: accent bar (top strip) ───────────────────────────────────────────
function accentBar(slide) {
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: "100%", h: 0.09, fill: { color: ACCENT }, line: { color: ACCENT }
  });
}

// ─── Helper: slide heading ─────────────────────────────────────────────────────
function slideTitle(slide, title) {
  slide.addText(title, {
    x: 0.45, y: 0.18, w: 9.1, h: 0.6,
    fontSize: 26, bold: true, color: WHITE, fontFace: "Calibri",
    charSpacing: 1, margin: 0
  });
  // orange underline
  slide.addShape(pres.ShapeType.rect, {
    x: 0.45, y: 0.82, w: 1.2, h: 0.045, fill: { color: ACCENT }, line: { color: ACCENT }
  });
}

// ─── Helper: card box ─────────────────────────────────────────────────────────
function card(slide, x, y, w, h, label, items, labelColor) {
  slide.addShape(pres.ShapeType.roundRect, {
    x, y, w, h,
    fill: { color: CARD_BG },
    line: { color: ACCENT, pt: 1.2 },
    rectRadius: 0.1
  });
  if (label) {
    slide.addText(label, {
      x: x + 0.15, y: y + 0.08, w: w - 0.3, h: 0.38,
      fontSize: 13, bold: true, color: labelColor || GOLD, fontFace: "Calibri",
      margin: 0
    });
  }
  if (items && items.length) {
    const bullets = items.map((t, i) => ({
      text: t,
      options: { bullet: true, breakLine: i < items.length - 1, color: GREY_LT, fontSize: 11.5, fontFace: "Calibri" }
    }));
    slide.addText(bullets, {
      x: x + 0.18, y: y + (label ? 0.48 : 0.12), w: w - 0.35,
      h: h - (label ? 0.55 : 0.2),
      margin: 0, valign: "top"
    });
  }
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE SLIDE
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  navyBg(s);

  // Large accent stripe left
  s.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: 0.25, h: "100%", fill: { color: ACCENT }, line: { color: ACCENT }
  });

  // Pill shape behind main title
  s.addShape(pres.ShapeType.roundRect, {
    x: 0.55, y: 1.45, w: 8.8, h: 1.6,
    fill: { color: CARD_BG },
    line: { color: ACCENT, pt: 2 },
    rectRadius: 0.18
  });

  s.addText("DRUGS FOR", {
    x: 0.7, y: 1.22, w: 8.6, h: 0.55,
    fontSize: 18, bold: false, color: SUBTITLE_C, fontFace: "Calibri",
    charSpacing: 8, align: "center", margin: 0
  });
  s.addText("PEPTIC ULCER DISEASE", {
    x: 0.7, y: 1.55, w: 8.6, h: 1.0,
    fontSize: 40, bold: true, color: WHITE, fontFace: "Calibri",
    charSpacing: 2, align: "center", margin: 0
  });

  s.addText("Pharmacological Management · Mechanisms · Clinical Protocols", {
    x: 0.7, y: 3.22, w: 8.6, h: 0.45,
    fontSize: 14, color: SUBTITLE_C, fontFace: "Calibri",
    italic: true, align: "center", margin: 0
  });

  // Bottom tag line
  s.addText("Sources: Goodman & Gilman · Harrison's · Yamada's Gastroenterology · KD Tripathi", {
    x: 0.4, y: 4.9, w: 9.2, h: 0.42,
    fontSize: 9.5, color: SUBTITLE_C, fontFace: "Calibri", align: "right", italic: true, margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 2 — OVERVIEW: WHY DRUGS ARE NEEDED (Pathophysiology)
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  navyBg(s);
  accentBar(s);
  slideTitle(s, "Pathophysiology — Why Pharmacotherapy?");

  // Imbalance diagram — two vertical panels
  const panels = [
    {
      x: 0.4, label: "AGGRESSIVE FACTORS",
      color: ACCENT,
      items: ["Excess HCl secretion", "Pepsin (mucosal proteolysis)", "H. pylori infection", "NSAIDs (COX-1 inhibition)", "Bile reflux", "Stress / smoking / alcohol"]
    },
    {
      x: 5.3, label: "DEFENSIVE FACTORS",
      color: TEAL,
      items: ["Mucus–bicarbonate layer", "Mucosal blood flow", "Prostaglandins (PGE₂)", "Tight epithelial junctions", "Cell renewal / restitution", "Alkaline tide / duodenal pH"]
    }
  ];
  panels.forEach(p => {
    s.addShape(pres.ShapeType.roundRect, {
      x: p.x, y: 1.0, w: 4.45, h: 3.85,
      fill: { color: CARD_BG },
      line: { color: p.color, pt: 2 },
      rectRadius: 0.12
    });
    s.addText(p.label, {
      x: p.x + 0.15, y: 1.06, w: 4.15, h: 0.45,
      fontSize: 13.5, bold: true, color: p.color, fontFace: "Calibri",
      charSpacing: 2, align: "center", margin: 0
    });
    const bullets = p.items.map((t, i) => ({
      text: t,
      options: { bullet: true, breakLine: i < p.items.length - 1, color: GREY_LT, fontSize: 12, fontFace: "Calibri" }
    }));
    s.addText(bullets, {
      x: p.x + 0.2, y: 1.55, w: 4.1, h: 3.1, margin: 0, valign: "top"
    });
  });

  // Middle arrow
  s.addShape(pres.ShapeType.rect, {
    x: 4.88, y: 2.65, w: 0.24, h: 0.06, fill: { color: ACCENT }, line: { color: ACCENT }
  });
  s.addText("vs", {
    x: 4.72, y: 2.38, w: 0.56, h: 0.56,
    fontSize: 18, bold: true, color: ACCENT, fontFace: "Calibri",
    align: "center", margin: 0
  });

  s.addText("Ulcer occurs when aggressive factors overcome defensive mechanisms", {
    x: 0.4, y: 4.9, w: 9.2, h: 0.35,
    fontSize: 10.5, color: SUBTITLE_C, fontFace: "Calibri", italic: true, align: "center", margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 3 — CLASSIFICATION OF ANTI-ULCER DRUGS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  navyBg(s);
  accentBar(s);
  slideTitle(s, "Classification of Anti-Ulcer Drugs");

  const classes = [
    { label: "1. Antacids", color: GOLD,
      items: ["Neutralise HCl already secreted", "Mg(OH)₂, Al(OH)₃, CaCO₃, NaHCO₃", "Fast relief; short duration"] },
    { label: "2. H₂ Receptor Antagonists", color: TEAL,
      items: ["Block histamine H₂-R on parietal cells", "Cimetidine, Ranitidine, Famotidine, Nizatidine", "↓ basal & nocturnal acid secretion"] },
    { label: "3. Proton Pump Inhibitors (PPIs)", color: ACCENT,
      items: ["Irreversibly block H⁺/K⁺-ATPase", "Omeprazole, Lansoprazole, Pantoprazole, Rabeprazole, Esomeprazole", "Most potent acid suppressants"] },
    { label: "4. Cytoprotective Agents", color: "#A8DADC",
      items: ["Sucralfate — forms protective coat", "Misoprostol (PGE₁ analogue) — ↑ mucus & HCO₃⁻", "Bismuth compounds"] },
    { label: "5. H. pylori Eradication", color: "#E9C46A",
      items: ["Triple therapy: PPI + Amoxicillin + Clarithromycin", "Bismuth quadruple therapy", "14-day course preferred"] },
    { label: "6. Potassium-Competitive Acid Blockers (P-CABs)", color: "#C77DFF",
      items: ["Vonoprazan, Revaprazan", "Rapid, potent, pH-independent", "Do not require acidic activation"] }
  ];

  const cols = [
    [classes[0], classes[1]],
    [classes[2], classes[3]],
    [classes[4], classes[5]]
  ];

  const colX = [0.35, 3.55, 6.75];
  const rowY = [0.98, 2.87];

  colX.forEach((cx, ci) => {
    rowY.forEach((cy, ri) => {
      const cls = cols[ci][ri];
      s.addShape(pres.ShapeType.roundRect, {
        x: cx, y: cy, w: 3.05, h: 1.72,
        fill: { color: CARD_BG },
        line: { color: cls.color, pt: 1.5 },
        rectRadius: 0.1
      });
      s.addText(cls.label, {
        x: cx + 0.12, y: cy + 0.07, w: 2.82, h: 0.36,
        fontSize: 11.5, bold: true, color: cls.color, fontFace: "Calibri", margin: 0
      });
      const bullets = cls.items.map((t, i) => ({
        text: t,
        options: { bullet: true, breakLine: i < cls.items.length - 1, color: GREY_LT, fontSize: 10, fontFace: "Calibri" }
      }));
      s.addText(bullets, {
        x: cx + 0.12, y: cy + 0.43, w: 2.85, h: 1.2, margin: 0, valign: "top"
      });
    });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 4 — ANTACIDS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  navyBg(s);
  accentBar(s);
  slideTitle(s, "Antacids");

  const cols = [
    {
      x: 0.35, label: "MECHANISM", color: GOLD,
      items: [
        "Neutralise secreted HCl in stomach lumen",
        "Raise intragastric pH → inactivate pepsin (pH > 4)",
        "Do NOT reduce HCl secretion",
        "Provide rapid symptomatic relief"
      ]
    },
    {
      x: 3.48, label: "TYPES & EXAMPLES", color: TEAL,
      items: [
        "Systemic: Sodium bicarbonate (NaHCO₃)",
        "Non-systemic — Mg-based: Mg(OH)₂, MgO (laxative effect)",
        "Non-systemic — Al-based: Al(OH)₃ (constipating)",
        "CaCO₃ (Tums) — fast-acting, rebound risk",
        "Combinations: Maalox (Mg + Al), Gaviscon"
      ]
    },
    {
      x: 6.6, label: "CLINICAL NOTES", color: ACCENT,
      items: [
        "Dose: 100–140 mEq, 1h & 3h after meals + bedtime",
        "Adverse effects: diarrhoea (Mg), constipation (Al)",
        "Drug interactions: chelate fluoroquinolones, tetracyclines",
        "Avoid high-Na antacids in hypertension / cardiac failure",
        "Al antacids → phosphate binding (useful in renal failure)"
      ]
    }
  ];

  cols.forEach(c => {
    s.addShape(pres.ShapeType.roundRect, {
      x: c.x, y: 0.98, w: 3.0, h: 3.8,
      fill: { color: CARD_BG },
      line: { color: c.color, pt: 1.5 },
      rectRadius: 0.1
    });
    s.addText(c.label, {
      x: c.x + 0.12, y: 1.05, w: 2.78, h: 0.38,
      fontSize: 12.5, bold: true, color: c.color, fontFace: "Calibri",
      charSpacing: 1.5, margin: 0
    });
    const bullets = c.items.map((t, i) => ({
      text: t,
      options: { bullet: true, breakLine: i < c.items.length - 1, color: GREY_LT, fontSize: 11, fontFace: "Calibri" }
    }));
    s.addText(bullets, {
      x: c.x + 0.15, y: 1.5, w: 2.75, h: 3.1, margin: 0, valign: "top"
    });
  });

  s.addText("Antacids provide fast, short-term relief but are not sufficient for ulcer healing alone", {
    x: 0.35, y: 4.92, w: 9.3, h: 0.33,
    fontSize: 10, color: SUBTITLE_C, fontFace: "Calibri", italic: true, align: "center", margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 5 — H₂ RECEPTOR ANTAGONISTS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  navyBg(s);
  accentBar(s);
  slideTitle(s, "H₂ Receptor Antagonists (H₂RAs)");

  // Large mechanism card
  s.addShape(pres.ShapeType.roundRect, {
    x: 0.35, y: 0.98, w: 9.3, h: 0.85,
    fill: { color: CARD_BG }, line: { color: TEAL, pt: 1.5 }, rectRadius: 0.1
  });
  s.addText([
    { text: "Mechanism: ", options: { bold: true, color: TEAL } },
    { text: "Competitively block histamine H₂ receptors on parietal cells → ↓ cAMP → ↓ H⁺/K⁺-ATPase activation → ↓ acid secretion. Block only one of three pathways (histamine, gastrin, ACh) → tachyphylaxis possible. Ranitidine withdrawn 2020 (NDMA carcinogen risk).", options: { color: GREY_LT } }
  ], {
    x: 0.5, y: 1.03, w: 9.0, h: 0.72, fontSize: 11.5, fontFace: "Calibri", margin: 0, valign: "middle"
  });

  // Drug comparison table header
  const hdr = ["Drug", "Dose (PUD)", "Relative Potency", "Special Features"];
  const hdrW = [1.8, 2.2, 2.2, 3.0];
  const tableX = 0.35;
  const tableY = 1.97;

  hdrW.forEach((w, i) => {
    const xPos = tableX + hdrW.slice(0, i).reduce((a, b) => a + b, 0);
    s.addShape(pres.ShapeType.rect, {
      x: xPos, y: tableY, w: w, h: 0.38,
      fill: { color: TEAL }, line: { color: BG, pt: 1 }
    });
    s.addText(hdr[i], {
      x: xPos + 0.05, y: tableY + 0.03, w: w - 0.1, h: 0.33,
      fontSize: 11, bold: true, color: BG, fontFace: "Calibri", margin: 0, valign: "middle"
    });
  });

  const rows = [
    ["Cimetidine",   "400 mg bid",  "1×",   "First H₂RA; many CYP drug interactions; anti-androgenic"],
    ["Ranitidine",   "300 mg hs",   "5–10×", "Withdrawn 2020 (NDMA contamination)"],
    ["Famotidine",   "40 mg hs",    "30–40×","No CYP450 interactions; safest in renal disease (dose adjust)"],
    ["Nizatidine",   "300 mg hs",   "10×",   "Similar to ranitidine; minimal hepatic first-pass"]
  ];
  rows.forEach((row, ri) => {
    const rowBg = ri % 2 === 0 ? "1B2E42" : "223450";
    hdrW.forEach((w, ci) => {
      const xPos = tableX + hdrW.slice(0, ci).reduce((a, b) => a + b, 0);
      const yPos = tableY + 0.38 + ri * 0.42;
      s.addShape(pres.ShapeType.rect, {
        x: xPos, y: yPos, w: w, h: 0.42,
        fill: { color: rowBg }, line: { color: CARD_BG, pt: 0.5 }
      });
      s.addText(row[ci], {
        x: xPos + 0.07, y: yPos + 0.04, w: w - 0.12, h: 0.35,
        fontSize: 10.5, color: GREY_LT, fontFace: "Calibri", margin: 0, valign: "middle",
        bold: ci === 0
      });
    });
  });

  s.addText("H₂RAs are useful for mild-moderate PUD & nocturnal acid suppression; PPIs preferred for active ulcer healing", {
    x: 0.35, y: 4.92, w: 9.3, h: 0.33,
    fontSize: 10, color: SUBTITLE_C, fontFace: "Calibri", italic: true, align: "center", margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 6 — PROTON PUMP INHIBITORS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  navyBg(s);
  accentBar(s);
  slideTitle(s, "Proton Pump Inhibitors (PPIs)");

  // Mechanism box
  s.addShape(pres.ShapeType.roundRect, {
    x: 0.35, y: 0.97, w: 9.3, h: 1.02,
    fill: { color: CARD_BG }, line: { color: ACCENT, pt: 1.8 }, rectRadius: 0.1
  });
  s.addText([
    { text: "Mechanism: ", options: { bold: true, color: ACCENT } },
    { text: "Substituted benzimidazole prodrugs. Absorbed as neutral species → concentrated in parietal cell secretory canaliculus (acidic, pH <2) → converted to active sulphenamide → covalently binds & irreversibly inhibits H⁺/K⁺-ATPase (final common pathway of ALL acid secretion). New pumps must be synthesised before secretion resumes (~18–24 h). ", options: { color: GREY_LT } },
    { text: "Most potent acid suppressants available.", options: { bold: true, color: GOLD } }
  ], {
    x: 0.5, y: 1.03, w: 9.05, h: 0.88, fontSize: 11, fontFace: "Calibri", margin: 0, valign: "middle"
  });

  // PPI drug cards (3 per row)
  const drugs = [
    { name: "Omeprazole",    dose: "20 mg/day",  note: "Prototype PPI; chiral precursor of esomeprazole; CYP2C19 metabolism" },
    { name: "Esomeprazole",  dose: "20–40 mg/day",note: "S-enantiomer; higher bioavailability; less CYP2C19 variability" },
    { name: "Lansoprazole",  dose: "30 mg/day",   note: "Faster onset; available as orally disintegrating tabs" },
    { name: "Pantoprazole",  dose: "40 mg/day",   note: "IV form available; fewest drug interactions; safest for long-term" },
    { name: "Rabeprazole",   dose: "20 mg/day",   note: "Non-enzymatic activation; faster effect; minimal CYP interactions" },
    { name: "Dexlansoprazole",dose:"30 mg/day",   note: "Dual delayed-release; maintains plasma levels longer" }
  ];

  const dColW = 3.0, dRowH = 1.12;
  const dStartX = [0.35, 3.5, 6.65];
  const dStartY = [2.1, 3.32];

  drugs.forEach((d, idx) => {
    const ci = idx % 3, ri = Math.floor(idx / 3);
    const x = dStartX[ci], y = dStartY[ri];
    s.addShape(pres.ShapeType.roundRect, {
      x, y, w: dColW, h: dRowH,
      fill: { color: CARD_BG }, line: { color: ACCENT, pt: 1 }, rectRadius: 0.08
    });
    s.addText(d.name, {
      x: x + 0.12, y: y + 0.06, w: 1.9, h: 0.34,
      fontSize: 12, bold: true, color: GOLD, fontFace: "Calibri", margin: 0
    });
    s.addText(d.dose, {
      x: x + 2.0, y: y + 0.06, w: 0.88, h: 0.34,
      fontSize: 10.5, color: ACCENT, fontFace: "Calibri", italic: true, margin: 0, align: "right"
    });
    s.addText(d.note, {
      x: x + 0.12, y: y + 0.43, w: 2.8, h: 0.62,
      fontSize: 9.5, color: GREY_LT, fontFace: "Calibri", margin: 0, valign: "top"
    });
  });

  s.addText("Administer 30 min before meals for optimal efficacy | Long-term use: risk of hypomagnesaemia, C. diff, bone fractures", {
    x: 0.35, y: 4.92, w: 9.3, h: 0.33,
    fontSize: 9.5, color: SUBTITLE_C, fontFace: "Calibri", italic: true, align: "center", margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 7 — CYTOPROTECTIVE AGENTS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  navyBg(s);
  accentBar(s);
  slideTitle(s, "Cytoprotective Agents");

  const agents = [
    {
      name: "Sucralfate", color: TEAL,
      mech: "Aluminium salt of sucrose octasulphate. Polymerises in acidic environment → forms viscous paste that adheres to ulcer crater base → physical barrier against acid, pepsin & bile. Also stimulates prostaglandin synthesis.",
      dose: "1 g QID (1h before meals & bedtime)",
      notes: ["Minimal systemic absorption", "Constipation (Al content)", "Chelates fluoroquinolones, digoxin — give 2h apart", "Avoid in renal failure (Al accumulation)", "Pregnancy category B — safe"]
    },
    {
      name: "Misoprostol (PGE₁ analogue)", color: "#E9C46A",
      mech: "Synthetic prostaglandin E₁ analogue. ↓ gastric acid secretion (via Gs inhibition in parietal cells). ↑ mucus secretion, ↑ bicarbonate secretion, ↑ mucosal blood flow → cytoprotection.",
      dose: "200 µg QID (with NSAID therapy)",
      notes: ["Drug of choice for NSAID-induced ulcer prophylaxis", "Adverse: diarrhoea, abdominal cramps (dose-dependent)", "CONTRAINDICATED in pregnancy (uterotonic → abortion)", "70–80% effective vs placebo for NSAID ulcer prevention"]
    },
    {
      name: "Bismuth Compounds", color: "#C77DFF",
      mech: "Bismuth subsalicylate / tripotassium dicitratobismuthate. Coats ulcer base. Anti-H. pylori activity (disrupts cell wall, inhibits urease, adhesion factors). ↑ mucus & PG synthesis.",
      dose: "525 mg QID (bismuth subsalicylate)",
      notes: ["Used in bismuth quadruple H. pylori therapy", "Stool / tongue blackening (warn patients)", "Avoid in renal impairment (bismuth toxicity)", "May cause encephalopathy with prolonged high-dose use"]
    }
  ];

  const colX = [0.3, 3.47, 6.64];
  agents.forEach((a, i) => {
    const x = colX[i];
    s.addShape(pres.ShapeType.roundRect, {
      x, y: 0.98, w: 3.02, h: 4.3,
      fill: { color: CARD_BG }, line: { color: a.color, pt: 1.8 }, rectRadius: 0.1
    });
    s.addText(a.name, {
      x: x + 0.12, y: 1.04, w: 2.8, h: 0.42,
      fontSize: 12, bold: true, color: a.color, fontFace: "Calibri", margin: 0
    });
    s.addText("Mechanism", {
      x: x + 0.12, y: 1.5, w: 2.8, h: 0.25,
      fontSize: 10, bold: true, color: GOLD, fontFace: "Calibri", margin: 0
    });
    s.addText(a.mech, {
      x: x + 0.12, y: 1.75, w: 2.82, h: 1.05,
      fontSize: 9.5, color: GREY_LT, fontFace: "Calibri", margin: 0, valign: "top"
    });
    s.addText(`Dose: ${a.dose}`, {
      x: x + 0.12, y: 2.82, w: 2.82, h: 0.3,
      fontSize: 9.5, bold: true, color: TEAL, fontFace: "Calibri", margin: 0
    });
    s.addText("Key Points", {
      x: x + 0.12, y: 3.14, w: 2.8, h: 0.25,
      fontSize: 10, bold: true, color: GOLD, fontFace: "Calibri", margin: 0
    });
    const bullets = a.notes.map((t, j) => ({
      text: t,
      options: { bullet: true, breakLine: j < a.notes.length - 1, color: GREY_LT, fontSize: 9, fontFace: "Calibri" }
    }));
    s.addText(bullets, {
      x: x + 0.12, y: 3.39, w: 2.85, h: 1.72, margin: 0, valign: "top"
    });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 8 — H. PYLORI ERADICATION
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  navyBg(s);
  accentBar(s);
  slideTitle(s, "H. pylori Eradication Therapy");

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    x: 0.35, y: 0.97, w: 9.3, h: 0.72,
    fill: { color: CARD_BG }, line: { color: GOLD, pt: 1.5 }, rectRadius: 0.1
  });
  s.addText([
    { text: "Why eradicate? ", options: { bold: true, color: GOLD } },
    { text: "H. pylori causes 70–90% of duodenal ulcers and 60–70% of gastric ulcers. Eradication prevents recurrence (reduces relapse from ~80% to <5% at 1 year) and reduces gastric cancer risk.", options: { color: GREY_LT } }
  ], {
    x: 0.5, y: 1.02, w: 9.05, h: 0.6, fontSize: 11, fontFace: "Calibri", margin: 0, valign: "middle"
  });

  // Regimen cards
  const regimens = [
    {
      label: "Standard Triple Therapy (14 days)", color: ACCENT,
      drugs: [
        "PPI (omeprazole 20 mg or lansoprazole 30 mg)  — BID",
        "Amoxicillin 1 g — BID",
        "Clarithromycin 500 mg — BID",
        "Efficacy: 70–85% (resistance limits efficacy)"
      ]
    },
    {
      label: "Bismuth Quadruple Therapy (14 days)", color: TEAL,
      drugs: [
        "PPI — BID",
        "Bismuth subsalicylate 525 mg — QID",
        "Metronidazole 500 mg — QID",
        "Tetracycline 500 mg — QID",
        "Efficacy: >90%; preferred with clarithromycin resistance"
      ]
    },
    {
      label: "Concomitant Therapy (14 days)", color: "#C77DFF",
      drugs: [
        "PPI — BID",
        "Amoxicillin 1 g — BID",
        "Clarithromycin 500 mg — BID",
        "Metronidazole 500 mg — BID",
        "Use when resistance patterns unknown"
      ]
    },
    {
      label: "Levofloxacin Triple (Rescue)", color: "#E9C46A",
      drugs: [
        "PPI — BID",
        "Levofloxacin 500 mg — OD",
        "Amoxicillin 1 g — BID",
        "Used as 2nd-line after failed standard therapy"
      ]
    }
  ];

  const boxW = 4.52, boxH = 1.72;
  const positions = [
    [0.35, 1.83], [4.97, 1.83],
    [0.35, 3.64], [4.97, 3.64]
  ];

  regimens.forEach((r, i) => {
    const [x, y] = positions[i];
    s.addShape(pres.ShapeType.roundRect, {
      x, y, w: boxW, h: boxH,
      fill: { color: CARD_BG }, line: { color: r.color, pt: 1.5 }, rectRadius: 0.1
    });
    s.addText(r.label, {
      x: x + 0.12, y: y + 0.07, w: boxW - 0.25, h: 0.35,
      fontSize: 11.5, bold: true, color: r.color, fontFace: "Calibri", margin: 0
    });
    const bullets = r.drugs.map((t, j) => ({
      text: t,
      options: { bullet: true, breakLine: j < r.drugs.length - 1, color: GREY_LT, fontSize: 10, fontFace: "Calibri" }
    }));
    s.addText(bullets, {
      x: x + 0.15, y: y + 0.44, w: boxW - 0.3, h: boxH - 0.5, margin: 0, valign: "top"
    });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 9 — PCABs & NEWER AGENTS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  navyBg(s);
  accentBar(s);
  slideTitle(s, "Potassium-Competitive Acid Blockers (P-CABs)");

  s.addShape(pres.ShapeType.roundRect, {
    x: 0.35, y: 0.98, w: 9.3, h: 1.08,
    fill: { color: CARD_BG }, line: { color: "#C77DFF", pt: 1.8 }, rectRadius: 0.1
  });
  s.addText([
    { text: "Mechanism: ", options: { bold: true, color: "#C77DFF" } },
    { text: "Reversibly block H⁺/K⁺-ATPase at the potassium-binding site (competitive with K⁺). Unlike PPIs, they do NOT require acidic conditions for activation → faster onset, longer duration of action, more consistent acid suppression at night. No prodrug conversion step required.", options: { color: GREY_LT } }
  ], {
    x: 0.5, y: 1.03, w: 9.05, h: 0.95, fontSize: 11, fontFace: "Calibri", margin: 0, valign: "middle"
  });

  const cols = [
    {
      x: 0.35, label: "ADVANTAGES OVER PPIs", color: TEAL,
      items: [
        "Faster onset (hours vs days for PPIs)",
        "More consistent nocturnal acid control",
        "No CYP2C19 polymorphism effect",
        "Less risk of early-morning acid surge",
        "Active at neutral pH — no food timing needed"
      ]
    },
    {
      x: 3.5, label: "APPROVED AGENTS", color: GOLD,
      items: [
        "Vonoprazan (Japan/USA — FDA 2022): 10–20 mg/day",
        "Revaprazan (Korea) — for gastric ulcer & GERD",
        "Tegoprazan — South Korea (2019)",
        "Fexuprazan — in clinical trials",
        "Keverprazan — investigational"
      ]
    },
    {
      x: 6.65, label: "CLINICAL USE", color: ACCENT,
      items: [
        "H. pylori eradication (vonoprazan triple: >90% eradication)",
        "GERD and erosive oesophagitis",
        "Peptic ulcer disease",
        "NSAID-induced ulcer prevention",
        "Potentially superior to PPIs in Asian populations (CYP2C19 rapid metabolisers)"
      ]
    }
  ];

  cols.forEach(c => {
    s.addShape(pres.ShapeType.roundRect, {
      x: c.x, y: 2.18, w: 3.0, h: 2.92,
      fill: { color: CARD_BG }, line: { color: c.color, pt: 1.5 }, rectRadius: 0.1
    });
    s.addText(c.label, {
      x: c.x + 0.12, y: 2.25, w: 2.78, h: 0.38,
      fontSize: 11.5, bold: true, color: c.color, fontFace: "Calibri", charSpacing: 1, margin: 0
    });
    const bullets = c.items.map((t, i) => ({
      text: t,
      options: { bullet: true, breakLine: i < c.items.length - 1, color: GREY_LT, fontSize: 10.5, fontFace: "Calibri" }
    }));
    s.addText(bullets, {
      x: c.x + 0.15, y: 2.68, w: 2.8, h: 2.35, margin: 0, valign: "top"
    });
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  s.addText("Vonoprazan received FDA approval in 2022 for H. pylori eradication — a significant advance over classical PPIs", {
    x: 0.35, y: 5.15, w: 9.3, h: 0.3,
    fontSize: 9.5, color: SUBTITLE_C, fontFace: "Calibri", italic: true, align: "center", margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 10 — NSAID-INDUCED ULCER MANAGEMENT
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  navyBg(s);
  accentBar(s);
  slideTitle(s, "NSAID-Induced Ulcer: Prevention & Management");

  // Pathophysiology bar
  s.addShape(pres.ShapeType.roundRect, {
    x: 0.35, y: 0.98, w: 9.3, h: 0.72,
    fill: { color: CARD_BG }, line: { color: ACCENT, pt: 1.5 }, rectRadius: 0.1
  });
  s.addText([
    { text: "Pathophysiology: ", options: { bold: true, color: ACCENT } },
    { text: "NSAIDs inhibit COX-1 → ↓ PGE₂ & PGI₂ → ↓ mucus, ↓ HCO₃⁻, ↓ mucosal blood flow → epithelial vulnerability. Direct topical injury (acidic NSAID molecules) also contributes.", options: { color: GREY_LT } }
  ], {
    x: 0.5, y: 1.03, w: 9.05, h: 0.6, fontSize: 11, fontFace: "Calibri", margin: 0, valign: "middle"
  });

  const cols = [
    {
      x: 0.35, label: "ACTIVE NSAID ULCER", color: ACCENT,
      items: [
        "If NSAID can be stopped: H₂RA or PPI (4–8 weeks)",
        "If NSAID must continue: PPI (first choice)",
        "H. pylori test-and-treat if positive",
        "Sucralfate as adjunct in selected cases",
        "COX-2 selective inhibitor if switching NSAID"
      ]
    },
    {
      x: 3.5, label: "ULCER PROPHYLAXIS", color: GOLD,
      items: [
        "Misoprostol 200 µg QID — clinically proven",
        "PPI co-prescription — most practical",
        "COX-2 inhibitor (celecoxib) instead of non-selective NSAID",
        "Risk factors requiring prophylaxis:",
        "  · Age >60, prior ulcer, anticoagulant use",
        "  · High-dose or dual NSAID therapy"
      ]
    },
    {
      x: 6.65, label: "DRUG TABLE (NSAID)", color: TEAL,
      items: [
        "Omeprazole 20 mg/day — standard PPI prophylaxis",
        "Pantoprazole 40 mg/day — IV option for hospitalised",
        "Misoprostol 200 µg QID — ↓ mucosal injury",
        "Famotidine 20 mg bid — H₂RA (less effective than PPI)",
        "Celecoxib — COX-2 selective (GI sparing)"
      ]
    }
  ];

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    s.addShape(pres.ShapeType.roundRect, {
      x: c.x, y: 1.83, w: 3.0, h: 3.35,
      fill: { color: CARD_BG }, line: { color: c.color, pt: 1.5 }, rectRadius: 0.1
    });
    s.addText(c.label, {
      x: c.x + 0.12, y: 1.9, w: 2.78, h: 0.38,
      fontSize: 11.5, bold: true, color: c.color, fontFace: "Calibri", charSpacing: 1, margin: 0
    });
    const bullets = c.items.map((t, i) => ({
      text: t,
      options: { bullet: true, breakLine: i < c.items.length - 1, color: GREY_LT, fontSize: 10.5, fontFace: "Calibri" }
    }));
    s.addText(bullets, {
      x: c.x + 0.15, y: 2.33, w: 2.8, h: 2.75, margin: 0, valign: "top"
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    x: 0.35, y: 5.23, w: 9.3, h: 0.3,
    fontSize: 9.5, color: SUBTITLE_C, fontFace: "Calibri", italic: true, align: "center", margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 11 — DRUG DOSES QUICK REFERENCE TABLE
// ═══════════════════════════════════════════════════════════════════════════════
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  navyBg(s);
  accentBar(s);
  slideTitle(s, "Drug Doses — Quick Reference");

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  const tY = 0.92;

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      x: curX, y: tY, w: colW[i], h: 0.38,
      fill: { color: ACCENT }, line: { color: BG, pt: 0.8 }
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    ["Pantoprazole",     "PPI",          "40 mg/day",         "PO/IV","IV for bleeding ulcer"],
    ["Rabeprazole",      "PPI",          "20 mg/day",         "PO",   "Fastest non-enzymatic activation"],
    ["Esomeprazole",     "PPI",          "20–40 mg/day",      "PO",   "S-enantiomer; better bioavail."],
    ["Famotidine",       "H₂RA",         "40 mg HS",          "PO",   "Safest H₂RA (no CYP interactions)"],
    ["Cimetidine",       "H₂RA",         "400 mg BD",         "PO",   "Multiple CYP interactions"],
    ["Sucralfate",       "Cytoprotective","1 g QID",          "PO",   "1h before meals — empty stomach"],
    ["Misoprostol",      "Cytoprotective","200 µg QID",       "PO",   "Contraindicated in pregnancy"],
    ["Vonoprazan",       "P-CAB",        "20 mg/day",         "PO",   "FDA 2022 — H. pylori therapy"],
    ["Amoxicillin",      "Antibiotic",   "1 g BD",            "PO",   "Part of H. pylori triple therapy"],
    ["Clarithromycin",   "Antibiotic",   "500 mg BD",         "PO",   "With PPI + amoxicillin × 14 days"],
    ["Metronidazole",    "Antibiotic",   "500 mg QID",        "PO",   "Part of bismuth quadruple therapy"]
  ];

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        bold: ci === 0
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}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 12 — SUMMARY & TAKE-HOME POINTS
// ═══════════════════════════════════════════════════════════════════════════════
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  navyBg(s);

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    fontSize: 28, bold: true, color: WHITE, fontFace: "Calibri", charSpacing: 6, margin: 0
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    x: 0.55, y: 0.8, w: 1.0, h: 0.05, fill: { color: ACCENT }, line: { color: ACCENT }
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    { icon: "▶", text: "PPIs are the gold standard for acid suppression — irreversible H⁺/K⁺-ATPase blockade, most effective class", color: ACCENT },
    { icon: "▶", text: "H₂ receptor antagonists (famotidine, cimetidine) are useful for mild disease; note ranitidine was withdrawn in 2020", color: TEAL },
    { icon: "▶", text: "Antacids provide fast symptomatic relief but do not heal ulcers; use as adjuncts", color: GOLD },
    { icon: "▶", text: "Sucralfate & Misoprostol are cytoprotective — misoprostol preferred for NSAID prophylaxis (contraindicated in pregnancy)", color: "#C77DFF" },
    { icon: "▶", text: "H. pylori eradication is curative — standard triple or bismuth quadruple therapy × 14 days reduces recurrence to <5%", color: GOLD },
    { icon: "▶", text: "P-CABs (vonoprazan) represent a new era — faster onset, pH-independent, superior nocturnal control, FDA-approved 2022", color: "#E9C46A" },
    { icon: "▶", text: "For NSAID ulcer: discontinue NSAID + PPI; if NSAID must continue, PPI or misoprostol co-prescription is mandatory", color: TEAL }
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// ─── Write file ───────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/peptic-ulcer-ppt/Peptic_Ulcer_Drugs.pptx" })
  .then(() => console.log("✅  Peptic_Ulcer_Drugs.pptx created successfully"))
  .catch(e => { console.error("❌  Error:", e); process.exit(1); });