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Make a medical presentation for HPV vaccinations in India and information about Human Papilloma Virus and Cancer Cervix and its Treatment for MD PSM resident

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Make a Medical presentation for HPV vaccinations in India and information about Human papilloma virus and Cancer cervix and its treatment for MD PSM RESIDENT

Reading File
Reading File
Reading File
Finding Sources
Searching the Web

HPV vaccination India 2025 national program CERVAVAC guidelines schedule

Searching PubMed

"HPV vaccine" AND "cervical cancer" AND India

Finding Sources
Searching the Web

India cervical cancer burden statistics 2025 incidence mortality HPV epidemiology

Searching the Web

cervical cancer treatment FIGO staging surgery radiotherapy chemotherapy guidelines 2025

Reading File
Reading File
Running Command

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

Writing File

~/hpv-presentation/create_hpv_presentation.js

const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.author = "MD PSM Resident";
pres.title = "HPV Vaccination in India - Cancer Cervix";

// ─────────────────────────────────────────────────────────────────
// DESIGN TOKENS
// ─────────────────────────────────────────────────────────────────
const C = {
  navy:      "1A237E",  // dominant dark
  teal:      "00695C",  // section accent
  red:       "C62828",  // alert / cancer color
  amber:     "E65100",  // warning
  green:     "2E7D32",  // vaccine / positive
  white:     "FFFFFF",
  offwhite:  "F5F5F5",
  lightBlue: "E3F2FD",
  lightTeal: "E0F2F1",
  lightGreen:"E8F5E9",
  lightRed:  "FFEBEE",
  text:      "212121",
  subtext:   "424242",
  muted:     "757575",
};

// ─────────────────────────────────────────────────────────────────
// HELPERS
// ─────────────────────────────────────────────────────────────────
function sectionBg(slide, color) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color } });
}

function addHeader(slide, title, subtitle, bgColor, titleColor) {
  bgColor = bgColor || C.navy;
  titleColor = titleColor || C.white;
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 1.3, fill: { color: bgColor } });
  slide.addText(title, {
    x: 0.4, y: 0.08, w: 9.2, h: 0.7,
    fontSize: 22, bold: true, color: titleColor, fontFace: "Calibri", margin: 0
  });
  if (subtitle) {
    slide.addText(subtitle, {
      x: 0.4, y: 0.72, w: 9.2, h: 0.5,
      fontSize: 13, color: bgColor === C.navy ? "90CAF9" : C.white, fontFace: "Calibri", italic: true, margin: 0
    });
  }
}

function addDivider(slide, y, color) {
  slide.addShape(pres.ShapeType.line, {
    x: 0.4, y: y, w: 9.2, h: 0,
    line: { color: color || C.teal, width: 1.5 }
  });
}

function bulletBox(slide, items, x, y, w, h, opts) {
  opts = opts || {};
  const textArr = items.map((item, i) => ({
    text: item,
    options: {
      bullet: { type: "bullet", code: "2022" },
      fontSize: opts.fontSize || 13,
      color: opts.color || C.text,
      breakLine: i < items.length - 1,
      paraSpaceAfter: 4,
      indentLevel: opts.indent || 0,
    }
  }));
  slide.addText(textArr, { x, y, w, h, fontFace: "Calibri", valign: "top" });
}

function statBox(slide, value, label, color, x, y, w, h) {
  slide.addShape(pres.ShapeType.roundRect, {
    x, y, w, h,
    fill: { color },
    line: { color: C.white, width: 0 },
    rectRadius: 0.08
  });
  slide.addText(value, {
    x: x + 0.1, y: y + 0.08, w: w - 0.2, h: h * 0.52,
    fontSize: 26, bold: true, color: C.white, align: "center",
    fontFace: "Calibri", margin: 0
  });
  slide.addText(label, {
    x: x + 0.05, y: y + h * 0.52, w: w - 0.1, h: h * 0.44,
    fontSize: 10, color: C.white, align: "center", fontFace: "Calibri",
    wrap: true, margin: 0
  });
}

function sectionDivider(slide, title, subtitle, bgColor) {
  bgColor = bgColor || C.teal;
  sectionBg(slide, bgColor);
  slide.addText(title, {
    x: 1, y: 1.6, w: 8, h: 1.2,
    fontSize: 36, bold: true, color: C.white, align: "center",
    fontFace: "Calibri", margin: 0
  });
  if (subtitle) {
    slide.addText(subtitle, {
      x: 1, y: 2.9, w: 8, h: 0.7,
      fontSize: 17, color: "B2DFDB", align: "center", fontFace: "Calibri",
      italic: true, margin: 0
    });
  }
  slide.addShape(pres.ShapeType.line, {
    x: 3, y: 2.85, w: 4, h: 0,
    line: { color: C.white, width: 2 }
  });
}

// ─────────────────────────────────────────────────────────────────
// SLIDE 1 — TITLE
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  sectionBg(s, C.navy);
  // Top decorative bar
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.22, fill: { color: C.red } });
  // Bottom decorative bar
  s.addShape(pres.ShapeType.rect, { x: 0, y: 5.4, w: 10, h: 0.225, fill: { color: C.green } });

  // India color strip (tricolor)
  s.addShape(pres.ShapeType.rect, { x: 0, y: 5.15, w: 10, h: 0.09, fill: { color: "FF9933" } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 5.24, w: 10, h: 0.09, fill: { color: C.white } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 5.33, w: 10, h: 0.09, fill: { color: "138808" } });

  s.addText("HPV VACCINATION IN INDIA", {
    x: 0.5, y: 0.5, w: 9, h: 0.8,
    fontSize: 30, bold: true, color: C.white, align: "center",
    fontFace: "Calibri", charSpacing: 3
  });
  s.addShape(pres.ShapeType.line, { x: 2, y: 1.35, w: 6, h: 0, line: { color: "90CAF9", width: 2 } });
  s.addText("Human Papillomavirus, Cancer Cervix & Treatment", {
    x: 0.5, y: 1.45, w: 9, h: 0.7,
    fontSize: 19, color: "90CAF9", align: "center", fontFace: "Calibri", italic: true
  });

  // Key highlights boxes
  const boxes = [
    { val: "Virology", col: "283593" },
    { val: "Epidemiology", col: "00695C" },
    { val: "Vaccination", col: "C62828" },
    { val: "Treatment", col: "E65100" },
  ];
  boxes.forEach((b, i) => {
    s.addShape(pres.ShapeType.roundRect, {
      x: 0.4 + i * 2.3, y: 2.3, w: 2.0, h: 0.55,
      fill: { color: b.col }, rectRadius: 0.06
    });
    s.addText(b.val, {
      x: 0.4 + i * 2.3, y: 2.3, w: 2.0, h: 0.55,
      fontSize: 12, bold: true, color: C.white, align: "center",
      fontFace: "Calibri", valign: "middle"
    });
  });

  s.addText([
    { text: "Presented by: MD PSM Resident", options: { bold: true, breakLine: true } },
    { text: "Department of Preventive & Social Medicine", options: { breakLine: true } },
    { text: "July 2026", options: { italic: true } }
  ], {
    x: 1, y: 3.2, w: 8, h: 1.6,
    fontSize: 14, color: "B3E5FC", align: "center", fontFace: "Calibri"
  });
}

// ─────────────────────────────────────────────────────────────────
// SLIDE 2 — CONTENTS
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 1.15, fill: { color: C.navy } });
  s.addText("TABLE OF CONTENTS", {
    x: 0.4, y: 0.2, w: 9.2, h: 0.75,
    fontSize: 24, bold: true, color: C.white, fontFace: "Calibri", align: "center"
  });

  const sections = [
    ["01", "Burden of Disease — Global & India", C.red],
    ["02", "Human Papillomavirus — Virology & Pathogenesis", C.navy],
    ["03", "Cancer Cervix — Epidemiology, Risk Factors & Screening", C.teal],
    ["04", "FIGO Staging & Clinical Features", C.amber],
    ["05", "Treatment of Cancer Cervix", "6A1B9A"],
    ["06", "HPV Vaccines — Types, Schedule & Efficacy", C.green],
    ["07", "HPV Vaccination in India — CERVAVAC & UIP", C.red],
    ["08", "Challenges, Strategies & Way Forward", C.teal],
  ];

  sections.forEach((sec, i) => {
    const col = i % 2 === 0 ? C.white : "EEF2FF";
    const row = Math.floor(i / 2);
    const col2 = i % 2;
    s.addShape(pres.ShapeType.roundRect, {
      x: 0.3 + col2 * 4.9, y: 1.3 + row * 1.05, w: 4.6, h: 0.9,
      fill: { color: col }, line: { color: sec[2], width: 1.5 }, rectRadius: 0.06
    });
    s.addShape(pres.ShapeType.roundRect, {
      x: 0.35 + col2 * 4.9, y: 1.35 + row * 1.05, w: 0.55, h: 0.8,
      fill: { color: sec[2] }, rectRadius: 0.04
    });
    s.addText(sec[0], {
      x: 0.35 + col2 * 4.9, y: 1.35 + row * 1.05, w: 0.55, h: 0.8,
      fontSize: 15, bold: true, color: C.white, align: "center", valign: "middle",
      fontFace: "Calibri", margin: 0
    });
    s.addText(sec[1], {
      x: 1.0 + col2 * 4.9, y: 1.35 + row * 1.05, w: 3.8, h: 0.8,
      fontSize: 12, bold: false, color: C.text, fontFace: "Calibri", valign: "middle",
      wrap: true, margin: 4
    });
  });
}

// ─────────────────────────────────────────────────────────────────
// SECTION DIVIDER — BURDEN
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 1", "Burden of Disease — Global & India", C.red);
}

// ─────────────────────────────────────────────────────────────────
// SLIDE 3 — GLOBAL BURDEN
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite } });
  addHeader(s, "Global Burden of Cervical Cancer", "WHO GLOBOCAN 2022 & ICO/IARC Data", C.red, C.white);

  const stats = [
    ["660,000", "New Cases\nAnnually (2022)"],
    ["350,000", "Deaths Annually\n(2022)"],
    ["4th", "Most Common Cancer\nin Women Globally"],
    ["~90%", "Deaths in LMICs\n(incl. India)"],
  ];
  const cols = ["B71C1C", "C62828", "D32F2F", "E53935"];
  stats.forEach((st, i) => {
    statBox(s, st[0], st[1], cols[i], 0.3 + i * 2.4, 1.4, 2.2, 1.4);
  });

  s.addText("HPV is causally linked to 99.7% of cervical cancers worldwide", {
    x: 0.4, y: 2.95, w: 9.2, h: 0.45,
    fontSize: 14, bold: true, color: C.red, align: "center", fontFace: "Calibri",
    fill: { color: "FFEBEE" }, margin: 6
  });

  addDivider(s, 3.55, C.red);

  s.addText("India-Specific Data (HPV Centre Fact Sheet 2023):", {
    x: 0.4, y: 3.65, w: 9.2, h: 0.4,
    fontSize: 13, bold: true, color: C.navy, fontFace: "Calibri"
  });

  const indiaStats = [
    ["123,907", "New cases/year\n(2nd most common\ncancer in women)", "1A237E"],
    ["77,348", "Deaths per year\n(2nd rank in\nfemale cancer deaths)", "00695C"],
    ["25%", "Of world's cervical\ncancer deaths\nin India", "C62828"],
    ["18.7", "Age-standardised\nrate per 100,000\npopulation", "E65100"],
  ];
  indiaStats.forEach((st, i) => {
    statBox(s, st[0], st[1], st[2], 0.3 + i * 2.4, 4.1, 2.2, 1.35);
  });
}

// ─────────────────────────────────────────────────────────────────
// SECTION DIVIDER — VIROLOGY
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 2", "Human Papillomavirus — Virology & Pathogenesis", C.navy);
}

// ─────────────────────────────────────────────────────────────────
// SLIDE 4 — HPV VIROLOGY
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite } });
  addHeader(s, "Human Papillomavirus — Structure & Classification", "Papillomaviridae Family — Non-enveloped dsDNA Virus", C.navy, C.white);

  // Left column
  s.addShape(pres.ShapeType.roundRect, { x: 0.3, y: 1.35, w: 4.4, h: 4.0, fill: { color: C.white }, line: { color: "BBDEFB", width: 1 }, rectRadius: 0.08 });
  s.addText("VIROLOGY", {
    x: 0.35, y: 1.4, w: 4.3, h: 0.4,
    fontSize: 12, bold: true, color: C.navy, fontFace: "Calibri", margin: 6
  });
  bulletBox(s, [
    "Non-enveloped double-stranded circular DNA virus",
    "Diameter: ~55 nm; Icosahedral capsid",
    "Family: Papillomaviridae",
    "Genome: ~8 kb — early (E) & late (L) genes",
    "E6 & E7 oncoproteins → inactivate p53 and pRb",
    ">200 HPV genotypes identified",
    "~40 types infect anogenital tract",
  ], 0.35, 1.85, 4.3, 3.3, { fontSize: 11.5 });

  // Right column — classification
  s.addShape(pres.ShapeType.roundRect, { x: 5.0, y: 1.35, w: 4.7, h: 4.0, fill: { color: C.white }, line: { color: "BBDEFB", width: 1 }, rectRadius: 0.08 });
  s.addText("CLASSIFICATION BY RISK", {
    x: 5.05, y: 1.4, w: 4.6, h: 0.4,
    fontSize: 12, bold: true, color: C.navy, fontFace: "Calibri", margin: 6
  });

  // High-risk box
  s.addShape(pres.ShapeType.roundRect, { x: 5.1, y: 1.85, w: 4.5, h: 1.5, fill: { color: "FFEBEE" }, line: { color: C.red, width: 1 }, rectRadius: 0.06 });
  s.addText("HIGH-RISK (oncogenic):", {
    x: 5.2, y: 1.9, w: 4.3, h: 0.35,
    fontSize: 11, bold: true, color: C.red, fontFace: "Calibri", margin: 0
  });
  s.addText("Types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68\nHPV 16 & 18 → responsible for ~70% of cervical cancers in India (83.2% of cancers have HPV 16/18)\nMost common: HPV 16 (56.1% of cervical cancers)", {
    x: 5.2, y: 2.3, w: 4.3, h: 1.0,
    fontSize: 10.5, color: C.text, fontFace: "Calibri", wrap: true
  });

  // Low-risk box
  s.addShape(pres.ShapeType.roundRect, { x: 5.1, y: 3.5, w: 4.5, h: 1.1, fill: { color: "E8F5E9" }, line: { color: C.green, width: 1 }, rectRadius: 0.06 });
  s.addText("LOW-RISK (non-oncogenic):", {
    x: 5.2, y: 3.55, w: 4.3, h: 0.35,
    fontSize: 11, bold: true, color: C.green, fontFace: "Calibri", margin: 0
  });
  s.addText("Types: 6, 11, 42, 43, 44\nHPV 6 & 11 → cause ~90% of anogenital warts (condylomata acuminata)", {
    x: 5.2, y: 3.92, w: 4.3, h: 0.65,
    fontSize: 10.5, color: C.text, fontFace: "Calibri", wrap: true
  });
}

// ─────────────────────────────────────────────────────────────────
// SLIDE 5 — PATHOGENESIS
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite } });
  addHeader(s, "Pathogenesis of HPV-Related Cervical Cancer", "From Infection to Invasive Carcinoma — a Multi-Step Process", C.navy, C.white);

  const steps = [
    { n: "1", title: "HPV Infection", body: "Entry at squamocolumnar junction (transformation zone)\nMicro-abrasions allow access to basal epithelium\n80% of sexually active women infected in lifetime", col: "1A237E" },
    { n: "2", title: "Viral Persistence", body: "Usually cleared in 9–15 months by immune system\nPersistence of high-risk HPV = key risk factor\nE6 binds/degrades p53 → inhibits apoptosis", col: "00695C" },
    { n: "3", title: "Integration", body: "Viral DNA integrates into host genome\nE7 binds/inactivates pRb → uncontrolled cell cycle\nActivation of telomerase → immortalisation", col: "C62828" },
    { n: "4", title: "CIN → Invasion", body: "CIN 1 (LSIL) → CIN 2 → CIN 3 (HSIL) → Carcinoma in situ\nHPV 16/18/31/33 account for ~90% of high-grade CIN\nProgression over 10–20 years (opportunity for screening)", col: "E65100" },
  ];

  steps.forEach((st, i) => {
    const x = 0.3 + i * 2.4;
    s.addShape(pres.ShapeType.roundRect, { x, y: 1.4, w: 2.15, h: 3.85, fill: { color: C.white }, line: { color: st.col, width: 2 }, rectRadius: 0.08 });
    s.addShape(pres.ShapeType.ellipse, { x: x + 0.7, y: 1.3, w: 0.75, h: 0.75, fill: { color: st.col } });
    s.addText(st.n, { x: x + 0.7, y: 1.3, w: 0.75, h: 0.75, fontSize: 18, bold: true, color: C.white, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
    s.addText(st.title, { x: x + 0.05, y: 2.15, w: 2.05, h: 0.5, fontSize: 12, bold: true, color: st.col, align: "center", fontFace: "Calibri", wrap: true });
    s.addText(st.body, { x: x + 0.1, y: 2.7, w: 1.95, h: 2.4, fontSize: 9.5, color: C.text, fontFace: "Calibri", wrap: true, valign: "top" });
    if (i < 3) {
      s.addText("→", { x: x + 2.15, y: 2.95, w: 0.25, h: 0.5, fontSize: 20, bold: true, color: C.muted, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
    }
  });
}

// ─────────────────────────────────────────────────────────────────
// SECTION DIVIDER — CANCER CERVIX
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 3", "Cancer Cervix — Epidemiology, Risk Factors & Screening", C.teal);
}

// ─────────────────────────────────────────────────────────────────
// SLIDE 6 — RISK FACTORS
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite } });
  addHeader(s, "Cancer Cervix — Risk Factors & Histology", "Squamous Cell Carcinoma (75–80%) | Adenocarcinoma (15–20%)", C.teal, C.white);

  s.addText("RISK FACTORS", { x: 0.3, y: 1.4, w: 5.2, h: 0.4, fontSize: 13, bold: true, color: C.teal, fontFace: "Calibri" });
  const rfs = [
    ["HPV Infection (necessary cause)", "Early age at first intercourse (< 16 yrs)"],
    ["Multiple sexual partners", "High parity / early marriage"],
    ["Immunosuppression (HIV, transplant)", "Long-term OCP use (> 5 years)"],
    ["Smoking / tobacco", "Low socioeconomic status"],
    ["Absence of screening / non-use of condoms", "Co-infection: Chlamydia trachomatis, HSV-2"],
  ];
  rfs.forEach((pair, i) => {
    const y = 1.85 + i * 0.6;
    pair.forEach((txt, j) => {
      s.addShape(pres.ShapeType.roundRect, { x: 0.3 + j * 2.7, y, w: 2.55, h: 0.52, fill: { color: "E0F2F1" }, line: { color: C.teal, width: 0.5 }, rectRadius: 0.05 });
      s.addText("• " + txt, { x: 0.35 + j * 2.7, y, w: 2.45, h: 0.52, fontSize: 10.5, color: C.text, fontFace: "Calibri", valign: "middle", wrap: true, margin: 4 });
    });
  });

  // Right side histology
  s.addShape(pres.ShapeType.roundRect, { x: 5.7, y: 1.35, w: 4.0, h: 4.0, fill: { color: C.white }, line: { color: C.teal, width: 1.5 }, rectRadius: 0.08 });
  s.addText("HISTOLOGICAL TYPES", { x: 5.8, y: 1.42, w: 3.8, h: 0.4, fontSize: 12, bold: true, color: C.teal, fontFace: "Calibri" });

  const histo = [
    ["Squamous Cell Carcinoma", "75–80%", C.teal],
    ["Adenocarcinoma", "15–20%", C.navy],
    ["Adenosquamous Carcinoma", "3–5%", C.amber],
    ["Small Cell / NEC", "<3%", C.red],
    ["Clear Cell / Serous", "Rare", C.muted],
  ];
  histo.forEach((h, i) => {
    const barW = parseFloat(h[1]) / 80 * 2.5 || 0.3;
    s.addText(h[0], { x: 5.85, y: 1.9 + i * 0.62, w: 2.2, h: 0.5, fontSize: 10.5, color: C.text, fontFace: "Calibri", valign: "middle" });
    s.addShape(pres.ShapeType.roundRect, { x: 8.1, y: 1.97 + i * 0.62, w: barW > 2.5 ? 2.5 : barW, h: 0.3, fill: { color: h[2] }, rectRadius: 0.04 });
    s.addText(h[1], { x: 8.12, y: 1.97 + i * 0.62, w: 1.2, h: 0.3, fontSize: 10, bold: true, color: C.white, fontFace: "Calibri", valign: "middle", margin: 0 });
  });
}

// ─────────────────────────────────────────────────────────────────
// SLIDE 7 — SCREENING
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite } });
  addHeader(s, "Cervical Cancer Screening — Methods & WHO Recommendations", "Screening Coverage in India: Only ~2% (NFHS-5) — A Critical Gap", C.teal, C.white);

  const methods = [
    { name: "PAP SMEAR (Cytology)", age: "21–65 years", freq: "Every 3 years", notes: "First-line in high-resource settings\nASC-US → reflex HPV testing", col: C.teal },
    { name: "HPV DNA Testing", age: "25–65 years", freq: "Every 5 years", notes: "Primary screening (primary HPV test)\nCo-test with cytology: 5-yearly", col: C.navy },
    { name: "VIA / VILI", age: "25–60 years", freq: "Every 3–5 years", notes: "Preferred in India/LMICs\nNo lab needed; nurse-administered\nScreen & treat approach (WHO)", col: C.amber },
    { name: "Colposcopy", age: "Triage / follow-up", freq: "As indicated", notes: "Directed biopsy for diagnosis\nUsed after abnormal Pap/HPV", col: "6A1B9A" },
  ];

  methods.forEach((m, i) => {
    const x = 0.3 + i * 2.4;
    s.addShape(pres.ShapeType.roundRect, { x, y: 1.38, w: 2.2, h: 3.95, fill: { color: C.white }, line: { color: m.col, width: 2 }, rectRadius: 0.08 });
    s.addShape(pres.ShapeType.rect, { x, y: 1.38, w: 2.2, h: 0.55, fill: { color: m.col }, rectRadius: 0 });
    s.addText(m.name, { x: x + 0.05, y: 1.4, w: 2.1, h: 0.5, fontSize: 10, bold: true, color: C.white, align: "center", valign: "middle", fontFace: "Calibri", wrap: true, margin: 0 });
    s.addText("Age group:", { x: x + 0.1, y: 2.02, w: 2.0, h: 0.25, fontSize: 9, bold: true, color: m.col, fontFace: "Calibri", margin: 0 });
    s.addText(m.age, { x: x + 0.1, y: 2.27, w: 2.0, h: 0.3, fontSize: 10.5, color: C.text, fontFace: "Calibri", margin: 0 });
    s.addText("Frequency:", { x: x + 0.1, y: 2.6, w: 2.0, h: 0.25, fontSize: 9, bold: true, color: m.col, fontFace: "Calibri", margin: 0 });
    s.addText(m.freq, { x: x + 0.1, y: 2.85, w: 2.0, h: 0.3, fontSize: 10.5, color: C.text, fontFace: "Calibri", margin: 0 });
    addDivider(s, 3.22, m.col);
    s.addText(m.notes, { x: x + 0.1, y: 3.28, w: 2.0, h: 2.0, fontSize: 10, color: C.subtext, fontFace: "Calibri", wrap: true, valign: "top" });
  });
}

// ─────────────────────────────────────────────────────────────────
// SECTION DIVIDER — STAGING
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 4", "FIGO Staging & Clinical Features", C.amber);
}

// ─────────────────────────────────────────────────────────────────
// SLIDE 8 — FIGO STAGING
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite } });
  addHeader(s, "FIGO 2018 Staging of Cervical Cancer", "Clinical + Imaging + Pathological Criteria (revised 2018)", C.amber, C.white);

  const stages = [
    { stage: "Stage I", desc: "Confined to cervix", substages: ["IA1: Depth <3mm", "IA2: Depth 3–5mm", "IB1: >5mm, ≤2cm", "IB2: >2cm, ≤4cm", "IB3: >4cm"], col: "1B5E20" },
    { stage: "Stage II", desc: "Beyond cervix, not to pelvic wall/lower vagina", substages: ["IIA1: Upper 2/3 vagina, ≤4cm", "IIA2: Upper 2/3 vagina, >4cm", "IIB: Parametrial involvement"], col: "E65100" },
    { stage: "Stage III", desc: "Pelvic wall, lower vagina, nodes, hydronephrosis", substages: ["IIIA: Lower 1/3 vagina", "IIIB: Pelvic wall / hydronephrosis", "IIIC1: Pelvic node metastasis", "IIIC2: Para-aortic nodes"], col: "B71C1C" },
    { stage: "Stage IV", desc: "Beyond true pelvis / distant metastasis", substages: ["IVA: Adjacent organs (bladder/rectum)", "IVB: Distant metastasis"], col: "37474F" },
  ];

  stages.forEach((st, i) => {
    const x = 0.2 + i * 2.45;
    s.addShape(pres.ShapeType.roundRect, { x, y: 1.35, w: 2.3, h: 4.0, fill: { color: C.white }, line: { color: st.col, width: 2 }, rectRadius: 0.08 });
    s.addShape(pres.ShapeType.rect, { x, y: 1.35, w: 2.3, h: 0.72, fill: { color: st.col } });
    s.addText(st.stage, { x, y: 1.38, w: 2.3, h: 0.38, fontSize: 16, bold: true, color: C.white, align: "center", fontFace: "Calibri", margin: 0 });
    s.addText(st.desc, { x: x + 0.05, y: 1.78, w: 2.2, h: 0.62, fontSize: 9, color: "ECEFF1", align: "center", fontFace: "Calibri", wrap: true, fill: { color: st.col }, margin: 2 });
    st.substages.forEach((sub, j) => {
      s.addShape(pres.ShapeType.roundRect, { x: x + 0.1, y: 2.16 + j * 0.58, w: 2.1, h: 0.5, fill: { color: i % 2 === 0 ? "F1F8E9" : "FFF3E0" }, line: { color: st.col, width: 0.5 }, rectRadius: 0.04 });
      s.addText(sub, { x: x + 0.15, y: 2.16 + j * 0.58, w: 2.0, h: 0.5, fontSize: 10, color: C.text, fontFace: "Calibri", valign: "middle", wrap: true, margin: 2 });
    });
  });
}

// ─────────────────────────────────────────────────────────────────
// SECTION DIVIDER — TREATMENT
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 5", "Treatment of Cancer Cervix", "6A1B9A");
}

// ─────────────────────────────────────────────────────────────────
// SLIDE 9 — TREATMENT OVERVIEW
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite } });
  addHeader(s, "Treatment of Cancer Cervix", "Based on FIGO Stage, Resources & Fertility Wishes — NCCN 2026", "6A1B9A", C.white);

  const treatments = [
    {
      stage: "Stage IA1", title: "Cone Biopsy / Simple Hysterectomy",
      detail: "Fertility desired: Cone biopsy (if margins –ve)\nNo fertility wish: Simple hysterectomy\nLVSI +ve: Radical trachelectomy + LND",
      col: "1B5E20", bg: "F1F8E9"
    },
    {
      stage: "Stage IA2–IB1", title: "Radical Hysterectomy (Type C)",
      detail: "Modified radical or radical hysterectomy\n+ Bilateral pelvic LND (±SLNB)\nRT alternative for non-surgical candidates",
      col: "2E7D32", bg: "E8F5E9"
    },
    {
      stage: "Stage IB2–IIA", title: "Surgery OR Chemoradiation",
      detail: "Radical hysterectomy for IB2–IB3\nConcurrent chemoradiation (cisplatin)\npreferred for IIA2 disease\nRT: EBRT + brachytherapy",
      col: "E65100", bg: "FFF3E0"
    },
    {
      stage: "Stage IIB–IVA", title: "Concurrent Chemoradiation (CRT)",
      detail: "EBRT (45 Gy / 25 fractions) to pelvis\n+ Concurrent cisplatin (40mg/m² weekly)\n+ Brachytherapy boost\nPembrolizumab (Stage III–IVA): Category 1 (NCCN 2026)",
      col: "B71C1C", bg: "FFEBEE"
    },
    {
      stage: "Stage IVB / Recurrent", title: "Systemic Therapy / Palliative",
      detail: "Platinum-based combination (cisplatin + paclitaxel)\nBevacizumab + chemo (Tewari 2014)\nPembrolizumab (PD-L1+)\nPaliative RT for symptoms",
      col: "37474F", bg: "ECEFF1"
    },
  ];

  treatments.forEach((t, i) => {
    const row = Math.floor(i / 3);
    const col2 = i % 3;
    const w = i < 3 ? 3.1 : 4.65;
    const x = i < 3 ? 0.3 + col2 * 3.15 : 0.3 + (i - 3) * 4.85;
    const y = row === 0 ? 1.38 : 3.55;
    const h = 2.0;
    s.addShape(pres.ShapeType.roundRect, { x, y, w, h, fill: { color: t.bg }, line: { color: t.col, width: 2 }, rectRadius: 0.07 });
    s.addShape(pres.ShapeType.rect, { x, y, w, h: 0.52, fill: { color: t.col } });
    s.addText(t.stage, { x, y, w, h: 0.28, fontSize: 10, bold: true, color: C.white, align: "center", fontFace: "Calibri", margin: 2 });
    s.addText(t.title, { x: x + 0.05, y: y + 0.28, w: w - 0.1, h: 0.28, fontSize: 10, color: C.white, align: "center", fontFace: "Calibri", wrap: true, margin: 0 });
    s.addText(t.detail, { x: x + 0.1, y: y + 0.6, w: w - 0.2, h: h - 0.7, fontSize: 9.5, color: C.text, fontFace: "Calibri", wrap: true, valign: "top" });
  });
}

// ─────────────────────────────────────────────────────────────────
// SLIDE 10 — PEMBROLIZUMAB & IMMUNOTHERAPY UPDATE
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite } });
  addHeader(s, "Immunotherapy Update — Pembrolizumab (KEYNOTE-A18)", "FDA Approval June 2025 — Locally Advanced Cervical Cancer", "6A1B9A", C.white);

  // Key data box
  s.addShape(pres.ShapeType.roundRect, { x: 0.3, y: 1.38, w: 4.4, h: 3.95, fill: { color: "EDE7F6" }, line: { color: "6A1B9A", width: 2 }, rectRadius: 0.08 });
  s.addText("KEYNOTE-A18 TRIAL", { x: 0.4, y: 1.45, w: 4.2, h: 0.45, fontSize: 14, bold: true, color: "6A1B9A", fontFace: "Calibri" });
  bulletBox(s, [
    "N = 1,060 patients (FIGO stage III–IVA)",
    "36-month Overall Survival:",
    "  Pembrolizumab + CRT: 82.6%",
    "  Placebo + CRT: 74.8%",
    "Statistically significant benefit (p<0.001)",
    "PFS improvement: HR 0.70 (95% CI 0.58–0.84)",
    "FDA updated indication: June 2025",
  ], 0.4, 1.95, 4.2, 3.2, { fontSize: 11.5 });

  // Right side mechanism + indications
  s.addShape(pres.ShapeType.roundRect, { x: 5.0, y: 1.38, w: 4.7, h: 1.8, fill: { color: C.white }, line: { color: "6A1B9A", width: 1 }, rectRadius: 0.07 });
  s.addText("Mechanism of Action", { x: 5.1, y: 1.45, w: 4.5, h: 0.38, fontSize: 12, bold: true, color: "6A1B9A", fontFace: "Calibri" });
  s.addText("PD-1 inhibitor → blocks PD-1/PD-L1 interaction → restores T-cell anti-tumour activity.\nHPV E6/E7-specific T cells reactivated.\nPD-L1 CPS ≥1 preferred, but benefit seen regardless.", {
    x: 5.1, y: 1.88, w: 4.5, h: 1.2, fontSize: 11, color: C.text, fontFace: "Calibri", wrap: true
  });

  s.addShape(pres.ShapeType.roundRect, { x: 5.0, y: 3.3, w: 4.7, h: 2.03, fill: { color: C.white }, line: { color: C.green, width: 1 }, rectRadius: 0.07 });
  s.addText("Other Systemic Agents", { x: 5.1, y: 3.37, w: 4.5, h: 0.38, fontSize: 12, bold: true, color: C.green, fontFace: "Calibri" });
  bulletBox(s, [
    "Bevacizumab + Chemo: +3.7 months OS (GOG-0240)",
    "Tisotumab vedotin: ADC for relapsed disease",
    "Cemiplimab (EMPOWER-Cervical 1)",
    "Atezolizumab — ongoing trials",
  ], 5.1, 3.78, 4.5, 1.45, { fontSize: 11 });
}

// ─────────────────────────────────────────────────────────────────
// SECTION DIVIDER — HPV VACCINES
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 6", "HPV Vaccines — Types, Schedule & Efficacy", C.green);
}

// ─────────────────────────────────────────────────────────────────
// SLIDE 11 — AVAILABLE HPV VACCINES
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite } });
  addHeader(s, "HPV Vaccines — Available Formulations", "All are VLP (Virus-Like Particle) Recombinant Vaccines — No Live Virus", C.green, C.white);

  const vaccines = [
    {
      name: "CERVARIX", brand: "GSK", type: "BIVALENT",
      types: "HPV 16, 18", adjuvant: "AS04 (Al hydroxide + MPL)",
      schedule: "0, 1, 6 months", notes: "Cross-protection against 31, 33, 45\nEfficacy: 93–100% against CIN 2/3 due to HPV 16/18",
      col: "1A237E"
    },
    {
      name: "GARDASIL-4", brand: "MSD", type: "QUADRIVALENT",
      types: "HPV 6, 11, 16, 18", adjuvant: "AAHS (amorphous Al hydroxyphosphate)",
      schedule: "0, 2, 6 months", notes: "Protects vs genital warts (types 6/11)\nEfficacy: 98–100% against CIN 2/3",
      col: "00695C"
    },
    {
      name: "CERVAVAC", brand: "Serum Institute of India", type: "QUADRIVALENT (India)",
      types: "HPV 6, 11, 16, 18", adjuvant: "Aluminium hydroxide",
      schedule: "9–14 yrs: 2 doses (0, 6m)\n15–26 yrs: 3 doses (0, 2, 6m)",
      notes: "Made in India — ₹200–400/dose (NIP)\nNon-inferior to Gardasil-4\nFirst domestically made HPV vaccine\nRoute: IM (deltoid or anterolateral thigh)",
      col: "C62828"
    },
    {
      name: "GARDASIL-9", brand: "MSD", type: "NONAVALENT",
      types: "HPV 6,11,16,18,31,33,45,52,58", adjuvant: "AAHS",
      schedule: "9–14: 2 doses (0, 6m)\n≥15: 3 doses (0, 2, 6m)",
      notes: "Covers 90% of cervical cancers\nWHO recommended\nNot yet in India NIP",
      col: "E65100"
    },
  ];

  vaccines.forEach((v, i) => {
    const x = 0.2 + i * 2.45;
    s.addShape(pres.ShapeType.roundRect, { x, y: 1.35, w: 2.3, h: 4.05, fill: { color: C.white }, line: { color: v.col, width: 2 }, rectRadius: 0.08 });
    s.addShape(pres.ShapeType.rect, { x, y: 1.35, w: 2.3, h: 0.72, fill: { color: v.col } });
    s.addText(v.name, { x, y: 1.38, w: 2.3, h: 0.36, fontSize: 14, bold: true, color: C.white, align: "center", fontFace: "Calibri", margin: 0 });
    s.addText(v.type, { x, y: 1.74, w: 2.3, h: 0.32, fontSize: 9, color: "B2DFDB", align: "center", fontFace: "Calibri", margin: 0 });
    const fields = [
      ["Brand", v.brand], ["Types covered", v.types], ["Adjuvant", v.adjuvant], ["Schedule", v.schedule]
    ];
    fields.forEach((f, j) => {
      s.addText(f[0] + ":", { x: x + 0.1, y: 2.12 + j * 0.62, w: 2.1, h: 0.22, fontSize: 8.5, bold: true, color: v.col, fontFace: "Calibri", margin: 0 });
      s.addText(f[1], { x: x + 0.1, y: 2.34 + j * 0.62, w: 2.1, h: 0.35, fontSize: 9.5, color: C.text, fontFace: "Calibri", wrap: true, margin: 0 });
    });
    addDivider(s, 4.6, v.col);
    s.addText(v.notes, { x: x + 0.1, y: 4.65, w: 2.1, h: 0.65, fontSize: 8.5, color: C.subtext, fontFace: "Calibri", wrap: true, italic: true });
  });
}

// ─────────────────────────────────────────────────────────────────
// SLIDE 12 — VACCINE EFFICACY
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite } });
  addHeader(s, "Vaccine Efficacy, Immunogenicity & Safety", "Pre-licensure Trial & Real-World Evidence", C.green, C.white);

  // Efficacy table
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.38, w: 9.4, h: 0.42, fill: { color: C.green } });
  ["Outcome", "Bivalent", "Quadrivalent", "Nonavalent"].forEach((h, i) => {
    s.addText(h, { x: 0.35 + i * 2.3, y: 1.42, w: 2.2, h: 0.35, fontSize: 11, bold: true, color: C.white, fontFace: "Calibri", valign: "middle", margin: 2 });
  });

  const rows = [
    ["CIN 2/3 due to HPV 16/18", "93–100%", "98–100%", "96–100%"],
    ["Cervical cancer prevention (long-term)", "~90%", "~90%", ">90%"],
    ["Genital warts", "—", "98–100%", "98–100%"],
    ["Seropositivity after 3 doses", ">99.9%", ">99.9%", ">99%"],
    ["Duration of protection", "10+ years", "10+ years", "10+ years"],
  ];
  rows.forEach((row, i) => {
    const bg = i % 2 === 0 ? C.lightGreen : C.white;
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.82 + i * 0.5, w: 9.4, h: 0.48, fill: { color: bg } });
    row.forEach((cell, j) => {
      s.addText(cell, { x: 0.35 + j * 2.3, y: 1.85 + i * 0.5, w: 2.2, h: 0.42, fontSize: 11, color: C.text, fontFace: "Calibri", valign: "middle", margin: 2 });
    });
  });

  s.addShape(pres.ShapeType.roundRect, { x: 0.3, y: 4.38, w: 9.4, h: 1.0, fill: { color: C.lightGreen }, line: { color: C.green, width: 1 }, rectRadius: 0.07 });
  s.addText("SAFETY PROFILE", { x: 0.4, y: 4.42, w: 9.2, h: 0.3, fontSize: 11, bold: true, color: C.green, fontFace: "Calibri" });
  s.addText("Common AEs: Injection site reactions (pain, redness, swelling) in ~80%; Syncope (brief — observe for 15 min post-injection)\nSerious AEs: Rare; No causal link to autoimmune disorders proven; Safe in immunocompromised\nContraindications: Hypersensitivity to yeast/Al compounds; Defer in pregnancy (but not harmful if given inadvertently)", {
    x: 0.4, y: 4.74, w: 9.2, h: 0.6, fontSize: 10.5, color: C.text, fontFace: "Calibri", wrap: true
  });
}

// ─────────────────────────────────────────────────────────────────
// SECTION DIVIDER — HPV IN INDIA
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 7", "HPV Vaccination in India — CERVAVAC & Universal Immunization Programme", C.red);
}

// ─────────────────────────────────────────────────────────────────
// SLIDE 13 — HPV VACCINATION INDIA
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite } });
  addHeader(s, "HPV Vaccination in India — National Programme", "India accounts for 25% of global cervical cancer deaths — Now Responding", C.red, C.white);

  s.addText("TIMELINE OF HPV VACCINATION IN INDIA", {
    x: 0.3, y: 1.38, w: 9.4, h: 0.38,
    fontSize: 13, bold: true, color: C.red, fontFace: "Calibri", align: "center"
  });

  const timeline = [
    { year: "2008", event: "Gardasil & Cervarix approved in India (private sector)", col: C.muted },
    { year: "2013", event: "ICMR/PATH HPV vaccine demonstration programme (AP & Gujarat) halted due to controversy", col: C.amber },
    { year: "2022", event: "CERVAVAC approved by CDSCO — Serum Institute; first indigenous HPV vaccine", col: C.teal },
    { year: "2023", event: "MoHFW contacts 7 states for phase-wise UIP rollout (girls 9–14 yrs); Budget allocated ₹200–400/dose", col: C.navy },
    { year: "2025–26", event: "Nationwide HPV vaccination launched under UIP; Target: 68 million girls; 11.2 million girls/year thereafter", col: C.green },
  ];

  timeline.forEach((t, i) => {
    s.addShape(pres.ShapeType.ellipse, { x: 0.3, y: 1.88 + i * 0.65, w: 0.65, h: 0.52, fill: { color: t.col } });
    s.addText(t.year, { x: 0.3, y: 1.88 + i * 0.65, w: 0.65, h: 0.52, fontSize: 9, bold: true, color: C.white, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
    if (i < 4) s.addShape(pres.ShapeType.line, { x: 0.625, y: 2.4 + i * 0.65, w: 0, h: 0.25, line: { color: t.col, width: 2 } });
    s.addShape(pres.ShapeType.roundRect, { x: 1.1, y: 1.88 + i * 0.65, w: 8.6, h: 0.52, fill: { color: C.white }, line: { color: t.col, width: 1 }, rectRadius: 0.05 });
    s.addText(t.event, { x: 1.2, y: 1.88 + i * 0.65, w: 8.4, h: 0.52, fontSize: 11.5, color: C.text, fontFace: "Calibri", valign: "middle", wrap: true });
  });
}

// ─────────────────────────────────────────────────────────────────
// SLIDE 14 — CERVAVAC & UIP DETAILS
// ─────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite } });
  addHeader(s, "CERVAVAC Under UIP — Schedule, Target & Cold Chain", "India's Indigenous Quadrivalent HPV Vaccine", C.red, C.white);

  // Left
  s.addShape(pres.ShapeType.roundRect, { x: 0.3, y: 1.38, w: 4.4, h: 4.0, fill: { color: C.white }, line: { color: C.red, width: 1.5 }, rectRadius: 0.08 });
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.38, w: 4.4, h: 0.5, fill: { color: C.red } });
  s.addText("VACCINATION SCHEDULE (CERVAVAC)", { x: 0.35, y: 1.4, w: 4.3, h: 0.45, fontSize: 11, bold: true, color: C.white, fontFace: "Calibri", valign: "middle", margin: 2 });

  const schedule = [
    ["Age Group", "Doses", "Schedule"],
    ["9–14 years (UIP primary)", "2 doses", "Month 0 & Month 6"],
    ["15–26 years", "3 doses", "Month 0, 2 & 6"],
    ["< 9 years", "Not recommended", "Safety not established"],
    ["Pregnancy", "Defer", "Not contraindicated if inadvertent"],
  ];
  schedule.forEach((row, i) => {
    const bg = i === 0 ? "FFCDD2" : (i % 2 === 1 ? "FFEBEE" : C.white);
    s.addShape(pres.ShapeType.rect, { x: 0.32, y: 1.9 + i * 0.56, w: 4.36, h: 0.54, fill: { color: bg } });
    [row[0], row[1], row[2]].forEach((cell, j) => {
      const w = [1.8, 1.1, 1.35];
      const x = [0.35, 2.18, 3.3];
      s.addText(cell, { x: x[j], y: 1.93 + i * 0.56, w: w[j], h: 0.48, fontSize: i === 0 ? 10 : 10.5, bold: i === 0, color: C.text, fontFace: "Calibri", valign: "middle", wrap: true, margin: 2 });
    });
  });

  s.addText("Route: IM | Site: Deltoid or anterolateral thigh | 0.5 mL/dose", {
    x: 0.35, y: 4.72, w: 4.3, h: 0.5,
    fontSize: 10.5, color: C.teal, fontFace: "Calibri", italic: true, valign: "middle"
  });

  // Right
  s.addShape(pres.ShapeType.roundRect, { x: 5.0, y: 1.38, w: 4.7, h: 4.0, fill: { color: C.white }, line: { color: C.navy, width: 1.5 }, rectRadius: 0.08 });
  s.addShape(pres.ShapeType.rect, { x: 5.0, y: 1.38, w: 4.7, h: 0.5, fill: { color: C.navy } });
  s.addText("KEY IMPLEMENTATION DETAILS", { x: 5.05, y: 1.4, w: 4.6, h: 0.45, fontSize: 11, bold: true, color: C.white, fontFace: "Calibri", valign: "middle", margin: 2 });

  bulletBox(s, [
    "Target population: Girls aged 9–14 years",
    "Delivery platform: School-based programme (Class 5/6)",
    "Estimated target: 68 million girls (phase-wise)",
    "Annual cohort: ~11.2 million girls per year",
    "Cold chain: 2–8°C (standard refrigerator chain)",
    "Catch-up vaccination: 15–26 years (private sector)",
    "States (2023 rollout): HP, TN, Sikkim, Punjab, Goa, Dadra & Daman, Puducherry",
    "Screening coverage VIA: Only 2% in India (NFHS-5) — major gap",
    "WHO prequalification of CERVAVAC: Under process",
    "Cost: ₹200–400 per dose under UIP (vs ₹3,000+ private)",
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}

// ─────────────────────────────────────────────────────────────────
// SLIDE 15 — WHO RECOMMENDATIONS (SINGLE DOSE)
// ─────────────────────────────────────────────────────────────────
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// ─────────────────────────────────────────────────────────────────
// SECTION DIVIDER — CHALLENGES
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// ─────────────────────────────────────────────────────────────────
// SLIDE 16 — CHALLENGES & STRATEGIES
// ─────────────────────────────────────────────────────────────────
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// ─────────────────────────────────────────────────────────────────
// SLIDE 17 — WAY FORWARD: INTEGRATED APPROACH
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// ─────────────────────────────────────────────────────────────────
// SLIDE 18 — KEY MESSAGES & CONCLUSION
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// ─────────────────────────────────────────────────────────────────
// SLIDE 19 — REFERENCES
// ─────────────────────────────────────────────────────────────────
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    "1. WHO. Human Papillomavirus (HPV) vaccines: WHO position paper (2022). Weekly Epidemiological Record 97(50):645–672",
    "2. ICO/IARC Information Centre on HPV and Cancer. India Human Papillomavirus and Related Cancers, Fact Sheet 2023",
    "3. Serum Institute of India. CERVAVAC® Summary of Product Characteristics, CDSCO 2022",
    "4. National Cancer Registry Programme, ICMR. Cancer Incidence Estimates for 2022 & Projection for 2025. Indian J Med Res 2022;156:598–607",
    "5. NCCN Clinical Practice Guidelines in Oncology — Cervical Cancer, Version 2.2026",
    "6. Colombo et al. ESMO-ESGO Consensus Conference Recommendations on Cervical Cancer. Ann Oncol 2024",
    "7. Monk BJ et al. KEYNOTE-A18: Pembrolizumab + Concurrent Chemoradiotherapy in Cervical Cancer. NEJM 2023",
    "8. Berek & Novak's Gynecology, 16th Edition. Cervical Intraepithelial Neoplasia (Chapter 29)",
    "9. Bhattacharya S et al. HPV immunisation in India — framework for routine rollout. J Fam Med Primary Care 2025;PMC11844949",
    "10. Pal D, Sahoo BK, Taywade M. Knowledge, Attitude & Practice regarding HPV vaccination in India: Systematic Review & Meta-analysis. Asian Pac J Cancer Prev 2024 (PMID: 38546062)",
    "11. MoHFW India. Universal Immunization Programme — HPV Vaccine Introduction Guidelines 2025",
    "12. Cervical cancer burden in India: ICMR-MOHFW descriptive epidemiological study. PMC12702179 (2025)",
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// ─────────────────────────────────────────────────────────────────
// WRITE FILE
// ─────────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/hpv-presentation/HPV_Vaccination_India_Cancer_Cervix.pptx" })
  .then(() => console.log("✅ Presentation saved successfully!"))
  .catch(e => { console.error("ERROR:", e); process.exit(1); });
Running Command

cd /home/daytona/workspace/hpv-presentation && node create_hpv_presentation.js 2…

Running Command

ls -lh /home/daytona/workspace/hpv-presentation/

Your presentation is ready! Here is your download link:

HPV Vaccination India Cancer Cervix

Presentation · PPTX

Presentation Overview (19 Slides)

The deck uses a professional dark-navy / teal / red color palette with consistent section dividers, stat boxes, timelines, comparison tables, and bullet card layouts. Here is what each section covers:
#SectionSlidesKey Content
—Title + Contents1–2Topic overview, table of contents
1Burden of Disease3Global: 660,000 cases/year; India: 123,907 cases, 77,348 deaths, 25% of world's deaths
2HPV Virology & Pathogenesis4–5Structure, classification (high/low risk types), E6/E7 oncoproteins, 4-step carcinogenesis pathway
3Cancer Cervix — Risk Factors & Screening6–710 risk factors, histological types, PAP/HPV/VIA/Colposcopy comparison
4FIGO 2018 Staging8All 4 stages with full substages in visual columns
5Treatment9–10Stage-based treatment table (Stage IA1 → IVB), KEYNOTE-A18 pembrolizumab data (June 2025 FDA approval), bevacizumab, ADCs
6HPV Vaccines11–12Cervarix, Gardasil-4, CERVAVAC, Gardasil-9 comparison; efficacy table; safety profile
7HPV Vaccination in India13–15Timeline 2008–2026, CERVAVAC UIP schedule (2-dose for 9–14 yrs), 68 million girls target, WHO 90-70-90 strategy
8Challenges & Way Forward16–177 challenges + 7 strategies, integrated prevention pillars (primary/secondary/tertiary)
—Key Messages + References18–195 take-home messages, 12 cited references (WHO, ICMR, NCCN, KEYNOTE-A18, PubMed)

Sources Used

  • ICO/IARC HPV Fact Sheet India 2023 — incidence, mortality, HPV type data
  • CERVAVAC SmPC, CDSCO 2022 — schedule and indications
  • GAVI/ICMR 2025 — India UIP rollout details
  • NCCN Guidelines v2.2026 — cervical cancer treatment
  • KEYNOTE-A18 — pembrolizumab in locally advanced disease
  • Berek & Novak's Gynecology (textbook) — pathogenesis and CIN
  • PubMed meta-analyses (PMID: 38546062, 41431853) — India KAP on HPV vaccination
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