const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Acute Pancreatitis: Treatment & Management";
pres.author = "Postgraduate Medical Education";

// ─── COLOR PALETTE ───────────────────────────────────────────────────────────
const C = {
  navy:    "0D2B4E",   // dominant dark bg
  teal:    "1A7A8A",   // heading bars / accents
  sky:     "2DB8CC",   // highlights / icons
  white:   "FFFFFF",
  offwhite:"F4F8FA",
  amber:   "F0A500",   // warning / key points
  red:     "C0392B",   // danger / critical
  grey:    "5A6A7A",   // body text on light bg
  lightbg: "EBF4F7",   // light slide bg
};

// ─── HELPER: section header bar ──────────────────────────────────────────────
function addTopBar(slide, title) {
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    x: 0, y: 0, w: 10, h: 0.7,
    fill: { color: C.teal }, line: { color: C.teal }
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    x: 0.3, y: 0, w: 9.4, h: 0.7,
    fontSize: 13, bold: true, color: C.white, valign: "middle", charSpacing: 2, margin: 0
  });
}

// ─── HELPER: footer ──────────────────────────────────────────────────────────
function addFooter(slide, text = "Acute Pancreatitis | Postgraduate Class") {
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    x: 0, y: 5.35, w: 10, h: 0.275,
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// ─── HELPER: colored card ────────────────────────────────────────────────────
function addCard(slide, x, y, w, h, bg, title, bullets, titleColor = C.white, textColor = C.navy) {
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}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  // Full dark bg
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  s.addText("ACUTE PANCREATITIS", {
    x: 0.5, y: 1.1, w: 7, h: 0.85,
    fontSize: 34, bold: true, color: C.white, charSpacing: 3
  });
  s.addShape(pres.shapes.RECTANGLE, { x: 0.5, y: 2.05, w: 3.5, h: 0.06, fill: { color: C.amber }, line: { color: C.amber } });
  s.addText("Treatment & Management", {
    x: 0.5, y: 2.2, w: 7, h: 0.55,
    fontSize: 18, color: C.sky, italic: true
  });
  s.addText("Postgraduate Medical Education  |  2026", {
    x: 0.5, y: 4.7, w: 7, h: 0.4,
    fontSize: 11, color: C.grey
  });
  s.addText([
    { text: "Sources: ", options: { bold: true, color: C.sky, fontSize: 8 } },
    { text: "Rosen's Emergency Medicine 9e  ·  Sleisenger & Fordtran's GI & Liver Disease  ·  Harrison's Principles 22e", options: { color: C.grey, fontSize: 8 } }
  ], { x: 0.5, y: 5.1, w: 9, h: 0.35 });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 2 — OVERVIEW / AGENDA
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
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  addTopBar(s, "Overview");

  const topics = [
    ["01", "Epidemiology & Aetiology"],
    ["02", "Pathophysiology"],
    ["03", "Diagnosis & Severity Classification"],
    ["04", "Fluid Resuscitation"],
    ["05", "Analgesia & Nutrition"],
    ["06", "Antibiotic Policy"],
    ["07", "Disease-Specific & ERCP"],
    ["08", "Complications & Interventions"],
    ["09", "Management Algorithm"],
    ["10", "Key Takeaways"],
  ];

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  const col2 = topics.slice(5);

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    s.addText(title, { x: 5.95, y: y + 0.08, w: 3.8, h: 0.38, fontSize: 12, color: C.grey });
  });

  addFooter(s);
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 3 — EPIDEMIOLOGY & AETIOLOGY
// ═══════════════════════════════════════════════════════════════════════════════
{
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  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite }, line: { color: C.offwhite } });
  addTopBar(s, "01  ·  Epidemiology & Aetiology");

  // Stats row
  const stats = [
    { val: "#1", label: "GI cause of\nhospitalisation (USA)" },
    { val: "40-70%", label: "Caused by\ngallstones" },
    { val: "25-35%", label: "Caused by\nalcohol" },
    { val: "≤30%", label: "Mortality in\nsevere cases" },
  ];
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    const x = 0.3 + i * 2.38;
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      x, y: 0.85, w: 2.1, h: 1.25,
      fill: { color: C.navy },
      shadow: { type: "outer", color: "000000", blur: 6, offset: 2, angle: 135, opacity: 0.15 }
    });
    s.addText(st.val, { x, y: 0.9, w: 2.1, h: 0.65, fontSize: 22, bold: true, color: C.amber, align: "center" });
    s.addText(st.label, { x, y: 1.52, w: 2.1, h: 0.55, fontSize: 8.5, color: C.sky, align: "center" });
  });

  s.addText("CAUSES", { x: 0.3, y: 2.3, w: 4, h: 0.35, fontSize: 10, bold: true, color: C.teal, charSpacing: 2 });

  const causes = [
    ["Gallstones", "40–70% of cases — most common overall"],
    ["Alcohol", "25–35% — second most common"],
    ["Hypertriglyceridaemia", "TG >1000 mg/dL — third most common"],
    ["Post-ERCP", "5–10% incidence after procedure"],
    ["Drugs", "Valproate, azathioprine, thiazides, steroids"],
    ["Rare", "Hypercalcaemia, trauma, autoimmune, viral (mumps, EBV, CMV), hereditary"],
    ["Idiopathic", "~15–20% — after excluding all known causes"],
  ];

  causes.forEach(([title, desc], i) => {
    const y = 2.72 + i * 0.38;
    s.addShape(pres.shapes.RECTANGLE, { x: 0.3, y, w: 0.08, h: 0.24, fill: { color: C.sky }, line: { color: C.sky } });
    s.addText([
      { text: title + "  ", options: { bold: true, color: C.navy, fontSize: 9.5 } },
      { text: desc, options: { color: C.grey, fontSize: 9.5 } }
    ], { x: 0.5, y, w: 9.2, h: 0.34 });
  });

  addFooter(s);
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 4 — PATHOPHYSIOLOGY
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.navy }, line: { color: C.navy } });
  addTopBar(s, "02  ·  Pathophysiology");

  const steps = [
    { x: 0.3,  label: "Inciting\nEvent", detail: "Gallstone, alcohol,\ndrug, duct obstruction" },
    { x: 2.55, label: "Acinar Cell\nInjury", detail: "Disruption of\nmembrane trafficking" },
    { x: 4.8,  label: "Trypsinogen\nActivation", detail: "Auto-activation →\ntrypsin release" },
    { x: 7.05, label: "Autodigestion\n+ SIRS", detail: "Cytokines, oedema,\nnecrosis, shock" },
  ];

  steps.forEach((st, i) => {
    s.addShape(pres.shapes.RECTANGLE, {
      x: st.x, y: 0.95, w: 2.0, h: 2.1,
      fill: { color: C.teal },
      shadow: { type: "outer", color: "000000", blur: 8, offset: 3, angle: 135, opacity: 0.25 }
    });
    s.addText(st.label, { x: st.x, y: 1.05, w: 2.0, h: 0.75, fontSize: 12, bold: true, color: C.white, align: "center" });
    s.addShape(pres.shapes.RECTANGLE, { x: st.x + 0.1, y: 1.82, w: 1.8, h: 0.04, fill: { color: C.amber }, line: { color: C.amber } });
    s.addText(st.detail, { x: st.x, y: 1.9, w: 2.0, h: 0.85, fontSize: 9, color: C.sky, align: "center" });
    if (i < 3) {
      s.addText("→", { x: st.x + 2.05, y: 1.3, w: 0.4, h: 0.5, fontSize: 22, color: C.amber, align: "center" });
    }
  });

  const consequences = [
    "Local: oedema, haemorrhage, necrosis, pseudocyst",
    "Pulmonary: ARDS, pleural effusion (esp. left-sided, up to 50%)",
    "Renal: acute kidney injury from hypoperfusion + inflammatory mediators",
    "Cardiovascular: SIRS → septic shock, DIC",
    "Metabolic: hyperglycaemia (↓ insulin), hypocalcaemia (↓ albumin + Mg²⁺)",
  ];

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  consequences.forEach((c, i) => {
    s.addText([
      { text: "▸  ", options: { color: C.sky, fontSize: 9.5 } },
      { text: c, options: { color: C.offwhite, fontSize: 9.5 } }
    ], { x: 0.3, y: 3.62 + i * 0.35, w: 9.4, h: 0.32 });
  });

  addFooter(s);
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 5 — DIAGNOSIS & SEVERITY
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite }, line: { color: C.offwhite } });
  addTopBar(s, "03  ·  Diagnosis & Severity Classification");

  // Diagnosis box
  s.addShape(pres.shapes.RECTANGLE, { x: 0.3, y: 0.85, w: 4.4, h: 2.2, fill: { color: C.navy } });
  s.addText("ATLANTA CRITERIA (≥2 of 3)", { x: 0.4, y: 0.9, w: 4.2, h: 0.4, fontSize: 10, bold: true, color: C.amber });
  const diag = [
    "① Epigastric pain characteristic of AP",
    "② Serum lipase or amylase ≥3× ULN",
    "③ Characteristic findings on CT / MRI",
  ];
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    s.addText(d, { x: 0.45, y: 1.38 + i * 0.5, w: 4.15, h: 0.42, fontSize: 10.5, color: C.white });
  });

  // Lipase note
  s.addShape(pres.shapes.RECTANGLE, { x: 0.3, y: 3.15, w: 4.4, h: 0.72, fill: { color: C.teal } });
  s.addText([
    { text: "Lipase", options: { bold: true, color: C.amber, fontSize: 10 } },
    { text: " preferred over amylase — more sensitive & specific.\nElevated for ", options: { color: C.white, fontSize: 9.5 } },
    { text: "1–2 weeks", options: { bold: true, color: C.amber, fontSize: 9.5 } },
    { text: " vs. 3–5 days. Degree does NOT correlate with severity.", options: { color: C.white, fontSize: 9.5 } },
  ], { x: 0.4, y: 3.18, w: 4.2, h: 0.68 });

  // Severity table
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  const rows = [
    { grade: "MILD", bg: "2E7D32", def: "No organ failure\nNo local/systemic complications", mort: "<1%" },
    { grade: "MOD. SEVERE", bg: "F57F17", def: "Transient organ failure (<48h)\nOR local complications", mort: "5–8%" },
    { grade: "SEVERE", bg: C.red, def: "Persistent organ failure (>48h)\nSingle or multi-organ", mort: "≤30%" },
  ];
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    const y = 1.32 + i * 1.2;
    s.addShape(pres.shapes.RECTANGLE, { x: 4.9, y, w: 1.55, h: 1.08, fill: { color: r.bg } });
    s.addText(r.grade, { x: 4.9, y, w: 1.55, h: 1.08, fontSize: 9.5, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
    s.addShape(pres.shapes.RECTANGLE, { x: 6.48, y, w: 2.65, h: 1.08, fill: { color: C.lightbg } });
    s.addText(r.def, { x: 6.52, y, w: 2.58, h: 1.08, fontSize: 9, color: C.navy, valign: "middle" });
    s.addShape(pres.shapes.RECTANGLE, { x: 9.16, y, w: 0.74, h: 1.08, fill: { color: C.navy } });
    s.addText(r.mort, { x: 9.16, y, w: 0.74, h: 1.08, fontSize: 10, bold: true, color: C.amber, align: "center", valign: "middle", margin: 0 });
  });

  s.addText("Scoring: BISAP · Ranson's · APACHE II · CT Severity Index", {
    x: 4.9, y: 4.95, w: 4.8, h: 0.35, fontSize: 9, color: C.grey, italic: true
  });

  addFooter(s);
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 6 — FLUID RESUSCITATION
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.navy }, line: { color: C.navy } });
  addTopBar(s, "04  ·  Fluid Resuscitation  —  The Cornerstone of Early Management");

  const cards = [
    { x: 0.3,  y: 0.9,  w: 2.9, h: 1.35, bg: C.teal,  title: "FLUID OF CHOICE",     bullets: ["Lactated Ringer's (LR)", "Reduces SIRS vs. normal saline", "Avoid NS → hyperchloraemic acidosis"] },
    { x: 3.4,  y: 0.9,  w: 2.9, h: 1.35, bg: "1E5C6B", title: "RATE",                bullets: ["250–500 mL/hr initially", "Reassess every 6 hours", "Titrate to clinical response"] },
    { x: 6.5,  y: 0.9,  w: 3.2, h: 1.35, bg: "15404E", title: "TARGETS",             bullets: ["Urine output >0.5 mL/kg/hr", "Heart rate <100 bpm", "MAP >65 mmHg, ↓ BUN & Hct"] },
    { x: 0.3,  y: 2.42, w: 4.4, h: 1.4,  bg: "1D3557", title: "CAUTION: OVER-RESUSCITATION", bullets: ["Abdominal compartment syndrome", "Pulmonary oedema / ARDS", "Worsens outcomes — do not blindly push fluids", "Colloids have NO proven benefit"] },
    { x: 4.9,  y: 2.42, w: 4.8, h: 1.4,  bg: "1D3557", title: "MONITORING",          bullets: ["Continuous: vitals, urine output, SpO₂", "Serial labs: FBC, BMP, LFTs, CRP, procalcitonin", "Repeat fluid assessment every 6h", "Consider CVP / invasive monitoring in severe AP"] },
  ];

  cards.forEach(c => {
    addCard(s, c.x, c.y, c.w, c.h, c.bg, c.title, c.bullets, C.amber, C.sky);
  });

  s.addShape(pres.shapes.RECTANGLE, { x: 0.3, y: 4.02, w: 9.4, h: 0.72, fill: { color: C.red } });
  s.addText([
    { text: "⚠  KEY POINT:  ", options: { bold: true, fontSize: 11, color: C.white } },
    { text: "Aggressive early IV fluid resuscitation with Lactated Ringer's is the single most important intervention in acute pancreatitis.", options: { fontSize: 10.5, color: C.white } }
  ], { x: 0.45, y: 4.02, w: 9.1, h: 0.72, valign: "middle" });

  addFooter(s);
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 7 — ANALGESIA & NUTRITION
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite }, line: { color: C.offwhite } });
  addTopBar(s, "05  ·  Analgesia & Nutrition");

  // Left: Analgesia
  s.addShape(pres.shapes.RECTANGLE, { x: 0.3, y: 0.85, w: 4.4, h: 0.42, fill: { color: C.teal }, line: { color: C.teal } });
  s.addText("ANALGESIA", { x: 0.3, y: 0.85, w: 4.4, h: 0.42, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });

  const analg = [
    ["IV Opioids", "Morphine, hydromorphone, fentanyl — safe and effective"],
    ["Morphine myth", "Concern about sphincter of Oddi spasm is NOT supported by evidence — do not withhold"],
    ["NSAIDs", "Ketorolac as adjunct; rectal indomethacin may reduce post-ERCP pancreatitis"],
    ["Epidural", "Consider in severe AP — specialist setting"],
  ];
  analg.forEach(([title, desc], i) => {
    const y = 1.38 + i * 0.6;
    s.addShape(pres.shapes.RECTANGLE, { x: 0.3, y, w: 0.07, h: 0.38, fill: { color: C.sky }, line: { color: C.sky } });
    s.addText([
      { text: title + ":  ", options: { bold: true, color: C.navy, fontSize: 10 } },
      { text: desc, options: { color: C.grey, fontSize: 9.5 } }
    ], { x: 0.48, y, w: 4.18, h: 0.5 });
  });

  // Right: Nutrition
  s.addShape(pres.shapes.RECTANGLE, { x: 5.0, y: 0.85, w: 4.7, h: 0.42, fill: { color: C.navy }, line: { color: C.navy } });
  s.addText("NUTRITION", { x: 5.0, y: 0.85, w: 4.7, h: 0.42, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });

  s.addShape(pres.shapes.RECTANGLE, { x: 5.0, y: 1.35, w: 4.7, h: 1.55, fill: { color: C.lightbg } });
  s.addText("MILD AP", { x: 5.1, y: 1.38, w: 4.5, h: 0.35, fontSize: 10, bold: true, color: C.teal });
  const mildNutr = [
    "Early oral feeding as soon as tolerated (even within 24h)",
    "Soft / low-fat diet — no need to wait for enzyme normalisation",
    "Start clear liquids, advance as tolerated",
  ];
  mildNutr.forEach((t, i) => {
    s.addText([
      { text: "✓  ", options: { color: C.teal, fontSize: 9.5 } },
      { text: t, options: { color: C.grey, fontSize: 9.5 } }
    ], { x: 5.05, y: 1.76 + i * 0.36, w: 4.55, h: 0.33 });
  });

  s.addShape(pres.shapes.RECTANGLE, { x: 5.0, y: 3.0, w: 4.7, h: 2.0, fill: { color: C.navy } });
  s.addText("MODERATE / SEVERE AP", { x: 5.1, y: 3.04, w: 4.5, h: 0.35, fontSize: 10, bold: true, color: C.amber });
  const sevNutr = [
    "Enteral nutrition strongly preferred over TPN",
    "NG or NJ tube — both equally effective (NG easier to place)",
    "Start within 24–72 hours of admission",
    "Enteral nutrition: ↓ infection, ↓ bacterial translocation, ↓ complications, cheaper",
    "TPN only if enteral route contraindicated (ileus, fistula, obstruction)",
    "Never keep NPO beyond 24–48h in severe AP",
  ];
  sevNutr.forEach((t, i) => {
    s.addText([
      { text: "▸  ", options: { color: C.sky, fontSize: 9 } },
      { text: t, options: { color: C.offwhite, fontSize: 9 } }
    ], { x: 5.05, y: 3.42 + i * 0.3, w: 4.55, h: 0.28 });
  });

  addFooter(s);
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 8 — ANTIBIOTIC POLICY
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offwhite }, line: { color: C.offwhite } });
  addTopBar(s, "06  ·  Antibiotic Policy");

  // BIG NO box
  s.addShape(pres.shapes.RECTANGLE, { x: 0.3, y: 0.85, w: 9.4, h: 1.05, fill: { color: C.red } });
  s.addText([
    { text: "✗  PROPHYLACTIC ANTIBIOTICS ARE NOT RECOMMENDED  ", options: { bold: true, fontSize: 14, color: C.white } },
    { text: "— even in sterile necrotising pancreatitis", options: { fontSize: 13, color: C.white } }
  ], { x: 0.4, y: 0.85, w: 9.2, h: 1.05, valign: "middle" });

  s.addText("Multiple RCTs and meta-analyses have consistently failed to show benefit of prophylactic antibiotics in preventing infected pancreatic necrosis.", {
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  });

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  const indications = [
    "Infected pancreatic necrosis (confirmed or strongly suspected)",
    "  · Fever + leukocytosis + gas in necrosis on CT",
    "  · Or: positive FNA culture",
    "Concurrent acute cholangitis",
    "Other proven bacterial infection (pneumonia, UTI, line sepsis)",
  ];
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      { text: ind.startsWith("  ·") ? "" : "✓  ", options: { color: "2E7D32", fontSize: 9.5, bold: true } },
      { text: ind, options: { color: C.navy, fontSize: 9.5 } }
    ], { x: 0.3, y: 3.15 + i * 0.37, w: 4.55, h: 0.34 });
  });

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  const drugs = [
    ["1st line", "Carbapenems (imipenem / meropenem)", "Excellent pancreatic penetration; broad spectrum"],
    ["2nd line", "Fluoroquinolone + metronidazole", "For penicillin-allergic patients"],
    ["Avoid", "Aminoglycosides", "Poor pancreatic penetration"],
  ];
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      { text: note, options: { color: C.grey, fontSize: 8.5 } }
    ], { x: 6.12, y, w: 3.5, h: 0.55 });
  });

  addFooter(s);
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 9 — DISEASE-SPECIFIC MANAGEMENT & ERCP
// ═══════════════════════════════════════════════════════════════════════════════
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  addTopBar(s, "07  ·  Disease-Specific Management & ERCP");

  const panels = [
    {
      x: 0.3, y: 0.85, w: 4.55, h: 4.4, bg: C.teal, title: "GALLSTONE PANCREATITIS",
      items: [
        ["ERCP within 24–72h", "ONLY if concurrent cholangitis or persistent biliary obstruction — NOT routine in mild AP"],
        ["Gallstones pass spontaneously", "ERCP not needed without obstruction/cholangitis"],
        ["Cholecystectomy", "Perform during SAME admission (or ≤2 weeks) to prevent recurrence"],
        ["Recurrence risk", "~25–30% if cholecystectomy is delayed"],
        ["Prophylactic stent at ERCP", "Reduces post-ERCP pancreatitis risk in high-risk patients"],
        ["Rectal indomethacin", "Given peri-procedurally significantly reduces post-ERCP pancreatitis"],
      ]
    },
    {
      x: 5.15, y: 0.85, w: 4.55, h: 2.0, bg: "1A5276", title: "HYPERTRIGLYCERIDAEMIA-INDUCED (TG >1000 mg/dL)",
      items: [
        ["Insulin infusion", "Even in non-diabetics — activates lipoprotein lipase, rapidly lowers TG"],
        ["Plasmapheresis", "For refractory cases or TG >2000 mg/dL"],
        ["Long-term", "Fibrates, omega-3, strict dietary fat restriction"],
      ]
    },
    {
      x: 5.15, y: 3.05, w: 4.55, h: 2.2, bg: "1D3557", title: "ALCOHOL-INDUCED",
      items: [
        ["Alcohol cessation", "Mandatory — reduces risk of recurrence and progression to chronic pancreatitis"],
        ["Withdrawal monitoring", "Watch for DTs, Wernicke's encephalopathy — thiamine supplementation"],
        ["Counselling / referral", "Addiction services; relapse prevention"],
        ["Note", "Enzyme levels may be falsely normal (amylase) early in alcohol-induced AP — use lipase"],
      ]
    },
  ];

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      x: p.x, y: p.y, w: p.w, h: p.h,
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    s.addText(p.title, { x: p.x + 0.12, y: p.y + 0.1, w: p.w - 0.24, h: 0.38, fontSize: 10, bold: true, color: C.amber });
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      s.addText([
        { text: k + ":  ", options: { bold: true, color: C.sky, fontSize: 9 } },
        { text: v, options: { color: C.white, fontSize: 9 } }
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    });
  });

  addFooter(s);
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 10 — COMPLICATIONS & INTERVENTIONS
// ═══════════════════════════════════════════════════════════════════════════════
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  addTopBar(s, "08  ·  Complications & Interventions");

  const comps = [
    {
      title: "PANCREATIC NECROSIS", color: C.navy,
      rows: [
        "Sterile necrosis → conservative management (supportive care)",
        "Infected necrosis → antibiotics + minimally invasive necrosectomy (step-up approach)",
        "Step-up: Percutaneous drainage → VARD → open surgery (last resort)",
        "Open necrosectomy mortality 30–40%; minimally invasive preferred",
        "Delay intervention until necrosis is 'walled-off' (≥3–4 weeks)",
      ]
    },
    {
      title: "PANCREATIC PSEUDOCYST", color: C.teal,
      rows: [
        "Most resolve spontaneously — observe",
        "Drainage if: symptomatic, growing, infected, causing obstruction",
        "Preferred: EUS-guided cyst-gastrostomy or cyst-duodenostomy",
        "Avoid premature drainage before maturation",
      ]
    },
    {
      title: "ABDOMINAL COMPARTMENT SYNDROME", color: "7B1FA2",
      rows: [
        "Monitor intra-abdominal pressure (IAP >20 mmHg + new organ failure)",
        "Reduce fluids, neuromuscular blockade, nasogastric decompression",
        "Percutaneous drainage of ascites",
        "Surgical decompression if refractory",
      ]
    },
    {
      title: "ORGAN FAILURE MANAGEMENT", color: C.red,
      rows: [
        "Pulmonary: O₂ therapy, CPAP/BiPAP, mechanical ventilation for ARDS",
        "Renal: renal replacement therapy (haemodialysis/haemofiltration)",
        "Cardiovascular: vasopressors (noradrenaline), inotropes for shock",
        "DIC: fresh frozen plasma, platelets as needed",
      ]
    },
  ];

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      x: pos.x, y: pos.y, w: pos.w, h,
      fill: { color: comp.color },
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    });
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  addFooter(s);
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 11 — MANAGEMENT ALGORITHM
// ═══════════════════════════════════════════════════════════════════════════════
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  addTopBar(s, "09  ·  Management Algorithm");

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    { x: 3.5, y: 1.72, w: 3.0, h: 0.65, bg: C.teal, text: "IV LR + Analgesia\nNPO initially", textColor: C.white },
    { x: 3.5, y: 2.62, w: 3.0, h: 0.65, bg: "1D3557", text: "Assess Severity\n(BISAP / APACHE II)", textColor: C.white },
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    s.addText([{ text: "✓  ", options: { color: C.amber, fontSize: 9 } }, { text: t, options: { color: C.white, fontSize: 9 } }],
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}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 12 — KEY TAKEAWAYS
// ═══════════════════════════════════════════════════════════════════════════════
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  // Accent
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  const takeaways = [
    ["Fluid", "Lactated Ringer's is fluid of choice; aggressive early resuscitation is the most critical intervention"],
    ["Analgesia", "IV opioids are safe; the morphine/sphincter of Oddi concern is a myth"],
    ["Feeding", "Early oral feeding in mild AP; enteral (NG/NJ) nutrition within 24–72h in severe AP — never prolonged NPO"],
    ["No prophylactic ABx", "Antibiotics only for infected necrosis or concurrent cholangitis — RCTs show no benefit prophylactically"],
    ["ERCP", "Only for gallstone AP with cholangitis or persistent biliary obstruction — not routine"],
    ["Cholecystectomy", "Same admission or within 2 weeks after gallstone AP to prevent ~30% recurrence"],
    ["Necrosectomy", "Step-up approach; delay ≥4 weeks until 'walled-off'; minimally invasive preferred"],
    ["Severity", "Persistent organ failure (>48h) = severe AP; mortality up to 30%"],
  ];

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// ═══════════════════════════════════════════════════════════════════════════════
// WRITE FILE
// ═══════════════════════════════════════════════════════════════════════════════
pres.writeFile({ fileName: "/home/daytona/workspace/acute-pancreatitis-ppt/Acute_Pancreatitis_Management.pptx" })
  .then(() => console.log("✅ Presentation saved successfully."))
  .catch(err => console.error("❌ Error:", err));

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/acute-pancreatitis-ppt/create_ppt.js'