Create a comprehensive 10 pages ppt on priapism with defition,etiology,pathogenesis,classification,clinical manifestation,diagnosis,differential diagnosis and treatment.Add important small diagrams wherever u think is important.add to the topics page itself
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Finding Sources
Searching the Web
priapism definition etiology pathogenesis classification treatment medical
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Running Command
mkdir -p /home/daytona/workspace/priapism-ppt && ls /home/daytona/workspace/pria…
Writing File
~/priapism-ppt/priapism.js
const pptxgen = require("pptxgenjs");
const { execSync } = require("child_process");
const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Priapism - A Comprehensive Overview";
// ── Color palette ──────────────────────────────────────────────────────────
const C = {
navy: "0A2342", // dominant dark
teal: "1B6CA8", // header accent
sky: "4FC3F7", // light accent
cream: "F5F7FA", // slide background
white: "FFFFFF",
yellow: "FFD600", // highlights
red: "D32F2F", // warning / emergency
gray: "455A64", // body text
lightgray: "ECEFF1",
orange: "F57C00",
};
// ── Helper: slide background ───────────────────────────────────────────────
function applyBg(slide, color) {
slide.background = { color };
}
// ── Helper: header bar ─────────────────────────────────────────────────────
function addHeader(slide, title, barColor = C.navy) {
slide.addShape(pres.ShapeType.rect, {
x: 0, y: 0, w: "100%", h: 0.65,
fill: { color: barColor },
});
slide.addText(title, {
x: 0.18, y: 0, w: 9.3, h: 0.65,
fontSize: 20, bold: true, color: C.white,
valign: "middle", fontFace: "Calibri",
});
}
// ── Helper: accent line under header ──────────────────────────────────────
function addAccentLine(slide) {
slide.addShape(pres.ShapeType.rect, {
x: 0, y: 0.65, w: "100%", h: 0.06,
fill: { color: C.sky },
});
}
// ── Helper: footer ─────────────────────────────────────────────────────────
function addFooter(slide, text = "Priapism – Comprehensive Review") {
slide.addShape(pres.ShapeType.rect, {
x: 0, y: 5.35, w: "100%", h: 0.275,
fill: { color: C.navy },
});
slide.addText(text, {
x: 0.2, y: 5.35, w: 9.6, h: 0.275,
fontSize: 8, color: C.sky, valign: "middle", fontFace: "Calibri",
});
}
// ── Helper: section label pill ─────────────────────────────────────────────
function addPill(slide, text, x, y, w = 1.6, h = 0.28, bg = C.teal) {
slide.addShape(pres.ShapeType.roundRect, {
x, y, w, h,
fill: { color: bg },
rectRadius: 0.08,
});
slide.addText(text, {
x, y, w, h,
fontSize: 8.5, bold: true, color: C.white,
align: "center", valign: "middle", fontFace: "Calibri",
});
}
// ── Helper: info box ───────────────────────────────────────────────────────
function addBox(slide, text, x, y, w, h, bg = C.lightgray, textColor = C.gray, fontSize = 9) {
slide.addShape(pres.ShapeType.roundRect, {
x, y, w, h,
fill: { color: bg },
line: { color: C.teal, width: 1 },
rectRadius: 0.06,
});
slide.addText(text, {
x: x + 0.05, y: y + 0.04, w: w - 0.1, h: h - 0.08,
fontSize, color: textColor, fontFace: "Calibri", valign: "top",
});
}
// ──────────────────────────────────────────────────────────────────────────
// Download images as base64
// ──────────────────────────────────────────────────────────────────────────
const imgUrls = [
"https://cdn.orris.care/cdss_images/8e9973b1867bd6ec17b0b5162757489d46fc2578c48adac73e2296cc045e19f7.png", // treatment flowchart
"https://cdn.orris.care/cdss_images/64a2acfaba5af7f769b33b99c963ade8f473905b7097803a4509063c7bce1b95.png", // penile anatomy
];
const imgs = JSON.parse(
execSync(
`node /home/daytona/skills/shared/scripts/fetch_images.js ${imgUrls.map(u => `"${u}"`).join(" ")}`
).toString()
);
const [flowchartImg, anatomyImg] = imgs;
// ══════════════════════════════════════════════════════════════════════════
// SLIDE 1 – TITLE SLIDE
// ══════════════════════════════════════════════════════════════════════════
{
const s = pres.addSlide();
applyBg(s, C.navy);
// Top decorative bar
s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: 0.08, fill: { color: C.sky } });
s.addShape(pres.ShapeType.rect, { x: 0, y: 0.08, w: "100%", h: 0.04, fill: { color: C.yellow } });
// Left colored strip
s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.18, h: "100%", fill: { color: C.teal } });
// Main title
s.addText("PRIAPISM", {
x: 0.4, y: 1.1, w: 9.2, h: 1.2,
fontSize: 54, bold: true, color: C.white,
fontFace: "Calibri", align: "center",
charSpacing: 8,
});
// Subtitle line
s.addShape(pres.ShapeType.rect, { x: 2.5, y: 2.35, w: 5, h: 0.05, fill: { color: C.sky } });
s.addText("A Comprehensive Clinical Overview", {
x: 0.4, y: 2.45, w: 9.2, h: 0.5,
fontSize: 18, color: C.sky, fontFace: "Calibri",
align: "center", italic: true,
});
// Topics listed
const topics = [
"Definition • Etiology • Pathogenesis",
"Classification • Clinical Manifestations",
"Diagnosis • Differential Diagnosis • Treatment",
];
topics.forEach((t, i) => {
s.addText(t, {
x: 1, y: 3.15 + i * 0.38, w: 8, h: 0.36,
fontSize: 12, color: C.lightgray, fontFace: "Calibri", align: "center",
});
});
// Bottom bar
s.addShape(pres.ShapeType.rect, { x: 0, y: 5.35, w: "100%", h: 0.275, fill: { color: C.teal } });
s.addText("Urology | Emergency Medicine | Internal Medicine", {
x: 0.2, y: 5.35, w: 9.6, h: 0.275,
fontSize: 8.5, color: C.white, valign: "middle", align: "center", fontFace: "Calibri",
});
}
// ══════════════════════════════════════════════════════════════════════════
// SLIDE 2 – TABLE OF CONTENTS
// ══════════════════════════════════════════════════════════════════════════
{
const s = pres.addSlide();
applyBg(s, C.cream);
addHeader(s, "Table of Contents");
addAccentLine(s);
addFooter(s);
const items = [
["01", "Definition", "What is priapism? Origin of the term and core criteria."],
["02", "Etiology", "Primary (idiopathic) and secondary causes – drugs, haematologic, trauma."],
["03", "Pathogenesis", "Molecular and vascular mechanisms driving each subtype."],
["04", "Classification", "Ischemic (low-flow) | Non-ischemic (high-flow) | Stuttering."],
["05", "Clinical Manifestations", "Presentation, pain, rigidity and distinguishing features."],
["06", "Diagnosis", "History, exam, corporal blood gas, colour Doppler ultrasound."],
["07", "Differential Diagnosis", "Conditions to exclude before treating."],
["08", "Treatment – Ischemic", "Stepwise management: aspiration → phenylephrine → shunt."],
["09", "Treatment – Non-ischemic & Stuttering", "Embolisation, PDE5 inhibitors, long-term care."],
["10", "Complications & Prognosis", "Erectile dysfunction, fibrosis and outcome predictors."],
];
const col1x = 0.22, col2x = 0.82, col3x = 1.75;
const rowH = 0.42, startY = 0.78;
items.forEach(([num, heading, desc], i) => {
const y = startY + i * rowH;
const bg = i % 2 === 0 ? C.lightgray : C.white;
s.addShape(pres.ShapeType.roundRect, {
x: col1x - 0.05, y: y - 0.02, w: 9.5, h: rowH - 0.04,
fill: { color: bg }, line: { color: C.teal, width: 0.4 }, rectRadius: 0.05,
});
// Number badge
s.addShape(pres.ShapeType.ellipse, {
x: col1x, y: y + 0.03, w: 0.34, h: 0.28,
fill: { color: C.teal },
});
s.addText(num, {
x: col1x, y: y + 0.03, w: 0.34, h: 0.28,
fontSize: 8, bold: true, color: C.white,
align: "center", valign: "middle", fontFace: "Calibri",
});
// Heading
s.addText(heading, {
x: col2x, y: y + 0.02, w: 2.4, h: 0.28,
fontSize: 9.5, bold: true, color: C.navy, fontFace: "Calibri", valign: "middle",
});
// Description
s.addText(desc, {
x: col3x + 1.5, y: y + 0.02, w: 5.8, h: 0.34,
fontSize: 8, color: C.gray, fontFace: "Calibri", valign: "middle",
});
});
}
// ══════════════════════════════════════════════════════════════════════════
// SLIDE 3 – DEFINITION
// ══════════════════════════════════════════════════════════════════════════
{
const s = pres.addSlide();
applyBg(s, C.cream);
addHeader(s, "01 | Definition");
addAccentLine(s);
addFooter(s);
// Big definition box
s.addShape(pres.ShapeType.roundRect, {
x: 0.22, y: 0.82, w: 9.56, h: 1.0,
fill: { color: C.navy }, line: { color: C.sky, width: 1.5 }, rectRadius: 0.1,
});
s.addText([
{ text: "Priapism", options: { bold: true, color: C.yellow, fontSize: 13 } },
{ text: " is defined as a prolonged and persistent penile erection ", options: { color: C.white, fontSize: 12 } },
{ text: "unrelated to sexual interest or stimulation", options: { bold: true, color: C.sky, fontSize: 12 } },
{ text: ", lasting more than ", options: { color: C.white, fontSize: 12 } },
{ text: "4 hours", options: { bold: true, color: C.yellow, fontSize: 13 } },
{ text: ", typically involving only the corpora cavernosa, with a soft glans and corpus spongiosum.", options: { color: C.white, fontSize: 12 } },
], { x: 0.35, y: 0.85, w: 9.3, h: 0.95, valign: "middle", fontFace: "Calibri" });
// Etymology box
s.addShape(pres.ShapeType.roundRect, {
x: 0.22, y: 1.92, w: 4.5, h: 0.82,
fill: { color: C.lightgray }, line: { color: C.teal, width: 1 }, rectRadius: 0.08,
});
s.addText("Etymology", { x: 0.3, y: 1.95, w: 4.3, h: 0.22, fontSize: 10, bold: true, color: C.navy, fontFace: "Calibri" });
s.addText('Named after Priapus, the ancient Greek god of fertility, known for his permanent, oversized erection. The term entered medical literature in the 17th century.', {
x: 0.3, y: 2.17, w: 4.3, h: 0.55, fontSize: 8.5, color: C.gray, fontFace: "Calibri",
});
// Key criteria box
s.addShape(pres.ShapeType.roundRect, {
x: 4.9, y: 1.92, w: 4.88, h: 0.82,
fill: { color: C.lightgray }, line: { color: C.teal, width: 1 }, rectRadius: 0.08,
});
s.addText("Key Criteria", { x: 4.98, y: 1.95, w: 4.6, h: 0.22, fontSize: 10, bold: true, color: C.navy, fontFace: "Calibri" });
s.addText([
{ text: "• Duration > 4 hours ", options: { bold: true } },
{ text: "• Not related to sexual stimulation\n", options: {} },
{ text: "• Corpora cavernosa involved ", options: { bold: true } },
{ text: "• Glans penis usually soft", options: {} },
], { x: 4.98, y: 2.17, w: 4.6, h: 0.55, fontSize: 8.5, color: C.gray, fontFace: "Calibri" });
// Epidemiology banner
s.addShape(pres.ShapeType.rect, {
x: 0.22, y: 2.83, w: 9.56, h: 0.22,
fill: { color: C.teal },
});
s.addText("Epidemiology: Incidence ~0.3–5.34 per 100,000 males/year | Bimodal peaks: 5–10 years (SCD) & 20–50 years (adults) | >95% of cases are ischemic", {
x: 0.3, y: 2.83, w: 9.4, h: 0.22,
fontSize: 8, color: C.white, valign: "middle", fontFace: "Calibri",
});
// Mini anatomy diagram placeholder note + image
s.addText("Penile Cross-Section Anatomy", {
x: 0.22, y: 3.12, w: 4.0, h: 0.22,
fontSize: 9, bold: true, color: C.navy, fontFace: "Calibri",
});
if (!anatomyImg.error) {
s.addImage({ data: anatomyImg.base64, x: 0.22, y: 3.35, w: 3.8, h: 1.78 });
}
// Key note boxes right side
const notes = [
["Corpus Spongiosum", "Surrounds urethra; typically NOT involved in priapism (remains soft)"],
["Corpora Cavernosa (×2)", "Erectile bodies; become engorged with stagnant blood in ischemic priapism"],
["Tunica Albuginea", "Fibrous sheath; becomes a compartment trapping blood in low-flow priapism"],
];
notes.forEach(([title, text], i) => {
const y = 3.12 + i * 0.68;
s.addShape(pres.ShapeType.roundRect, {
x: 4.25, y, w: 5.53, h: 0.62,
fill: { color: C.white }, line: { color: C.sky, width: 1 }, rectRadius: 0.06,
});
s.addText(title, { x: 4.35, y: y + 0.04, w: 5.3, h: 0.2, fontSize: 9, bold: true, color: C.teal, fontFace: "Calibri" });
s.addText(text, { x: 4.35, y: y + 0.24, w: 5.3, h: 0.34, fontSize: 8, color: C.gray, fontFace: "Calibri" });
});
}
// ══════════════════════════════════════════════════════════════════════════
// SLIDE 4 – ETIOLOGY
// ══════════════════════════════════════════════════════════════════════════
{
const s = pres.addSlide();
applyBg(s, C.cream);
addHeader(s, "02 | Etiology");
addAccentLine(s);
addFooter(s);
// Two columns: Ischemic causes | Non-ischemic causes
// ISCHEMIC column
s.addShape(pres.ShapeType.rect, { x: 0.22, y: 0.78, w: 4.6, h: 0.3, fill: { color: C.navy } });
s.addText("ISCHEMIC (LOW-FLOW) CAUSES", {
x: 0.25, y: 0.78, w: 4.55, h: 0.3,
fontSize: 9.5, bold: true, color: C.white, valign: "middle", fontFace: "Calibri",
});
const ischemicGroups = [
["Haematologic", ["Sickle cell disease (most common in children)", "Thalassaemia", "Leukemia / lymphoma", "Polycythaemia", "Glucose-6-phosphate deficiency"]],
["Medications", ["Intracavernous injections (papaverine, phentolamine, PGE1)", "PDE5 inhibitors (rare, <1%)", "Trazodone, chlorpromazine, prazosin", "Anticoagulants (heparin, warfarin)", "Cocaine, alcohol (up to 21% of cases)"]],
["Neurogenic", ["Spinal cord injury / stenosis", "Cauda equina lesions", "General anaesthesia"]],
["Neoplastic", ["Penile, prostate, bladder, rectal carcinoma", "Renal cell carcinoma"]],
["Idiopathic", ["~60% of all adult ischemic cases", "Presumed microvascular dysregulation"]],
];
let yPos = 1.15;
ischemicGroups.forEach(([group, items]) => {
s.addText(group, {
x: 0.28, y: yPos, w: 4.45, h: 0.22,
fontSize: 8.5, bold: true, color: C.teal, fontFace: "Calibri",
});
yPos += 0.22;
items.forEach(item => {
s.addText("• " + item, {
x: 0.38, y: yPos, w: 4.3, h: 0.19,
fontSize: 7.5, color: C.gray, fontFace: "Calibri",
});
yPos += 0.19;
});
yPos += 0.05;
});
// NON-ISCHEMIC column
s.addShape(pres.ShapeType.rect, { x: 5.12, y: 0.78, w: 4.66, h: 0.3, fill: { color: C.teal } });
s.addText("NON-ISCHEMIC (HIGH-FLOW) CAUSES", {
x: 5.15, y: 0.78, w: 4.6, h: 0.3,
fontSize: 9.5, bold: true, color: C.white, valign: "middle", fontFace: "Calibri",
});
const nonIschemicItems = [
["Perineal / penile blunt trauma", "Most common cause (straddle injuries)"],
["Arteriocavernosal fistula", "Post-traumatic; unregulated arterial inflow"],
["Cavernous artery pseudoaneurysm", "Follows penile fracture or needle injury"],
["Pelvic surgery / biopsy", "Iatrogenic arteriovenous communication"],
["Perineal interventions", "Post-TURP, post-radical prostatectomy"],
];
yPos = 1.15;
nonIschemicItems.forEach(([title, detail]) => {
s.addShape(pres.ShapeType.roundRect, {
x: 5.12, y: yPos, w: 4.66, h: 0.54,
fill: { color: C.white }, line: { color: C.sky, width: 0.8 }, rectRadius: 0.05,
});
s.addText(title, { x: 5.22, y: yPos + 0.04, w: 4.46, h: 0.2, fontSize: 9, bold: true, color: C.navy, fontFace: "Calibri" });
s.addText(detail, { x: 5.22, y: yPos + 0.25, w: 4.46, h: 0.22, fontSize: 8, color: C.gray, fontFace: "Calibri" });
yPos += 0.6;
});
// Stuttering note at bottom
s.addShape(pres.ShapeType.roundRect, {
x: 5.12, y: yPos + 0.05, w: 4.66, h: 0.62,
fill: { color: C.yellow }, line: { color: C.orange, width: 1 }, rectRadius: 0.07,
});
s.addText("Stuttering / Intermittent Priapism", {
x: 5.2, y: yPos + 0.08, w: 4.5, h: 0.22,
fontSize: 9, bold: true, color: C.navy, fontFace: "Calibri",
});
s.addText("Same causes as ischemic priapism. Strongly associated with sickle cell disease; PDE5 dysregulation implicated.", {
x: 5.2, y: yPos + 0.3, w: 4.5, h: 0.35,
fontSize: 8, color: C.navy, fontFace: "Calibri",
});
}
// ══════════════════════════════════════════════════════════════════════════
// SLIDE 5 – PATHOGENESIS
// ══════════════════════════════════════════════════════════════════════════
{
const s = pres.addSlide();
applyBg(s, C.cream);
addHeader(s, "03 | Pathogenesis");
addAccentLine(s);
addFooter(s);
// ── ISCHEMIC pathway (left) ────────────────────────────────────────────
s.addShape(pres.ShapeType.rect, { x: 0.22, y: 0.78, w: 4.55, h: 0.28, fill: { color: C.navy } });
s.addText("ISCHEMIC PRIAPISM PATHWAY", { x: 0.25, y: 0.78, w: 4.5, h: 0.28, fontSize: 9, bold: true, color: C.white, valign: "middle", fontFace: "Calibri" });
const ischemicSteps = [
["Initiating event", "↑ Venous congestion / drugs / SCD sickling"],
["Venous outflow obstruction", "Emissary veins compressed by engorged sinusoids"],
["↓ Arterial inflow", "Corporal pressure approaches systolic → flow halts"],
["Stagnant blood pool", "Hypoxia (pO₂ <30 mmHg), Hypercapnia (pCO₂ >60 mmHg), Acidosis (pH <7.25)"],
["Smooth muscle damage", "Reactive oxygen species → cavernous SMC necrosis"],
["Fibroblast activation", "Collagen deposition → corporal fibrosis"],
["OUTCOME", "Erectile dysfunction (>30% with prolonged priapism)"],
];
const arrowColor = C.teal;
let yP = 1.12;
ischemicSteps.forEach(([step, detail], i) => {
const boxColor = i === ischemicSteps.length - 1 ? C.red : (i % 2 === 0 ? C.white : C.lightgray);
const textColor = i === ischemicSteps.length - 1 ? C.white : C.navy;
s.addShape(pres.ShapeType.roundRect, {
x: 0.22, y: yP, w: 4.55, h: 0.46,
fill: { color: boxColor }, line: { color: C.teal, width: 0.8 }, rectRadius: 0.05,
});
s.addText(step, { x: 0.3, y: yP + 0.02, w: 1.5, h: 0.18, fontSize: 7.5, bold: true, color: i === ischemicSteps.length - 1 ? C.yellow : C.teal, fontFace: "Calibri" });
s.addText(detail, { x: 0.3, y: yP + 0.2, w: 4.35, h: 0.22, fontSize: 7.5, color: textColor, fontFace: "Calibri" });
yP += 0.54;
if (i < ischemicSteps.length - 1) {
s.addShape(pres.ShapeType.line, { x: 2.43, y: yP - 0.06, w: 0, h: 0.06, line: { color: arrowColor, width: 1.5 }, lineHeadEnd: "arrow" });
}
});
// ── NON-ISCHEMIC pathway (right) ──────────────────────────────────────
s.addShape(pres.ShapeType.rect, { x: 5.12, y: 0.78, w: 4.66, h: 0.28, fill: { color: C.teal } });
s.addText("NON-ISCHEMIC PRIAPISM PATHWAY", { x: 5.15, y: 0.78, w: 4.6, h: 0.28, fontSize: 9, bold: true, color: C.white, valign: "middle", fontFace: "Calibri" });
const nonSteps = [
["Blunt perineal trauma", "Disrupts cavernosal artery wall"],
["Pseudoaneurysm / fistula forms", "Arteriocavernosal or arteriovenous communication"],
["Unregulated arterial inflow", "↑ Blood flow bypasses normal resistance"],
["Maintained venous drainage", "Blood remains oxygenated → NO pain, NO ischemia"],
["Persistent tumescence", "Partial, non-painful, non-rigid erection"],
["Outcome if untreated", "Spontaneous resolution possible; embolisation curative"],
];
yP = 1.12;
nonSteps.forEach(([step, detail], i) => {
s.addShape(pres.ShapeType.roundRect, {
x: 5.12, y: yP, w: 4.66, h: 0.46,
fill: { color: i % 2 === 0 ? C.white : C.lightgray }, line: { color: C.sky, width: 0.8 }, rectRadius: 0.05,
});
s.addText(step, { x: 5.2, y: yP + 0.02, w: 1.5, h: 0.18, fontSize: 7.5, bold: true, color: C.teal, fontFace: "Calibri" });
s.addText(detail, { x: 5.2, y: yP + 0.2, w: 4.45, h: 0.22, fontSize: 7.5, color: C.gray, fontFace: "Calibri" });
yP += 0.54;
});
// Molecular note strip
s.addShape(pres.ShapeType.rect, { x: 0.22, y: 5.12, w: 9.56, h: 0.22, fill: { color: C.navy } });
s.addText("Molecular: PDE5 dysregulation → ↓ cGMP → abnormal NO signalling → smooth muscle relaxation persists (stuttering priapism mechanism)", {
x: 0.3, y: 5.12, w: 9.4, h: 0.22, fontSize: 7.5, color: C.sky, valign: "middle", fontFace: "Calibri",
});
}
// ══════════════════════════════════════════════════════════════════════════
// SLIDE 6 – CLASSIFICATION
// ══════════════════════════════════════════════════════════════════════════
{
const s = pres.addSlide();
applyBg(s, C.cream);
addHeader(s, "04 | Classification");
addAccentLine(s);
addFooter(s);
const types = [
{
name: "TYPE 1 – ISCHEMIC\n(Low-Flow / Veno-Occlusive)",
freq: "~95% of cases",
mechanism: "Venous outflow obstruction → stagnant hypoxic blood in corpora cavernosa",
pain: "Painful (penile ischaemia)",
rigidity: "Fully rigid",
blood: "Dark (hypoxic, acidotic)",
emergency: "YES – Urological emergency",
boxColor: C.navy,
textColor: C.white,
badgeColor: C.red,
},
{
name: "TYPE 2 – NON-ISCHEMIC\n(High-Flow / Arterial)",
freq: "<5% of cases",
mechanism: "Arteriocavernosal fistula → unregulated arterial inflow with intact venous drainage",
pain: "Painless",
rigidity: "Partial / incomplete",
blood: "Bright red (well-oxygenated)",
emergency: "NO – Not an emergency",
boxColor: C.teal,
textColor: C.white,
badgeColor: C.sky,
},
{
name: "TYPE 3 – STUTTERING\n(Intermittent / Recurrent)",
freq: "Subset of ischemic",
mechanism: "Repeated self-limited ischemic episodes; PDE5 dysregulation; strong SCD association",
pain: "Painful episodes (self-limiting)",
rigidity: "Fully rigid during episodes",
blood: "Hypoxic during episodes",
emergency: "RECURRENT – chronic management needed",
boxColor: C.gray,
textColor: C.white,
badgeColor: C.yellow,
},
];
types.forEach((t, i) => {
const x = 0.22 + i * 3.27;
// Header
s.addShape(pres.ShapeType.roundRect, {
x, y: 0.78, w: 3.1, h: 0.62,
fill: { color: t.boxColor }, rectRadius: 0.08,
});
s.addText(t.name, { x: x + 0.08, y: 0.8, w: 2.95, h: 0.58, fontSize: 9.5, bold: true, color: t.textColor, fontFace: "Calibri", valign: "middle" });
// Badge
s.addShape(pres.ShapeType.roundRect, {
x: x + 1.7, y: 0.82, w: 1.28, h: 0.22,
fill: { color: t.badgeColor }, rectRadius: 0.06,
});
s.addText(t.freq, { x: x + 1.7, y: 0.82, w: 1.28, h: 0.22, fontSize: 7, bold: true, color: C.navy, align: "center", valign: "middle", fontFace: "Calibri" });
// Detail rows
const rows = [
["Mechanism", t.mechanism],
["Pain", t.pain],
["Rigidity", t.rigidity],
["Blood gas", t.blood],
["Emergency?", t.emergency],
];
rows.forEach(([label, val], j) => {
const yy = 1.5 + j * 0.6;
const rowBg = j % 2 === 0 ? C.lightgray : C.white;
s.addShape(pres.ShapeType.rect, { x, y: yy, w: 3.1, h: 0.56, fill: { color: rowBg } });
s.addText(label, { x: x + 0.06, y: yy + 0.03, w: 0.95, h: 0.2, fontSize: 8, bold: true, color: C.teal, fontFace: "Calibri" });
s.addText(val, { x: x + 0.06, y: yy + 0.24, w: 2.95, h: 0.28, fontSize: 8, color: C.gray, fontFace: "Calibri" });
});
});
// Comparison table key at bottom
s.addShape(pres.ShapeType.rect, { x: 0.22, y: 4.62, w: 9.56, h: 0.58, fill: { color: C.lightgray }, line: { color: C.teal, width: 0.8 } });
s.addText("AUA Classification Note:", { x: 0.3, y: 4.64, w: 3, h: 0.2, fontSize: 9, bold: true, color: C.navy, fontFace: "Calibri" });
s.addText("The American Urological Association (AUA) 2003 Guidelines and European Association of Urology (EAU) classify priapism into the three subtypes above. Diagnosis relies on history + corporal blood gas analysis + colour Doppler ultrasound. Stuttering priapism is categorised under the ischemic spectrum.", {
x: 0.3, y: 4.84, w: 9.36, h: 0.34, fontSize: 8, color: C.gray, fontFace: "Calibri",
});
}
// ══════════════════════════════════════════════════════════════════════════
// SLIDE 7 – CLINICAL MANIFESTATIONS
// ══════════════════════════════════════════════════════════════════════════
{
const s = pres.addSlide();
applyBg(s, C.cream);
addHeader(s, "05 | Clinical Manifestations");
addAccentLine(s);
addFooter(s);
// Two panels
// Left – Ischemic
s.addShape(pres.ShapeType.rect, { x: 0.22, y: 0.78, w: 4.55, h: 0.3, fill: { color: C.navy } });
s.addText("ISCHEMIC PRIAPISM", { x: 0.25, y: 0.78, w: 4.5, h: 0.3, fontSize: 10, bold: true, color: C.white, valign: "middle", fontFace: "Calibri" });
const ischemicFeatures = [
["Onset", "Usually gradual; hours after sexual activity / medication / sleep (SCD)"],
["Duration", "> 4 hours (often 6–48 hours before presentation)"],
["Pain", "Progressive, severe penile pain (ischaemic in nature)"],
["Erection quality", "Fully rigid corpora cavernosa; glans and corpus spongiosum SOFT"],
["Appearance", "Engorged shaft; skin may appear dusky/congested"],
["Systemic features", "Anxiety, urinary retention (rare), haematuria"],
["SCD-specific", "Triggered by acidosis, dehydration, cold, infection; nocturnal episodes"],
["Time-ischaemia correlation", "< 24h – good prognosis; > 48h – high risk of ED"],
];
ischemicFeatures.forEach(([label, val], i) => {
const yy = 1.14 + i * 0.48;
const bg = i % 2 === 0 ? C.lightgray : C.white;
s.addShape(pres.ShapeType.rect, { x: 0.22, y: yy, w: 4.55, h: 0.44, fill: { color: bg } });
s.addText(label, { x: 0.3, y: yy + 0.03, w: 1.2, h: 0.18, fontSize: 8, bold: true, color: C.teal, fontFace: "Calibri" });
s.addText(val, { x: 0.3, y: yy + 0.22, w: 4.35, h: 0.2, fontSize: 7.5, color: C.gray, fontFace: "Calibri" });
});
// Right – Non-Ischemic + Stuttering
s.addShape(pres.ShapeType.rect, { x: 5.0, y: 0.78, w: 4.78, h: 0.3, fill: { color: C.teal } });
s.addText("NON-ISCHEMIC & STUTTERING", { x: 5.03, y: 0.78, w: 4.72, h: 0.3, fontSize: 10, bold: true, color: C.white, valign: "middle", fontFace: "Calibri" });
const niFeatures = [
["Onset", "Usually hours to days after perineal trauma"],
["Duration", "Persistent, may last weeks/months if untreated"],
["Pain", "ABSENT or minimal – key distinguishing feature"],
["Erection quality", "Partial tumescence; not fully rigid"],
["Appearance", "Normal skin colour; no congestion"],
["History clue", "Straddle injury, fall astride, bicycle accident"],
["Bruising", "Perineal or penile bruising may be present"],
];
niFeatures.forEach(([label, val], i) => {
const yy = 1.14 + i * 0.48;
const bg = i % 2 === 0 ? C.lightgray : C.white;
s.addShape(pres.ShapeType.rect, { x: 5.0, y: yy, w: 4.78, h: 0.44, fill: { color: bg } });
s.addText(label, { x: 5.08, y: yy + 0.03, w: 1.2, h: 0.18, fontSize: 8, bold: true, color: C.navy, fontFace: "Calibri" });
s.addText(val, { x: 5.08, y: yy + 0.22, w: 4.58, h: 0.2, fontSize: 7.5, color: C.gray, fontFace: "Calibri" });
});
// Stuttering box
s.addShape(pres.ShapeType.roundRect, {
x: 5.0, y: 4.52, w: 4.78, h: 0.64,
fill: { color: C.yellow }, line: { color: C.orange, width: 1 }, rectRadius: 0.07,
});
s.addText("Stuttering: ", { x: 5.08, y: 4.56, w: 1.0, h: 0.22, fontSize: 9, bold: true, color: C.navy, fontFace: "Calibri" });
s.addText("Recurrent self-limiting painful episodes < 3 hours; complete detumescence between episodes; sleep-associated; progressive risk of ischemic event over time.", {
x: 5.08, y: 4.76, w: 4.6, h: 0.36, fontSize: 8, color: C.navy, fontFace: "Calibri",
});
}
// ══════════════════════════════════════════════════════════════════════════
// SLIDE 8 – DIAGNOSIS
// ══════════════════════════════════════════════════════════════════════════
{
const s = pres.addSlide();
applyBg(s, C.cream);
addHeader(s, "06 | Diagnosis");
addAccentLine(s);
addFooter(s);
// History column
s.addShape(pres.ShapeType.rect, { x: 0.22, y: 0.78, w: 3.0, h: 0.28, fill: { color: C.navy } });
s.addText("HISTORY", { x: 0.25, y: 0.78, w: 2.95, h: 0.28, fontSize: 9, bold: true, color: C.white, valign: "middle", fontFace: "Calibri" });
const histItems = [
"Duration of erection (critical for management)",
"Trauma to perineum / penis",
"Prior episodes + treatments",
"Known SCD or haematologic disorder",
"Medications: PDE5i, intracavernous injections, trazodone, antipsychotics",
"Illicit drug / alcohol use",
"Erectile function at baseline",
];
histItems.forEach((item, i) => {
s.addText("• " + item, {
x: 0.28, y: 1.11 + i * 0.3, w: 2.88, h: 0.28,
fontSize: 7.8, color: C.gray, fontFace: "Calibri",
});
});
// Examination column
s.addShape(pres.ShapeType.rect, { x: 3.4, y: 0.78, w: 3.0, h: 0.28, fill: { color: C.teal } });
s.addText("EXAMINATION", { x: 3.43, y: 0.78, w: 2.95, h: 0.28, fontSize: 9, bold: true, color: C.white, valign: "middle", fontFace: "Calibri" });
const examItems = [
"Fully rigid (ischemic) vs. partially tumescent (non-ischemic)",
"Glans and corpus spongiosum: soft in priapism",
"Perineal / penile bruising (trauma?)",
"Abdominal: lymphadenopathy, masses",
"Neurological: reflexes, sensation",
"Signs of SCD (jaundice, splenomegaly)",
];
examItems.forEach((item, i) => {
s.addText("• " + item, {
x: 3.46, y: 1.11 + i * 0.3, w: 2.88, h: 0.28,
fontSize: 7.8, color: C.gray, fontFace: "Calibri",
});
});
// Investigations column
s.addShape(pres.ShapeType.rect, { x: 6.6, y: 0.78, w: 3.18, h: 0.28, fill: { color: C.gray } });
s.addText("INVESTIGATIONS", { x: 6.63, y: 0.78, w: 3.12, h: 0.28, fontSize: 9, bold: true, color: C.white, valign: "middle", fontFace: "Calibri" });
const invItems = [
"Corporal blood gas (needle aspiration)",
"FBC, retics, Hb electrophoresis",
"Coagulation screen",
"Urine toxicology / drug screen",
"Colour Doppler USS (gold standard for NI)",
"Pudendal arteriography (if embolisation planned)",
"MRI penis (fibrosis assessment)",
];
invItems.forEach((item, i) => {
s.addText("• " + item, {
x: 6.66, y: 1.11 + i * 0.3, w: 3.06, h: 0.28,
fontSize: 7.8, color: C.gray, fontFace: "Calibri",
});
});
// Blood gas table
s.addShape(pres.ShapeType.rect, { x: 0.22, y: 3.28, w: 9.56, h: 0.26, fill: { color: C.navy } });
s.addText("CORPORAL BLOOD GAS ANALYSIS – Diagnostic Criteria", {
x: 0.3, y: 3.28, w: 9.4, h: 0.26, fontSize: 9, bold: true, color: C.white, valign: "middle", fontFace: "Calibri",
});
const bgHeaders = ["Parameter", "Normal Penile Blood", "Ischemic Priapism", "Non-Ischemic Priapism"];
const bgData = [
["pO₂", ">90 mmHg", "<30 mmHg (↓↓↓)", ">90 mmHg (normal)"],
["pCO₂", "<40 mmHg", ">60 mmHg (↑↑↑)", "<40 mmHg (normal)"],
["pH", "7.40", "<7.25 (acidotic)", "7.40 (normal)"],
["Colour", "Bright red", "Dark / maroon", "Bright red"],
];
const colW = [1.8, 2.2, 2.8, 2.76];
const colX = [0.22, 2.02, 4.22, 7.0];
// Header row
bgHeaders.forEach((h, i) => {
s.addShape(pres.ShapeType.rect, { x: colX[i], y: 3.56, w: colW[i], h: 0.28, fill: { color: C.teal } });
s.addText(h, { x: colX[i] + 0.04, y: 3.56, w: colW[i] - 0.08, h: 0.28, fontSize: 8.5, bold: true, color: C.white, valign: "middle", fontFace: "Calibri" });
});
bgData.forEach((row, ri) => {
const rowBg = ri % 2 === 0 ? C.lightgray : C.white;
row.forEach((cell, ci) => {
s.addShape(pres.ShapeType.rect, { x: colX[ci], y: 3.86 + ri * 0.3, w: colW[ci], h: 0.28, fill: { color: rowBg }, line: { color: C.sky, width: 0.4 } });
const textColor = cell.includes("↓↓↓") || cell.includes("acidotic") ? C.red : (cell.includes("↑↑↑") ? C.red : C.gray);
s.addText(cell, { x: colX[ci] + 0.04, y: 3.86 + ri * 0.3, w: colW[ci] - 0.08, h: 0.28, fontSize: 8, color: textColor, valign: "middle", fontFace: "Calibri" });
});
});
// Doppler note
s.addShape(pres.ShapeType.roundRect, {
x: 0.22, y: 5.07, w: 9.56, h: 0.26,
fill: { color: C.sky }, rectRadius: 0.04,
});
s.addText("Colour Doppler Ultrasound: Absent/minimal cavernous arterial flow = Ischemic | Turbulent high-velocity flow / fistula = Non-Ischemic (sensitivity 100%, specificity 73%)", {
x: 0.3, y: 5.07, w: 9.4, h: 0.26, fontSize: 7.8, color: C.navy, valign: "middle", fontFace: "Calibri",
});
}
// ══════════════════════════════════════════════════════════════════════════
// SLIDE 9 – DIFFERENTIAL DIAGNOSIS
// ══════════════════════════════════════════════════════════════════════════
{
const s = pres.addSlide();
applyBg(s, C.cream);
addHeader(s, "07 | Differential Diagnosis");
addAccentLine(s);
addFooter(s);
const diffs = [
{
condition: "Penile Fracture",
similarity: "Acute penile swelling/pain",
distinction: "Preceded by audible 'pop' during intercourse; immediate detumescence; associated urethral injury. No sustained erection.",
urgent: true,
},
{
condition: "Pseudopriapism",
similarity: "Rigid penis",
distinction: "Penile prosthesis malfunction (infected / mechanical failure); no true erection. History of implant insertion. Soft proximal shaft.",
urgent: false,
},
{
condition: "Metastatic Penile Involvement",
similarity: "Persistent tumescence",
distinction: "Penile metastasis from bladder, prostate, rectum. Involves corpus spongiosum + cavernosa. Painless, firm nodule. Imaging shows mass.",
urgent: false,
},
{
condition: "Peyronie's Disease",
similarity: "Penile deformity during erection",
distinction: "Fibrous plaques causing angulation; pain during erection (not outside); resolves with detumescence. No sustained erection at rest.",
urgent: false,
},
{
condition: "Venous Thrombosis (penile)",
similarity: "Penile pain + rigidity",
distinction: "Isolated dorsal vein thrombosis; linear cord-like induration along dorsum; associated with trauma / Behcet's. Duplex USS diagnostic.",
urgent: false,
},
{
condition: "Phimosis / Paraphimosis",
similarity: "Penile engorgement, pain",
distinction: "Glans oedema in paraphimosis; inability to retract/replace foreskin. Corpora cavernosa are normal.",
urgent: true,
},
{
condition: "Neurological Erection",
similarity: "Persistent erection with SCI",
distinction: "Reflex erections with spinal cord injury; associated with lesion level; not ischaemic. May coexist with true priapism.",
urgent: false,
},
];
diffs.forEach((d, i) => {
const yy = 0.78 + i * 0.62;
const bg = i % 2 === 0 ? C.lightgray : C.white;
s.addShape(pres.ShapeType.roundRect, { x: 0.22, y: yy, w: 9.56, h: 0.58, fill: { color: bg }, line: { color: C.sky, width: 0.6 }, rectRadius: 0.05 });
if (d.urgent) {
s.addShape(pres.ShapeType.rect, { x: 0.22, y: yy, w: 0.1, h: 0.58, fill: { color: C.red } });
}
s.addText(d.condition, { x: 0.4, y: yy + 0.04, w: 2.0, h: 0.22, fontSize: 9.5, bold: true, color: C.navy, fontFace: "Calibri" });
s.addText("Mimics: " + d.similarity, { x: 0.4, y: yy + 0.26, w: 2.0, h: 0.22, fontSize: 7.5, color: C.teal, fontFace: "Calibri", italic: true });
s.addText(d.distinction, { x: 2.55, y: yy + 0.08, w: 7.15, h: 0.44, fontSize: 8, color: C.gray, fontFace: "Calibri" });
});
}
// ══════════════════════════════════════════════════════════════════════════
// SLIDE 10 – TREATMENT (ISCHEMIC) with flowchart
// ══════════════════════════════════════════════════════════════════════════
{
const s = pres.addSlide();
applyBg(s, C.cream);
addHeader(s, "08 | Treatment – Ischemic Priapism");
addAccentLine(s);
addFooter(s);
// Left: step-by-step
s.addShape(pres.ShapeType.rect, { x: 0.22, y: 0.78, w: 5.1, h: 0.28, fill: { color: C.navy } });
s.addText("STEPWISE MANAGEMENT (AUA / EAU Guidelines)", { x: 0.25, y: 0.78, w: 5.05, h: 0.28, fontSize: 9, bold: true, color: C.white, valign: "middle", fontFace: "Calibri" });
const steps = [
["STEP 1", "General measures", "Analgesia (opioids IV/IM), anxiolysis. Treat underlying cause (hydration + oxygenation for SCD; exchange transfusion if needed)."],
["STEP 2", "Corporal aspiration", "21-gauge butterfly needle into lateral corpus cavernosum at 3 or 9 o'clock. Aspirate 20–30 mL until bright red blood appears. May repeat."],
["STEP 3", "α-adrenergic injection", "Phenylephrine (drug of choice): 100–200 µg in 1 mL saline; repeat every 3–5 min (max 1000 µg). Monitor BP/HR (cardiac risk)."],
["STEP 4", "Corporal irrigation", "Saline irrigation with aspiration cycles if aspiration alone insufficient."],
["STEP 5", "Surgical shunt", "Distal: Winter shunt (16G Tru-Cut needle via glans) or Ebbehoj / Al-Ghorab shunts. Proximal: Quackels (cavernosospongiosum) or Grayhack (saphenous vein) shunts."],
["STEP 6", "Penile prosthesis", "Consider early prosthesis insertion (< 2 weeks) if > 36–72h ischemia to prevent fibrosis / preserve length."],
];
let yPos = 1.12;
steps.forEach(([num, title, detail]) => {
s.addShape(pres.ShapeType.roundRect, { x: 0.22, y: yPos, w: 5.1, h: 0.62, fill: { color: C.white }, line: { color: C.teal, width: 0.8 }, rectRadius: 0.06 });
s.addShape(pres.ShapeType.ellipse, { x: 0.27, y: yPos + 0.06, w: 0.52, h: 0.3, fill: { color: C.navy } });
s.addText(num, { x: 0.27, y: yPos + 0.06, w: 0.52, h: 0.3, fontSize: 7, bold: true, color: C.white, align: "center", valign: "middle", fontFace: "Calibri" });
s.addText(title, { x: 0.86, y: yPos + 0.04, w: 4.38, h: 0.22, fontSize: 9, bold: true, color: C.teal, fontFace: "Calibri" });
s.addText(detail, { x: 0.86, y: yPos + 0.26, w: 4.38, h: 0.32, fontSize: 7.5, color: C.gray, fontFace: "Calibri" });
yPos += 0.67;
});
// Right: management flowchart image
s.addShape(pres.ShapeType.rect, { x: 5.55, y: 0.78, w: 4.23, h: 0.28, fill: { color: C.teal } });
s.addText("MANAGEMENT FLOWCHART", { x: 5.58, y: 0.78, w: 4.18, h: 0.28, fontSize: 9, bold: true, color: C.white, valign: "middle", fontFace: "Calibri" });
if (!flowchartImg.error) {
s.addImage({ data: flowchartImg.base64, x: 5.55, y: 1.1, w: 4.23, h: 3.2 });
}
// Phenylephrine dosing box
s.addShape(pres.ShapeType.roundRect, {
x: 5.55, y: 4.38, w: 4.23, h: 0.78,
fill: { color: C.yellow }, line: { color: C.orange, width: 1 }, rectRadius: 0.08,
});
s.addText("Phenylephrine – Drug of Choice", { x: 5.62, y: 4.42, w: 4.1, h: 0.2, fontSize: 9.5, bold: true, color: C.navy, fontFace: "Calibri" });
s.addText([
{ text: "Dose: ", options: { bold: true } },
{ text: "100–500 µg in 1 mL NS every 3–5 min (max 1 mg/dose) | " },
{ text: "Preferred: ", options: { bold: true } },
{ text: "Selective α1-agonist, minimal cardiac effects | " },
{ text: "Alternative: ", options: { bold: true } },
{ text: "Epinephrine 10–20 µg or norepinephrine" },
], { x: 5.62, y: 4.64, w: 4.1, h: 0.5, fontSize: 7.5, color: C.navy, fontFace: "Calibri" });
}
// ══════════════════════════════════════════════════════════════════════════
// SLIDE 11 – TREATMENT (NON-ISCHEMIC & STUTTERING) + COMPLICATIONS
// ══════════════════════════════════════════════════════════════════════════
{
const s = pres.addSlide();
applyBg(s, C.cream);
addHeader(s, "09–10 | Non-Ischemic Treatment · Stuttering · Complications & Prognosis");
addAccentLine(s);
addFooter(s);
// Non-Ischemic Treatment
s.addShape(pres.ShapeType.rect, { x: 0.22, y: 0.78, w: 3.1, h: 0.28, fill: { color: C.teal } });
s.addText("NON-ISCHEMIC TX", { x: 0.25, y: 0.78, w: 3.05, h: 0.28, fontSize: 9, bold: true, color: C.white, valign: "middle", fontFace: "Calibri" });
const niTx = [
["Observation", "20–60% resolve spontaneously; not an emergency."],
["Selective arterial embolisation", "Gold standard. Superselective catheterisation of internal pudendal artery. Success 74–80%. Temporary (gelfoam) preferred to preserve potency."],
["Surgical ligation", "For failed embolisation; direct surgical ligation of arteriocavernosal fistula via perineal approach."],
["Ice-pack", "Initial conservative measure to reduce blood flow."],
];
niTx.forEach(([title, desc], i) => {
const yy = 1.1 + i * 0.56;
s.addShape(pres.ShapeType.roundRect, { x: 0.22, y: yy, w: 3.1, h: 0.52, fill: { color: i%2===0?C.lightgray:C.white }, line: { color: C.sky, width: 0.8 }, rectRadius: 0.05 });
s.addText(title, { x: 0.3, y: yy + 0.03, w: 2.9, h: 0.2, fontSize: 8.5, bold: true, color: C.navy, fontFace: "Calibri" });
s.addText(desc, { x: 0.3, y: yy + 0.24, w: 2.9, h: 0.26, fontSize: 7.5, color: C.gray, fontFace: "Calibri" });
});
// Stuttering Treatment
s.addShape(pres.ShapeType.rect, { x: 3.48, y: 0.78, w: 3.1, h: 0.28, fill: { color: C.navy } });
s.addText("STUTTERING TX", { x: 3.51, y: 0.78, w: 3.05, h: 0.28, fontSize: 9, bold: true, color: C.white, valign: "middle", fontFace: "Calibri" });
const stutterTx = [
["Acute episode", "Same as ischemic: aspiration + phenylephrine"],
["PDE5 inhibitors (chronic)", "Paradoxically prevent recurrence by restoring PDE5 activity & NO signalling (sildenafil 25–50 mg daily)"],
["Pseudoephedrine", "Oral α-agonist; 30–60 mg at bedtime for prophylaxis"],
["GnRH agonists", "Reduce testosterone; used in refractory cases (leuprolide)"],
["Hydroxyurea", "For SCD patients; reduces sickling episodes"],
["Baclofen / Digoxin", "Second-line; limited evidence"],
];
stutterTx.forEach(([title, desc], i) => {
const yy = 1.1 + i * 0.46;
s.addShape(pres.ShapeType.roundRect, { x: 3.48, y: yy, w: 3.1, h: 0.42, fill: { color: i%2===0?C.lightgray:C.white }, line: { color: C.teal, width: 0.8 }, rectRadius: 0.05 });
s.addText(title, { x: 3.56, y: yy + 0.02, w: 2.9, h: 0.18, fontSize: 8, bold: true, color: C.teal, fontFace: "Calibri" });
s.addText(desc, { x: 3.56, y: yy + 0.2, w: 2.9, h: 0.2, fontSize: 7.5, color: C.gray, fontFace: "Calibri" });
});
// Complications + Prognosis
s.addShape(pres.ShapeType.rect, { x: 6.74, y: 0.78, w: 3.04, h: 0.28, fill: { color: C.red } });
s.addText("COMPLICATIONS & PROGNOSIS", { x: 6.77, y: 0.78, w: 2.98, h: 0.28, fontSize: 8, bold: true, color: C.white, valign: "middle", fontFace: "Calibri" });
const comps = [
["Erectile dysfunction", "Most feared complication. >30% with prolonged priapism (>24–48h). Fibrosis of cavernous SMC."],
["Corporal fibrosis", "Progressive replacement of erectile tissue by scar; leads to Peyronie-like deformity."],
["Penile shortening", "Fibrosis → loss of elasticity → overall penile length reduction."],
["Urinary retention", "Rare; due to urethral oedema / haematoma."],
["Infection / sepsis", "Post-intervention; rare if technique clean."],
];
comps.forEach(([title, desc], i) => {
const yy = 1.1 + i * 0.55;
s.addShape(pres.ShapeType.roundRect, { x: 6.74, y: yy, w: 3.04, h: 0.5, fill: { color: i%2===0?C.lightgray:C.white }, line: { color: C.red, width: 0.8 }, rectRadius: 0.05 });
s.addText(title, { x: 6.82, y: yy + 0.02, w: 2.85, h: 0.18, fontSize: 8, bold: true, color: C.red, fontFace: "Calibri" });
s.addText(desc, { x: 6.82, y: yy + 0.22, w: 2.85, h: 0.26, fontSize: 7.5, color: C.gray, fontFace: "Calibri" });
});
// Prognosis time bar at bottom
s.addShape(pres.ShapeType.rect, { x: 0.22, y: 4.82, w: 9.56, h: 0.22, fill: { color: C.navy } });
s.addText("PROGNOSIS TIMELINE:", { x: 0.3, y: 4.82, w: 1.6, h: 0.22, fontSize: 8, bold: true, color: C.yellow, valign: "middle", fontFace: "Calibri" });
s.addText("< 4h: ED rare | 4–24h: ED 10–35% | 24–48h: ED 50–80% | > 48h: ED >90% | > 72h: Penile prosthesis likely needed", {
x: 1.9, y: 4.82, w: 7.8, h: 0.22, fontSize: 8, color: C.sky, valign: "middle", fontFace: "Calibri",
});
// Key message banner
s.addShape(pres.ShapeType.roundRect, { x: 0.22, y: 5.07, w: 9.56, h: 0.26, fill: { color: C.sky }, rectRadius: 0.04 });
s.addText("KEY MESSAGE: Ischemic priapism is a time-sensitive urological emergency. Prompt diagnosis and treatment within 4–6 hours optimises erectile function preservation.", {
x: 0.3, y: 5.07, w: 9.4, h: 0.26, fontSize: 8, bold: true, color: C.navy, valign: "middle", fontFace: "Calibri",
});
}
// ── Write file ─────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/priapism-ppt/Priapism_Comprehensive.pptx" })
.then(() => console.log("✅ Priapism_Comprehensive.pptx created successfully"))
.catch(err => { console.error("ERROR:", err); process.exit(1); });
Running Command
cd /home/daytona/workspace/priapism-ppt && node priapism.js 2>&1
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