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

// ─── Colour Palette ───────────────────────────────────────────────
const C = {
  navy:    "0B1F3A",   // dominant dark bg
  teal:    "0E7C7B",   // accent headers
  gold:    "E8B84B",   // highlight accent
  white:   "FFFFFF",
  offwhite:"F0F4F8",
  light:   "D6E4F0",
  muted:   "8FA8C0",
  dark:    "0A0A0A",
};

// Helper to fetch images as base64
function fetchImages(urls) {
  try {
    const result = execSync(
      `node /home/daytona/skills/shared/scripts/fetch_images.js ${urls.map(u => `"${u}"`).join(" ")}`,
      { maxBuffer: 50 * 1024 * 1024 }
    );
    return JSON.parse(result.toString());
  } catch(e) {
    console.error("Image fetch error:", e.message);
    return urls.map(u => ({ url: u, base64: null, error: e.message }));
  }
}

// ─── FETCH ALL IMAGES ─────────────────────────────────────────────
console.log("Fetching images...");
const imageUrls = [
  // Anatomy
  "https://cdn.orris.care/cdss_images/BAILY_1760544538998_9e3f7096-e11f-42a6-af86-e3980ee4d060.png",
  // Blood supply / vascular
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_24348363da0ea019115c14371ab50f9cef8c4d4012ceb85a196085a0b07a7963.jpg",
  // Mammography / investigations
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_8adbb935f8e23498f42a61a67fdae5488efe68374dffb869b898de7a4e27c7ce.jpg",
  // Paget clinical photo 1
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_768f8bbe54b7bf9cbd33dbe6ba53d61951f513253d6ff754036e2643b13d7560.jpg",
  // Paget gross path
  "https://cdn.orris.care/cdss_images/Pathology_1760046308106_064d80fa-6861-425b-8386-771852f124b7.jpg",
  // Paget histology
  "https://cdn.orris.care/cdss_images/Pathology_1760046325023_3c2d372a-662b-47d4-b75f-cba16d3f3ba0.jpg",
  // Paget histology 2
  "https://cdn.orris.care/cdss_images/Pathology_1760046316258_91a977c7-cdfe-413d-824c-7a9bcaec017e.jpg",
  // Nipple discharge types
  "https://cdn.orris.care/cdss_images/BAILY_1760544510978_88bb767f-701c-4fb3-a131-878758c36ce9.png",
  // Galactography
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_33cd2596ce7536c363c5b821da07720ce78773bdcbc55648b32360b0ffade72d.jpg",
  // Congenital - polythelia
  "https://cdn.orris.care/cdss_images/DermNetNZ_1760031084522_6fb41c3a-98d3-4b46-bae1-b8070facecc0.jpg",
  // Congenital - supernumerary nipple
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_3d8c5f604daf24f0dd4638f6ca90cbb7b3e285de7b1f470a3100e025cd83c162.jpg",
  // Surgical anatomy
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_a686f7592d07c83536f1ca585bad049fabdfd4d8dae5079a68caab176f9b3dda.jpg",
];

const imgs = fetchImages(imageUrls);
// Map to named variables
const [
  imgAnatomy, imgVascular, imgMammo, imgPagetClinical, imgPagetGross,
  imgPagetHisto1, imgPagetHisto2, imgNippleDischarge, imgGalacto,
  imgPolythelia, imgSupernumerary, imgSurgAnatomy
] = imgs;

console.log("Images fetched. Building PPT...");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.author  = "Surgical Seminar Group";
pres.title   = "Breast in Surgery";

// ══════════════════════════════════════════════════════════════════
// HELPER FUNCTIONS
// ══════════════════════════════════════════════════════════════════
function addBg(slide, color) {
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: "100%", h: "100%",
    fill: { color: color || C.navy },
    line: { type: "none" }
  });
}

function accentBar(slide, y, color) {
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: y, w: "100%", h: 0.06,
    fill: { color: color || C.teal }, line: { type: "none" }
  });
}

function sectionTag(slide, text) {
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: 2.5, h: 0.42,
    fill: { color: C.teal }, line: { type: "none" }
  });
  slide.addText(text.toUpperCase(), {
    x: 0, y: 0, w: 2.5, h: 0.42,
    fontSize: 9, bold: true, color: C.white, align: "center", valign: "middle",
    charSpacing: 2, margin: 0
  });
}

function slideTitle(slide, title, subtitle) {
  slide.addText(title, {
    x: 0.45, y: 0.55, w: 9.1, h: 0.7,
    fontSize: 26, bold: true, color: C.gold, fontFace: "Calibri",
    margin: 0
  });
  if (subtitle) {
    slide.addText(subtitle, {
      x: 0.45, y: 1.2, w: 9.1, h: 0.38,
      fontSize: 13, color: C.light, fontFace: "Calibri", italic: true, margin: 0
    });
  }
  accentBar(slide, 1.55, C.teal);
}

function bullets(slide, items, opts) {
  const o = Object.assign({ x: 0.45, y: 1.75, w: 5.1, h: 3.5, fontSize: 14 }, opts);
  slide.addText(
    items.map((t, i) => ({
      text: t,
      options: { bullet: { code: "2022" }, breakLine: i < items.length - 1, color: C.offwhite, fontSize: o.fontSize, fontFace: "Calibri" }
    })),
    { x: o.x, y: o.y, w: o.w, h: o.h, valign: "top", lineSpacingMultiple: 1.3 }
  );
}

function addImg(slide, imgObj, x, y, w, h) {
  if (imgObj && imgObj.base64) {
    slide.addImage({ data: imgObj.base64, x, y, w, h });
  }
}

function imgCaption(slide, text, x, y, w) {
  slide.addText(text, {
    x, y, w, h: 0.3,
    fontSize: 8, color: C.muted, align: "center", italic: true, margin: 0
  });
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE SLIDE
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);

  // Gold gradient bar left
  s.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: 0.12, h: "100%",
    fill: { color: C.gold }, line: { type: "none" }
  });
  s.addShape(pres.ShapeType.rect, {
    x: 0.12, y: 0, w: 0.08, h: "100%",
    fill: { color: C.teal }, line: { type: "none" }
  });

  // Anatomy image on right
  addImg(s, imgAnatomy, 5.5, 0.3, 4.3, 5.0);
  // Dark overlay on image
  s.addShape(pres.ShapeType.rect, {
    x: 5.5, y: 0.3, w: 4.3, h: 5.0,
    fill: { color: "000000", transparency: 55 }, line: { type: "none" }
  });

  s.addText("BREAST", {
    x: 0.4, y: 0.8, w: 5.0, h: 1.0,
    fontSize: 56, bold: true, color: C.white, fontFace: "Calibri",
    charSpacing: 8, margin: 0
  });
  s.addText("IN SURGERY", {
    x: 0.4, y: 1.7, w: 5.0, h: 0.75,
    fontSize: 34, bold: true, color: C.gold, fontFace: "Calibri",
    charSpacing: 4, margin: 0
  });
  accentBar(s, 2.55, C.teal);

  s.addText("A Comprehensive Surgical Seminar", {
    x: 0.4, y: 2.75, w: 5.0, h: 0.45,
    fontSize: 14, color: C.light, italic: true, fontFace: "Calibri", margin: 0
  });

  // Topic list on slide 1
  const topics = [
    "1. Introduction",
    "2. Anatomy",
    "3. Investigations",
    "4. Diseases of the Nipple",
    "5. Paget's Disease",
    "6. Treatment of Paget's Disease",
    "7. Nipple Discharge",
    "8. Treatment for Discharge",
    "9. Congenital Abnormalities",
    "10. Conclusion",
  ];
  s.addText(
    topics.map((t, i) => ({
      text: t,
      options: { breakLine: i < topics.length - 1, fontSize: 11, color: C.offwhite, fontFace: "Calibri" }
    })),
    { x: 0.4, y: 3.3, w: 4.8, h: 2.1, valign: "top", lineSpacingMultiple: 1.4 }
  );

  s.addText("Presented by a Team of 10 | 30-Minute Seminar", {
    x: 0.3, y: 5.2, w: 9.4, h: 0.32,
    fontSize: 9.5, color: C.muted, align: "center", fontFace: "Calibri", margin: 0
  });
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 2 — INTRODUCTION
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);
  sectionTag(s, "Introduction");
  slideTitle(s, "Introduction to the Breast in Surgery");

  bullets(s, [
    "The breast is a vital organ in surgical practice — both for benign and malignant conditions",
    "Breast disease accounts for a significant proportion of outpatient surgical referrals worldwide",
    "Conditions range from congenital anomalies to life-threatening malignancies",
    "Surgical management requires thorough knowledge of anatomy, pathology, and investigations",
    "Key clinical topics: nipple diseases, Paget's disease, nipple discharge, and congenital defects",
    "Early diagnosis and multidisciplinary management are the cornerstones of breast surgery",
  ], { x: 0.45, y: 1.75, w: 5.5, h: 3.6, fontSize: 13.5 });

  // Box on right
  s.addShape(pres.ShapeType.rect, {
    x: 6.2, y: 1.75, w: 3.55, h: 3.6,
    fill: { color: "0E3A58" }, line: { color: C.teal, w: 1.5 }
  });
  s.addText("Key Facts", {
    x: 6.2, y: 1.75, w: 3.55, h: 0.4,
    fontSize: 12, bold: true, color: C.gold, align: "center", fontFace: "Calibri", margin: 0
  });
  s.addText([
    { text: "• 1 in 8 women develop breast cancer\n", options: { fontSize: 12, color: C.offwhite } },
    { text: "• Most common cancer in women globally\n", options: { fontSize: 12, color: C.offwhite } },
    { text: "• Benign conditions are 3x more common than malignant\n", options: { fontSize: 12, color: C.offwhite } },
    { text: "• Paget's disease = 1–3% of all breast cancers\n", options: { fontSize: 12, color: C.offwhite } },
    { text: "• Nipple discharge is the 3rd most common breast complaint", options: { fontSize: 12, color: C.offwhite } },
  ], { x: 6.3, y: 2.25, w: 3.35, h: 2.9, valign: "top", lineSpacingMultiple: 1.4 });
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 3 — ANATOMY (Structure)
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);
  sectionTag(s, "Anatomy");
  slideTitle(s, "Anatomy of the Breast", "Structure, Boundaries & Quadrants");

  bullets(s, [
    "Location: Anterior chest wall, 2nd–6th rib vertically; sternum to mid-axillary line",
    "Structure: Glandular tissue (15–20 lobes), fibrous stroma, adipose tissue",
    "Each lobe drains via a lactiferous duct → lactiferous sinus → nipple",
    "Cooper's ligaments: fibrous suspensory bands connecting skin to deep fascia",
    "Nipple-Areola Complex (NAC): circular pigmented area; contains smooth muscle",
    "4 quadrants + axillary tail of Spence (upper outer quadrant most common cancer site)",
    "Extends into axilla as axillary tail — clinically important in staging",
  ], { x: 0.45, y: 1.75, w: 5.2, h: 3.7, fontSize: 13 });

  addImg(s, imgAnatomy, 5.7, 1.65, 4.1, 3.8);
  imgCaption(s, "Cross-section: breast anatomy with abscess location (Bailey & Love)", 5.7, 5.45, 4.1);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 4 — ANATOMY (Blood Supply & Lymphatics)
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);
  sectionTag(s, "Anatomy");
  slideTitle(s, "Blood Supply, Lymphatics & Nerve Supply");

  const col1 = [
    "ARTERIAL SUPPLY:",
    "• Internal thoracic artery (medial breast) — perforators via 2nd–4th intercostals",
    "• Lateral thoracic artery (lateral breast)",
    "• Thoracoacromial artery",
    "• Posterior intercostal arteries",
    "",
    "VENOUS DRAINAGE:",
    "• Axillary vein, internal thoracic vein",
    "• Intercostal veins (route for haematogenous spread to spine)",
  ];
  const col2 = [
    "LYMPHATIC DRAINAGE:",
    "• Axillary nodes (75%) — main clinical pathway",
    "• Internal mammary nodes (medial breast)",
    "• Supraclavicular nodes (advanced disease)",
    "",
    "NERVE SUPPLY:",
    "• Anterior & lateral cutaneous branches of intercostal nerves T4–T6",
    "• Nipple sensation: 4th intercostal nerve (key in surgery)",
  ];

  s.addText(
    col1.map((t, i) => ({ text: t, options: { breakLine: i < col1.length - 1, fontSize: 11.5, color: t.endsWith(":") ? C.gold : C.offwhite, bold: t.endsWith(":"), fontFace: "Calibri" } })),
    { x: 0.4, y: 1.75, w: 4.6, h: 3.7, valign: "top", lineSpacingMultiple: 1.35 }
  );
  s.addText(
    col2.map((t, i) => ({ text: t, options: { breakLine: i < col2.length - 1, fontSize: 11.5, color: t.endsWith(":") ? C.gold : C.offwhite, bold: t.endsWith(":"), fontFace: "Calibri" } })),
    { x: 5.15, y: 1.75, w: 4.6, h: 3.7, valign: "top", lineSpacingMultiple: 1.35 }
  );
  // Divider line
  s.addShape(pres.ShapeType.line, {
    x: 5.0, y: 1.75, w: 0, h: 3.6,
    line: { color: C.teal, w: 1, dashType: "dash" }
  });
  addImg(s, imgVascular, 7.2, 2.0, 2.6, 2.8);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 5 — INVESTIGATIONS
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);
  sectionTag(s, "Investigations");
  slideTitle(s, "Investigations of Breast Disease", "The Triple Assessment Approach");

  // Triple assessment box
  s.addShape(pres.ShapeType.rect, {
    x: 0.35, y: 1.7, w: 9.3, h: 0.7,
    fill: { color: C.teal }, line: { type: "none" }
  });
  s.addText("TRIPLE ASSESSMENT  =  Clinical Examination  +  Imaging  +  Pathology", {
    x: 0.35, y: 1.7, w: 9.3, h: 0.7,
    fontSize: 14, bold: true, color: C.white, align: "center", valign: "middle", fontFace: "Calibri", margin: 0
  });

  // Three columns
  const cols = [
    { title: "1. Clinical", items: ["History & physical exam", "Lump characterization", "Skin & nipple changes", "Lymph node assessment", "BIRADS classification"] },
    { title: "2. Imaging", items: ["Mammography: gold standard in >35 yrs", "Ultrasound: first-line in <35 yrs", "MRI: extent of disease, high-risk patients", "Ductography: nipple discharge workup", "CT/PET: staging in malignancy"] },
    { title: "3. Pathology", items: ["FNAC: rapid cytology", "Core needle biopsy (CNB): histology", "Excision biopsy: diagnostic + therapeutic", "Sentinel lymph node biopsy", "IHC: ER, PR, HER2 status"] },
  ];

  cols.forEach((col, i) => {
    const x = 0.35 + i * 3.15;
    s.addShape(pres.ShapeType.rect, {
      x, y: 2.5, w: 3.05, h: 2.9,
      fill: { color: "0E2A45" }, line: { color: C.teal, w: 1 }
    });
    s.addText(col.title, {
      x, y: 2.5, w: 3.05, h: 0.42,
      fontSize: 13, bold: true, color: C.gold, align: "center", valign: "middle", fontFace: "Calibri", margin: 0
    });
    s.addText(
      col.items.map((t, j) => ({ text: "• " + t, options: { breakLine: j < col.items.length - 1, fontSize: 11, color: C.offwhite, fontFace: "Calibri" } })),
      { x: x + 0.1, y: 3.0, w: 2.85, h: 2.3, valign: "top", lineSpacingMultiple: 1.35 }
    );
  });

  addImg(s, imgMammo, 3.5, 2.5, 3.0, 2.9);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 6 — DISEASES OF THE NIPPLE (overview)
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);
  sectionTag(s, "Nipple Diseases");
  slideTitle(s, "Diseases of the Nipple", "Classification & Overview");

  const categories = [
    { hd: "Congenital", items: ["Inverted nipple (grades I–III)", "Supernumerary nipple (polythelia)", "Absent nipple (athelia)", "Accessory breast tissue (polymastia)"] },
    { hd: "Inflammatory / Infective", items: ["Periductal mastitis", "Duct ectasia", "Subareolar abscess", "Lactational mastitis"] },
    { hd: "Neoplastic", items: ["Paget's disease of nipple", "Nipple adenoma", "Syringomatous adenoma", "Metastatic disease to nipple"] },
    { hd: "Discharge-Related", items: ["Duct papilloma (most common benign)", "Fibrocystic change", "Galactorrhoea", "Duct carcinoma in situ (DCIS)"] },
  ];

  categories.forEach((cat, i) => {
    const x = 0.35 + (i % 2) * 4.75;
    const y = i < 2 ? 1.85 : 3.7;
    s.addShape(pres.ShapeType.rect, {
      x, y, w: 4.55, h: 1.65,
      fill: { color: i % 2 === 0 ? "0E2A45" : "0A1F35" }, line: { color: C.teal, w: 1 }
    });
    s.addText(cat.hd, {
      x, y, w: 4.55, h: 0.38,
      fontSize: 12.5, bold: true, color: C.gold, align: "center", valign: "middle", fontFace: "Calibri", margin: 0
    });
    s.addText(
      cat.items.map((t, j) => ({ text: "• " + t, options: { breakLine: j < cat.items.length - 1, fontSize: 11, color: C.offwhite, fontFace: "Calibri" } })),
      { x: x + 0.15, y: y + 0.4, w: 4.25, h: 1.15, valign: "top", lineSpacingMultiple: 1.25 }
    );
  });
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 7 — PAGET'S DISEASE (Clinical)
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);
  sectionTag(s, "Paget's Disease");
  slideTitle(s, "Paget's Disease of the Nipple", "Definition, Pathogenesis & Clinical Features");

  bullets(s, [
    "Definition: Intraepidermal adenocarcinoma of the nipple-areola complex (NAC)",
    "Incidence: 1–3% of all breast cancers; predominantly women >40 yrs",
    "Pathogenesis: Migration of malignant ductal cells (Paget cells) from underlying DCIS/invasive cancer to epidermis",
    "Associated with underlying carcinoma in 82–95% of cases",
    "Clinical: Eczematoid rash → erythema, scaling, crusting, ulceration, bloody discharge",
    "Key differentials: Eczema, contact dermatitis, Bowen's disease",
    "Diagnosis: Nipple biopsy (wedge/punch); immunohistochemistry CK7+, HER2+",
    "Imaging: Mammography ± MRI to detect underlying tumour",
  ], { x: 0.45, y: 1.75, w: 5.3, h: 3.7, fontSize: 12.5 });

  addImg(s, imgPagetClinical, 5.9, 1.75, 3.9, 2.6);
  imgCaption(s, "Clinical: Paget's disease — eczematoid NAC ulceration", 5.9, 4.35, 3.9);
  addImg(s, imgPagetGross, 5.9, 4.45, 3.9, 1.0);
  imgCaption(s, "Gross pathology: mastectomy specimen (nipple involvement)", 5.9, 5.4, 3.9);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 8 — PAGET'S DISEASE (Histology)
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);
  sectionTag(s, "Paget's Disease");
  slideTitle(s, "Paget's Disease — Histopathology");

  s.addText("Paget Cells — H&E Features", {
    x: 0.45, y: 1.75, w: 4.6, h: 0.4,
    fontSize: 14, bold: true, color: C.gold, fontFace: "Calibri", margin: 0
  });
  bullets(s, [
    "Large, round cells with pale/clear cytoplasm",
    "Enlarged, hyperchromatic nuclei with prominent nucleoli",
    "Arranged singly or in clusters within epidermis",
    "Pagetoid spread along basal layer upwards",
    "Mucin production (PAS+); unlike melanoma (S100−)",
    "IHC: CK7+, GCDFP-15+, HER2 overexpression",
    "Often associated with underlying DCIS or invasive ductal carcinoma",
    "Differential: Melanoma (HMB-45+), Bowen's disease (CK5/6+)",
  ], { x: 0.45, y: 2.2, w: 4.6, h: 3.1, fontSize: 12.5 });

  addImg(s, imgPagetHisto1, 5.2, 1.68, 4.55, 2.5);
  imgCaption(s, "H&E: Paget cells with pale cytoplasm and prominent nuclei", 5.2, 4.15, 4.55);
  addImg(s, imgPagetHisto2, 5.2, 4.3, 4.55, 1.1);
  imgCaption(s, "Paget disease + underlying invasive ductal carcinoma", 5.2, 5.37, 4.55);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 9 — TREATMENT FOR PAGET'S DISEASE
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);
  sectionTag(s, "Paget's Disease");
  slideTitle(s, "Treatment of Paget's Disease", "Surgical & Adjuvant Strategies");

  const rows = [
    ["Clinical Scenario", "Preferred Treatment"],
    ["Paget's + no underlying mass (DCIS only)", "Central lumpectomy (NAC excision) + RT OR mastectomy"],
    ["Paget's + underlying DCIS", "Breast-conserving surgery (BCS) + radiotherapy if margins clear"],
    ["Paget's + invasive carcinoma (unifocal)", "Wide local excision (WLE) + sentinel lymph node biopsy + RT"],
    ["Paget's + invasive carcinoma (multifocal)", "Modified radical mastectomy (MRM) + axillary clearance"],
    ["HER2+ tumours", "Trastuzumab (Herceptin) ± pertuzumab + chemotherapy"],
    ["ER+ tumours", "Adjuvant hormonal therapy (tamoxifen / aromatase inhibitors)"],
  ];

  s.addTable(rows, {
    x: 0.35, y: 1.75, w: 9.3, h: 3.5,
    border: { pt: 1, color: C.teal },
    fill: C.navy,
    fontSize: 11.5,
    fontFace: "Calibri",
    color: C.offwhite,
    align: "left",
    rowH: 0.42,
    firstRowCols: { fill: { color: C.teal }, bold: true, color: C.white, align: "center" },
  });

  s.addText("• Surgery is the mainstay. Radiotherapy is mandatory after BCS to reduce local recurrence.", {
    x: 0.35, y: 5.35, w: 9.3, h: 0.25,
    fontSize: 10.5, color: C.muted, italic: true, fontFace: "Calibri", margin: 0
  });
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 10 — NIPPLE DISCHARGE (types)
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);
  sectionTag(s, "Nipple Discharge");
  slideTitle(s, "Discharge from the Nipple", "Classification & Causes");

  bullets(s, [
    "Defined as: Fluid expressed from the nipple either spontaneously or on pressure",
    "3rd most common breast symptom after lump and pain",
    "",
    "PHYSIOLOGICAL: Milky (galactorrhoea) — pregnancy, prolactinoma, drugs (haloperidol, metoclopramide)",
    "",
    "PATHOLOGICAL (requires investigation):",
    "• Serous — duct ectasia, fibrocystic disease",
    "• Bloodstained / serosanguinous — intraductal papilloma (#1 cause), DCIS, carcinoma",
    "• Purulent — infection / abscess",
    "• Cheesy — duct ectasia, periductal mastitis",
    "• Green / multicoloured — fibrocystic change",
    "• Watery / clear — malignancy until proven otherwise",
  ], { x: 0.45, y: 1.75, w: 5.2, h: 3.7, fontSize: 12 });

  addImg(s, imgNippleDischarge, 5.75, 1.65, 4.0, 3.0);
  imgCaption(s, "Types of nipple discharge: (a) serous  (b) pus  (c) bloody  (d) cheesy  (e) greenish  (f) watery — Bailey & Love", 5.75, 4.65, 4.0);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 11 — NIPPLE DISCHARGE (Investigation)
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);
  sectionTag(s, "Nipple Discharge");
  slideTitle(s, "Investigations for Nipple Discharge");

  const steps = [
    { num: "01", title: "History & Exam", body: "Unilateral vs bilateral; spontaneous vs expressed; single vs multi-duct; colour; associated mass" },
    { num: "02", title: "Cytology", body: "Discharge smear cytology (sensitivity ~50%) — detect malignant cells; limited by low sensitivity" },
    { num: "03", title: "Mammography", body: "Standard in women >35; detect underlying mass, microcalcifications (DCIS)" },
    { num: "04", title: "Ultrasound", body: "First-line in <35 yrs; detect intraductal lesions, papillomas, dilated ducts" },
    { num: "05", title: "Ductography (Galactography)", body: "Contrast injection into discharging duct — filling defect = papilloma; 'trunk sign' = malignancy" },
    { num: "06", title: "Ductoscopy (Fiberoptic)", body: "Direct visualisation; biopsy of intraductal lesions; increasingly used" },
  ];

  steps.forEach((step, i) => {
    const x = 0.35 + (i % 3) * 3.2;
    const y = i < 3 ? 1.75 : 3.55;
    s.addShape(pres.ShapeType.rect, {
      x, y, w: 3.1, h: 1.6,
      fill: { color: "0E2A45" }, line: { color: C.teal, w: 1 }
    });
    s.addText(step.num, {
      x, y, w: 0.55, h: 1.6,
      fontSize: 20, bold: true, color: C.teal, align: "center", valign: "middle", fontFace: "Calibri", margin: 0
    });
    s.addShape(pres.ShapeType.line, {
      x: x + 0.55, y: y + 0.2, w: 0, h: 1.2,
      line: { color: C.teal, w: 1 }
    });
    s.addText(step.title, {
      x: x + 0.65, y, w: 2.38, h: 0.4,
      fontSize: 12, bold: true, color: C.gold, valign: "middle", fontFace: "Calibri", margin: 0
    });
    s.addText(step.body, {
      x: x + 0.65, y: y + 0.4, w: 2.38, h: 1.12,
      fontSize: 10.5, color: C.offwhite, fontFace: "Calibri", valign: "top", lineSpacingMultiple: 1.25, margin: 0
    });
  });
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 12 — TREATMENT FOR NIPPLE DISCHARGE
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);
  sectionTag(s, "Nipple Discharge");
  slideTitle(s, "Treatment of Nipple Discharge", "Conservative to Surgical Approaches");

  bullets(s, [
    "PHYSIOLOGICAL / BILATERAL DISCHARGE:",
    "  → Reassurance; treat underlying cause (e.g., stop offending drug, treat prolactinoma with bromocriptine)",
    "",
    "SINGLE DUCT DISCHARGE (benign likely — papilloma):",
    "  → Microdochectomy: excision of single discharging duct (Hadfield's operation)",
    "  → Sent for histopathology",
    "",
    "MULTIPLE DUCT DISCHARGE (duct ectasia, fibrocystic):",
    "  → Hadfield's procedure: total duct excision (Adair-Urban operation)",
    "  → Antibiotics if periductal mastitis",
    "",
    "BLOODSTAINED / SUSPICIOUS DISCHARGE:",
    "  → Core biopsy / excision biopsy to exclude malignancy",
    "  → If malignancy confirmed → Treat as per cancer protocol (BCS / mastectomy)",
    "",
    "Ductoscopy-guided resection: Increasingly preferred for precision excision",
  ], { x: 0.45, y: 1.75, w: 5.5, h: 3.6, fontSize: 11.8 });

  addImg(s, imgGalacto, 6.15, 1.78, 3.6, 2.0);
  imgCaption(s, "Galactography: tree pattern (benign), filling defect (papilloma), trunk sign (malignancy)", 6.15, 3.78, 3.6);
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 13 — CONGENITAL ABNORMALITIES
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);
  sectionTag(s, "Congenital Abnormalities");
  slideTitle(s, "Congenital Abnormalities of the Breast", "Embryology & Classification");

  // Embryology box
  s.addShape(pres.ShapeType.rect, {
    x: 0.35, y: 1.72, w: 9.3, h: 0.62,
    fill: { color: "0E3A58" }, line: { color: C.gold, w: 1 }
  });
  s.addText("Embryology: Breast develops from ectodermal milk line (axilla → groin) by 6th week. Regression occurs except at 4th intercostal space.", {
    x: 0.45, y: 1.72, w: 9.1, h: 0.62,
    fontSize: 11.5, color: C.offwhite, valign: "middle", fontFace: "Calibri", italic: true, margin: 0
  });

  const abnormalities = [
    { name: "Polythelia", desc: "Supernumerary nipple(s) along milk line — most common (1 in 50); usually benign; associated with urinary tract anomalies" },
    { name: "Polymastia", desc: "Accessory breast tissue — most common in axilla; may lactate; excision if symptomatic" },
    { name: "Athelia", desc: "Absence of nipple; isolated or with amastia; associated with Poland syndrome" },
    { name: "Amastia", desc: "Complete absence of breast tissue; Poland syndrome (+ pectoralis hypoplasia, limb defects)" },
    { name: "Inverted Nipple", desc: "Grade I: can be everted manually; Grade II: reduced evertibility; Grade III: cannot be everted. Surgery for grade III" },
    { name: "Tuberous Breast", desc: "Hernia-type deformity — narrow base, areolar enlargement, ptosis; surgical correction (augmentation + areolaplasty)" },
  ];

  abnormalities.forEach((ab, i) => {
    const x = 0.35 + (i % 3) * 3.2;
    const y = i < 3 ? 2.5 : 4.05;
    s.addShape(pres.ShapeType.rect, {
      x, y, w: 3.1, h: 1.4,
      fill: { color: "0A1F35" }, line: { color: i < 3 ? C.teal : C.gold, w: 1 }
    });
    s.addText(ab.name, {
      x, y, w: 3.1, h: 0.36,
      fontSize: 12.5, bold: true, color: i < 3 ? C.teal : C.gold, align: "center", valign: "middle", fontFace: "Calibri", margin: 0
    });
    s.addText(ab.desc, {
      x: x + 0.1, y: y + 0.38, w: 2.9, h: 0.95,
      fontSize: 10.5, color: C.offwhite, fontFace: "Calibri", valign: "top", lineSpacingMultiple: 1.2, margin: 0
    });
  });
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 14 — CONGENITAL (with images)
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);
  sectionTag(s, "Congenital Abnormalities");
  slideTitle(s, "Polythelia & Supernumerary Nipple — Clinical Images");

  addImg(s, imgPolythelia, 0.35, 1.75, 4.5, 3.2);
  imgCaption(s, "Polythelia: Supernumerary nipple along the milk line (DermNet NZ)", 0.35, 4.95, 4.5);

  addImg(s, imgSupernumerary, 5.2, 1.75, 4.5, 3.2);
  imgCaption(s, "Bilateral polythelia on the abdominal wall — congenital milk line remnant", 5.2, 4.95, 4.5);

  s.addText("Management: Usually conservative (reassurance). Surgical excision if: cosmetically bothersome, associated accessory glandular tissue, diagnostic uncertainty.", {
    x: 0.35, y: 5.1, w: 9.3, h: 0.38,
    fontSize: 11, color: C.muted, italic: true, fontFace: "Calibri", align: "center", margin: 0
  });
}

// ══════════════════════════════════════════════════════════════════
// SLIDE 15 — CONCLUSION
// ══════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addBg(s, C.navy);

  // Gold left bar
  s.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: 0.12, h: "100%",
    fill: { color: C.gold }, line: { type: "none" }
  });

  s.addText("CONCLUSION", {
    x: 0.4, y: 0.3, w: 9.2, h: 0.6,
    fontSize: 30, bold: true, color: C.gold, fontFace: "Calibri", charSpacing: 5, margin: 0
  });
  accentBar(s, 0.95, C.teal);

  const summaryPoints = [
    ["Anatomy", "Thorough knowledge of quadrants, blood supply, lymphatics and nerve supply is essential for all breast surgery"],
    ["Investigations", "Triple assessment (clinical + imaging + pathology) is the gold standard; always use it before treatment"],
    ["Diseases of Nipple", "Broad range from benign inflammatory conditions to malignancy; history and examination guide workup"],
    ["Paget's Disease", "Rare but important — associated with underlying carcinoma in >80%; requires biopsy + imaging for staging"],
    ["Treatment (Paget's)", "Surgery ± radiotherapy ± systemic therapy based on extent; BCS increasingly favored over mastectomy"],
    ["Nipple Discharge", "Bloodstained / spontaneous single-duct = investigate urgently; bilateral milky = usually physiological"],
    ["Treatment (Discharge)", "Microdochectomy for single duct; total duct excision for multiple duct; biopsy any suspicious lesion"],
    ["Congenital", "Polythelia most common; Poland syndrome most complex; management usually conservative unless symptomatic"],
  ];

  summaryPoints.forEach(([topic, desc], i) => {
    const x = 0.4 + (i % 2) * 4.75;
    const y = 1.1 + Math.floor(i / 2) * 1.05;
    s.addShape(pres.ShapeType.rect, {
      x, y, w: 4.6, h: 0.92,
      fill: { color: "0E2A45" }, line: { color: i % 2 === 0 ? C.teal : C.gold, w: 1 }
    });
    s.addText(topic + ": ", {
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      fontSize: 12, bold: true, color: i % 2 === 0 ? C.teal : C.gold, valign: "middle", fontFace: "Calibri", margin: 0
    });
    s.addText(desc, {
      x: x + 0.12, y: y + 0.38, w: 4.38, h: 0.5,
      fontSize: 10.5, color: C.offwhite, fontFace: "Calibri", valign: "top", lineSpacingMultiple: 1.2, margin: 0
    });
  });

  s.addText("Thank You  |  Questions Welcome", {
    x: 0.35, y: 5.25, w: 9.3, h: 0.35,
    fontSize: 13, bold: true, color: C.gold, align: "center", fontFace: "Calibri", margin: 0
  });
}

// ══════════════════════════════════════════════════════════════════
// WRITE FILE
// ══════════════════════════════════════════════════════════════════
const outPath = "/home/daytona/workspace/breast-surgery-ppt/Breast_in_Surgery.pptx";
pres.writeFile({ fileName: outPath }).then(() => {
  console.log("PPT written to: " + outPath);
}).catch(err => {
  console.error("Error writing PPT:", err);
  process.exit(1);
});