ls /home/daytona/workspace/ 2>/dev/null && mkdir -p /home/daytona/workspace/surg…

~/surgical-infection-pptx/build.js

const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Surgical Infection";
pres.author = "Medical Lecture";

// ─── COLOUR PALETTE ───────────────────────────────────────────
const DARK_BG   = "0D1B2A";   // deep navy
const MID_BG    = "1B2A3B";   // mid navy
const ACCENT    = "E63946";   // blood red
const GOLD      = "F4A261";   // warm amber
const WHITE     = "FFFFFF";
const LIGHT     = "D8E8F0";   // light blue-grey
const SUBTEXT   = "A8C5D8";
const DIVIDER   = "E63946";

// ─── HELPER: accent bar ───────────────────────────────────────
function accentBar(slide, color = ACCENT) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.18, h: 5.625, fill: { color } });
}

// ─── HELPER: dark title slide layout ─────────────────────────
function darkBg(slide) {
  slide.background = { color: DARK_BG };
}
function midBg(slide) {
  slide.background = { color: MID_BG };
}

// ─── SLIDE 1: Title ───────────────────────────────────────────
{
  const s = pres.addSlide();
  darkBg(s);
  // Full-width red stripe top
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.12, fill: { color: ACCENT } });
  // Full-width gold stripe bottom
  s.addShape(pres.ShapeType.rect, { x: 0, y: 5.5, w: 10, h: 0.125, fill: { color: GOLD } });

  // Big title
  s.addText("SURGICAL INFECTION", {
    x: 0.5, y: 0.8, w: 9, h: 1.5,
    fontSize: 48, bold: true, color: WHITE, fontFace: "Calibri",
    align: "center", valign: "middle", charSpacing: 4
  });

  // Red divider line
  s.addShape(pres.ShapeType.rect, { x: 2.5, y: 2.4, w: 5, h: 0.06, fill: { color: ACCENT } });

  // Subtitle
  s.addText("Necrosis · Gangrene · Ulcer · Fistula · Purulent Diseases\nFuruncle · Carbuncle · Abscess · Phlegmon · Osteomyelitis", {
    x: 0.5, y: 2.6, w: 9, h: 1.2,
    fontSize: 18, color: SUBTEXT, fontFace: "Calibri",
    align: "center", valign: "middle"
  });

  s.addText("Surgical Pathology Lecture Series", {
    x: 0.5, y: 4.8, w: 9, h: 0.5,
    fontSize: 13, color: GOLD, fontFace: "Calibri", align: "center", italic: true
  });
}

// ─── SLIDE 2: Classification of Surgical Infection ────────────
{
  const s = pres.addSlide();
  midBg(s);
  accentBar(s);

  s.addText("CLASSIFICATION OF SURGICAL INFECTION", {
    x: 0.4, y: 0.15, w: 9.4, h: 0.6,
    fontSize: 22, bold: true, color: GOLD, fontFace: "Calibri", margin: 0
  });
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.8, w: 9.2, h: 0.05, fill: { color: ACCENT } });

  const cols = [
    {
      title: "By Causative Agent",
      items: ["Aerobic (Staph., Strep., E.coli)", "Anaerobic (Cl. perfringens, Bacteroides)", "Mixed flora", "Specific: TB, Actinomycosis"]
    },
    {
      title: "By Clinical Course",
      items: ["Acute (rapid onset)", "Chronic (slow, persistent)", "Subacute (intermediate)"]
    },
    {
      title: "By Extent",
      items: ["Local (abscess, furuncle)", "Diffuse (phlegmon, cellulitis)", "Systemic (sepsis, SIRS/MODS)"]
    }
  ];

  cols.forEach((col, i) => {
    const x = 0.4 + i * 3.15;
    s.addShape(pres.ShapeType.rect, { x, y: 0.95, w: 2.95, h: 4.35, fill: { color: DARK_BG }, line: { color: ACCENT, width: 1.2 } });
    s.addShape(pres.ShapeType.rect, { x, y: 0.95, w: 2.95, h: 0.5, fill: { color: ACCENT } });
    s.addText(col.title, { x: x + 0.05, y: 0.97, w: 2.85, h: 0.46, fontSize: 12, bold: true, color: WHITE, fontFace: "Calibri", valign: "middle", align: "center", margin: 0 });
    const bullets = col.items.map((t, j) => ({ text: t, options: { bullet: { code: "25B6" }, color: j === 0 ? LIGHT : SUBTEXT, fontSize: 11, breakLine: true } }));
    s.addText(bullets, { x: x + 0.12, y: 1.55, w: 2.72, h: 3.6, fontFace: "Calibri", valign: "top" });
  });
}

// ─── SLIDE 3: Necrosis & Gangrene ─────────────────────────────
{
  const s = pres.addSlide();
  midBg(s);
  accentBar(s);

  s.addText("NECROSIS & GANGRENE", {
    x: 0.4, y: 0.15, w: 9.4, h: 0.6, fontSize: 22, bold: true, color: GOLD, fontFace: "Calibri", margin: 0
  });
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.8, w: 9.2, h: 0.05, fill: { color: ACCENT } });

  // Left box - Necrosis
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.95, w: 4.4, h: 4.4, fill: { color: DARK_BG }, line: { color: GOLD, width: 1 } });
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.95, w: 4.4, h: 0.48, fill: { color: GOLD } });
  s.addText("NECROSIS", { x: 0.42, y: 0.97, w: 4.36, h: 0.44, fontSize: 13, bold: true, color: DARK_BG, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
  s.addText([
    { text: "Definition: ", options: { bold: true, color: GOLD } },
    { text: "Death of tissue in a living organism\n\n", options: { color: LIGHT } },
    { text: "Types: ", options: { bold: true, color: GOLD } },
    { text: "Coagulative · Liquefactive · Caseous · Fat · Fibrinoid\n\n", options: { color: LIGHT } },
    { text: "Causes: ", options: { bold: true, color: GOLD } },
    { text: "Ischaemia, infection, trauma, toxins, physical agents\n\n", options: { color: LIGHT } },
    { text: "Treatment: ", options: { bold: true, color: GOLD } },
    { text: "Debridement / surgical excision of devitalised tissue; address underlying cause", options: { color: SUBTEXT } }
  ], { x: 0.55, y: 1.52, w: 4.1, h: 3.7, fontSize: 11.5, fontFace: "Calibri", valign: "top" });

  // Right box - Gangrene
  s.addShape(pres.ShapeType.rect, { x: 5.2, y: 0.95, w: 4.4, h: 4.4, fill: { color: DARK_BG }, line: { color: ACCENT, width: 1 } });
  s.addShape(pres.ShapeType.rect, { x: 5.2, y: 0.95, w: 4.4, h: 0.48, fill: { color: ACCENT } });
  s.addText("GANGRENE", { x: 5.22, y: 0.97, w: 4.36, h: 0.44, fontSize: 13, bold: true, color: WHITE, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
  s.addText([
    { text: "Dry Gangrene: ", options: { bold: true, color: GOLD } },
    { text: "Arterial occlusion → mummification; no bacteria; clear demarcation\n\n", options: { color: LIGHT } },
    { text: "Wet Gangrene: ", options: { bold: true, color: GOLD } },
    { text: "Venous obstruction + infection; oedematous, foul-smelling; spreads rapidly\n\n", options: { color: LIGHT } },
    { text: "Gas Gangrene: ", options: { bold: true, color: GOLD } },
    { text: "Clostridium perfringens; gas in tissue (crepitus); life-threatening\n\n", options: { color: LIGHT } },
    { text: "Treatment: ", options: { bold: true, color: GOLD } },
    { text: "Amputation/debridement, IV antibiotics, HBO therapy (gas gangrene)", options: { color: SUBTEXT } }
  ], { x: 5.35, y: 1.52, w: 4.1, h: 3.7, fontSize: 11.5, fontFace: "Calibri", valign: "top" });
}

// ─── SLIDE 4: Trophic Ulcer & Fistula ─────────────────────────
{
  const s = pres.addSlide();
  midBg(s);
  accentBar(s);

  s.addText("TROPHIC ULCER & FISTULA", {
    x: 0.4, y: 0.15, w: 9.4, h: 0.6, fontSize: 22, bold: true, color: GOLD, fontFace: "Calibri", margin: 0
  });
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.8, w: 9.2, h: 0.05, fill: { color: ACCENT } });

  // Trophic Ulcer
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.95, w: 4.4, h: 4.4, fill: { color: DARK_BG }, line: { color: GOLD, width: 1 } });
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.95, w: 4.4, h: 0.48, fill: { color: GOLD } });
  s.addText("TROPHIC ULCER", { x: 0.42, y: 0.97, w: 4.36, h: 0.44, fontSize: 13, bold: true, color: DARK_BG, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
  s.addText([
    { text: "Definition: ", options: { bold: true, color: GOLD } },
    { text: "Chronic ulcer from impaired tissue nutrition/innervation\n\n", options: { color: LIGHT } },
    { text: "Causes: ", options: { bold: true, color: GOLD } },
    { text: "Venous insufficiency, arterial disease, diabetes, neuropathy, pressure\n\n", options: { color: LIGHT } },
    { text: "Features: ", options: { bold: true, color: GOLD } },
    { text: "Indolent, punched-out edges, poor granulation tissue, often painless\n\n", options: { color: LIGHT } },
    { text: "Treatment: ", options: { bold: true, color: GOLD } },
    { text: "Treat cause · Wound debridement · Compression therapy · Skin grafting · Antibiotics if infected", options: { color: SUBTEXT } }
  ], { x: 0.55, y: 1.52, w: 4.1, h: 3.7, fontSize: 11.5, fontFace: "Calibri", valign: "top" });

  // Fistula
  s.addShape(pres.ShapeType.rect, { x: 5.2, y: 0.95, w: 4.4, h: 4.4, fill: { color: DARK_BG }, line: { color: ACCENT, width: 1 } });
  s.addShape(pres.ShapeType.rect, { x: 5.2, y: 0.95, w: 4.4, h: 0.48, fill: { color: ACCENT } });
  s.addText("FISTULA", { x: 5.22, y: 0.97, w: 4.36, h: 0.44, fontSize: 13, bold: true, color: WHITE, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
  s.addText([
    { text: "Definition: ", options: { bold: true, color: GOLD } },
    { text: "Abnormal communication between two epithelial surfaces\n\n", options: { color: LIGHT } },
    { text: "Types: ", options: { bold: true, color: GOLD } },
    { text: "Internal · External · Complete · Incomplete\n\n", options: { color: LIGHT } },
    { text: "Causes: ", options: { bold: true, color: GOLD } },
    { text: "Crohn's disease, infection, radiation, malignancy, foreign body, post-op leak\n\n", options: { color: LIGHT } },
    { text: "Memory: FRIEND: ", options: { bold: true, color: GOLD } },
    { text: "Foreign body · Radiation · Infection · Epithelialisation · Neoplasm · Distal obstruction\n\n", options: { color: LIGHT } },
    { text: "Treatment: ", options: { bold: true, color: GOLD } },
    { text: "Conservative (NBM, TPN, octreotide) or surgical resection/repair", options: { color: SUBTEXT } }
  ], { x: 5.35, y: 1.52, w: 4.1, h: 3.7, fontSize: 11.5, fontFace: "Calibri", valign: "top" });
}

// ─── SLIDE 5: General Reaction to Infection ───────────────────
{
  const s = pres.addSlide();
  midBg(s);
  accentBar(s);

  s.addText("GENERAL REACTION TO INFECTION", {
    x: 0.4, y: 0.15, w: 9.4, h: 0.6, fontSize: 22, bold: true, color: GOLD, fontFace: "Calibri", margin: 0
  });
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.8, w: 9.2, h: 0.05, fill: { color: ACCENT } });

  const stages = [
    { label: "Local Response", desc: "Calor · Rubor · Dolor · Tumor · Functio laesa (Celsus signs)\nVasodilation, increased permeability, neutrophil migration" },
    { label: "SIRS", desc: "Systemic Inflammatory Response Syndrome\nTemp >38°C or <36°C · HR >90 · RR >20 · WBC >12,000 or <4,000" },
    { label: "Sepsis", desc: "SIRS + confirmed/suspected infection source\nOrgan dysfunction: lactate >2, altered consciousness, oliguria" },
    { label: "Septic Shock", desc: "Sepsis + refractory hypotension (MAP <65 mmHg) despite fluids\nVasopressors required; mortality >40%" },
    { label: "MODS", desc: "Multiple Organ Dysfunction Syndrome — end-stage\nLiver, kidney, lung, coagulation, CNS failure" }
  ];

  stages.forEach((st, i) => {
    const x = 0.35 + i * 1.87;
    const isRed = i >= 3;
    s.addShape(pres.ShapeType.rect, { x, y: 0.95, w: 1.72, h: 4.4, fill: { color: DARK_BG }, line: { color: isRed ? ACCENT : GOLD, width: 1.2 } });
    s.addShape(pres.ShapeType.rect, { x, y: 0.95, w: 1.72, h: 0.55, fill: { color: isRed ? ACCENT : GOLD } });
    s.addText(st.label, { x: x + 0.04, y: 0.97, w: 1.64, h: 0.51, fontSize: 10.5, bold: true, color: isRed ? WHITE : DARK_BG, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
    s.addText(st.desc, { x: x + 0.08, y: 1.58, w: 1.56, h: 3.6, fontSize: 10, color: LIGHT, fontFace: "Calibri", valign: "top" });
  });
}

// ─── SLIDE 6: Principles of Treatment ────────────────────────
{
  const s = pres.addSlide();
  midBg(s);
  accentBar(s);

  s.addText("GENERAL PRINCIPLES OF TREATMENT", {
    x: 0.4, y: 0.15, w: 9.4, h: 0.6, fontSize: 22, bold: true, color: GOLD, fontFace: "Calibri", margin: 0
  });
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.8, w: 9.2, h: 0.05, fill: { color: ACCENT } });

  const principles = [
    { num: "01", title: "Drainage", body: "Incision & drainage of all pus collections (ubi pus, ibi evacua)\nIrrigationof cavity; leave drain in situ" },
    { num: "02", title: "Debridement", body: "Excise all necrotic and devitalised tissue\nRepeat if necessary (\"second-look\" surgery)" },
    { num: "03", title: "Antibiotics", body: "Empirical then culture-directed\nIV for systemic infection; topical for superficial; duration by response" },
    { num: "04", title: "Supportive Care", body: "Fluid resuscitation · Analgesia · Nutrition (enteral preferred)\nControl blood glucose · Treat comorbidities" },
    { num: "05", title: "Source Control", body: "Identify and eliminate infectious source\nClose bowel perforation, remove infected prosthesis/foreign body" },
    { num: "06", title: "Wound Management", body: "VAC therapy / negative pressure wound therapy\nDelayed primary or secondary closure once infection resolves" }
  ];

  principles.forEach((p, i) => {
    const row = Math.floor(i / 3);
    const col = i % 3;
    const x = 0.38 + col * 3.1;
    const y = 0.95 + row * 2.3;
    s.addShape(pres.ShapeType.rect, { x, y, w: 2.9, h: 2.1, fill: { color: DARK_BG }, line: { color: ACCENT, width: 1 } });
    s.addShape(pres.ShapeType.rect, { x, y, w: 0.52, h: 2.1, fill: { color: ACCENT } });
    s.addText(p.num, { x: x + 0.04, y: y + 0.6, w: 0.44, h: 0.9, fontSize: 16, bold: true, color: WHITE, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
    s.addText(p.title, { x: x + 0.6, y: y + 0.05, w: 2.22, h: 0.4, fontSize: 12, bold: true, color: GOLD, fontFace: "Calibri", margin: 0 });
    s.addShape(pres.ShapeType.rect, { x: x + 0.6, y: y + 0.46, w: 2.22, h: 0.04, fill: { color: ACCENT } });
    s.addText(p.body, { x: x + 0.6, y: y + 0.54, w: 2.22, h: 1.48, fontSize: 10, color: LIGHT, fontFace: "Calibri", valign: "top" });
  });
}

// ─── SLIDE 7: Furuncle, Carbuncle & Hidradenitis ──────────────
{
  const s = pres.addSlide();
  midBg(s);
  accentBar(s);

  s.addText("FURUNCLE · CARBUNCLE · HIDRADENITIS", {
    x: 0.4, y: 0.15, w: 9.4, h: 0.6, fontSize: 22, bold: true, color: GOLD, fontFace: "Calibri", margin: 0
  });
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.8, w: 9.2, h: 0.05, fill: { color: ACCENT } });

  const items = [
    {
      title: "FURUNCLE (Boil)",
      color: ACCENT,
      points: [
        "Acute suppurative infection of hair follicle & surrounding tissue",
        "Organism: Staphylococcus aureus",
        "Site: neck, face, axilla, buttocks",
        "Rx: warm compresses; I&D when fluctuant; oral flucloxacillin"
      ]
    },
    {
      title: "CARBUNCLE",
      color: GOLD,
      points: [
        "Multiple furuncles coalescing with multiple sinus tracts",
        "Common in diabetics and immunocompromised patients",
        "Site: back of neck (nape), back",
        "Rx: wide surgical excision + IV antibiotics; glycaemic control"
      ]
    },
    {
      title: "HIDRADENITIS SUPPURATIVA",
      color: "3A86FF",
      points: [
        "Chronic recurrent abscess of apocrine sweat glands",
        "Site: axilla, groin, perineum",
        "Hurley staging I-III (mild to severe)",
        "Rx: antibiotics, anti-androgens, biologics (adalimumab); surgical excision for Hurley III"
      ]
    }
  ];

  items.forEach((item, i) => {
    const x = 0.4 + i * 3.15;
    s.addShape(pres.ShapeType.rect, { x, y: 0.95, w: 2.95, h: 4.4, fill: { color: DARK_BG }, line: { color: item.color, width: 1.2 } });
    s.addShape(pres.ShapeType.rect, { x, y: 0.95, w: 2.95, h: 0.5, fill: { color: item.color } });
    const titleColor = item.color === GOLD ? DARK_BG : WHITE;
    s.addText(item.title, { x: x + 0.05, y: 0.97, w: 2.85, h: 0.46, fontSize: 11, bold: true, color: titleColor, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
    const bullets = item.points.map((pt, j) => ({
      text: pt,
      options: { bullet: { code: "25CF" }, color: j === 0 ? LIGHT : SUBTEXT, fontSize: 10.5, breakLine: true, paraSpaceAfter: 6 }
    }));
    s.addText(bullets, { x: x + 0.1, y: 1.54, w: 2.75, h: 3.7, fontFace: "Calibri", valign: "top" });
  });
}

// ─── SLIDE 8: Abscess & Phlegmon ──────────────────────────────
{
  const s = pres.addSlide();
  midBg(s);
  accentBar(s);

  s.addText("ABSCESS & PHLEGMON (CELLULITIS)", {
    x: 0.4, y: 0.15, w: 9.4, h: 0.6, fontSize: 22, bold: true, color: GOLD, fontFace: "Calibri", margin: 0
  });
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.8, w: 9.2, h: 0.05, fill: { color: ACCENT } });

  // Abscess
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.95, w: 4.4, h: 4.4, fill: { color: DARK_BG }, line: { color: ACCENT, width: 1.2 } });
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.95, w: 4.4, h: 0.48, fill: { color: ACCENT } });
  s.addText("ABSCESS", { x: 0.42, y: 0.97, w: 4.36, h: 0.44, fontSize: 13, bold: true, color: WHITE, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
  s.addText([
    { text: "Localised collection of pus surrounded by a pyogenic membrane (fibrous capsule)\n\n", options: { color: LIGHT } },
    { text: "Celsus Signs: ", options: { bold: true, color: GOLD } },
    { text: "Heat, Redness, Pain, Swelling + Loss of function\n\n", options: { color: LIGHT } },
    { text: "Organisms: ", options: { bold: true, color: GOLD } },
    { text: "S. aureus (most common), Streptococcus, E. coli, anaerobes\n\n", options: { color: LIGHT } },
    { text: "Signs of pointing: ", options: { bold: true, color: GOLD } },
    { text: "Fluctuation, oedema, skin thinning\n\n", options: { color: LIGHT } },
    { text: "Treatment: ", options: { bold: true, color: GOLD } },
    { text: "Incision & drainage + cavity irrigation; antibiotics; culture pus", options: { color: SUBTEXT } }
  ], { x: 0.55, y: 1.52, w: 4.1, h: 3.7, fontSize: 11, fontFace: "Calibri", valign: "top" });

  // Phlegmon
  s.addShape(pres.ShapeType.rect, { x: 5.2, y: 0.95, w: 4.4, h: 4.4, fill: { color: DARK_BG }, line: { color: GOLD, width: 1.2 } });
  s.addShape(pres.ShapeType.rect, { x: 5.2, y: 0.95, w: 4.4, h: 0.48, fill: { color: GOLD } });
  s.addText("PHLEGMON (Diffuse Cellulitis)", { x: 5.22, y: 0.97, w: 4.36, h: 0.44, fontSize: 12, bold: true, color: DARK_BG, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
  s.addText([
    { text: "Diffuse non-localised acute purulent inflammation spreading through soft tissue\n\n", options: { color: LIGHT } },
    { text: "Spreads along fascial planes, fat, muscle, connective tissue — NO wall\n\n", options: { color: LIGHT } },
    { text: "Organisms: ", options: { bold: true, color: GOLD } },
    { text: "Streptococcus pyogenes (most), mixed anaerobes\n\n", options: { color: LIGHT } },
    { text: "Features: ", options: { bold: true, color: GOLD } },
    { text: "Diffuse brawny induration, no fluctuation, rapidly expanding, high fever, toxaemia\n\n", options: { color: LIGHT } },
    { text: "Treatment: ", options: { bold: true, color: GOLD } },
    { text: "IV antibiotics (penicillin + metronidazole); surgical debridement for necrotising forms; elevation", options: { color: SUBTEXT } }
  ], { x: 5.35, y: 1.52, w: 4.1, h: 3.7, fontSize: 11, fontFace: "Calibri", valign: "top" });
}

// ─── SLIDE 9: Purulent Diseases of Fingers, Mastitis, Paraproctitis ─────────
{
  const s = pres.addSlide();
  midBg(s);
  accentBar(s);

  s.addText("FINGER INFECTIONS · MASTITIS · PARAPROCTITIS", {
    x: 0.4, y: 0.15, w: 9.4, h: 0.6, fontSize: 20, bold: true, color: GOLD, fontFace: "Calibri", margin: 0
  });
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.8, w: 9.2, h: 0.05, fill: { color: ACCENT } });

  const boxes = [
    {
      title: "PURULENT FINGER DISEASES",
      color: ACCENT,
      content: [
        { h: "Paronychia", b: "Infection of nail fold; drain lateral incision" },
        { h: "Felon (Pulp space)", b: "Tense, exquisitely painful fingertip; emergency I&D through lateral incision" },
        { h: "Tendon sheath (Tenosynovitis)", b: "Kanavel's 4 signs: uniform swelling, flexed posture, tenderness over sheath, pain on passive extension; surgical drainage" },
        { h: "Web space / palmar space", b: "Collar-stud abscess; dorsal + palmar incisions" }
      ]
    },
    {
      title: "MASTITIS",
      color: GOLD,
      content: [
        { h: "Lactational mastitis", b: "Puerperal: S. aureus from infant's mouth via cracked nipple; cellulitis stage → abscess" },
        { h: "Treatment", b: "Antibiotics (flucloxacillin); continue breastfeeding; I&D for abscess; needle aspiration under USS" },
        { h: "Non-lactational", b: "Periductal mastitis, fat necrosis; treat underlying cause" }
      ]
    },
    {
      title: "PARAPROCTITIS",
      color: "3A86FF",
      content: [
        { h: "Definition", b: "Acute abscess in perirectal fatty tissue; associated with anal glands" },
        { h: "Classification", b: "Perianal (subcutaneous) · Ischiorectal · Pelvirectal · Submucous" },
        { h: "Organisms", b: "E. coli, Bacteroides, Streptococcus (mixed flora)" },
        { h: "Treatment", b: "Urgent I&D under GA; fistula in ano develops in 40% → fistulotomy" }
      ]
    }
  ];

  boxes.forEach((box, i) => {
    const x = 0.38 + i * 3.12;
    s.addShape(pres.ShapeType.rect, { x, y: 0.95, w: 2.95, h: 4.4, fill: { color: DARK_BG }, line: { color: box.color, width: 1.2 } });
    s.addShape(pres.ShapeType.rect, { x, y: 0.95, w: 2.95, h: 0.5, fill: { color: box.color } });
    const tc = box.color === GOLD ? DARK_BG : WHITE;
    s.addText(box.title, { x: x + 0.04, y: 0.97, w: 2.87, h: 0.46, fontSize: 10.5, bold: true, color: tc, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
    const richText = [];
    box.content.forEach((item, j) => {
      richText.push({ text: item.h + ": ", options: { bold: true, color: GOLD, fontSize: 10.5 } });
      richText.push({ text: item.b + (j < box.content.length - 1 ? "\n\n" : ""), options: { color: LIGHT, fontSize: 10.5 } });
    });
    s.addText(richText, { x: x + 0.1, y: 1.55, w: 2.75, h: 3.7, fontFace: "Calibri", valign: "top" });
  });
}

// ─── SLIDE 10: Osteomyelitis ──────────────────────────────────
{
  const s = pres.addSlide();
  midBg(s);
  accentBar(s);

  s.addText("OSTEOMYELITIS", {
    x: 0.4, y: 0.15, w: 9.4, h: 0.6, fontSize: 24, bold: true, color: GOLD, fontFace: "Calibri", margin: 0
  });
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.8, w: 9.2, h: 0.05, fill: { color: ACCENT } });

  // Left col: definition + types
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.95, w: 4.5, h: 4.4, fill: { color: DARK_BG }, line: { color: GOLD, width: 1 } });
  s.addText([
    { text: "Definition\n", options: { bold: true, color: GOLD, fontSize: 12 } },
    { text: "Infection of bone and bone marrow, typically by bacteria\n\n", options: { color: LIGHT, fontSize: 11 } },
    { text: "Haematogenous (most common in children)\n", options: { bold: true, color: GOLD, fontSize: 11 } },
    { text: "S. aureus #1; metaphysis of long bones; boys 3-15 yrs\n\n", options: { color: LIGHT, fontSize: 11 } },
    { text: "Contiguous / Post-traumatic\n", options: { bold: true, color: GOLD, fontSize: 11 } },
    { text: "Direct inoculation from open fracture, surgery, diabetic foot\n\n", options: { color: LIGHT, fontSize: 11 } },
    { text: "Organisms\n", options: { bold: true, color: GOLD, fontSize: 11 } },
    { text: "S. aureus (all ages) · Salmonella (sickle cell) · GBS (neonates) · Pseudomonas (IV drug users)", options: { color: SUBTEXT, fontSize: 11 } }
  ], { x: 0.55, y: 1.05, w: 4.2, h: 4.2, fontFace: "Calibri", valign: "top" });

  // Right col: stages + Rx
  s.addShape(pres.ShapeType.rect, { x: 5.2, y: 0.95, w: 4.4, h: 4.4, fill: { color: DARK_BG }, line: { color: ACCENT, width: 1 } });
  s.addText([
    { text: "Acute Signs\n", options: { bold: true, color: ACCENT, fontSize: 12 } },
    { text: "Severe pain, localised tenderness, swelling, fever, raised ESR/CRP, WBC\n\n", options: { color: LIGHT, fontSize: 11 } },
    { text: "Imaging\n", options: { bold: true, color: GOLD, fontSize: 11 } },
    { text: "X-ray: normal first 10 days → periosteal reaction\nMRI: gold standard for early diagnosis\nTC-99 bone scan: highly sensitive\n\n", options: { color: LIGHT, fontSize: 11 } },
    { text: "Treatment\n", options: { bold: true, color: GOLD, fontSize: 11 } },
    { text: "IV antibiotics 4-6 weeks (flucloxacillin ± fusidic acid)\nSurgical: sequestrectomy, saucerisation, drainage of subperiosteal abscess\nChronic: Cierny-Mader classification guides debridement + dead space management", options: { color: SUBTEXT, fontSize: 11 } }
  ], { x: 5.35, y: 1.05, w: 4.1, h: 4.2, fontFace: "Calibri", valign: "top" });
}

// ─── SLIDE 11: Microbiology & Antibiotic Principles ──────────
{
  const s = pres.addSlide();
  midBg(s);
  accentBar(s);

  s.addText("KEY MICROBIOLOGY & ANTIBIOTIC PRINCIPLES", {
    x: 0.4, y: 0.15, w: 9.4, h: 0.6, fontSize: 20, bold: true, color: GOLD, fontFace: "Calibri", margin: 0
  });
  s.addShape(pres.ShapeType.rect, { x: 0.4, y: 0.8, w: 9.2, h: 0.05, fill: { color: ACCENT } });

  // Table header
  const headers = ["Organism", "Gram Stain", "Key Infections", "First-Line Antibiotic"];
  const colW = [2.0, 1.5, 3.2, 2.7];
  const startX = 0.35;
  let x = startX;
  headers.forEach((h, i) => {
    s.addShape(pres.ShapeType.rect, { x, y: 0.95, w: colW[i], h: 0.44, fill: { color: ACCENT } });
    s.addText(h, { x: x + 0.05, y: 0.97, w: colW[i] - 0.1, h: 0.4, fontSize: 11, bold: true, color: WHITE, fontFace: "Calibri", align: "center", valign: "middle", margin: 0 });
    x += colW[i];
  });

  const rows = [
    ["S. aureus", "+ve (clusters)", "Abscess, osteomyelitis, mastitis, furuncle", "Flucloxacillin / Vancomycin (MRSA)"],
    ["S. pyogenes", "+ve (chains)", "Cellulitis, phlegmon, necrotising fasciitis", "Penicillin G / Amoxicillin"],
    ["E. coli", "-ve (rod)", "Paraproctitis, intra-abdominal, UTI", "Ciprofloxacin / Pip-taz"],
    ["C. perfringens", "+ve (rod)", "Gas gangrene, clostridial myonecrosis", "Penicillin G + Metronidazole"],
    ["Bacteroides", "-ve (anaerobe)", "Intra-abdominal, perirectal abscess", "Metronidazole / Clindamycin"],
    ["Pseudomonas", "-ve (rod)", "Burn wounds, diabetic foot, IV drug use", "Piperacillin-tazobactam"]
  ];

  rows.forEach((row, ri) => {
    x = startX;
    const bg = ri % 2 === 0 ? DARK_BG : MID_BG;
    row.forEach((cell, ci) => {
      s.addShape(pres.ShapeType.rect, { x, y: 1.44 + ri * 0.65, w: colW[ci], h: 0.62, fill: { color: bg } });
      s.addText(cell, { x: x + 0.05, y: 1.46 + ri * 0.65, w: colW[ci] - 0.1, h: 0.58, fontSize: 10, color: ci === 0 ? GOLD : LIGHT, fontFace: "Calibri", valign: "middle", margin: 0 });
      x += colW[ci];
    });
  });
}

// ─── SLIDE 12: Summary / Key Takeaways ────────────────────────
{
  const s = pres.addSlide();
  darkBg(s);
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.12, fill: { color: ACCENT } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 5.5, w: 10, h: 0.125, fill: { color: GOLD } });

  s.addText("KEY TAKEAWAYS", {
    x: 0.5, y: 0.25, w: 9, h: 0.65, fontSize: 28, bold: true, color: GOLD, fontFace: "Calibri", align: "center", charSpacing: 3
  });
  s.addShape(pres.ShapeType.rect, { x: 2.0, y: 0.95, w: 6, h: 0.06, fill: { color: ACCENT } });

  const takeaways = [
    { icon: "01", text: "Pus must always be drained — \"Ubi pus, ibi evacua\" (where there is pus, drain it)" },
    { icon: "02", text: "Classification: aerobic vs anaerobic, acute vs chronic, local vs systemic (sepsis → MODS)" },
    { icon: "03", text: "Gangrene = tissue death; Gas gangrene (Clostridium) is a surgical emergency requiring immediate debridement + HBO" },
    { icon: "04", text: "Abscess = walled collection → I&D; Phlegmon = diffuse spread → systemic antibiotics + debridement" },
    { icon: "05", text: "Haematogenous osteomyelitis: S. aureus, metaphysis of long bones, children; MRI is gold standard" },
    { icon: "06", text: "Tendon sheath infection = surgical emergency (Kanavel's signs); paraproctitis → fistula in ~40%" }
  ];

  takeaways.forEach((t, i) => {
    const row = Math.floor(i / 2);
    const col = i % 2;
    const x = 0.4 + col * 4.85;
    const y = 1.12 + row * 1.35;
    s.addShape(pres.ShapeType.rect, { x, y, w: 4.55, h: 1.2, fill: { color: MID_BG }, line: { color: ACCENT, width: 0.8 } });
    s.addShape(pres.ShapeType.rect, { x, y, w: 0.48, h: 1.2, fill: { color: ACCENT } });
    s.addText(t.icon, { x: x + 0.04, y: y + 0.3, w: 0.4, h: 0.6, fontSize: 14, bold: true, color: WHITE, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
    s.addText(t.text, { x: x + 0.58, y: y + 0.08, w: 3.88, h: 1.04, fontSize: 10.5, color: LIGHT, fontFace: "Calibri", valign: "middle" });
  });
}

// ─── SAVE ──────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/surgical-infection-pptx/Surgical_Infection.pptx" })
  .then(() => console.log("DONE: Surgical_Infection.pptx saved."))
  .catch(err => { console.error(err); process.exit(1); });

cd /home/daytona/workspace/surgical-infection-pptx && node build.js 2>&1

ls -lh /home/daytona/workspace/surgical-infection-pptx/Surgical_Infection.pptx