Make presentation on hepatitis for pharmacy students divide topic into five students
Checking Date & Time
Reading File
Reading File
Reading File
Finding Sources
Finding Sources
Finding Sources
Finding Sources
Finding Sources
Finding Sources
Reading File
Finding Sources
Searching Images
hepatitis virus types comparison table
Reading File
Searching Images
hepatitis B serology markers diagnosis
Searching Images
hepatitis C direct acting antiviral treatment sofosbuvir
Searching Images
hepatitis A vaccine hepatitis B vaccine schedule
Running Command
ls -la /home/daytona/workspace/ && mkdir -p /home/daytona/workspace/hepatitis-pptx
Writing File
~/hepatitis-pptx/build.js
const pptxgen = require("pptxgenjs");
const { execSync } = require("child_process");
// ─── Fetch images ────────────────────────────────────────────────────────────
const imageUrls = [
"https://cdn.orris.care/cdss_images/HARRISON_1763033912702_6c8b3aeb-d09d-4456-9e4a-51e468791295.png", // HAV-HEV nomenclature table
"https://cdn.orris.care/cdss_images/HARRISON_1763031941963_b8714721-0c5c-4031-a531-da171f3c8e24.png", // chronic HBV serology timeline
"https://cdn.orris.care/cdss_images/GLGCA_41753_1766502006027_6fb9687b-4165-46fa-a1ed-7ae80b6c4566_21bf0166-de59-45a3-9836-5b11d5412c80.png", // HBV/HDV lab diagnosis table
"https://cdn.orris.care/cdss_images/GLGCA_25111_1766507250153_31c81149-4a38-4e6a-b6cf-03ba3e4a07f8_9859b8d5-ed1c-4ff6-a126-066bcccaf791.png", // HCV DAA lifecycle (try)
"https://cdn.orris.care/cdss_images/GLGCA_2232415_1763366073233_eb427168-5573-434d-9914-2a97b7413bae.png", // HCV lifecycle & DAA targets
"https://cdn.orris.care/cdss_images/GLGCA_4779637_1766686947536_b2bfdfdc-a8c3-49f6-b774-cb9299224a8f_a4791fd6-8d67-4a9b-afc8-071fa27ef5b8.png", // HAV vaccine table
];
console.log("Fetching images...");
let images = [];
try {
const result = execSync(
`node /home/daytona/skills/shared/scripts/fetch_images.js ${imageUrls.map(u => `"${u}"`).join(" ")}`,
{ timeout: 60000 }
).toString();
images = JSON.parse(result);
console.log("Images fetched:", images.map((img, i) => `${i}: ${img.error ? "ERROR: " + img.error : "OK"}`).join(", "));
} catch (e) {
console.error("Image fetch error:", e.message);
images = imageUrls.map(() => ({ base64: null, error: "fetch failed" }));
}
// ─── Color palette ───────────────────────────────────────────────────────────
const C = {
navy: "0D2B55", // deep navy (dominant bg)
teal: "0E7C7B", // teal accent (section headers)
gold: "F4A11D", // gold accent (highlights / student labels)
white: "FFFFFF",
offWhite:"EEF2F7",
lightBg: "1A3A6B", // slightly lighter navy for card bg
subtleGray: "A8B8CC",
darkText: "0D1F3C",
red: "D94F3D",
green: "2EAF6C",
};
// ─── Helpers ─────────────────────────────────────────────────────────────────
function addSlide(pres, bgColor) {
const sld = pres.addSlide();
sld.background = { color: bgColor || C.navy };
return sld;
}
function sectionBanner(sld, studentNum, studentLabel, topic) {
// Top banner stripe
sld.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.33, h: 0.55, fill: { color: C.teal } });
sld.addText(`STUDENT ${studentNum} · ${studentLabel}`, {
x: 0.3, y: 0, w: 9, h: 0.55,
fontSize: 11, bold: true, color: C.white, valign: "middle", margin: 0
});
sld.addText(`HEPATITIS · PHARMACY`, {
x: 9.5, y: 0, w: 3.5, h: 0.55,
fontSize: 9, color: C.offWhite, align: "right", valign: "middle", margin: 0
});
}
function slideTitle(sld, title, subtitle, yTitle) {
yTitle = yTitle || 0.7;
sld.addText(title, {
x: 0.4, y: yTitle, w: 12.5, h: 0.65,
fontSize: 26, bold: true, color: C.gold, fontFace: "Calibri"
});
if (subtitle) {
sld.addText(subtitle, {
x: 0.4, y: yTitle + 0.65, w: 12.5, h: 0.38,
fontSize: 13, color: C.subtleGray, italic: true
});
}
}
function bulletBox(sld, bullets, x, y, w, h, opts) {
opts = opts || {};
const items = bullets.map((b, i) => {
if (typeof b === "object" && b.sub) {
return [
{ text: b.head, options: { bullet: { indent: 15 }, bold: true, color: C.gold, fontSize: opts.fontSize || 13, breakLine: false } },
{ text: " — " + b.sub, options: { bold: false, color: C.offWhite, fontSize: opts.fontSize || 13, breakLine: true } }
];
}
return { text: b, options: { bullet: { indent: 15 }, color: C.offWhite, fontSize: opts.fontSize || 13, breakLine: i < bullets.length - 1 } };
}).flat();
sld.addText(items, { x, y, w, h, valign: "top", lineSpacingMultiple: 1.25, ...opts });
}
function divider(sld, y) {
sld.addShape(pres.ShapeType.line, {
x: 0.4, y, w: 12.5, h: 0,
line: { color: C.teal, width: 1.2, dashType: "solid" }
});
}
// ─── Init ─────────────────────────────────────────────────────────────────────
const pres = new pptxgen();
pres.layout = "LAYOUT_WIDE"; // 13.33" × 7.5"
pres.title = "Hepatitis — Pharmacy Students Presentation";
pres.author = "Orris Medical AI";
// ════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE SLIDE
// ════════════════════════════════════════════════════════════
{
const sld = addSlide(pres, C.navy);
// decorative vertical stripe
sld.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.18, h: 7.5, fill: { color: C.teal } });
sld.addShape(pres.ShapeType.rect, { x: 0.18, y: 0, w: 0.08, h: 7.5, fill: { color: C.gold } });
sld.addText("HEPATITIS", {
x: 0.6, y: 1.2, w: 12, h: 1.6,
fontSize: 72, bold: true, color: C.white, fontFace: "Calibri", charSpacing: 8
});
sld.addText("A Comprehensive Pharmacy Review", {
x: 0.6, y: 2.85, w: 10, h: 0.6,
fontSize: 22, color: C.gold, italic: true
});
// 5 student badges
const students = [
{ n: "1", label: "Overview & Epidemiology" },
{ n: "2", label: "Pathophysiology" },
{ n: "3", label: "Diagnosis & Serology" },
{ n: "4", label: "Pharmacotherapy" },
{ n: "5", label: "Prevention & Vaccination" },
];
students.forEach((s, i) => {
const bx = 0.6 + i * 2.5;
sld.addShape(pres.ShapeType.roundRect, { x: bx, y: 3.7, w: 2.3, h: 1.1, rectRadius: 0.12, fill: { color: C.lightBg }, line: { color: C.teal, width: 1.5 } });
sld.addText(`Student ${s.n}`, { x: bx, y: 3.72, w: 2.3, h: 0.38, fontSize: 10, bold: true, color: C.gold, align: "center" });
sld.addText(s.label, { x: bx + 0.08, y: 4.08, w: 2.14, h: 0.6, fontSize: 9.5, color: C.offWhite, align: "center" });
});
sld.addText("Pharmacy Students Group Presentation · April 2026", {
x: 0.6, y: 5.1, w: 10, h: 0.35,
fontSize: 11, color: C.subtleGray
});
sld.addText("Sources: Harrison's, Goldman-Cecil, Robbins Pathology, Sleisenger & Fordtran, Red Book 2021", {
x: 0.6, y: 6.95, w: 12, h: 0.35,
fontSize: 8.5, color: C.subtleGray, italic: true
});
}
// ════════════════════════════════════════════════════════════
// STUDENT 1 — OVERVIEW & EPIDEMIOLOGY
// ════════════════════════════════════════════════════════════
// Slide 2 — Types of Hepatitis Viruses
{
const sld = addSlide(pres);
sectionBanner(sld, 1, "Overview & Epidemiology", "Types of Hepatitis Viruses");
slideTitle(sld, "Types of Hepatitis Viruses", "Five major viruses — distinct genomes, transmission routes & risks");
bulletBox(sld, [
{ head: "Hepatitis A (HAV)", sub: "ssRNA picornavirus · fecal-oral · self-limiting acute disease" },
{ head: "Hepatitis B (HBV)", sub: "dsDNA hepadnavirus · parenteral/sexual/perinatal · can become chronic" },
{ head: "Hepatitis C (HCV)", sub: "ssRNA flavivirus · blood-borne · 70–85% progress to chronic" },
{ head: "Hepatitis D (HDV)", sub: "RNA deltavirus · requires HBV coinfection · worsens HBV severity" },
{ head: "Hepatitis E (HEV)", sub: "ssRNA hepevirus · fecal-oral · high mortality in pregnancy (20%)" },
], 0.4, 1.7, 7.2, 4.8, { fontSize: 13.5 });
// image — Harrison's nomenclature table
if (images[0] && !images[0].error) {
sld.addImage({ data: images[0].base64, x: 7.8, y: 1.5, w: 5.2, h: 3.0 });
sld.addText("Harrison's Principles of Internal Medicine 22E · Table 339-1", {
x: 7.8, y: 4.55, w: 5.2, h: 0.28, fontSize: 7.5, color: C.subtleGray, italic: true, align: "center"
});
}
}
// Slide 3 — Global Epidemiology
{
const sld = addSlide(pres);
sectionBanner(sld, 1, "Overview & Epidemiology", "Global Burden of Hepatitis");
slideTitle(sld, "Global Epidemiology", "Hepatitis remains a leading cause of liver-related mortality worldwide");
// Stat cards
const stats = [
{ val: "354 M", lbl: "Chronic HBV + HCV infections globally (WHO)" },
{ val: "~1.4M", lbl: "Deaths/year from viral hepatitis" },
{ val: "90%", lbl: "of infants exposed to HBV at birth develop chronic infection (without vaccination)" },
{ val: "70–85%", lbl: "of acute HCV infections become chronic" },
{ val: "20%", lbl: "Mortality rate of HEV in pregnant women" },
];
stats.forEach((s, i) => {
const rx = (i % 3) * 4.2 + 0.4;
const ry = 1.8 + Math.floor(i / 3) * 2.1;
sld.addShape(pres.ShapeType.roundRect, { x: rx, y: ry, w: 3.9, h: 1.85, rectRadius: 0.14, fill: { color: C.lightBg }, line: { color: C.teal, width: 1.2 } });
sld.addText(s.val, { x: rx, y: ry + 0.08, w: 3.9, h: 0.75, fontSize: 30, bold: true, color: C.gold, align: "center" });
sld.addText(s.lbl, { x: rx + 0.1, y: ry + 0.82, w: 3.7, h: 0.9, fontSize: 10.5, color: C.offWhite, align: "center" });
});
sld.addText("Sources: WHO Global Hepatitis Report · Goldman-Cecil Medicine · Harrison's 22E", {
x: 0.4, y: 6.9, w: 12.5, h: 0.3, fontSize: 8, color: C.subtleGray, italic: true
});
}
// Slide 4 — Transmission Routes
{
const sld = addSlide(pres);
sectionBanner(sld, 1, "Overview & Epidemiology", "Transmission Routes");
slideTitle(sld, "Transmission Routes", "Understanding spread is key to prevention counselling");
divider(sld, 1.5);
// Two columns
bulletBox(sld, [
"🦠 HAV & HEV",
"→ Contaminated food/water",
"→ Poor sanitation & hygiene",
"→ Travel to endemic regions",
"→ Close household contact",
"",
"🩸 HBV, HCV & HDV",
"→ Contaminated blood/needles",
"→ Sexual contact (especially HBV)",
"→ Perinatal (mother-to-child)",
"→ Tattooing / unscreened blood products",
], 0.4, 1.6, 5.6, 4.9, { fontSize: 12.5 });
// Risk factors box
sld.addShape(pres.ShapeType.roundRect, { x: 6.5, y: 1.6, w: 6.5, h: 4.8, rectRadius: 0.14, fill: { color: C.lightBg }, line: { color: C.gold, width: 1.5 } });
sld.addText("High-Risk Groups for Pharmacy Counselling", {
x: 6.5, y: 1.65, w: 6.5, h: 0.5, fontSize: 13, bold: true, color: C.gold, align: "center"
});
divider(sld, 2.22);
bulletBox(sld, [
"Injection drug users (HBV, HCV, HDV)",
"Healthcare workers — needlestick exposure",
"Travellers to endemic regions (HAV, HEV)",
"Pregnant women — risk of vertical HBV/HCV",
"Patients on haemodialysis (HCV)",
"Men who have sex with men (HAV, HBV)",
"Immunocompromised patients (all types)",
], 6.7, 2.28, 6.1, 4.0, { fontSize: 12 });
}
// ════════════════════════════════════════════════════════════
// STUDENT 2 — PATHOPHYSIOLOGY
// ════════════════════════════════════════════════════════════
// Slide 5 — Liver Injury Mechanisms
{
const sld = addSlide(pres);
sectionBanner(sld, 2, "Pathophysiology", "Mechanisms of Hepatic Injury");
slideTitle(sld, "Mechanisms of Hepatic Injury", "Immune-mediated damage is the hallmark of viral hepatitis");
bulletBox(sld, [
{ head: "Direct cytopathic effect", sub: "HCV, HEV can directly damage hepatocytes" },
{ head: "CD8+ T-cell mediated killing", sub: "Primary mechanism in HBV; T-cells destroy infected hepatocytes presenting viral antigens (HBcAg, HBsAg)" },
{ head: "Cytokine storm", sub: "TNF-α, IFN-γ, IL-2 — amplify inflammation, cause bystander injury" },
{ head: "Interface hepatitis", sub: "Lymphocytic infiltration at the portal-parenchymal junction; drives fibrosis" },
{ head: "Hepatocyte apoptosis", sub: "Councilman bodies (acidophilic apoptotic remnants) — hallmark histology" },
{ head: "Stellate cell activation", sub: "Chronic inflammation → TGF-β → collagen deposition → FIBROSIS → CIRRHOSIS" },
], 0.4, 1.7, 12.5, 4.8, { fontSize: 13 });
}
// Slide 6 — Acute vs Chronic Hepatitis
{
const sld = addSlide(pres);
sectionBanner(sld, 2, "Pathophysiology", "Acute vs Chronic Disease");
slideTitle(sld, "Acute vs Chronic Hepatitis", "Clinical course depends on immune response and viral persistence");
// Acute column
sld.addShape(pres.ShapeType.roundRect, { x: 0.4, y: 1.6, w: 5.9, h: 4.8, rectRadius: 0.14, fill: { color: C.lightBg }, line: { color: C.green, width: 1.5 } });
sld.addText("ACUTE HEPATITIS", { x: 0.4, y: 1.65, w: 5.9, h: 0.45, fontSize: 14, bold: true, color: C.green, align: "center" });
bulletBox(sld, [
"Duration < 6 months",
"AST/ALT markedly elevated (10–50× ULN)",
"Symptoms: jaundice, RUQ pain, fatigue, nausea",
"Fulminant hepatitis: rare but life-threatening (HBV > HAV)",
"Histology: lobular disarray, Councilman bodies",
"HAV & HEV → always self-limiting in immunocompetent",
"HBV acute → 95% adults recover; 5% chronic",
"HCV acute → 15–30% spontaneous clearance",
], 0.6, 2.15, 5.5, 4.1, { fontSize: 11.5 });
// Chronic column
sld.addShape(pres.ShapeType.roundRect, { x: 7.0, y: 1.6, w: 5.9, h: 4.8, rectRadius: 0.14, fill: { color: C.lightBg }, line: { color: C.red, width: 1.5 } });
sld.addText("CHRONIC HEPATITIS", { x: 7.0, y: 1.65, w: 5.9, h: 0.45, fontSize: 14, bold: true, color: C.red, align: "center" });
bulletBox(sld, [
"Duration > 6 months",
"HBV: risk highest in neonates (90%); lowest in adults (5%)",
"HCV: 70–85% of acute infections",
"HDV: always chronic if superinfection on HBV carrier",
"Histology: periportal fibrosis, bridging, ground-glass hepatocytes (HBV)",
"Complications: cirrhosis, portal hypertension, HCC",
"HCC risk: 100× higher with chronic HBV than controls",
"MELD score guides transplant prioritization",
], 7.2, 2.15, 5.5, 4.1, { fontSize: 11.5 });
// Arrow between
sld.addShape(pres.ShapeType.rect, { x: 6.35, y: 3.55, w: 0.6, h: 0.4, fill: { color: C.teal } });
sld.addText("→", { x: 6.32, y: 3.52, w: 0.66, h: 0.46, fontSize: 22, bold: true, color: C.white, align: "center" });
}
// Slide 7 — HBV Histology Image
{
const sld = addSlide(pres);
sectionBanner(sld, 2, "Pathophysiology", "Histological Features");
slideTitle(sld, "Histological Hallmarks of Viral Hepatitis");
sld.addText("The histological findings below correlate with the degree of hepatocellular injury, inflammation, and fibrosis:", {
x: 0.4, y: 1.48, w: 12.5, h: 0.4, fontSize: 12, color: C.offWhite, italic: true
});
bulletBox(sld, [
{ head: "Councilman bodies", sub: "Eosinophilic apoptotic hepatocytes — hallmark of acute viral hepatitis" },
{ head: "Ground-glass hepatocytes", sub: "HBsAg-laden cytoplasm in chronic HBV — pale, homogeneous staining" },
{ head: "Portal lymphocytic infiltrates", sub: "Predominant CD4+/CD8+ T-lymphocytes in HBV & HCV" },
{ head: "Bridging fibrosis", sub: "Connects adjacent portal tracts — precursor to cirrhosis" },
{ head: "Regenerative nodules", sub: "Cirrhotic remodelling — disrupts hepatic architecture" },
], 0.4, 2.0, 6.8, 4.5, { fontSize: 12.5 });
sld.addText("Liver biopsy: chronic HBV with cirrhosis\nGround-glass cytoplasm, regenerative nodules, dense fibrous septa visible", {
x: 7.5, y: 5.3, w: 5.5, h: 0.8, fontSize: 9, color: C.subtleGray, italic: true, align: "center"
});
}
// ════════════════════════════════════════════════════════════
// STUDENT 3 — DIAGNOSIS & SEROLOGY
// ════════════════════════════════════════════════════════════
// Slide 8 — Clinical Presentation
{
const sld = addSlide(pres);
sectionBanner(sld, 3, "Diagnosis & Serology", "Clinical Presentation");
slideTitle(sld, "Clinical Presentation of Hepatitis", "From subclinical infection to fulminant hepatic failure");
// 3-phase timeline bar
const phases = [
{ label: "Prodrome", dur: "1–2 weeks", sx: "Fatigue, anorexia, nausea, RUQ discomfort, fever (HAV)", color: C.teal },
{ label: "Icteric Phase", dur: "2–6 weeks", sx: "Jaundice, dark urine (bilirubinuria), pale stools, pruritus, tender hepatomegaly", color: C.gold },
{ label: "Recovery", dur: "Weeks–months", sx: "Symptom resolution; LFTs normalise; risk of chronicity (HBV/HCV)", color: C.green },
];
phases.forEach((p, i) => {
const bx = 0.4 + i * 4.3;
sld.addShape(pres.ShapeType.roundRect, { x: bx, y: 1.7, w: 4.1, h: 1.0, rectRadius: 0.1, fill: { color: p.color } });
sld.addText(`${p.label} · ${p.dur}`, { x: bx, y: 1.72, w: 4.1, h: 0.45, fontSize: 12.5, bold: true, color: C.darkText, align: "center" });
sld.addText(p.sx, { x: bx + 0.08, y: 2.18, w: 3.94, h: 0.48, fontSize: 9.5, color: C.darkText, align: "center" });
});
divider(sld, 2.85);
sld.addText("Key Laboratory Findings:", { x: 0.4, y: 2.95, w: 12.5, h: 0.4, fontSize: 13, bold: true, color: C.gold });
bulletBox(sld, [
{ head: "ALT/AST", sub: "Markedly elevated (hepatocellular pattern); ALT > AST in viral hepatitis" },
{ head: "Bilirubin", sub: "Total and direct bilirubin elevated; urobilinogen in urine" },
{ head: "Alkaline phosphatase / GGT", sub: "Mildly elevated (unless cholestatic component)" },
{ head: "PT / INR", sub: "Prolonged in severe or fulminant disease — best marker of synthetic function" },
{ head: "Albumin", sub: "Decreased in chronic hepatitis (impaired synthetic function)" },
], 0.4, 3.4, 12.5, 3.7, { fontSize: 12.5 });
}
// Slide 9 — Serological Markers
{
const sld = addSlide(pres);
sectionBanner(sld, 3, "Diagnosis & Serology", "Serological Markers");
slideTitle(sld, "Serological Diagnosis", "Specific serological markers identify virus type, phase and immunity status");
// HAV
sld.addShape(pres.ShapeType.roundRect, { x: 0.4, y: 1.6, w: 3.8, h: 2.45, rectRadius: 0.1, fill: { color: C.lightBg }, line: { color: C.teal, width: 1.2 } });
sld.addText("Hepatitis A", { x: 0.4, y: 1.62, w: 3.8, h: 0.38, fontSize: 12, bold: true, color: C.teal, align: "center" });
bulletBox(sld, [
"IgM anti-HAV → Acute infection",
"IgG anti-HAV → Past infection / immunity",
"No chronic carrier state",
], 0.55, 2.04, 3.5, 1.9, { fontSize: 11 });
// HBV
sld.addShape(pres.ShapeType.roundRect, { x: 4.5, y: 1.6, w: 4.1, h: 2.45, rectRadius: 0.1, fill: { color: C.lightBg }, line: { color: C.gold, width: 1.2 } });
sld.addText("Hepatitis B", { x: 4.5, y: 1.62, w: 4.1, h: 0.38, fontSize: 12, bold: true, color: C.gold, align: "center" });
bulletBox(sld, [
"HBsAg → Active infection (surface antigen)",
"Anti-HBs → Immunity (recovery/vaccine)",
"IgM anti-HBc → Acute HBV",
"IgG anti-HBc → Past/chronic exposure",
"HBeAg → High replication / infectivity",
"HBV DNA → Viral load (PCR)",
], 4.65, 2.04, 3.8, 2.0, { fontSize: 10.5 });
// HCV
sld.addShape(pres.ShapeType.roundRect, { x: 8.9, y: 1.6, w: 4.1, h: 2.45, rectRadius: 0.1, fill: { color: C.lightBg }, line: { color: C.red, width: 1.2 } });
sld.addText("Hepatitis C", { x: 8.9, y: 1.62, w: 4.1, h: 0.38, fontSize: 12, bold: true, color: C.red, align: "center" });
bulletBox(sld, [
"Anti-HCV ELISA → Screening test",
"HCV RNA (PCR) → Confirms active infection",
"HCV genotype → Guides DAA therapy",
"Anti-HCV alone ≠ active infection",
"(does not distinguish acute/chronic/resolved)",
], 9.05, 2.04, 3.8, 2.0, { fontSize: 10.5 });
// Bottom: HBV serology timeline image
if (images[1] && !images[1].error) {
sld.addImage({ data: images[1].base64, x: 0.4, y: 4.2, w: 7.5, h: 2.9 });
sld.addText("Chronic HBV serology timeline — Harrison's Principles of Internal Medicine 22E", {
x: 0.4, y: 7.15, w: 7.5, h: 0.28, fontSize: 7.5, color: C.subtleGray, italic: true, align: "center"
});
}
if (images[2] && !images[2].error) {
sld.addImage({ data: images[2].base64, x: 8.2, y: 4.2, w: 4.9, h: 2.9 });
sld.addText("HBV/HDV lab diagnosis markers — Clinical Microbiology Guide", {
x: 8.2, y: 7.15, w: 4.9, h: 0.28, fontSize: 7.5, color: C.subtleGray, italic: true, align: "center"
});
}
}
// Slide 10 — Diagnostic Algorithm
{
const sld = addSlide(pres);
sectionBanner(sld, 3, "Diagnosis & Serology", "Diagnostic Algorithm");
slideTitle(sld, "Diagnostic Algorithm for Hepatitis", "Step-by-step approach to identifying hepatitis type");
const steps = [
{ n: "1", title: "Suspect viral hepatitis", body: "↑ ALT/AST + jaundice/fatigue + risk factors" },
{ n: "2", title: "Initial screening panel", body: "IgM anti-HAV · HBsAg · IgM anti-HBc · Anti-HCV" },
{ n: "3", title: "Confirm & characterise", body: "HCV RNA (if anti-HCV+) · HBV DNA, HBeAg, anti-HBe · HEV IgM (if travel history)" },
{ n: "4", title: "Assess severity", body: "LFTs (ALT, AST, bilirubin, albumin) · PT/INR · CBC · Ultrasound / fibroscan" },
{ n: "5", title: "Chronic disease workup", body: "Liver biopsy (HAI score) · AFP (HCC surveillance) · EGD (varices) · MELD score" },
];
steps.forEach((s, i) => {
const sy = 1.75 + i * 1.0;
sld.addShape(pres.ShapeType.ellipse, { x: 0.3, y: sy, w: 0.55, h: 0.55, fill: { color: C.teal } });
sld.addText(s.n, { x: 0.3, y: sy, w: 0.55, h: 0.55, fontSize: 16, bold: true, color: C.white, align: "center", valign: "middle" });
sld.addShape(pres.ShapeType.roundRect, { x: 1.05, y: sy, w: 11.8, h: 0.82, rectRadius: 0.08, fill: { color: C.lightBg }, line: { color: C.teal, width: 0.8 } });
sld.addText(s.title, { x: 1.15, y: sy + 0.04, w: 3.5, h: 0.38, fontSize: 13, bold: true, color: C.gold });
sld.addText(s.body, { x: 4.8, y: sy + 0.06, w: 7.8, h: 0.62, fontSize: 11.5, color: C.offWhite, valign: "middle" });
});
}
// ════════════════════════════════════════════════════════════
// STUDENT 4 — PHARMACOTHERAPY
// ════════════════════════════════════════════════════════════
// Slide 11 — HBV Treatment
{
const sld = addSlide(pres);
sectionBanner(sld, 4, "Pharmacotherapy", "Hepatitis B Treatment");
slideTitle(sld, "Pharmacotherapy: Hepatitis B", "Goals — Suppress viral replication, prevent cirrhosis & HCC");
bulletBox(sld, [
{ head: "PEG-Interferon α-2a", sub: "Subcutaneous · 48 weeks · finite therapy · HBeAg seroconversion in ~30%" },
{ head: "Tenofovir disoproxil (TDF)", sub: "1st-line NRT analogue · high barrier to resistance · safe in pregnancy" },
{ head: "Tenofovir alafenamide (TAF)", sub: "Preferred over TDF — lower bone/renal toxicity; 25 mg/day orally" },
{ head: "Entecavir (ETV)", sub: "1st-line; high genetic barrier to resistance; avoid in lamivudine-resistant HBV" },
{ head: "Lamivudine / Adefovir", sub: "Older agents; high resistance rates — no longer preferred first-line" },
], 0.4, 1.7, 12.5, 4.2, { fontSize: 13 });
divider(sld, 5.8);
sld.addText("Treatment indications: HBeAg+ with HBV DNA >20,000 IU/mL · HBeAg− with HBV DNA >2,000 IU/mL · Any HBV with compensated or decompensated cirrhosis", {
x: 0.4, y: 5.9, w: 12.5, h: 0.55, fontSize: 10.5, color: C.subtleGray, italic: true
});
}
// Slide 12 — HCV Treatment (DAAs)
{
const sld = addSlide(pres);
sectionBanner(sld, 4, "Pharmacotherapy", "Hepatitis C — Direct-Acting Antivirals");
slideTitle(sld, "Pharmacotherapy: Hepatitis C", "DAAs achieve >95% sustained virological response (SVR) — effectively curative");
// Left: drug classes
bulletBox(sld, [
{ head: "NS3/4A Protease Inhibitors (-previr)", sub: "Glecaprevir, Grazoprevir, Voxilaprevir — block polyprotein processing" },
{ head: "NS5A Inhibitors (-asvir)", sub: "Pibrentasvir, Ledipasvir, Velpatasvir — block RNA replication complex" },
{ head: "NS5B Polymerase Inhibitors (-buvir)", sub: "Sofosbuvir (NUC) — inhibits RNA-dependent RNA polymerase" },
"",
{ head: "Key Regimens (pan-genotypic):", sub: "" },
{ head: "Glecaprevir/Pibrentasvir (Maviret)", sub: "8–12 weeks · pan-genotypic · treatment-naive non-cirrhotic: 8 wks" },
{ head: "Sofosbuvir/Velpatasvir (Epclusa)", sub: "12 weeks · pan-genotypic · can be used in decompensated cirrhosis (+ ribavirin)" },
{ head: "Ledipasvir/Sofosbuvir (Harvoni)", sub: "8–12 weeks · genotype 1 preferred" },
], 0.4, 1.7, 6.8, 5.1, { fontSize: 12 });
// HCV lifecycle image
if (images[4] && !images[4].error) {
sld.addImage({ data: images[4].base64, x: 7.5, y: 1.5, w: 5.5, h: 4.0 });
sld.addText("HCV life cycle & DAA molecular targets", {
x: 7.5, y: 5.55, w: 5.5, h: 0.28, fontSize: 8, color: C.subtleGray, italic: true, align: "center"
});
}
}
// Slide 13 — Other hepatitis treatments
{
const sld = addSlide(pres);
sectionBanner(sld, 4, "Pharmacotherapy", "HAV · HDV · HEV & Supportive Care");
slideTitle(sld, "Other Hepatitis — Management", "Supportive care, emerging therapies and special situations");
// cards
const cards = [
{ title: "Hepatitis A (HAV)", color: C.teal, items: [
"No specific antiviral therapy",
"Supportive care: rest, hydration, avoid hepatotoxic drugs & alcohol",
"Post-exposure prophylaxis: Ig within 14 days + vaccine",
"Hospitalise if PT/INR ↑ or severe bilirubin elevation",
]},
{ title: "Hepatitis D (HDV)", color: C.red, items: [
"Peg-interferon α-2a — only approved therapy; 48 weeks",
"Bulevirtide (EU approved, 2020) — entry inhibitor; prevents HBV/HDV co-entry",
"Control HBV with NRTIs — reducing HBV replication limits HDV",
"Liver transplant for end-stage disease",
]},
{ title: "Hepatitis E (HEV)", color: C.gold, items: [
"Usually self-limiting — supportive care",
"Ribavirin — immunocompromised/chronic HEV (off-label)",
"Hecolin® vaccine — approved in China (genotype 1); not WHO pre-qualified",
"Stop immunosuppression in transplant recipients if possible",
]},
];
cards.forEach((c, i) => {
const bx = 0.4 + i * 4.3;
sld.addShape(pres.ShapeType.roundRect, { x: bx, y: 1.6, w: 4.1, h: 5.3, rectRadius: 0.14, fill: { color: C.lightBg }, line: { color: c.color, width: 1.8 } });
sld.addText(c.title, { x: bx, y: 1.64, w: 4.1, h: 0.45, fontSize: 13.5, bold: true, color: c.color, align: "center" });
bulletBox(sld, c.items, bx + 0.12, 2.14, 3.86, 4.6, { fontSize: 11.5 });
});
}
// ════════════════════════════════════════════════════════════
// STUDENT 5 — PREVENTION & VACCINATION
// ════════════════════════════════════════════════════════════
// Slide 14 — Vaccines
{
const sld = addSlide(pres);
sectionBanner(sld, 5, "Prevention & Vaccination", "Hepatitis Vaccines");
slideTitle(sld, "Hepatitis Vaccines", "Vaccination is the most powerful tool for preventing viral hepatitis");
bulletBox(sld, [
{ head: "Hepatitis A Vaccine (Havrix / Vaqta)", sub: "Inactivated · 2-dose series (0, 6–12 months) · >94% seroprotection after 2 doses · lifelong immunity" },
{ head: "Hepatitis B Vaccine (Engerix-B / Recombivax HB)", sub: "Recombinant HBsAg · 3-dose series (0, 1, 6 months) · confirm Anti-HBs ≥10 mIU/mL post-series" },
{ head: "Heplisav-B (HepB-CpG)", sub: "Adjuvanted with CpG1018 · 2-dose series (0, 4 weeks) · higher seroprotection rates vs standard" },
{ head: "Twinrix (HAV + HBV)", sub: "Combined · 3 doses (0, 1, 6 months) · ≥18 years · accelerated schedule available" },
{ head: "HEV vaccine (Hecolin®)", sub: "Approved in China only · genotype 1 · 3 doses · especially important for pregnant women in endemic areas" },
{ head: "No vaccine for HCV or HDV", sub: "HDV: preventing/treating HBV prevents HDV · HCV: research ongoing" },
], 0.4, 1.7, 12.5, 4.8, { fontSize: 12.5 });
}
// Slide 15 — Vaccine schedule + image
{
const sld = addSlide(pres);
sectionBanner(sld, 5, "Prevention & Vaccination", "Vaccine Schedules & Special Populations");
slideTitle(sld, "Vaccine Schedules & Special Populations");
// Left: schedule content
bulletBox(sld, [
"Universal HBV vaccination: birth dose within 24 hours + 2–3 booster doses",
"HBsAg+ mothers: infant receives HBV vaccine + HBIG at birth (prevents 85–95% vertical transmission)",
"HAV: recommended for all travellers to endemic regions, MSM, PWID, chronic liver disease patients",
"Healthcare workers: mandatory HBV vaccination; confirm anti-HBs response",
"Dialysis patients: double-dose HBV vaccine + regular anti-HBs monitoring",
"HIV+ patients: Heplisav-B preferred (superior response with CpG adjuvant)",
"Pregnancy: HBV vaccine safe; HAV vaccine may be given if high risk",
], 0.4, 1.65, 7.0, 5.0, { fontSize: 12 });
// HAV vaccine table image
if (images[5] && !images[5].error) {
sld.addImage({ data: images[5].base64, x: 7.7, y: 1.5, w: 5.4, h: 3.5 });
sld.addText("Hepatitis A vaccine schedules — Sexually Transmitted Infections reference guide", {
x: 7.7, y: 5.05, w: 5.4, h: 0.28, fontSize: 7.5, color: C.subtleGray, italic: true, align: "center"
});
}
}
// Slide 16 — Post-Exposure Prophylaxis
{
const sld = addSlide(pres);
sectionBanner(sld, 5, "Prevention & Vaccination", "Post-Exposure Prophylaxis");
slideTitle(sld, "Post-Exposure Prophylaxis (PEP)", "Time-critical interventions for pharmacy practice");
// HBV PEP
sld.addShape(pres.ShapeType.roundRect, { x: 0.4, y: 1.6, w: 5.9, h: 5.3, rectRadius: 0.12, fill: { color: C.lightBg }, line: { color: C.gold, width: 1.5 } });
sld.addText("HBV Post-Exposure Prophylaxis", { x: 0.4, y: 1.64, w: 5.9, h: 0.42, fontSize: 13, bold: true, color: C.gold, align: "center" });
bulletBox(sld, [
"Unvaccinated: HBIG (0.06 mL/kg IM) + HBV vaccine — within 24 h",
"Previously vaccinated with adequate anti-HBs (≥10 mIU/mL): no action",
"Previously vaccinated — non-responder: HBIG × 2 doses (1 month apart)",
"Needle-stick or sexual exposure: administer within 7 days (ideally 24 h)",
"HBIG = Hepatitis B Immunoglobulin (passive immunity)",
"Efficacy of combined HBIG + vaccine: 85–95%",
], 0.55, 2.1, 5.6, 4.5, { fontSize: 11.5 });
// HAV PEP
sld.addShape(pres.ShapeType.roundRect, { x: 7.0, y: 1.6, w: 5.9, h: 5.3, rectRadius: 0.12, fill: { color: C.lightBg }, line: { color: C.teal, width: 1.5 } });
sld.addText("HAV Post-Exposure Prophylaxis", { x: 7.0, y: 1.64, w: 5.9, h: 0.42, fontSize: 13, bold: true, color: C.teal, align: "center" });
bulletBox(sld, [
"Immune globulin (IGIM) — effective if given within 14 days of exposure",
"HAV vaccine preferred for healthy persons aged 1–40 years",
"Both IGIM + vaccine for immunocompromised, chronic liver disease, or >40 years",
"Travel prophylaxis: single HAV vaccine dose sufficient for most destinations",
"Dose: IGIM 0.1 mL/kg IM for short-term travel (≤1 month)",
"Breastfeeding: not contraindicated with hepatitis B vaccination",
], 7.15, 2.1, 5.6, 4.5, { fontSize: 11.5 });
}
// ════════════════════════════════════════════════════════════
// SUMMARY SLIDE
// ════════════════════════════════════════════════════════════
{
const sld = addSlide(pres, C.navy);
sld.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.18, h: 7.5, fill: { color: C.gold } });
sld.addShape(pres.ShapeType.rect, { x: 0.18, y: 0, w: 0.08, h: 7.5, fill: { color: C.teal } });
sld.addText("Key Takeaways", { x: 0.5, y: 0.2, w: 12.5, h: 0.7, fontSize: 32, bold: true, color: C.gold });
divider(sld, 0.95);
const takeaways = [
{ n: "1", text: "Five distinct hepatitis viruses (A–E) differ in genome, transmission, chronicity risk and clinical outcomes." },
{ n: "2", text: "Immune-mediated hepatocellular injury (CD8+ T-cells, cytokines) drives both acute damage and chronic fibrosis/cirrhosis." },
{ n: "3", text: "Serology is the cornerstone of diagnosis: HBsAg, anti-HBc IgM, HCV RNA, and anti-HAV IgM guide management." },
{ n: "4", text: "HBV treatment: TDF/TAF or Entecavir (NRTIs) suppress viral replication; PEG-IFN for finite therapy. HCV DAAs achieve >95% cure." },
{ n: "5", text: "Vaccination (HBV at birth, HAV for at-risk groups) combined with HBIG PEP are the most effective preventive strategies." },
];
takeaways.forEach((t, i) => {
const ty = 1.1 + i * 1.1;
sld.addShape(pres.ShapeType.ellipse, { x: 0.5, y: ty + 0.05, w: 0.55, h: 0.55, fill: { color: C.teal } });
sld.addText(t.n, { x: 0.5, y: ty + 0.05, w: 0.55, h: 0.55, fontSize: 16, bold: true, color: C.white, align: "center", valign: "middle" });
sld.addText(t.text, { x: 1.25, y: ty, w: 11.8, h: 0.75, fontSize: 13, color: C.offWhite, valign: "middle" });
});
sld.addText("Sources: Harrison's 22E · Goldman-Cecil Medicine · Robbins & Kumar Pathology · Sleisenger & Fordtran · Red Book 2021 · Washington Manual", {
x: 0.5, y: 6.9, w: 12.5, h: 0.35, fontSize: 8.5, color: C.subtleGray, italic: true
});
}
// ─── Write file ────────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/hepatitis-pptx/Hepatitis_Pharmacy_Presentation.pptx" })
.then(() => console.log("SUCCESS: Presentation created!"))
.catch(err => { console.error("ERROR:", err); process.exit(1); });
Running Command
cd /home/daytona/workspace/hepatitis-pptx && node build.js 2>&1
Writing File
~/hepatitis-pptx/build.js
const pptxgen = require("pptxgenjs");
const { execSync } = require("child_process");
const fs = require("fs");
// ─── Fetch images in small batches ───────────────────────────────────────────
const imageUrls = [
"https://cdn.orris.care/cdss_images/HARRISON_1763033912702_6c8b3aeb-d09d-4456-9e4a-51e468791295.png",
"https://cdn.orris.care/cdss_images/HARRISON_1763031941963_b8714721-0c5c-4031-a531-da171f3c8e24.png",
"https://cdn.orris.care/cdss_images/GLGCA_41753_1766502006027_6fb9687b-4165-46fa-a1ed-7ae80b6c4566_21bf0166-de59-45a3-9836-5b11d5412c80.png",
"https://cdn.orris.care/cdss_images/GLGCA_2232415_1763366073233_eb427168-5573-434d-9914-2a97b7413bae.png",
"https://cdn.orris.care/cdss_images/GLGCA_4779637_1766686947536_b2bfdfdc-a8c3-49f6-b774-cb9299224a8f_a4791fd6-8d67-4a9b-afc8-071fa27ef5b8.png",
];
function fetchImages(urls) {
const results = [];
for (const url of urls) {
try {
const r = execSync(
`node /home/daytona/skills/shared/scripts/fetch_images.js "${url}"`,
{ timeout: 30000, maxBuffer: 20 * 1024 * 1024 }
).toString();
const parsed = JSON.parse(r);
results.push(parsed[0]);
} catch (e) {
console.warn("Image fetch failed for", url, ":", e.message.slice(0, 80));
results.push({ url, base64: null, error: e.message });
}
}
return results;
}
console.log("Fetching images one by one...");
const images = fetchImages(imageUrls);
console.log("Images:", images.map((img, i) => `${i}:${img && !img.error ? "OK" : "FAIL"}`).join(", "));
// ─── Color palette ────────────────────────────────────────────────────────────
const C = {
navy: "0D2B55",
teal: "0E7C7B",
gold: "F4A11D",
white: "FFFFFF",
offWhite: "EEF2F7",
lightBg: "1A3A6B",
subtleGray:"A8B8CC",
darkText: "0D1F3C",
red: "D94F3D",
green: "2EAF6C",
};
const pres = new pptxgen();
pres.layout = "LAYOUT_WIDE"; // 13.33" × 7.5"
pres.title = "Hepatitis — Pharmacy Students Presentation";
pres.author = "Orris Medical AI";
// ─── Helpers ──────────────────────────────────────────────────────────────────
function addSlide(bgColor) {
const sld = pres.addSlide();
sld.background = { color: bgColor || C.navy };
return sld;
}
function sectionBanner(sld, studentNum, studentLabel, topic) {
sld.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.33, h: 0.52, fill: { color: C.teal } });
sld.addText(`STUDENT ${studentNum} · ${studentLabel.toUpperCase()}`, {
x: 0.3, y: 0, w: 9, h: 0.52,
fontSize: 10, bold: true, color: C.white, valign: "middle", margin: 0
});
sld.addText("HEPATITIS · PHARMACY", {
x: 9.5, y: 0, w: 3.5, h: 0.52,
fontSize: 9, color: C.offWhite, align: "right", valign: "middle", margin: 0
});
}
function slideTitle(sld, title, subtitle) {
sld.addText(title, {
x: 0.4, y: 0.62, w: 12.5, h: 0.68,
fontSize: 26, bold: true, color: C.gold, fontFace: "Calibri"
});
if (subtitle) {
sld.addText(subtitle, {
x: 0.4, y: 1.3, w: 12.5, h: 0.35,
fontSize: 12, color: C.subtleGray, italic: true
});
}
}
// Converts bullet items (string or {head, sub} objects) to rich text array
function makeBulletItems(bullets, fontSize) {
const fs2 = fontSize || 12;
const items = [];
for (let i = 0; i < bullets.length; i++) {
const b = bullets[i];
if (!b || b === "") {
items.push({ text: " ", options: { fontSize: fs2 * 0.5, breakLine: true } });
} else if (typeof b === "object" && b.head !== undefined) {
// head + sub on same line
items.push({ text: b.head, options: { bullet: { indent: 14 }, bold: true, color: C.gold, fontSize: fs2, breakLine: !b.sub } });
if (b.sub) {
items.push({ text: " — " + b.sub, options: { bold: false, color: C.offWhite, fontSize: fs2, breakLine: true } });
}
} else {
items.push({ text: String(b), options: { bullet: { indent: 14 }, color: C.offWhite, fontSize: fs2, breakLine: true } });
}
}
// remove breakLine from last real item
if (items.length > 0) {
items[items.length - 1].options.breakLine = false;
}
return items;
}
function bulletBox(sld, bullets, x, y, w, h, fontSize) {
const items = makeBulletItems(bullets, fontSize);
sld.addText(items, { x, y, w, h, valign: "top", lineSpacingMultiple: 1.28 });
}
function divider(sld, y) {
sld.addShape(pres.ShapeType.line, {
x: 0.4, y, w: 12.5, h: 0,
line: { color: C.teal, width: 1.2 }
});
}
// ════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE SLIDE
// ════════════════════════════════════════════════════════════
{
const sld = addSlide(C.navy);
sld.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.18, h: 7.5, fill: { color: C.teal } });
sld.addShape(pres.ShapeType.rect, { x: 0.18, y: 0, w: 0.08, h: 7.5, fill: { color: C.gold } });
sld.addText("HEPATITIS", {
x: 0.6, y: 0.9, w: 12, h: 1.6,
fontSize: 72, bold: true, color: C.white, fontFace: "Calibri", charSpacing: 8
});
sld.addText("A Comprehensive Pharmacy Review", {
x: 0.6, y: 2.55, w: 10, h: 0.6,
fontSize: 22, color: C.gold, italic: true
});
const students = [
{ n: "1", label: "Overview &\nEpidemiology" },
{ n: "2", label: "Pathophysiology" },
{ n: "3", label: "Diagnosis &\nSerology" },
{ n: "4", label: "Pharmacotherapy" },
{ n: "5", label: "Prevention &\nVaccination" },
];
students.forEach((s, i) => {
const bx = 0.5 + i * 2.5;
sld.addShape(pres.ShapeType.roundRect, { x: bx, y: 3.4, w: 2.3, h: 1.2, rectRadius: 0.12, fill: { color: C.lightBg }, line: { color: C.teal, width: 1.5 } });
sld.addText("Student " + s.n, { x: bx, y: 3.42, w: 2.3, h: 0.4, fontSize: 11, bold: true, color: C.gold, align: "center" });
sld.addText(s.label, { x: bx + 0.08, y: 3.82, w: 2.14, h: 0.68, fontSize: 10, color: C.offWhite, align: "center" });
});
sld.addText("Pharmacy Students Group Presentation | April 2026", {
x: 0.6, y: 4.85, w: 10, h: 0.35,
fontSize: 11, color: C.subtleGray
});
sld.addText("Sources: Harrison's 22E · Goldman-Cecil Medicine · Robbins Pathology · Sleisenger & Fordtran · Red Book 2021", {
x: 0.6, y: 7.05, w: 12, h: 0.3,
fontSize: 8.5, color: C.subtleGray, italic: true
});
}
// ════════════════════════════════════════════════════════════
// STUDENT 1 — OVERVIEW & EPIDEMIOLOGY
// ════════════════════════════════════════════════════════════
// Slide 2 — Types of Hepatitis Viruses
{
const sld = addSlide();
sectionBanner(sld, 1, "Overview & Epidemiology", "Types");
slideTitle(sld, "Types of Hepatitis Viruses", "Five major viruses — distinct genomes, transmission routes and clinical courses");
bulletBox(sld, [
{ head: "Hepatitis A (HAV)", sub: "ssRNA picornavirus | fecal-oral | self-limiting acute disease, no chronicity" },
{ head: "Hepatitis B (HBV)", sub: "dsDNA hepadnavirus (3.2 kb) | parenteral/sexual/perinatal | chronic in 5–10% adults; 90% neonates" },
{ head: "Hepatitis C (HCV)", sub: "ssRNA flavivirus | blood-borne | 70–85% progress to chronic; 6 genotypes" },
{ head: "Hepatitis D (HDV)", sub: "RNA deltavirus | requires HBV co-infection | worsens HBV severity significantly" },
{ head: "Hepatitis E (HEV)", sub: "ssRNA hepevirus | fecal-oral | usually self-limiting; 20% mortality in pregnant women" },
], 0.4, 1.65, 7.0, 5.0, 13);
if (images[0] && !images[0].error) {
sld.addImage({ data: images[0].base64, x: 7.7, y: 1.45, w: 5.3, h: 3.0 });
sld.addText("Harrison's Principles of Internal Medicine 22E — Table 339-1", {
x: 7.7, y: 4.5, w: 5.3, h: 0.28, fontSize: 7.5, color: C.subtleGray, italic: true, align: "center"
});
}
}
// Slide 3 — Global Epidemiology
{
const sld = addSlide();
sectionBanner(sld, 1, "Overview & Epidemiology", "Global Burden");
slideTitle(sld, "Global Epidemiology", "Hepatitis remains a leading infectious cause of liver-related mortality worldwide");
const stats = [
{ val: "354 M", lbl: "People with chronic HBV or HCV infection globally (WHO 2022)" },
{ val: "~1.4 M", lbl: "Deaths per year attributed to viral hepatitis" },
{ val: "90%", lbl: "Neonates exposed to HBV without vaccination who develop chronic infection" },
{ val: "70–85%", lbl: "Acute HCV infections that progress to chronicity" },
{ val: "20%", lbl: "Case fatality rate of HEV in pregnant women (3rd trimester)" },
{ val: "2 M+", lbl: "New HCV infections per year (injection drug use main driver)" },
];
stats.forEach((s, i) => {
const rx = (i % 3) * 4.3 + 0.4;
const ry = 1.65 + Math.floor(i / 3) * 2.2;
sld.addShape(pres.ShapeType.roundRect, { x: rx, y: ry, w: 4.0, h: 1.95, rectRadius: 0.14, fill: { color: C.lightBg }, line: { color: C.teal, width: 1.2 } });
sld.addText(s.val, { x: rx, y: ry + 0.1, w: 4.0, h: 0.75, fontSize: 30, bold: true, color: C.gold, align: "center" });
sld.addText(s.lbl, { x: rx + 0.1, y: ry + 0.88, w: 3.8, h: 0.95, fontSize: 10.5, color: C.offWhite, align: "center" });
});
}
// Slide 4 — Transmission Routes
{
const sld = addSlide();
sectionBanner(sld, 1, "Overview & Epidemiology", "Transmission");
slideTitle(sld, "Transmission Routes & High-Risk Groups", "Key counselling points for pharmacy practice");
sld.addShape(pres.ShapeType.roundRect, { x: 0.3, y: 1.6, w: 6.0, h: 5.3, rectRadius: 0.12, fill: { color: C.lightBg }, line: { color: C.teal, width: 1.3 } });
sld.addText("Fecal-Oral (HAV, HEV)", { x: 0.4, y: 1.65, w: 5.8, h: 0.42, fontSize: 13.5, bold: true, color: C.teal, align: "center" });
bulletBox(sld, [
"Contaminated food or water",
"Poor sanitation / inadequate hand hygiene",
"Travel to endemic areas",
"Shellfish from polluted waters",
"Close household or institutional contact",
], 0.5, 2.12, 5.7, 2.2, 12);
sld.addText("Parenteral / Blood-Borne (HBV, HCV, HDV)", { x: 0.4, y: 4.3, w: 5.8, h: 0.42, fontSize: 12, bold: true, color: C.gold, align: "center" });
bulletBox(sld, [
"Sharing needles (PWID — major HCV driver)",
"Sexual contact (especially HBV in MSM)",
"Perinatal: mother-to-child (HBV, HCV)",
"Needlestick injuries in healthcare workers",
"Unscreened blood products / tattooing",
], 0.5, 4.75, 5.7, 2.0, 12);
sld.addShape(pres.ShapeType.roundRect, { x: 6.8, y: 1.6, w: 6.2, h: 5.3, rectRadius: 0.12, fill: { color: C.lightBg }, line: { color: C.gold, width: 1.3 } });
sld.addText("High-Risk Groups for Pharmacy Counselling", { x: 6.9, y: 1.65, w: 6.0, h: 0.42, fontSize: 13, bold: true, color: C.gold, align: "center" });
bulletBox(sld, [
"Injection drug users (HCV, HBV, HDV)",
"Healthcare workers — needlestick exposure",
"Travellers to HAV/HEV endemic regions",
"Pregnant women — vertical transmission risk",
"Haemodialysis patients (HCV)",
"Men who have sex with men (HAV, HBV)",
"Immunocompromised / HIV co-infected patients",
"Household contacts of HBV-infected individuals",
"Infants born to HBsAg-positive mothers",
], 7.0, 2.12, 5.8, 4.6, 12);
}
// ════════════════════════════════════════════════════════════
// STUDENT 2 — PATHOPHYSIOLOGY
// ════════════════════════════════════════════════════════════
// Slide 5 — Mechanisms of Hepatic Injury
{
const sld = addSlide();
sectionBanner(sld, 2, "Pathophysiology", "Mechanisms of Hepatic Injury");
slideTitle(sld, "Mechanisms of Hepatic Injury", "Immune-mediated hepatocellular damage is the hallmark of viral hepatitis");
bulletBox(sld, [
{ head: "Direct cytopathic effect", sub: "HCV & HEV can directly damage hepatocytes; limited in HBV" },
{ head: "CD8+ cytotoxic T-cell killing", sub: "Primary HBV mechanism — T-cells destroy infected hepatocytes presenting HBcAg/HBsAg on MHC-I" },
{ head: "Cytokine-mediated inflammation", sub: "TNF-α, IFN-γ, IL-2, IL-6 — amplify hepatic inflammation and cause bystander hepatocyte injury" },
{ head: "Interface hepatitis", sub: "Lymphocytic infiltration at portal-parenchymal junction — drives fibrosis progression (HAI score)" },
{ head: "Hepatocyte apoptosis", sub: "Councilman (acidophilic) bodies — apoptotic remnants; hallmark histological finding in acute hepatitis" },
{ head: "Hepatic stellate cell activation", sub: "Chronic injury → TGF-β release → stellate cells activate → collagen deposition → FIBROSIS → CIRRHOSIS" },
{ head: "Oxidative stress & mitochondrial dysfunction", sub: "Contributes to hepatocyte necrosis and lipid peroxidation in chronic HCV" },
], 0.4, 1.65, 12.5, 5.5, 13);
}
// Slide 6 — Acute vs Chronic Hepatitis
{
const sld = addSlide();
sectionBanner(sld, 2, "Pathophysiology", "Acute vs Chronic Disease");
slideTitle(sld, "Acute vs Chronic Hepatitis", "Clinical course depends on viral load, host immunity and viral persistence");
sld.addShape(pres.ShapeType.roundRect, { x: 0.3, y: 1.55, w: 6.0, h: 5.45, rectRadius: 0.14, fill: { color: C.lightBg }, line: { color: C.green, width: 1.5 } });
sld.addText("ACUTE HEPATITIS (<6 months)", { x: 0.3, y: 1.59, w: 6.0, h: 0.45, fontSize: 13.5, bold: true, color: C.green, align: "center" });
bulletBox(sld, [
"AST/ALT markedly elevated (10–50× ULN)",
"Jaundice, RUQ pain, fatigue, nausea, anorexia",
"Fulminant hepatitis: rare — coagulopathy + encephalopathy",
"Histology: lobular disarray, Councilman bodies, ballooning",
"HAV & HEV → always self-limiting in immunocompetent",
"Acute HBV → 95% adults recover spontaneously",
"Acute HCV → 15–30% spontaneous clearance",
"Management: supportive; avoid hepatotoxic drugs & alcohol",
], 0.5, 2.1, 5.7, 4.7, 11.5);
sld.addShape(pres.ShapeType.roundRect, { x: 7.0, y: 1.55, w: 6.0, h: 5.45, rectRadius: 0.14, fill: { color: C.lightBg }, line: { color: C.red, width: 1.5 } });
sld.addText("CHRONIC HEPATITIS (>6 months)", { x: 7.0, y: 1.59, w: 6.0, h: 0.45, fontSize: 13.5, bold: true, color: C.red, align: "center" });
bulletBox(sld, [
"Defined as persistence of HBsAg or HCV RNA >6 months",
"HBV: risk 90% in neonates; 5% in immunocompetent adults",
"HCV: 70–85% of acute infections become chronic",
"HDV: always chronic if HBV superinfection",
"Ground-glass hepatocytes (HBsAg-laden cytoplasm) in HBV",
"Complications: cirrhosis, portal hypertension, HCC",
"HCC risk: 100× higher with chronic HBV vs general population",
"Monitor: LFTs, viral load, AFP, HCC surveillance every 6 months",
], 7.2, 2.1, 5.7, 4.7, 11.5);
}
// ════════════════════════════════════════════════════════════
// STUDENT 3 — DIAGNOSIS & SEROLOGY
// ════════════════════════════════════════════════════════════
// Slide 7 — Clinical Presentation
{
const sld = addSlide();
sectionBanner(sld, 3, "Diagnosis & Serology", "Clinical Presentation");
slideTitle(sld, "Clinical Presentation", "From asymptomatic infection to fulminant hepatic failure");
const phases = [
{ label: "Prodrome", dur: "1–2 weeks", sx: "Fatigue, anorexia, nausea, low-grade fever, RUQ discomfort, myalgia", color: C.teal },
{ label: "Icteric Phase", dur: "2–6 weeks", sx: "Jaundice, dark urine (bilirubinuria), pale stools, pruritus, tender hepatomegaly", color: C.gold },
{ label: "Recovery", dur: "Weeks–months", sx: "Symptom resolution; LFTs normalise; risk of chronicity persists for HBV/HCV/HDV", color: C.green },
];
phases.forEach((p, i) => {
const bx = 0.4 + i * 4.3;
sld.addShape(pres.ShapeType.roundRect, { x: bx, y: 1.65, w: 4.1, h: 1.05, rectRadius: 0.1, fill: { color: p.color } });
sld.addText(p.label + " | " + p.dur, { x: bx + 0.08, y: 1.67, w: 3.94, h: 0.44, fontSize: 12.5, bold: true, color: C.darkText, align: "center" });
sld.addText(p.sx, { x: bx + 0.08, y: 2.12, w: 3.94, h: 0.55, fontSize: 10, color: C.darkText, align: "center" });
});
divider(sld, 2.85);
sld.addText("Key Laboratory Findings:", { x: 0.4, y: 2.9, w: 12.5, h: 0.4, fontSize: 13.5, bold: true, color: C.gold });
bulletBox(sld, [
{ head: "ALT / AST", sub: "Markedly elevated (hepatocellular pattern); ALT > AST distinguishes viral from alcoholic hepatitis" },
{ head: "Total & Direct Bilirubin", sub: "Elevated with jaundice; urobilinogen in urine; absent urobilinogen in complete obstruction" },
{ head: "Alkaline Phosphatase / GGT", sub: "Mildly elevated unless cholestatic component; GGT rises with alcohol use" },
{ head: "Prothrombin Time / INR", sub: "Best marker of hepatic synthetic function; prolonged in severe/fulminant hepatitis" },
{ head: "Albumin", sub: "Decreased in chronic hepatitis — reflects long-term synthetic failure" },
], 0.4, 3.35, 12.5, 3.85, 12.5);
}
// Slide 8 — Serological Markers
{
const sld = addSlide();
sectionBanner(sld, 3, "Diagnosis & Serology", "Serological Markers");
slideTitle(sld, "Serological Diagnosis", "Specific markers identify virus type, phase and immunity status");
// HAV card
sld.addShape(pres.ShapeType.roundRect, { x: 0.3, y: 1.58, w: 3.9, h: 2.55, rectRadius: 0.1, fill: { color: C.lightBg }, line: { color: C.teal, width: 1.3 } });
sld.addText("Hepatitis A", { x: 0.3, y: 1.61, w: 3.9, h: 0.4, fontSize: 13, bold: true, color: C.teal, align: "center" });
bulletBox(sld, [
"IgM anti-HAV → Acute active infection",
"IgG anti-HAV → Past infection or vaccination immunity",
"No chronic carrier state",
"Window period: IgM appears 5–10 days after symptoms",
], 0.45, 2.06, 3.65, 2.0, 11);
// HBV card
sld.addShape(pres.ShapeType.roundRect, { x: 4.5, y: 1.58, w: 4.3, h: 2.55, rectRadius: 0.1, fill: { color: C.lightBg }, line: { color: C.gold, width: 1.3 } });
sld.addText("Hepatitis B", { x: 4.5, y: 1.61, w: 4.3, h: 0.4, fontSize: 13, bold: true, color: C.gold, align: "center" });
bulletBox(sld, [
"HBsAg — Active infection (surface antigen)",
"Anti-HBs — Immunity (recovery or vaccine)",
"IgM anti-HBc — Acute HBV infection",
"IgG anti-HBc — Past or chronic exposure",
"HBeAg — High viral replication / infectivity",
"Anti-HBe — Seroconversion, lower infectivity",
"HBV DNA (PCR) — Viral load monitoring",
], 4.65, 2.05, 4.0, 2.05, 10.5);
// HCV card
sld.addShape(pres.ShapeType.roundRect, { x: 9.1, y: 1.58, w: 3.9, h: 2.55, rectRadius: 0.1, fill: { color: C.lightBg }, line: { color: C.red, width: 1.3 } });
sld.addText("Hepatitis C", { x: 9.1, y: 1.61, w: 3.9, h: 0.4, fontSize: 13, bold: true, color: C.red, align: "center" });
bulletBox(sld, [
"Anti-HCV (ELISA) → Screening",
"HCV RNA (PCR) → Confirms active infection",
"HCV genotype → Guides DAA selection",
"Anti-HCV alone ≠ active infection",
"(cannot distinguish acute/chronic/resolved)",
"SVR12 = cure (no HCV RNA at 12 weeks post-therapy)",
], 9.25, 2.05, 3.65, 2.0, 10.5);
// Bottom images
if (images[1] && !images[1].error) {
sld.addImage({ data: images[1].base64, x: 0.3, y: 4.28, w: 7.5, h: 2.85 });
sld.addText("Chronic HBV serology timeline — Harrison's 22E", {
x: 0.3, y: 7.15, w: 7.5, h: 0.28, fontSize: 7.5, color: C.subtleGray, italic: true, align: "center"
});
}
if (images[2] && !images[2].error) {
sld.addImage({ data: images[2].base64, x: 8.1, y: 4.28, w: 5.0, h: 2.85 });
sld.addText("HBV/HDV laboratory diagnosis markers — Clinical Microbiology Guide", {
x: 8.1, y: 7.15, w: 5.0, h: 0.28, fontSize: 7.5, color: C.subtleGray, italic: true, align: "center"
});
}
}
// Slide 9 — Diagnostic Algorithm
{
const sld = addSlide();
sectionBanner(sld, 3, "Diagnosis & Serology", "Diagnostic Algorithm");
slideTitle(sld, "Diagnostic Algorithm", "Systematic approach to identifying hepatitis type and severity");
const steps = [
{ n: "1", title: "Suspect Viral Hepatitis", body: "Elevated ALT/AST + jaundice/fatigue + risk factors (travel, PWID, sexual exposure, healthcare worker)" },
{ n: "2", title: "Initial Screening Panel", body: "IgM anti-HAV · HBsAg · IgM anti-HBc · Anti-HCV ELISA · HEV IgM if travel history" },
{ n: "3", title: "Confirmatory & Characterisation Tests", body: "HCV RNA PCR (if anti-HCV+) · HBV DNA + HBeAg/anti-HBe · HBsAg quantification for HBV" },
{ n: "4", title: "Severity Assessment", body: "Full LFTs · PT/INR · Albumin · CBC · Abdominal ultrasound / FibroScan (liver stiffness)" },
{ n: "5", title: "Chronic Disease Workup", body: "Liver biopsy (Knodell/HAI score) · AFP (HCC surveillance every 6 months) · EGD for varices · MELD score" },
];
steps.forEach((s, i) => {
const sy = 1.62 + i * 1.07;
sld.addShape(pres.ShapeType.ellipse, { x: 0.3, y: sy, w: 0.58, h: 0.58, fill: { color: C.teal } });
sld.addText(s.n, { x: 0.3, y: sy, w: 0.58, h: 0.58, fontSize: 17, bold: true, color: C.white, align: "center", valign: "middle" });
sld.addShape(pres.ShapeType.roundRect, { x: 1.05, y: sy, w: 12.0, h: 0.88, rectRadius: 0.08, fill: { color: C.lightBg }, line: { color: C.teal, width: 0.8 } });
sld.addText(s.title, { x: 1.18, y: sy + 0.05, w: 3.6, h: 0.38, fontSize: 12.5, bold: true, color: C.gold });
sld.addText(s.body, { x: 5.0, y: sy + 0.06, w: 7.8, h: 0.72, fontSize: 11, color: C.offWhite, valign: "middle" });
});
}
// ════════════════════════════════════════════════════════════
// STUDENT 4 — PHARMACOTHERAPY
// ════════════════════════════════════════════════════════════
// Slide 10 — HBV Treatment
{
const sld = addSlide();
sectionBanner(sld, 4, "Pharmacotherapy", "Hepatitis B Treatment");
slideTitle(sld, "Pharmacotherapy: Hepatitis B (HBV)", "Goal — Suppress viral replication, prevent cirrhosis and hepatocellular carcinoma");
bulletBox(sld, [
{ head: "PEG-Interferon α-2a (Pegasys)", sub: "SC injection · 48 weeks · finite therapy · ~30% HBeAg seroconversion · many side effects" },
{ head: "Tenofovir disoproxil fumarate (TDF)", sub: "1st-line NRTI analogue · very high barrier to resistance · safe in pregnancy (Cat B)" },
{ head: "Tenofovir alafenamide (TAF)", sub: "Preferred over TDF — lower bone/renal toxicity · 25 mg/day orally" },
{ head: "Entecavir (ETV)", sub: "1st-line · high barrier to resistance · avoid in lamivudine-resistant HBV (cross-resistance risk)" },
{ head: "Lamivudine / Adefovir / Telbivudine", sub: "Older agents — high resistance rates; no longer preferred 1st-line therapy" },
], 0.4, 1.65, 12.5, 4.4, 13);
divider(sld, 5.85);
sld.addText("Treatment indications (AASLD): HBeAg+ with HBV DNA >20,000 IU/mL | HBeAg− with HBV DNA >2,000 IU/mL + elevated ALT | Any HBV with cirrhosis regardless of HBV DNA", {
x: 0.4, y: 5.95, w: 12.5, h: 0.55, fontSize: 10.5, color: C.subtleGray, italic: true
});
sld.addText("Sources: Harrison's 22E · AASLD HBV Guidelines", {
x: 0.4, y: 7.1, w: 12.5, h: 0.3, fontSize: 8, color: C.subtleGray, italic: true
});
}
// Slide 11 — HCV Treatment (DAAs)
{
const sld = addSlide();
sectionBanner(sld, 4, "Pharmacotherapy", "Hepatitis C — Direct-Acting Antivirals");
slideTitle(sld, "Pharmacotherapy: Hepatitis C (HCV)", "Direct-acting antivirals (DAAs) achieve >95% sustained virological response — effectively curative");
bulletBox(sld, [
{ head: "NS3/4A Protease Inhibitors (-previr)", sub: "Glecaprevir, Grazoprevir, Voxilaprevir — block polyprotein processing; pan-genotypic" },
{ head: "NS5A Inhibitors (-asvir)", sub: "Pibrentasvir, Ledipasvir, Velpatasvir — inhibit RNA replication complex; pan-genotypic" },
{ head: "NS5B Polymerase Inhibitors (-buvir)", sub: "Sofosbuvir (nucleotide analogue) — inhibits RNA-dependent RNA polymerase; backbone of all regimens" },
{ head: "Glecaprevir + Pibrentasvir (Maviret)", sub: "8 weeks for treatment-naive non-cirrhotic · pan-genotypic · 12 weeks for cirrhosis" },
{ head: "Sofosbuvir + Velpatasvir (Epclusa)", sub: "12 weeks · pan-genotypic · with ribavirin for decompensated cirrhosis" },
{ head: "Ledipasvir + Sofosbuvir (Harvoni)", sub: "8–12 weeks · genotype 1 preferred · 8 weeks if non-cirrhotic + low viral load" },
], 0.4, 1.65, 7.2, 5.5, 12.5);
if (images[3] && !images[3].error) {
sld.addImage({ data: images[3].base64, x: 7.8, y: 1.45, w: 5.2, h: 4.2 });
sld.addText("HCV life cycle & DAA molecular targets — Hepatitis C in CKD", {
x: 7.8, y: 5.68, w: 5.2, h: 0.28, fontSize: 7.5, color: C.subtleGray, italic: true, align: "center"
});
}
}
// Slide 12 — HAV / HDV / HEV Management
{
const sld = addSlide();
sectionBanner(sld, 4, "Pharmacotherapy", "HAV · HDV · HEV Management");
slideTitle(sld, "Management: HAV, HDV & HEV", "Supportive care remains central; emerging therapies for HDV");
const cards = [
{ title: "Hepatitis A (HAV)", color: C.teal, items: [
"No specific antiviral therapy available",
"Supportive care: rest, hydration, adequate nutrition",
"Avoid hepatotoxic drugs (paracetamol high-dose, statins) & alcohol",
"Post-exposure: IGIM (within 14 days) + HAV vaccine",
"Hospitalise if PT/INR prolonged or severe bilirubin elevation",
"Prognosis: excellent; <1% fulminant hepatitis",
]},
{ title: "Hepatitis D (HDV)", color: C.red, items: [
"Peg-interferon α-2a: only established therapy; 48 weeks",
"Bulevirtide (Hepcludi): EU-approved 2020 — entry inhibitor; prevents HBV/HDV co-entry into hepatocytes",
"Control HBV with NRTIs — reducing HBV replication limits HDV",
"Lonafarnib (farnesyl inhibitor) — investigational",
"Liver transplantation for end-stage disease",
]},
{ title: "Hepatitis E (HEV)", color: C.gold, items: [
"Immunocompetent: supportive care — self-limiting",
"Ribavirin (off-label): for chronic HEV in transplant recipients or immunocompromised (3–6 months)",
"PEG-interferon: used with ribavirin failure in transplant recipients",
"Reduce immunosuppression if possible in organ transplant patients",
"Hecolin vaccine (China only) — 3 doses; not WHO pre-qualified",
]},
];
cards.forEach((c, i) => {
const bx = 0.3 + i * 4.35;
sld.addShape(pres.ShapeType.roundRect, { x: bx, y: 1.58, w: 4.15, h: 5.55, rectRadius: 0.14, fill: { color: C.lightBg }, line: { color: c.color, width: 1.8 } });
sld.addText(c.title, { x: bx, y: 1.62, w: 4.15, h: 0.44, fontSize: 13.5, bold: true, color: c.color, align: "center" });
bulletBox(sld, c.items, bx + 0.1, 2.1, 3.95, 4.9, 11);
});
}
// ════════════════════════════════════════════════════════════
// STUDENT 5 — PREVENTION & VACCINATION
// ════════════════════════════════════════════════════════════
// Slide 13 — Vaccines
{
const sld = addSlide();
sectionBanner(sld, 5, "Prevention & Vaccination", "Hepatitis Vaccines");
slideTitle(sld, "Hepatitis Vaccines", "Vaccination is the most effective public health tool for preventing viral hepatitis");
bulletBox(sld, [
{ head: "Hepatitis A Vaccine (Havrix / Vaqta)", sub: "Inactivated · 2-dose series (0, 6–12 months) · >94% seroprotection · lifelong immunity after complete series" },
{ head: "Hepatitis B Vaccine (Engerix-B / Recombivax HB)", sub: "Recombinant HBsAg · 3-dose series (0, 1, 6 months) · confirm anti-HBs ≥10 mIU/mL post-vaccination" },
{ head: "Heplisav-B (HepB-CpG adjuvanted)", sub: "2-dose series (0, 4 weeks) · CpG1018 adjuvant → superior immunogenicity · preferred in adults ≥18 years" },
{ head: "Twinrix (HAV + HBV combined)", sub: "3 doses (0, 1, 6 months) · adults ≥18 years · accelerated schedule: 0, 7, 21–30 days + booster at 12 months" },
{ head: "Hecolin® (HEV vaccine)", sub: "Approved in China only · genotype 1 · 3 doses · important for pregnant women and travellers to endemic areas" },
{ head: "No vaccine for HCV or HDV", sub: "HDV prevention: control HBV through vaccination · HCV: no vaccine; prevention relies on harm reduction strategies" },
], 0.4, 1.65, 12.5, 5.3, 12.5);
}
// Slide 14 — Vaccine schedules with image
{
const sld = addSlide();
sectionBanner(sld, 5, "Prevention & Vaccination", "Schedules & Special Populations");
slideTitle(sld, "Vaccine Schedules & Special Populations");
bulletBox(sld, [
"Universal HBV at birth: dose within 24 hours + 2–3 booster doses (ACIP schedule)",
"HBsAg+ mothers: infant receives HBV vaccine + HBIG at birth → prevents 85–95% vertical transmission",
"HAV: all travellers to endemic regions · MSM · PWID · chronic liver disease patients",
"Healthcare workers: mandatory HBV vaccination + post-series anti-HBs confirmation",
"Dialysis patients: double-dose HBV vaccine + regular anti-HBs monitoring every 12 months",
"HIV-positive patients: Heplisav-B preferred (CpG adjuvant provides superior response)",
"Pregnancy: HBV vaccine safe in all trimesters · HAV may be given if at-risk",
"Non-responders (<10 mIU/mL): revaccinate with Heplisav-B series or additional 3-dose series",
], 0.4, 1.6, 7.2, 5.4, 12);
if (images[4] && !images[4].error) {
sld.addImage({ data: images[4].base64, x: 7.8, y: 1.45, w: 5.2, h: 3.8 });
sld.addText("Hepatitis A vaccine schedules (Havrix, Vaqta, Twinrix) — STI Reference Guide", {
x: 7.8, y: 5.28, w: 5.2, h: 0.35, fontSize: 7.5, color: C.subtleGray, italic: true, align: "center"
});
}
}
// Slide 15 — Post-Exposure Prophylaxis
{
const sld = addSlide();
sectionBanner(sld, 5, "Prevention & Vaccination", "Post-Exposure Prophylaxis");
slideTitle(sld, "Post-Exposure Prophylaxis (PEP)", "Time-critical interventions — essential pharmacist counselling points");
sld.addShape(pres.ShapeType.roundRect, { x: 0.3, y: 1.58, w: 6.0, h: 5.45, rectRadius: 0.12, fill: { color: C.lightBg }, line: { color: C.gold, width: 1.5 } });
sld.addText("HBV Post-Exposure Prophylaxis", { x: 0.3, y: 1.62, w: 6.0, h: 0.44, fontSize: 13, bold: true, color: C.gold, align: "center" });
bulletBox(sld, [
"Unvaccinated: HBIG (0.06 mL/kg IM) + HBV vaccine within 24 hours",
"Previously vaccinated with adequate anti-HBs (≥10 mIU/mL): no action needed",
"Previously vaccinated non-responder: HBIG × 2 doses (1 month apart)",
"Needle-stick or sexual exposure: administer within 7 days (ideally <24 h)",
"HBIG = Hepatitis B Immune Globulin — provides passive immediate immunity",
"Combined HBIG + vaccine efficacy: 85–95% for perinatal exposure",
"HCV: no proven PEP — monitor HCV RNA at 4–6 weeks post-exposure",
"Follow-up LFTs and viral markers at 6 weeks, 3 months, 6 months",
], 0.48, 2.1, 5.7, 4.75, 11.2);
sld.addShape(pres.ShapeType.roundRect, { x: 7.0, y: 1.58, w: 6.0, h: 5.45, rectRadius: 0.12, fill: { color: C.lightBg }, line: { color: C.teal, width: 1.5 } });
sld.addText("HAV Post-Exposure Prophylaxis", { x: 7.0, y: 1.62, w: 6.0, h: 0.44, fontSize: 13, bold: true, color: C.teal, align: "center" });
bulletBox(sld, [
"IGIM is effective if given within 14 days of exposure",
"HAV vaccine preferred for healthy persons aged 1–40 years (rapid immunisation)",
"Immunocompromised / chronic liver disease / >40 years: IGIM + vaccine",
"IGIM dose: 0.1 mL/kg IM for short-term travel (≤1 month)",
"0.2 mL/kg IM for longer stays in endemic areas",
"Not indicated >14 days after exposure or if clinical disease has started",
"HEV: no licensed PEP; supportive care only",
"Breastfeeding: not contraindicated with hepatitis B vaccination",
], 7.18, 2.1, 5.7, 4.75, 11.2);
}
// ════════════════════════════════════════════════════════════
// SUMMARY / KEY TAKEAWAYS SLIDE
// ════════════════════════════════════════════════════════════
{
const sld = addSlide(C.navy);
sld.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.2, h: 7.5, fill: { color: C.gold } });
sld.addShape(pres.ShapeType.rect, { x: 0.2, y: 0, w: 0.08, h: 7.5, fill: { color: C.teal } });
sld.addText("Key Takeaways", { x: 0.55, y: 0.15, w: 12.5, h: 0.75, fontSize: 34, bold: true, color: C.gold });
divider(sld, 0.95);
const takeaways = [
{ n: "1", s: "Student 1", text: "Five distinct hepatitis viruses (A–E) differ in genome type, transmission route, chronicity risk and clinical outcomes. HAV/HEV are fecal-oral; HBV/HCV/HDV are bloodborne." },
{ n: "2", s: "Student 2", text: "Immune-mediated hepatocellular injury (CD8+ T-cells, TNF-α, IL-6) drives both acute inflammation and chronic fibrosis; stellate cell activation is the key fibrosis pathway." },
{ n: "3", s: "Student 3", text: "Serology is the cornerstone of diagnosis: HBsAg, IgM anti-HBc, HCV RNA PCR, and IgM anti-HAV guide management decisions and treatment timing." },
{ n: "4", s: "Student 4", text: "HBV: 1st-line TDF/TAF or entecavir (long-term NRTIs). HCV: pan-genotypic DAA regimens achieve >95% SVR12 — a functional cure of HCV infection." },
{ n: "5", s: "Student 5", text: "Universal HBV vaccination (birth dose) + HBIG PEP for exposed neonates prevents the majority of chronic infections. HAV vaccine for travellers and at-risk groups." },
];
takeaways.forEach((t, i) => {
const ty = 1.08 + i * 1.2;
sld.addShape(pres.ShapeType.ellipse, { x: 0.45, y: ty + 0.08, w: 0.56, h: 0.56, fill: { color: C.teal } });
sld.addText(t.n, { x: 0.45, y: ty + 0.08, w: 0.56, h: 0.56, fontSize: 16, bold: true, color: C.white, align: "center", valign: "middle" });
sld.addText(t.s + ": ", { x: 1.2, y: ty + 0.08, w: 1.5, h: 0.56, fontSize: 11, bold: true, color: C.gold, valign: "middle" });
sld.addText(t.text, { x: 2.7, y: ty, w: 10.3, h: 0.85, fontSize: 12, color: C.offWhite, valign: "middle" });
});
sld.addText("References: Harrison's Principles of Internal Medicine 22E · Goldman-Cecil Medicine · Robbins & Kumar Basic Pathology · Sleisenger & Fordtran's GI & Liver Disease · Red Book 2021", {
x: 0.4, y: 7.1, w: 12.7, h: 0.28, fontSize: 7.5, color: C.subtleGray, italic: true
});
}
// ─── Write file ────────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/hepatitis-pptx/Hepatitis_Pharmacy_Presentation.pptx" })
.then(() => console.log("SUCCESS: Presentation created!"))
.catch(err => { console.error("ERROR:", err); process.exit(1); });
Your credits are exhausted. Your daily credits reset tomorrow, or you can purchase a top-up for more.
This is a shared conversation. Sign in to Orris to start your own chat.