ls /home/daytona/workspace/ 2>/dev/null || echo "workspace does not exist yet"

mkdir -p /home/daytona/workspace/neonatal-sepsis-ppt

~/neonatal-sepsis-ppt/build.js

const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Neonatal Sepsis";
pres.author = "Medical Education";

// ── Colour palette ──────────────────────────────────────────
const NAVY    = "0D2B4E";   // dominant dark background
const TEAL    = "1A7A8A";   // supporting accent (headers / bars)
const LIGHT   = "E8F4F8";   // light panel / text-box fill
const WHITE   = "FFFFFF";
const AMBER   = "F0A500";   // highlight accent
const RED     = "C0392B";   // danger / alert
const GRAY    = "4A5568";   // body text on light bg
const LTGRAY  = "D1DCE8";   // divider / subtle element

// ── Reusable helpers ─────────────────────────────────────────
function addSlideBg(slide, color) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: "100%", fill: { color } });
}

function addHeader(slide, title, bgColor = TEAL) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: "100%", h: 0.85, fill: { color: bgColor } });
  slide.addText(title, {
    x: 0.35, y: 0, w: 9.3, h: 0.85,
    fontSize: 22, bold: true, color: WHITE, valign: "middle", margin: 0
  });
}

function addFooter(slide) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 5.3, w: "100%", h: 0.325, fill: { color: NAVY } });
  slide.addText("Neonatal Sepsis  |  Medical Education", {
    x: 0.2, y: 5.3, w: 9.6, h: 0.325,
    fontSize: 8, color: LTGRAY, valign: "middle", margin: 0
  });
}

// ════════════════════════════════════════════════════════════
// SLIDE 1 — Title
// ════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addSlideBg(s, NAVY);

  // teal accent bar left
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.18, h: "100%", fill: { color: TEAL } });

  // amber accent bar
  s.addShape(pres.ShapeType.rect, { x: 0.18, y: 2.35, w: 5.8, h: 0.06, fill: { color: AMBER } });

  s.addText("NEONATAL SEPSIS", {
    x: 0.45, y: 1.2, w: 9, h: 1.1,
    fontSize: 44, bold: true, color: WHITE, align: "left", charSpacing: 3
  });
  s.addText("A Comprehensive Clinical Overview", {
    x: 0.45, y: 2.5, w: 9, h: 0.55,
    fontSize: 19, color: LIGHT, align: "left", italic: true
  });
  s.addText("Definition  •  Classification  •  Aetiology  •  Clinical Features\nDiagnosis  •  Management  •  Complications  •  Prevention", {
    x: 0.45, y: 3.2, w: 9, h: 0.95,
    fontSize: 12, color: LTGRAY, align: "left", lineSpacingMultiple: 1.4
  });
  s.addText("Sources: Tintinalli's Emergency Medicine | Red Book 2021 | Sherris Medical Microbiology", {
    x: 0.45, y: 5.05, w: 9.1, h: 0.35,
    fontSize: 8, color: LTGRAY, align: "left", italic: true
  });
}

// ════════════════════════════════════════════════════════════
// SLIDE 2 — Definition & Epidemiology
// ════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addSlideBg(s, WHITE);
  addHeader(s, "Definition & Epidemiology", NAVY);
  addFooter(s);

  // left panel
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.05, w: 4.5, h: 3.9, fill: { color: LIGHT }, line: { color: TEAL, width: 1.5 } });
  s.addText("DEFINITION", { x: 0.45, y: 1.1, w: 4.2, h: 0.4, fontSize: 13, bold: true, color: TEAL });
  s.addText([
    { text: "Neonatal sepsis", options: { bold: true, color: NAVY } },
    { text: " is a systemic inflammatory response syndrome (SIRS) in a neonate (0–28 days) caused by suspected or proven infection — bacterial, viral, or fungal.", options: { color: GRAY } }
  ], { x: 0.45, y: 1.55, w: 4.15, h: 1.2, fontSize: 11, lineSpacingMultiple: 1.4 });

  s.addText("KEY FACTS", { x: 0.45, y: 2.85, w: 4.2, h: 0.4, fontSize: 13, bold: true, color: TEAL });
  s.addText([
    { text: "• Most common cause of neonatal cardiorespiratory distress\n", options: { breakLine: false } },
    { text: "• Neonates have ~2× risk of serious bacterial infection vs. infants aged 4–8 weeks\n", options: { breakLine: false } },
    { text: "• Leading cause of neonatal mortality globally\n", options: { breakLine: false } },
    { text: "• Incidence: 1–5 per 1,000 live births (varies by setting)", options: {} }
  ], { x: 0.45, y: 3.3, w: 4.15, h: 1.55, fontSize: 10.5, color: GRAY, lineSpacingMultiple: 1.45, bullet: false });

  // right panel — fever / hypothermia thresholds
  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.05, w: 4.55, h: 1.65, fill: { color: "FFF3CD" }, line: { color: AMBER, width: 1.5 } });
  s.addText("TEMPERATURE THRESHOLDS", { x: 5.25, y: 1.1, w: 4.2, h: 0.38, fontSize: 12, bold: true, color: "8B4513" });
  s.addText([
    { text: "Fever:  ", options: { bold: true, color: RED } },
    { text: "Rectal temp ≥ 38°C (100.4°F)\n", options: { color: GRAY } },
    { text: "Hypothermia:  ", options: { bold: true, color: "1A5276" } },
    { text: "Rectal temp < 36.5°C (97.7°F)", options: { color: GRAY } }
  ], { x: 5.25, y: 1.55, w: 4.25, h: 1.0, fontSize: 11, lineSpacingMultiple: 1.5 });

  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 2.85, w: 4.55, h: 2.1, fill: { color: LIGHT }, line: { color: TEAL, width: 1.5 } });
  s.addText("GESTATIONAL AGE GROUPS", { x: 5.25, y: 2.9, w: 4.2, h: 0.38, fontSize: 12, bold: true, color: TEAL });
  s.addText([
    { text: "Term neonate: ", options: { bold: true, color: NAVY } },
    { text: "≥ 37 weeks\n", options: { color: GRAY } },
    { text: "Preterm: ", options: { bold: true, color: NAVY } },
    { text: "< 37 weeks (higher risk)\n", options: { color: GRAY } },
    { text: "Very preterm: ", options: { bold: true, color: NAVY } },
    { text: "< 32 weeks (highest risk)\n", options: { color: GRAY } },
    { text: "Late-preterm: ", options: { bold: true, color: NAVY } },
    { text: "34–36+6 weeks", options: { color: GRAY } }
  ], { x: 5.25, y: 3.3, w: 4.25, h: 1.5, fontSize: 10.5, lineSpacingMultiple: 1.4 });
}

// ════════════════════════════════════════════════════════════
// SLIDE 3 — Classification (EOS vs LOS)
// ════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addSlideBg(s, WHITE);
  addHeader(s, "Classification: Early-Onset vs Late-Onset Sepsis", NAVY);
  addFooter(s);

  // EOS card
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.05, w: 4.5, h: 3.95, fill: { color: "E8F8F5" }, line: { color: "1ABC9C", width: 2 } });
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.05, w: 4.5, h: 0.55, fill: { color: "1ABC9C" } });
  s.addText("EARLY-ONSET SEPSIS (EOS)", { x: 0.35, y: 1.05, w: 4.4, h: 0.55, fontSize: 13, bold: true, color: WHITE, valign: "middle", margin: 0 });
  const eosBullets = [
    "Onset: First 7 days of life (usually <72 h)",
    "Presentation: Fulminant, rapid deterioration",
    "Source: Maternal / perinatal risk factors",
    "Risk factors: Maternal fever, Group B Strep+ vaginal swab, prolonged rupture of membranes (>18 h), fetal distress, chorioamnionitis",
    "Common complications: Septic shock, neutropenia",
    "Organisms: GBS, E. coli, Listeria, Klebsiella"
  ];
  eosBullets.forEach((b, i) => {
    s.addText("• " + b, { x: 0.5, y: 1.72 + i * 0.52, w: 4.15, h: 0.48, fontSize: 10, color: GRAY, lineSpacingMultiple: 1.3 });
  });

  // LOS card
  s.addShape(pres.ShapeType.rect, { x: 5.2, y: 1.05, w: 4.5, h: 3.95, fill: { color: "EBF5FB" }, line: { color: TEAL, width: 2 } });
  s.addShape(pres.ShapeType.rect, { x: 5.2, y: 1.05, w: 4.5, h: 0.55, fill: { color: TEAL } });
  s.addText("LATE-ONSET SEPSIS (LOS)", { x: 5.25, y: 1.05, w: 4.4, h: 0.55, fontSize: 13, bold: true, color: WHITE, valign: "middle", margin: 0 });
  const losBullets = [
    "Onset: After day 7 (up to 28 days)",
    "Presentation: More gradual onset",
    "Source: Hospital-acquired / community-acquired",
    "Risk factors: Low birth weight, invasive procedures, prolonged NICU stay, IV catheters, TPN",
    "Common complications: Meningitis (more frequent vs EOS)",
    "Organisms: CoNS, S. aureus, E. coli, Candida"
  ];
  losBullets.forEach((b, i) => {
    s.addText("• " + b, { x: 5.4, y: 1.72 + i * 0.52, w: 4.15, h: 0.48, fontSize: 10, color: GRAY, lineSpacingMultiple: 1.3 });
  });
}

// ════════════════════════════════════════════════════════════
// SLIDE 4 — Aetiology / Organisms
// ════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addSlideBg(s, WHITE);
  addHeader(s, "Aetiology & Common Organisms", NAVY);
  addFooter(s);

  const categories = [
    {
      label: "Gram-Positive Bacteria",
      color: "1ABC9C",
      items: ["Group B Streptococcus (GBS) — most common EOS", "Staphylococcus aureus (MRSA/MSSA)", "Coagulase-negative Staphylococcus (CoNS) — LOS", "Listeria monocytogenes — sepsis & meningitis", "Enterococcus spp."]
    },
    {
      label: "Gram-Negative Bacteria",
      color: TEAL,
      items: ["Escherichia coli — #1 gram-negative EOS", "Klebsiella pneumoniae", "Pseudomonas aeruginosa (immunocompromised)", "Haemophilus influenzae", "Serratia marcescens (NICU outbreaks)"]
    },
    {
      label: "Viral & Fungal Pathogens",
      color: AMBER,
      items: ["Enteroviruses (coxsackievirus, echovirus) — acquired at delivery", "Herpes simplex virus (HSV) — disseminated form", "RSV, Influenza A — postnatal acquisition", "Candida spp. — especially in VLBW infants", "Cytomegalovirus (CMV)"]
    }
  ];

  categories.forEach((cat, ci) => {
    const xPos = 0.28 + ci * 3.35;
    s.addShape(pres.ShapeType.rect, { x: xPos, y: 1.05, w: 3.1, h: 4.0, fill: { color: LIGHT }, line: { color: cat.color, width: 1.5 } });
    s.addShape(pres.ShapeType.rect, { x: xPos, y: 1.05, w: 3.1, h: 0.5, fill: { color: cat.color } });
    s.addText(cat.label, { x: xPos + 0.08, y: 1.05, w: 2.95, h: 0.5, fontSize: 11, bold: true, color: WHITE, valign: "middle", margin: 0 });
    cat.items.forEach((item, ii) => {
      s.addText("• " + item, { x: xPos + 0.12, y: 1.65 + ii * 0.6, w: 2.85, h: 0.55, fontSize: 9.5, color: GRAY, lineSpacingMultiple: 1.3 });
    });
  });

  s.addText("Note: Height of temperature does NOT distinguish viral vs bacterial aetiology in neonates.", {
    x: 0.3, y: 5.05, w: 9.4, h: 0.28, fontSize: 8.5, color: RED, italic: true
  });
}

// ════════════════════════════════════════════════════════════
// SLIDE 5 — Risk Factors
// ════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addSlideBg(s, WHITE);
  addHeader(s, "Risk Factors", NAVY);
  addFooter(s);

  const rfGroups = [
    {
      title: "Maternal / Perinatal", color: RED,
      items: ["Maternal GBS colonisation (vaginal swab +ve)", "Prolonged rupture of membranes (>18 h)", "Chorioamnionitis / maternal fever", "Preterm labour (<37 weeks)", "Perinatal asphyxia / fetal distress", "Maternal UTI during pregnancy"]
    },
    {
      title: "Neonatal", color: TEAL,
      items: ["Prematurity (esp. <32 weeks)", "Low birth weight / VLBW (<1500 g)", "Male sex (1.5–2× higher risk)", "Congenital anomalies", "Skin / mucosal barrier disruption", "Immunodeficiency (primary or secondary)"]
    },
    {
      title: "Hospital / Iatrogenic", color: AMBER,
      items: ["Prolonged NICU admission", "Invasive procedures (intubation, catheters)", "Central venous / umbilical catheters", "Total parenteral nutrition (TPN)", "Prolonged antibiotic use (alters flora)", "Overcrowding / poor hand hygiene"]
    }
  ];

  rfGroups.forEach((grp, gi) => {
    const xPos = 0.28 + gi * 3.35;
    s.addShape(pres.ShapeType.rect, { x: xPos, y: 1.05, w: 3.1, h: 4.0, fill: { color: LIGHT }, line: { color: grp.color, width: 1.5 } });
    s.addShape(pres.ShapeType.rect, { x: xPos, y: 1.05, w: 3.1, h: 0.5, fill: { color: grp.color } });
    s.addText(grp.title, { x: xPos + 0.08, y: 1.05, w: 2.95, h: 0.5, fontSize: 12, bold: true, color: WHITE, valign: "middle", margin: 0 });
    grp.items.forEach((item, ii) => {
      s.addText("• " + item, { x: xPos + 0.12, y: 1.65 + ii * 0.57, w: 2.85, h: 0.52, fontSize: 10, color: GRAY, lineSpacingMultiple: 1.3 });
    });
  });
}

// ════════════════════════════════════════════════════════════
// SLIDE 6 — Clinical Features
// ════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addSlideBg(s, WHITE);
  addHeader(s, "Clinical Features", NAVY);
  addFooter(s);

  const systems = [
    { sys: "Temperature", color: RED, icon: "🌡", features: ["Fever ≥ 38°C", "Hypothermia < 36.5°C", "Temperature instability"] },
    { sys: "CNS", color: "6C3483", icon: "🧠", features: ["Lethargy / hypotonia", "Irritability", "Seizures", "Bulging fontanelle (meningitis)"] },
    { sys: "Respiratory", color: TEAL, icon: "🫁", features: ["Tachypnoea", "Apnoea", "Grunting / nasal flaring", "Intercostal retractions"] },
    { sys: "Cardiovascular", color: "1A5276", icon: "❤️", features: ["Tachycardia", "Hypotension", "Poor perfusion / mottling", "Prolonged capillary refill"] },
    { sys: "GI", color: "117A65", icon: "🍼", features: ["Poor feeding / vomiting", "Abdominal distension", "Diarrhoea", "Hepatomegaly"] },
    { sys: "Other Signs", color: AMBER, icon: "⚠️", features: ["Jaundice", "Petechiae / purpura", "Pallor / cyanosis", "Sclerema neonatorum"] }
  ];

  systems.forEach((sys, si) => {
    const col = si % 3;
    const row = Math.floor(si / 3);
    const x = 0.25 + col * 3.3;
    const y = 1.05 + row * 2.1;
    s.addShape(pres.ShapeType.rect, { x, y, w: 3.05, h: 1.9, fill: { color: LIGHT }, line: { color: sys.color, width: 1.5 } });
    s.addShape(pres.ShapeType.rect, { x, y, w: 3.05, h: 0.45, fill: { color: sys.color } });
    s.addText(sys.sys.toUpperCase(), { x: x + 0.1, y, w: 2.9, h: 0.45, fontSize: 11, bold: true, color: WHITE, valign: "middle", margin: 0 });
    sys.features.forEach((f, fi) => {
      s.addText("• " + f, { x: x + 0.12, y: y + 0.52 + fi * 0.33, w: 2.8, h: 0.32, fontSize: 9.5, color: GRAY });
    });
  });
}

// ════════════════════════════════════════════════════════════
// SLIDE 7 — Diagnosis
// ════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addSlideBg(s, WHITE);
  addHeader(s, "Diagnosis & Investigations", NAVY);
  addFooter(s);

  // Left column
  s.addShape(pres.ShapeType.rect, { x: 0.28, y: 1.0, w: 4.55, h: 4.1, fill: { color: LIGHT }, line: { color: NAVY, width: 1 } });
  s.addText("SEPSIS WORKUP  (Full Evaluation)", { x: 0.4, y: 1.05, w: 4.3, h: 0.4, fontSize: 12, bold: true, color: NAVY });
  const workup = [
    ["Blood culture", "Gold standard — obtain before antibiotics"],
    ["CBC with differential", "Neutropenia / leukocytosis, I:T ratio >0.2"],
    ["CSF analysis", "Cell count, protein, glucose, culture — lower threshold in neonates"],
    ["Urine culture", "Catheter specimen — for LOS evaluation"],
    ["CRP / Procalcitonin", "Serial CRP more useful; PCT rises faster"],
    ["Blood glucose", "Hypoglycaemia common in septic neonates"],
    ["Chest X-ray", "Rule out pneumonia"],
    ["Metabolic panel", "BMP, LFTs, coagulation studies"]
  ];
  workup.forEach(([test, detail], i) => {
    s.addText([
      { text: test + ": ", options: { bold: true, color: TEAL } },
      { text: detail, options: { color: GRAY } }
    ], { x: 0.45, y: 1.52 + i * 0.44, w: 4.25, h: 0.42, fontSize: 9.5, lineSpacingMultiple: 1.2 });
  });

  // Right column
  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.0, w: 4.6, h: 1.95, fill: { color: "FDECEA" }, line: { color: RED, width: 1.5 } });
  s.addText("DANGER SIGNS — Admit Immediately", { x: 5.2, y: 1.05, w: 4.35, h: 0.4, fontSize: 11.5, bold: true, color: RED });
  const danger = ["Bulging fontanelle or stiff neck", "Petechiae or purpuric rash", "Shock: hypotension, poor perfusion", "Apnoea or severe respiratory distress", "Seizures or coma"];
  danger.forEach((d, i) => {
    s.addText("• " + d, { x: 5.25, y: 1.5 + i * 0.28, w: 4.3, h: 0.26, fontSize: 9.5, color: GRAY });
  });

  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 3.1, w: 4.6, h: 2.0, fill: { color: "E8F4F8" }, line: { color: TEAL, width: 1.5 } });
  s.addText("IMPORTANT NOTES", { x: 5.2, y: 3.15, w: 4.35, h: 0.4, fontSize: 11.5, bold: true, color: TEAL });
  const notes = [
    "Nuchal rigidity absent in most neonates with meningitis",
    "No focal localising signs — presentations are non-specific",
    "Threshold for full workup (incl. LP) is lower than older infants",
    "Admit ALL neonates with suspected sepsis",
    "Start empiric antibiotics without delay"
  ];
  notes.forEach((n, i) => {
    s.addText("• " + n, { x: 5.25, y: 3.6 + i * 0.27, w: 4.3, h: 0.26, fontSize: 9.5, color: GRAY });
  });
}

// ════════════════════════════════════════════════════════════
// SLIDE 8 — Management
// ════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addSlideBg(s, WHITE);
  addHeader(s, "Management", NAVY);
  addFooter(s);

  // Top bar — general
  s.addShape(pres.ShapeType.rect, { x: 0.28, y: 1.0, w: 9.45, h: 0.6, fill: { color: NAVY } });
  s.addText("ALL NEONATES WITH SUSPECTED SEPSIS: Admit  •  IV Access  •  Blood Culture  •  Start Empiric Antibiotics  •  Monitor", {
    x: 0.35, y: 1.0, w: 9.3, h: 0.6, fontSize: 10.5, bold: true, color: WHITE, valign: "middle", margin: 0
  });

  // Left — Antibiotics
  s.addShape(pres.ShapeType.rect, { x: 0.28, y: 1.7, w: 4.55, h: 3.4, fill: { color: LIGHT }, line: { color: TEAL, width: 1.5 } });
  s.addShape(pres.ShapeType.rect, { x: 0.28, y: 1.7, w: 4.55, h: 0.45, fill: { color: TEAL } });
  s.addText("EMPIRIC ANTIBIOTIC THERAPY", { x: 0.38, y: 1.7, w: 4.35, h: 0.45, fontSize: 12, bold: true, color: WHITE, valign: "middle", margin: 0 });

  const abxData = [
    ["1st Line (EOS):", "Ampicillin 50 mg/kg + Gentamicin 2.5 mg/kg IV"],
    ["", "• Ampicillin: covers GBS & Listeria"],
    ["", "• Gentamicin: covers E. coli & gram-negatives"],
    ["Suspected gram-neg meningitis:", "Replace gentamicin with Cefotaxime or Ceftazidime 50 mg/kg (better CNS penetration)"],
    ["AVOID Ceftriaxone:", "Displaces bilirubin → kernicterus risk"],
    ["Suspected HSV:", "Add IV Acyclovir (maternal HSV Hx, lymphocytic CSF)"],
    ["LOS / NICU:", "Vancomycin + Gram-neg cover; consider Antifungal if risk"],
    ["Duration:", "7–10 days bacteraemia; 14–21 days meningitis; review at 48–72 h"]
  ];

  abxData.forEach(([label, detail], i) => {
    s.addText([
      { text: label ? label + "  " : "", options: { bold: true, color: TEAL } },
      { text: detail, options: { color: GRAY } }
    ], { x: 0.42, y: 2.22 + i * 0.38, w: 4.3, h: 0.36, fontSize: 9.5, lineSpacingMultiple: 1.2 });
  });

  // Right — Supportive
  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.7, w: 4.6, h: 3.4, fill: { color: "F4F6F6" }, line: { color: NAVY, width: 1.5 } });
  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.7, w: 4.6, h: 0.45, fill: { color: NAVY } });
  s.addText("SUPPORTIVE CARE", { x: 5.2, y: 1.7, w: 4.4, h: 0.45, fontSize: 12, bold: true, color: WHITE, valign: "middle", margin: 0 });

  const supportive = [
    ["Thermoregulation:", "Incubator / warmer; correct hypo/hyperthermia"],
    ["Respiratory:", "O₂ supplementation; CPAP or mechanical ventilation as needed"],
    ["Cardiovascular:", "IV fluids (10–20 mL/kg NS); dopamine/dobutamine for shock"],
    ["Glucose:", "IV dextrose for hypoglycaemia; monitor q1–2 h"],
    ["Nutritional:", "NG feeds or TPN if oral feeds not tolerated"],
    ["Haematological:", "Treat DIC; fresh frozen plasma; platelet transfusion if <50,000"],
    ["Monitoring:", "Continuous cardiorespiratory, SpO₂, BP; daily weights"],
    ["Meningitis:", "Dexamethasone not routinely recommended in neonates"]
  ];
  supportive.forEach(([label, detail], i) => {
    s.addText([
      { text: label + "  ", options: { bold: true, color: NAVY } },
      { text: detail, options: { color: GRAY } }
    ], { x: 5.22, y: 2.22 + i * 0.38, w: 4.35, h: 0.36, fontSize: 9.5, lineSpacingMultiple: 1.2 });
  });
}

// ════════════════════════════════════════════════════════════
// SLIDE 9 — Complications
// ════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addSlideBg(s, WHITE);
  addHeader(s, "Complications", NAVY);
  addFooter(s);

  const complications = [
    { title: "Meningitis", color: "8E44AD", desc: "More common in LOS. GBS, E. coli & Listeria main organisms. Can lead to hydrocephalus, brain abscess, neurodevelopmental delay." },
    { title: "Septic Shock", color: RED, desc: "Distributive shock. More frequent in EOS. Requires aggressive fluid resuscitation and vasopressor support." },
    { title: "DIC", color: "C0392B", desc: "Disseminated intravascular coagulation. Thrombocytopenia + coagulopathy. Treat with FFP and platelets." },
    { title: "Necrotising Enterocolitis", color: "117A65", desc: "Sepsis is a trigger factor. Bowel ischaemia, pneumatosis intestinalis. May require surgical intervention." },
    { title: "Intraventricular Haemorrhage", color: "1A5276", desc: "Especially in preterm neonates. Leads to post-haemorrhagic hydrocephalus, cerebral palsy." },
    { title: "Neurodevelopmental Delay", color: TEAL, desc: "Long-term sequela. Hearing loss, cerebral palsy, cognitive impairment — particularly after neonatal meningitis." }
  ];

  complications.forEach((comp, ci) => {
    const col = ci % 3;
    const row = Math.floor(ci / 3);
    const x = 0.25 + col * 3.3;
    const y = 1.05 + row * 2.1;
    s.addShape(pres.ShapeType.rect, { x, y, w: 3.05, h: 1.95, fill: { color: LIGHT }, line: { color: comp.color, width: 1.5 } });
    s.addShape(pres.ShapeType.rect, { x, y, w: 3.05, h: 0.45, fill: { color: comp.color } });
    s.addText(comp.title.toUpperCase(), { x: x + 0.1, y, w: 2.9, h: 0.45, fontSize: 11, bold: true, color: WHITE, valign: "middle", margin: 0 });
    s.addText(comp.desc, { x: x + 0.12, y: y + 0.52, w: 2.8, h: 1.38, fontSize: 9.5, color: GRAY, lineSpacingMultiple: 1.35 });
  });
}

// ════════════════════════════════════════════════════════════
// SLIDE 10 — Prevention
// ════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addSlideBg(s, WHITE);
  addHeader(s, "Prevention", NAVY);
  addFooter(s);

  // Left: Intrapartum prophylaxis
  s.addShape(pres.ShapeType.rect, { x: 0.28, y: 1.05, w: 4.55, h: 4.05, fill: { color: LIGHT }, line: { color: "1ABC9C", width: 1.5 } });
  s.addShape(pres.ShapeType.rect, { x: 0.28, y: 1.05, w: 4.55, h: 0.48, fill: { color: "1ABC9C" } });
  s.addText("INTRAPARTUM ANTIBIOTIC PROPHYLAXIS (IAP)", { x: 0.38, y: 1.05, w: 4.35, h: 0.48, fontSize: 11, bold: true, color: WHITE, valign: "middle", margin: 0 });
  const iap = [
    "Screen all pregnant women for GBS at 36–37+6 weeks (vaginal + rectal swabs)",
    "1st line: IV Penicillin G 5 MU, then 2.5–3 MU q4h until delivery",
    "Alternative: IV Ampicillin 2 g then 1 g q4h",
    "Penicillin allergy (low risk): IV Cefazolin",
    "Penicillin allergy (high risk): IV Clindamycin or Vancomycin based on sensitivities",
    "Adequate IAP = ≥1 dose penicillin/ampicillin/cefazolin ≥4 h before delivery",
    "IAP indicated: GBS+, prior GBS infant, GBS bacteriuria, unknown status + risk factors"
  ];
  iap.forEach((item, i) => {
    s.addText("• " + item, { x: 0.42, y: 1.62 + i * 0.48, w: 4.25, h: 0.46, fontSize: 9.5, color: GRAY, lineSpacingMultiple: 1.25 });
  });

  // Right: NICU & General
  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.05, w: 4.6, h: 1.95, fill: { color: "EBF5FB" }, line: { color: NAVY, width: 1.5 } });
  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.05, w: 4.6, h: 0.48, fill: { color: NAVY } });
  s.addText("NICU INFECTION CONTROL", { x: 5.2, y: 1.05, w: 4.4, h: 0.48, fontSize: 12, bold: true, color: WHITE, valign: "middle", margin: 0 });
  const nicu = ["Strict hand hygiene (most effective single measure)", "Minimal invasive procedures; remove catheters early", "Bundles for CLABSI prevention", "Cohorting of infected infants; isolation precautions"];
  nicu.forEach((item, i) => {
    s.addText("• " + item, { x: 5.25, y: 1.62 + i * 0.34, w: 4.3, h: 0.32, fontSize: 9.5, color: GRAY });
  });

  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 3.1, w: 4.6, h: 2.0, fill: { color: "FEF9E7" }, line: { color: AMBER, width: 1.5 } });
  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 3.1, w: 4.6, h: 0.48, fill: { color: AMBER } });
  s.addText("ANTENATAL & GENERAL MEASURES", { x: 5.2, y: 3.1, w: 4.4, h: 0.48, fontSize: 11.5, bold: true, color: WHITE, valign: "middle", margin: 0 });
  const general = ["Prompt treatment of maternal infections (UTI, STIs)", "Avoid unnecessary prolonged ROM; expedite delivery", "Breast milk / colostrum — passive immunity transfer", "Hepatitis B vaccination at birth", "Neonatal Sepsis Calculator (EOS risk tool) for management decisions"];
  general.forEach((item, i) => {
    s.addText("• " + item, { x: 5.25, y: 3.67 + i * 0.28, w: 4.3, h: 0.27, fontSize: 9.5, color: GRAY });
  });
}

// ════════════════════════════════════════════════════════════
// SLIDE 11 — Summary / Key Takeaways
// ════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  addSlideBg(s, NAVY);

  // background accent
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.18, h: "100%", fill: { color: TEAL } });
  s.addShape(pres.ShapeType.rect, { x: 0.18, y: 0.85, w: 9.6, h: 0.06, fill: { color: AMBER } });

  s.addText("KEY TAKEAWAYS", {
    x: 0.45, y: 0.1, w: 9.1, h: 0.7, fontSize: 26, bold: true, color: WHITE, valign: "middle", charSpacing: 3
  });

  const takeaways = [
    { num: "01", point: "Neonatal sepsis is the leading cause of neonatal cardiorespiratory distress; early recognition saves lives." },
    { num: "02", point: "EOS (<7 days): Fulminant, maternal risk factors, GBS/E. coli/Listeria. LOS (>7 days): Gradual, NICU-related, CoNS/Candida." },
    { num: "03", point: "Signs are non-specific — any temperature instability, apnoea, feeding problem or lethargy warrants full workup." },
    { num: "04", point: "Empiric: Ampicillin + Gentamicin. Suspected gram-neg meningitis: replace gentamicin with Cefotaxime. AVOID ceftriaxone (kernicterus)." },
    { num: "05", point: "Add IV Acyclovir for suspected HSV. Admit ALL neonates — do not manage sepsis in outpatient settings." },
    { num: "06", point: "Prevention: GBS screening at 36–37 weeks; adequate IAP reduces EOS by up to 80%. Hand hygiene is the #1 NICU measure." }
  ];

  takeaways.forEach((t, i) => {
    const y = 1.05 + i * 0.74;
    s.addShape(pres.ShapeType.rect, { x: 0.45, y, w: 0.52, h: 0.58, fill: { color: TEAL } });
    s.addText(t.num, { x: 0.45, y, w: 0.52, h: 0.58, fontSize: 14, bold: true, color: WHITE, align: "center", valign: "middle", margin: 0 });
    s.addShape(pres.ShapeType.rect, { x: 1.05, y, w: 8.55, h: 0.58, fill: { color: "112240" } });
    s.addText(t.point, { x: 1.12, y: y + 0.01, w: 8.4, h: 0.56, fontSize: 10.5, color: LIGHT, valign: "middle", lineSpacingMultiple: 1.3 });
  });
}

// ════════════════════════════════════════════════════════════
// Save
// ════════════════════════════════════════════════════════════
pres.writeFile({ fileName: "/home/daytona/workspace/neonatal-sepsis-ppt/Neonatal_Sepsis.pptx" })
  .then(() => console.log("SUCCESS: Neonatal_Sepsis.pptx created"))
  .catch(e => { console.error("ERROR:", e); process.exit(1); });

cd /home/daytona/workspace/neonatal-sepsis-ppt && node build.js

ls -lh /home/daytona/workspace/neonatal-sepsis-ppt/

cp /home/daytona/workspace/neonatal-sepsis-ppt/Neonatal_Sepsis.pptx /home/dayton…

libreoffice --headless --convert-to pdf /home/daytona/workspace/neonatal-sepsis-…

libreoffice --headless --convert-to pdf /home/daytona/workspace/neonatal-sepsis-…

ls -lh /home/daytona/Neonatal_Sepsis.pdf