const pptxgen = require("pptxgenjs"); const { execSync } = require("child_process"); // Fetch all images const urls = [ "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_c3790cd86d85f3cbd5ad67853864a1df84bb034550ab5ecedd6d5a3e2a96c146.jpg", // 0: SIS classification submucosal "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_fa9565b5f9c6222e8558da0455425b6073baa605497c13e0629c01a11064c96c.jpg", // 1: MRI FIGO types "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_d9791548d6ea40cfdf8691f9c1c0844bca40531404690e2571d2efebe7bf2940.jpg", // 2: myomectomy surgical "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_38fc64d20243fcd2cb8417d8de5b840256153355a03b6e9ebb483f182d9ad1c1.jpg", // 3: ultrasound submucosal "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_61afc9bc6549898fc0a160c290a8fcfdd2ee6d5735f6bc8d9bc87c9cb84d71d8.jpg" // 4: MRI large intramural ]; const images = JSON.parse(execSync( `node /home/daytona/skills/shared/scripts/fetch_images.js ${urls.map(u => `"${u}"`).join(" ")}`, { maxBuffer: 50 * 1024 * 1024 } ).toString()); // --- Color palette --- const C = { deepPlum: "3D1A5E", // dominant dark bg medPurple: "7B3FA0", // supporting rosePink: "C2456A", // accent/header softLilac: "D4A8E8", // light text on dark offWhite: "F5F0FB", // body text white: "FFFFFF", lightPink: "F7D6E5", darkText: "1A0A2E", accentGold: "E8B84B", tealGreen: "2DBEAA", }; let pres = new pptxgen(); pres.layout = "LAYOUT_16x9"; pres.title = "Uterine Myoma (Fibroid)"; // ============================ // HELPER: gradient-like bg via shape // ============================ function addBg(slide) { slide.background = { color: C.deepPlum }; } function addDecoStripe(slide) { // Top accent bar slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.08, fill: { color: C.rosePink }, line: { color: C.rosePink } }); // Bottom accent bar slide.addShape(pres.ShapeType.rect, { x: 0, y: 5.545, w: 10, h: 0.08, fill: { color: C.medPurple }, line: { color: C.medPurple } }); } function sectionLabel(slide, label) { slide.addShape(pres.ShapeType.roundRect, { x: 0.4, y: 0.15, w: 2.2, h: 0.38, fill: { color: C.rosePink }, line: { color: C.rosePink }, rectRadius: 0.05 }); slide.addText(label.toUpperCase(), { x: 0.4, y: 0.15, w: 2.2, h: 0.38, fontSize: 9, bold: true, color: C.white, align: "center", valign: "middle", charSpacing: 2, margin: 0 }); } // ============================ // SLIDE 1 — TITLE // ============================ { let s = pres.addSlide(); s.background = { color: C.deepPlum }; // Large decorative circle bg s.addShape(pres.ShapeType.ellipse, { x: 6.2, y: -1.2, w: 5.5, h: 5.5, fill: { color: C.medPurple, transparency: 70 }, line: { color: C.medPurple, transparency: 70 } }); s.addShape(pres.ShapeType.ellipse, { x: -1.5, y: 3.2, w: 4, h: 4, fill: { color: C.rosePink, transparency: 80 }, line: { color: C.rosePink, transparency: 80 } }); // Top accent bar s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.1, fill: { color: C.rosePink }, line: { color: C.rosePink } }); // Main title s.addText("Uterine Myoma", { x: 0.55, y: 1.1, w: 8.9, h: 1.2, fontSize: 52, bold: true, color: C.white, charSpacing: 1, align: "left" }); s.addText("(Fibroid / Leiomyoma)", { x: 0.55, y: 2.2, w: 8.9, h: 0.7, fontSize: 26, bold: false, color: C.softLilac, align: "left", italic: true }); // Divider line s.addShape(pres.ShapeType.line, { x: 0.55, y: 3.05, w: 5.5, h: 0, line: { color: C.accentGold, width: 2.5 } }); // Sub info s.addText([ { text: "Benign smooth muscle tumor of the uterus", options: { breakLine: true } }, { text: "Most common pelvic tumor in women of reproductive age", options: { breakLine: false } } ], { x: 0.55, y: 3.25, w: 7.5, h: 1.0, fontSize: 14, color: C.softLilac, align: "left" }); // Bottom bar s.addShape(pres.ShapeType.rect, { x: 0, y: 5.45, w: 10, h: 0.18, fill: { color: C.rosePink }, line: { color: C.rosePink } }); s.addText("Gynecology · Obstetrics", { x: 0, y: 5.45, w: 10, h: 0.18, fontSize: 9, color: C.white, align: "center", valign: "middle", bold: true, charSpacing: 3, margin: 0 }); } // ============================ // SLIDE 2 — OVERVIEW / OUTLINE // ============================ { let s = pres.addSlide(); addBg(s); addDecoStripe(s); s.addText("Outline", { x: 0.5, y: 0.2, w: 9, h: 0.65, fontSize: 30, bold: true, color: C.white }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 0.87, w: 9, h: 0, line: { color: C.accentGold, width: 1.5 } }); const topics = [ ["01", "Definition & Epidemiology"], ["02", "Etiology & Risk Factors"], ["03", "Classification (FIGO)"], ["04", "Pathology & Pathogenesis"], ["05", "Clinical Features & Diagnosis"], ["06", "Imaging"], ["07", "Management"], ["08", "Surgical Options"], ["09", "Complications & Prognosis"], ]; const col1 = topics.slice(0, 5); const col2 = topics.slice(5); col1.forEach(([num, title], i) => { const y = 1.05 + i * 0.82; s.addShape(pres.ShapeType.roundRect, { x: 0.4, y: y, w: 0.48, h: 0.48, fill: { color: C.rosePink }, line: { color: C.rosePink }, rectRadius: 0.06 }); s.addText(num, { x: 0.4, y: y, w: 0.48, h: 0.48, fontSize: 13, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 }); s.addText(title, { x: 1.0, y: y + 0.04, w: 3.8, h: 0.4, fontSize: 13, color: C.offWhite, valign: "middle" }); }); col2.forEach(([num, title], i) => { const y = 1.05 + i * 0.82; s.addShape(pres.ShapeType.roundRect, { x: 5.2, y: y, w: 0.48, h: 0.48, fill: { color: C.tealGreen }, line: { color: C.tealGreen }, rectRadius: 0.06 }); s.addText(num, { x: 5.2, y: y, w: 0.48, h: 0.48, fontSize: 13, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 }); s.addText(title, { x: 5.8, y: y + 0.04, w: 3.8, h: 0.4, fontSize: 13, color: C.offWhite, valign: "middle" }); }); } // ============================ // SLIDE 3 — DEFINITION & EPIDEMIOLOGY // ============================ { let s = pres.addSlide(); addBg(s); addDecoStripe(s); sectionLabel(s, "Definition"); s.addText("Definition & Epidemiology", { x: 0.5, y: 0.6, w: 9, h: 0.65, fontSize: 28, bold: true, color: C.white }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 1.27, w: 9, h: 0, line: { color: C.accentGold, width: 1.5 } }); // Definition box s.addShape(pres.ShapeType.roundRect, { x: 0.4, y: 1.38, w: 9.2, h: 0.85, fill: { color: C.medPurple, transparency: 50 }, line: { color: C.softLilac, width: 1 }, rectRadius: 0.1 }); s.addText("Uterine myomas (fibroids / leiomyomas) are benign monoclonal tumors arising from the smooth muscle cells of the myometrium, with varying amounts of fibrous connective tissue stroma.", { x: 0.55, y: 1.42, w: 9.0, h: 0.78, fontSize: 13, color: C.white, valign: "middle", italic: true }); const epiData = [ { icon: "🏥", stat: "20–40%", label: "of women of reproductive age affected" }, { icon: "📈", stat: "70–80%", label: "lifetime prevalence by age 50" }, { icon: "⚫", stat: "2–3×", label: "higher incidence in Black vs. White women" }, { icon: "📅", stat: "Peak", label: "4th–5th decade; regress post-menopause" }, { icon: "🔬", stat: "#1", label: "Most common pelvic tumor in women" }, ]; epiData.forEach((item, i) => { const col = i % 3; const row = Math.floor(i / 3); const x = 0.4 + col * 3.1; const y = 2.45 + row * 1.1; const w = 2.9; s.addShape(pres.ShapeType.roundRect, { x, y, w, h: 0.95, fill: { color: i < 3 ? C.rosePink : C.tealGreen, transparency: 60 }, line: { color: C.white, transparency: 70, width: 1 }, rectRadius: 0.1 }); s.addText(item.stat, { x: x + 0.08, y: y + 0.04, w: w - 0.16, h: 0.38, fontSize: 22, bold: true, color: C.accentGold, align: "center", margin: 0 }); s.addText(item.label, { x: x + 0.08, y: y + 0.42, w: w - 0.16, h: 0.46, fontSize: 10.5, color: C.offWhite, align: "center", margin: 0 }); }); } // ============================ // SLIDE 4 — ETIOLOGY & RISK FACTORS // ============================ { let s = pres.addSlide(); addBg(s); addDecoStripe(s); sectionLabel(s, "Etiology"); s.addText("Etiology & Risk Factors", { x: 0.5, y: 0.6, w: 9, h: 0.65, fontSize: 28, bold: true, color: C.white }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 1.27, w: 9, h: 0, line: { color: C.accentGold, width: 1.5 } }); // Left column: Hormonal s.addShape(pres.ShapeType.roundRect, { x: 0.4, y: 1.4, w: 4.2, h: 3.8, fill: { color: C.medPurple, transparency: 70 }, line: { color: C.softLilac, width: 1 }, rectRadius: 0.12 }); s.addText("HORMONAL FACTORS", { x: 0.5, y: 1.5, w: 4.0, h: 0.38, fontSize: 13, bold: true, color: C.accentGold, align: "center", charSpacing: 1, margin: 0 }); const hormonal = [ "Estrogen & progesterone dependent growth", "Express more estrogen receptors than normal myometrium", "Aromatase overexpression → local estrogen production", "Regress after menopause (↓ estrogen)", "Early menarche is a risk factor", "Nulliparity (no protective effect of pregnancy)", ]; s.addText(hormonal.map(t => ({ text: t, options: { bullet: { code: "25B8", color: C.rosePink }, breakLine: true, color: C.offWhite } })), { x: 0.55, y: 1.98, w: 3.9, h: 3.1, fontSize: 12, color: C.offWhite }); // Right column: Risk factors s.addShape(pres.ShapeType.roundRect, { x: 5.2, y: 1.4, w: 4.2, h: 3.8, fill: { color: C.rosePink, transparency: 75 }, line: { color: C.softLilac, width: 1 }, rectRadius: 0.12 }); s.addText("RISK FACTORS", { x: 5.3, y: 1.5, w: 4.0, h: 0.38, fontSize: 13, bold: true, color: C.accentGold, align: "center", charSpacing: 1, margin: 0 }); const risks = [ "African American ethnicity", "Obesity (↑ peripheral estrogen conversion)", "Family history (genetic predisposition)", "Hypertension", "Diet: red meat, fewer green vegetables", "Alcohol consumption", "Protective: multiparity, OCP use, smoking (↓ estrogen)", ]; s.addText(risks.map(t => ({ text: t, options: { bullet: { code: "25B8", color: C.tealGreen }, breakLine: true, color: C.offWhite } })), { x: 5.35, y: 1.98, w: 3.9, h: 3.1, fontSize: 12, color: C.offWhite }); } // ============================ // SLIDE 5 — CLASSIFICATION (FIGO) + Image // ============================ { let s = pres.addSlide(); addBg(s); addDecoStripe(s); sectionLabel(s, "Classification"); s.addText("FIGO Classification of Uterine Myomas", { x: 0.5, y: 0.6, w: 9, h: 0.65, fontSize: 26, bold: true, color: C.white }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 1.27, w: 9, h: 0, line: { color: C.accentGold, width: 1.5 } }); // Classification table const classes = [ { type: "SM — Submucosal", items: ["Type 0: Pedunculated intracavitary", "Type 1: <50% intramural", "Type 2: ≥50% intramural"] }, { type: "O — Other", items: ["Type 3: Contacts endometrium (100% intramural)", "Type 4: Intramural", "Type 5: Subserosal ≥50% intramural"] }, { type: "", items: ["Type 6: Subserosal <50% intramural", "Type 7: Subserosal pedunculated", "Type 8: Other (cervical, parasitic)"] }, { type: "Hybrid", items: ["Two numbers (e.g., 2–5): span both sub- and serosal"] }, ]; classes.forEach((cls, i) => { const y = 1.45 + i * 0.95; if (cls.type) { s.addShape(pres.ShapeType.roundRect, { x: 0.4, y: y, w: 1.9, h: 0.38, fill: { color: i === 0 ? C.rosePink : i === 1 ? C.tealGreen : C.medPurple }, line: { color: C.white, transparency: 40 }, rectRadius: 0.06 }); s.addText(cls.type, { x: 0.4, y: y, w: 1.9, h: 0.38, fontSize: 10.5, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 }); } cls.items.forEach((item, j) => { s.addText(`• ${item}`, { x: cls.type ? 2.4 : 0.5, y: y + j * 0.3 - (j > 0 && cls.type ? 0.08 : 0), w: 4.8, h: 0.28, fontSize: 11.5, color: C.offWhite, valign: "middle" }); }); }); // MRI image on right if (!images[1].error) { s.addImage({ data: images[1].base64, x: 5.55, y: 1.35, w: 4.1, h: 3.8 }); s.addShape(pres.ShapeType.roundRect, { x: 5.55, y: 1.35, w: 4.1, h: 3.8, fill: { color: C.white, transparency: 100 }, line: { color: C.softLilac, width: 1 }, rectRadius: 0.1 }); s.addText("MRI: FIGO fibroid types (T2-weighted)", { x: 5.55, y: 5.12, w: 4.1, h: 0.22, fontSize: 8.5, color: C.softLilac, align: "center", italic: true }); } } // ============================ // SLIDE 6 — PATHOLOGY & PATHOGENESIS // ============================ { let s = pres.addSlide(); addBg(s); addDecoStripe(s); sectionLabel(s, "Pathology"); s.addText("Pathology & Pathogenesis", { x: 0.5, y: 0.6, w: 9, h: 0.65, fontSize: 28, bold: true, color: C.white }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 1.27, w: 9, h: 0, line: { color: C.accentGold, width: 1.5 } }); // Gross pathology s.addShape(pres.ShapeType.roundRect, { x: 0.4, y: 1.38, w: 4.5, h: 1.65, fill: { color: C.medPurple, transparency: 65 }, line: { color: C.softLilac, width: 0.8 }, rectRadius: 0.1 }); s.addText("GROSS PATHOLOGY", { x: 0.5, y: 1.45, w: 4.3, h: 0.3, fontSize: 12, bold: true, color: C.accentGold, charSpacing: 1.5, margin: 0 }); const gross = ["Well-circumscribed, firm, whorled appearance", "Pseudocapsule of compressed myometrium", "Cut surface: white/grey, trabeculated", "Size: mm to >20 cm; may be multiple"]; s.addText(gross.map(t => ({ text: t, options: { bullet: true, breakLine: true } })), { x: 0.5, y: 1.82, w: 4.3, h: 1.2, fontSize: 12, color: C.offWhite }); // Microscopy s.addShape(pres.ShapeType.roundRect, { x: 5.1, y: 1.38, w: 4.5, h: 1.65, fill: { color: C.rosePink, transparency: 70 }, line: { color: C.softLilac, width: 0.8 }, rectRadius: 0.1 }); s.addText("MICROSCOPY", { x: 5.2, y: 1.45, w: 4.3, h: 0.3, fontSize: 12, bold: true, color: C.accentGold, charSpacing: 1.5, margin: 0 }); const micro = ["Interlacing bundles of smooth muscle cells", "Sparse mitoses (<5/10 HPF in benign)", "Dense fibrous stroma", "Cellular variant: increased cellularity, rare mitoses"]; s.addText(micro.map(t => ({ text: t, options: { bullet: true, breakLine: true } })), { x: 5.2, y: 1.82, w: 4.3, h: 1.2, fontSize: 12, color: C.offWhite }); // Degenerations s.addText("DEGENERATION TYPES", { x: 0.5, y: 3.18, w: 9, h: 0.32, fontSize: 13, bold: true, color: C.tealGreen, charSpacing: 1.5, margin: 0 }); const degens = [ { type: "Hyaline", desc: "Most common (65%); replacement by collagen", color: C.rosePink }, { type: "Cystic", desc: "Liquefaction of hyaline areas", color: C.medPurple }, { type: "Calcific", desc: "Calcium deposition, 'womb stone'", color: C.tealGreen }, { type: "Red (Carneous)", desc: "Hemorrhagic infarction; painful; common in pregnancy", color: "C4382A" }, { type: "Sarcomatous", desc: "<0.5% malignant transformation to leiomyosarcoma", color: C.accentGold }, ]; degens.forEach((d, i) => { const x = 0.4 + (i % 3) * 3.1; const y = 3.58 + Math.floor(i / 3) * 0.98; s.addShape(pres.ShapeType.roundRect, { x, y, w: 2.9, h: 0.85, fill: { color: d.color, transparency: 65 }, line: { color: d.color, transparency: 20, width: 1 }, rectRadius: 0.1 }); s.addText(d.type, { x: x + 0.08, y: y + 0.04, w: 2.74, h: 0.3, fontSize: 12, bold: true, color: C.white, align: "center", margin: 0 }); s.addText(d.desc, { x: x + 0.08, y: y + 0.36, w: 2.74, h: 0.44, fontSize: 10, color: C.offWhite, align: "center", margin: 0 }); }); } // ============================ // SLIDE 7 — CLINICAL FEATURES // ============================ { let s = pres.addSlide(); addBg(s); addDecoStripe(s); sectionLabel(s, "Clinical Features"); s.addText("Clinical Features", { x: 0.5, y: 0.6, w: 9, h: 0.65, fontSize: 28, bold: true, color: C.white }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 1.27, w: 9, h: 0, line: { color: C.accentGold, width: 1.5 } }); // Asymptomatic note s.addShape(pres.ShapeType.roundRect, { x: 0.4, y: 1.38, w: 9.2, h: 0.55, fill: { color: C.tealGreen, transparency: 70 }, line: { color: C.tealGreen, width: 1 }, rectRadius: 0.08 }); s.addText("⚠ ~50% of myomas are asymptomatic and discovered incidentally. Symptoms correlate with size, number, and location.", { x: 0.55, y: 1.4, w: 9.0, h: 0.5, fontSize: 12, color: C.white, valign: "middle" }); const symptomGroups = [ { header: "MENSTRUAL (Submucosal most common)", color: C.rosePink, items: ["Menorrhagia — heavy menstrual bleeding (most common)", "Metrorrhagia — irregular bleeding", "Dysmenorrhea", "Iron-deficiency anemia"], x: 0.4, y: 2.1, w: 3.0 }, { header: "PRESSURE / BULK", color: C.medPurple, items: ["Pelvic pressure/heaviness", "Urinary frequency, urgency, retention", "Constipation, tenesmus", "Dyspareunia"], x: 3.6, y: 2.1, w: 3.0 }, { header: "REPRODUCTIVE", color: C.tealGreen, items: ["Subfertility/infertility", "Recurrent pregnancy loss", "Preterm labor", "Malpresentation, PPH"], x: 6.8, y: 2.1, w: 2.8 } ]; symptomGroups.forEach(({ header, color, items, x, y, w }) => { s.addShape(pres.ShapeType.roundRect, { x, y, w, h: 3.15, fill: { color, transparency: 72 }, line: { color, transparency: 20, width: 1 }, rectRadius: 0.12 }); s.addText(header, { x: x + 0.08, y: y + 0.08, w: w - 0.16, h: 0.42, fontSize: 10.5, bold: true, color: C.accentGold, align: "center", margin: 0 }); s.addText(items.map(t => ({ text: t, options: { bullet: { code: "25B8", color }, breakLine: true } })), { x: x + 0.12, y: y + 0.6, w: w - 0.2, h: 2.5, fontSize: 11, color: C.offWhite }); }); } // ============================ // SLIDE 8 — DIAGNOSIS // ============================ { let s = pres.addSlide(); addBg(s); addDecoStripe(s); sectionLabel(s, "Diagnosis"); s.addText("Diagnosis", { x: 0.5, y: 0.6, w: 9, h: 0.65, fontSize: 28, bold: true, color: C.white }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 1.27, w: 9, h: 0, line: { color: C.accentGold, width: 1.5 } }); // Left: clinical + labs s.addShape(pres.ShapeType.roundRect, { x: 0.4, y: 1.38, w: 4.5, h: 3.8, fill: { color: C.medPurple, transparency: 68 }, line: { color: C.softLilac, width: 0.8 }, rectRadius: 0.1 }); s.addText("CLINICAL EVALUATION", { x: 0.5, y: 1.48, w: 4.2, h: 0.3, fontSize: 12, bold: true, color: C.accentGold, charSpacing: 1.5, margin: 0 }); const clinical = [ "Bimanual pelvic exam: enlarged, irregular, non-tender uterus", "Uterine size reported in weeks of gestation", "Mass may be palpable abdominally if large", ]; s.addText(clinical.map(t => ({ text: t, options: { bullet: true, breakLine: true } })), { x: 0.55, y: 1.85, w: 4.2, h: 0.95, fontSize: 11.5, color: C.offWhite }); s.addText("LABORATORY", { x: 0.5, y: 2.92, w: 4.2, h: 0.3, fontSize: 12, bold: true, color: C.accentGold, charSpacing: 1.5, margin: 0 }); const labs = ["CBC: hypochromic microcytic anemia", "Pregnancy test (rule out)", "LFT/RFT if surgical planning", "Pap smear, endometrial biopsy if indicated"]; s.addText(labs.map(t => ({ text: t, options: { bullet: true, breakLine: true } })), { x: 0.55, y: 3.28, w: 4.2, h: 1.8, fontSize: 11.5, color: C.offWhite }); // Right: imaging s.addShape(pres.ShapeType.roundRect, { x: 5.1, y: 1.38, w: 4.5, h: 3.8, fill: { color: C.rosePink, transparency: 70 }, line: { color: C.softLilac, width: 0.8 }, rectRadius: 0.1 }); s.addText("IMAGING", { x: 5.2, y: 1.48, w: 4.2, h: 0.3, fontSize: 12, bold: true, color: C.accentGold, charSpacing: 1.5, margin: 0 }); const imaging = [ { modality: "Ultrasound (1st line)", detail: "Hypoechoic, well-defined; TAS or TVS; SIS for submucosal" }, { modality: "MRI (Gold standard)", detail: "Best for size, location, degeneration mapping; pre-surgical" }, { modality: "Hysteroscopy", detail: "Direct visualization; therapeutic for SM types 0–2" }, { modality: "HSG", detail: "Filling defect; evaluates tubal patency in infertility" }, { modality: "CT", detail: "Limited; calcifications; excludes other pelvic masses" }, ]; imaging.forEach(({ modality, detail }, i) => { const y = 1.88 + i * 0.64; s.addText(modality, { x: 5.2, y, w: 4.3, h: 0.25, fontSize: 11.5, bold: true, color: C.tealGreen, margin: 0 }); s.addText(detail, { x: 5.35, y: y + 0.24, w: 4.1, h: 0.3, fontSize: 10.5, color: C.offWhite, margin: 0 }); }); } // ============================ // SLIDE 9 — IMAGING (with images) // ============================ { let s = pres.addSlide(); addBg(s); addDecoStripe(s); sectionLabel(s, "Imaging"); s.addText("Imaging of Uterine Myomas", { x: 0.5, y: 0.6, w: 9, h: 0.65, fontSize: 28, bold: true, color: C.white }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 1.27, w: 9, h: 0, line: { color: C.accentGold, width: 1.5 } }); // Image 3: Ultrasound submucosal if (!images[3].error) { s.addImage({ data: images[3].base64, x: 0.4, y: 1.38, w: 4.4, h: 3.7 }); } s.addShape(pres.ShapeType.roundRect, { x: 0.4, y: 4.92, w: 4.4, h: 0.35, fill: { color: C.darkText, transparency: 40 }, line: { color: C.darkText }, rectRadius: 0.05 }); s.addText("Ultrasound: submucosal fibroid with endometrial distortion", { x: 0.4, y: 4.94, w: 4.4, h: 0.3, fontSize: 9, color: C.softLilac, align: "center", italic: true, margin: 0 }); // Image 4: MRI large intramural if (!images[4].error) { s.addImage({ data: images[4].base64, x: 5.1, y: 1.38, w: 4.5, h: 3.7 }); } s.addShape(pres.ShapeType.roundRect, { x: 5.1, y: 4.92, w: 4.5, h: 0.35, fill: { color: C.darkText, transparency: 40 }, line: { color: C.darkText }, rectRadius: 0.05 }); s.addText("MRI: large intramural-subserosal leiomyoma (T1+T2 multiplanar)", { x: 5.1, y: 4.94, w: 4.5, h: 0.3, fontSize: 9, color: C.softLilac, align: "center", italic: true, margin: 0 }); } // ============================ // SLIDE 10 — SIS / Submucosal classification image // ============================ { let s = pres.addSlide(); addBg(s); addDecoStripe(s); sectionLabel(s, "Imaging"); s.addText("Submucosal Classification — 3D SIS", { x: 0.5, y: 0.6, w: 9, h: 0.65, fontSize: 26, bold: true, color: C.white }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 1.27, w: 9, h: 0, line: { color: C.accentGold, width: 1.5 } }); if (!images[0].error) { s.addImage({ data: images[0].base64, x: 0.4, y: 1.38, w: 5.4, h: 3.8 }); } s.addText("3D saline-infusion sonohysterography (SIS): submucosal myoma types 0, I, II", { x: 0.4, y: 5.1, w: 5.4, h: 0.25, fontSize: 8.5, color: C.softLilac, italic: true, align: "center" }); const sisTypes = [ { type: "Type 0", desc: "Pedunculated\nFully intracavitary\n(α <20°)" }, { type: "Type I", desc: ">50% protrudes\ninto cavity\n(α >20° ≤90°)" }, { type: "Type II", desc: "<50% protrudes\n≥50% intramural\n(α >90°)" }, ]; sisTypes.forEach(({ type, desc }, i) => { const x = 5.95 + i * 1.32; s.addShape(pres.ShapeType.roundRect, { x: 5.95, y: 1.4 + i * 1.3, w: 3.6, h: 1.1, fill: { color: [C.rosePink, C.tealGreen, C.medPurple][i], transparency: 65 }, line: { color: C.white, transparency: 50, width: 1 }, rectRadius: 0.1 }); s.addText(type, { x: 5.95, y: 1.4 + i * 1.3, w: 1.0, h: 1.1, fontSize: 14, bold: true, color: C.accentGold, align: "center", valign: "middle", margin: 0 }); s.addText(desc, { x: 7.0, y: 1.43 + i * 1.3, w: 2.5, h: 1.05, fontSize: 11, color: C.offWhite, valign: "middle", margin: 0 }); }); // Surgical significance s.addShape(pres.ShapeType.roundRect, { x: 5.95, y: 4.38, w: 3.6, h: 0.8, fill: { color: C.darkText, transparency: 30 }, line: { color: C.accentGold, width: 1 }, rectRadius: 0.1 }); s.addText("Types 0 & I: hysteroscopic resection\nType II: may need combined approach", { x: 5.95, y: 4.43, w: 3.6, h: 0.7, fontSize: 11, color: C.accentGold, align: "center", valign: "middle", bold: true }); } // ============================ // SLIDE 11 — MANAGEMENT OVERVIEW // ============================ { let s = pres.addSlide(); addBg(s); addDecoStripe(s); sectionLabel(s, "Management"); s.addText("Management Overview", { x: 0.5, y: 0.6, w: 9, h: 0.65, fontSize: 28, bold: true, color: C.white }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 1.27, w: 9, h: 0, line: { color: C.accentGold, width: 1.5 } }); const mgmtCols = [ { title: "EXPECTANT", icon: "👁", color: C.tealGreen, items: ["Asymptomatic fibroids", "Perimenopausal (await regression)", "Annual surveillance ultrasound", "Monitor for growth or symptoms"], x: 0.4 }, { title: "MEDICAL", icon: "💊", color: C.medPurple, items: ["NSAIDs: dysmenorrhea relief", "Combined OCP / Progestogens: ↓ bleeding", "GnRH agonists: ↓ size 30–50% (pre-op)", "Ulipristal acetate (SPRM)", "Levonorgestrel IUS (Mirena)", "Tranexamic acid: acute bleeding"], x: 3.55 }, { title: "INTERVENTIONAL", icon: "🏥", color: C.rosePink, items: ["Uterine Artery Embolization (UAE)", "MR-guided Focused Ultrasound (MRgFUS/HIFU)", "Endometrial ablation (small SM fibroids)", "Radiofrequency ablation"], x: 6.7 } ]; const colW = 2.9; mgmtCols.forEach(({ title, icon, color, items, x }) => { const h = 0.52 + items.length * 0.5; s.addShape(pres.ShapeType.roundRect, { x, y: 1.42, w: colW, h: 3.8, fill: { color, transparency: 70 }, line: { color, transparency: 20, width: 1.2 }, rectRadius: 0.12 }); s.addText(`${icon} ${title}`, { x: x + 0.1, y: 1.52, w: colW - 0.2, h: 0.42, fontSize: 12, bold: true, color: C.accentGold, align: "center", charSpacing: 0.5, margin: 0 }); s.addShape(pres.ShapeType.line, { x: x + 0.2, y: 2.0, w: colW - 0.4, h: 0, line: { color: C.white, transparency: 60, width: 0.8 } }); s.addText(items.map(t => ({ text: t, options: { bullet: { code: "25B8", color }, breakLine: true } })), { x: x + 0.12, y: 2.1, w: colW - 0.22, h: 3.1, fontSize: 11, color: C.offWhite }); }); } // ============================ // SLIDE 12 — MEDICAL MANAGEMENT DETAIL // ============================ { let s = pres.addSlide(); addBg(s); addDecoStripe(s); sectionLabel(s, "Medical Tx"); s.addText("Medical Management — Key Drugs", { x: 0.5, y: 0.6, w: 9, h: 0.65, fontSize: 26, bold: true, color: C.white }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 1.27, w: 9, h: 0, line: { color: C.accentGold, width: 1.5 } }); const drugs = [ { name: "GnRH Agonists", eg: "Leuprolide, Goserelin", moa: "↓ estrogen → hypoestrogenic state", use: "Preoperative downsizing (3–6 months); correct anemia", note: "SE: menopausal sx, bone loss; add-back therapy if >6 mo" }, { name: "GnRH Antagonists", eg: "Elagolix, Relugolix", moa: "Direct GnRH receptor blockade, faster onset", use: "Symptomatic control; FDA-approved for fibroid bleeding", note: "No flare effect; oral administration" }, { name: "Progestogens / LNG-IUS", eg: "NETA, MPA, Mirena IUS", moa: "Endometrial atrophy → ↓ menstrual flow", use: "Menorrhagia control (especially SM/IM)", note: "LNG-IUS expulsion risk if cavity distorted" }, { name: "SPRMs", eg: "Ulipristal acetate", moa: "Selective progesterone receptor modulator", use: "Intermittent treatment; ↓ fibroid volume", note: "Hepatotoxicity concerns → limited availability" }, { name: "Tranexamic Acid", eg: "1g TID during menses", moa: "Antifibrinolytic → ↓ blood loss ~50%", use: "Acute/heavy menstrual bleeding", note: "No effect on fibroid size" }, ]; drugs.forEach((d, i) => { const y = 1.38 + i * 0.83; s.addShape(pres.ShapeType.roundRect, { x: 0.4, y, w: 9.2, h: 0.78, fill: { color: i % 2 === 0 ? C.medPurple : C.rosePink, transparency: 75 }, line: { color: C.softLilac, transparency: 60, width: 0.7 }, rectRadius: 0.08 }); s.addText(d.name, { x: 0.52, y: y + 0.04, w: 2.0, h: 0.32, fontSize: 12, bold: true, color: C.accentGold, margin: 0 }); s.addText(`(${d.eg})`, { x: 0.52, y: y + 0.37, w: 2.0, h: 0.3, fontSize: 10, color: C.softLilac, italic: true, margin: 0 }); s.addText(`MOA: ${d.moa}`, { x: 2.65, y: y + 0.04, w: 3.5, h: 0.33, fontSize: 10.5, color: C.offWhite, margin: 0 }); s.addText(`Use: ${d.use}`, { x: 2.65, y: y + 0.38, w: 3.5, h: 0.32, fontSize: 10, color: C.offWhite, margin: 0 }); s.addText(d.note, { x: 6.3, y: y + 0.1, w: 3.1, h: 0.58, fontSize: 10, color: C.softLilac, italic: true, valign: "middle", margin: 0 }); }); } // ============================ // SLIDE 13 — SURGICAL OPTIONS + myomectomy image // ============================ { let s = pres.addSlide(); addBg(s); addDecoStripe(s); sectionLabel(s, "Surgery"); s.addText("Surgical Management", { x: 0.5, y: 0.6, w: 9, h: 0.65, fontSize: 28, bold: true, color: C.white }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 1.27, w: 9, h: 0, line: { color: C.accentGold, width: 1.5 } }); // Myomectomy s.addShape(pres.ShapeType.roundRect, { x: 0.4, y: 1.38, w: 4.5, h: 3.8, fill: { color: C.medPurple, transparency: 65 }, line: { color: C.softLilac, width: 0.8 }, rectRadius: 0.1 }); s.addText("MYOMECTOMY (uterus-preserving)", { x: 0.5, y: 1.48, w: 4.3, h: 0.32, fontSize: 11.5, bold: true, color: C.accentGold, charSpacing: 0.5, margin: 0 }); const myomRoutes = [ { route: "Hysteroscopic", crit: "SM types 0–2; ≤3 cm", best: "Best for cavity distortion & infertility" }, { route: "Laparoscopic", crit: "≤4–6 fibroids, ≤8–10 cm", best: "Minimal access; faster recovery" }, { route: "Robotic", crit: "Complex/deep intramural", best: "Precision closure; still expensive" }, { route: "Open (Laparotomy)", crit: "Large/multiple/subserosal", best: "Most versatile; still gold standard for fertility" }, ]; myomRoutes.forEach(({ route, crit, best }, i) => { const y = 1.88 + i * 0.8; s.addText(route, { x: 0.55, y, w: 1.6, h: 0.28, fontSize: 11.5, bold: true, color: C.tealGreen, margin: 0 }); s.addText(crit, { x: 0.55, y: y + 0.3, w: 4.2, h: 0.25, fontSize: 10.5, color: C.offWhite, italic: true, margin: 0 }); s.addText(best, { x: 0.55, y: y + 0.54, w: 4.2, h: 0.22, fontSize: 10, color: C.softLilac, margin: 0 }); }); // Surgical image on right if (!images[2].error) { s.addImage({ data: images[2].base64, x: 5.1, y: 1.38, w: 4.5, h: 3.1 }); } s.addText("Laparoscopic myomectomy: pseudocapsule-sparing technique", { x: 5.1, y: 4.42, w: 4.5, h: 0.22, fontSize: 8.5, color: C.softLilac, align: "center", italic: true }); // Hysterectomy note s.addShape(pres.ShapeType.roundRect, { x: 5.1, y: 4.7, w: 4.5, h: 0.98, fill: { color: C.rosePink, transparency: 68 }, line: { color: C.rosePink, width: 1 }, rectRadius: 0.1 }); s.addText("HYSTERECTOMY (definitive treatment)", { x: 5.2, y: 4.76, w: 4.3, h: 0.28, fontSize: 11.5, bold: true, color: C.accentGold, margin: 0 }); s.addText("Indications: failed medical tx, no desire for fertility, large symptomatic myomas, recurrent post-myomectomy. Routes: TAH, VH, TLH, LAVH.", { x: 5.2, y: 5.0, w: 4.3, h: 0.6, fontSize: 10, color: C.offWhite, margin: 0 }); } // ============================ // SLIDE 14 — MYOMA IN PREGNANCY // ============================ { let s = pres.addSlide(); addBg(s); addDecoStripe(s); sectionLabel(s, "Pregnancy"); s.addText("Myoma in Pregnancy", { x: 0.5, y: 0.6, w: 9, h: 0.65, fontSize: 28, bold: true, color: C.white }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 1.27, w: 9, h: 0, line: { color: C.accentGold, width: 1.5 } }); const trimGroups = [ { header: "1st TRIMESTER", color: C.tealGreen, items: ["Spontaneous abortion risk ↑ (submucosal)", "Red degeneration (Carneous) — acute pain, fever", "Sub-placental fibroids → implantation failure"], x: 0.4 }, { header: "2nd TRIMESTER", color: C.medPurple, items: ["Red degeneration most common (15–20 wks)", "Mechanical pressure effects", "Preterm labor risk", "Managed conservatively (analgesia, hydration)"], x: 3.55 }, { header: "3RD TRIMESTER & LABOUR", color: C.rosePink, items: ["Malpresentation (transverse, breech)", "Placenta previa (lower segment)", "Obstructed labour (lower segment / cervical)", "Postpartum haemorrhage (PPH)", "Caesarean section often required"], x: 6.7 } ]; trimGroups.forEach(({ header, color, items, x }) => { s.addShape(pres.ShapeType.roundRect, { x, y: 1.42, w: 2.95, h: 3.8, fill: { color, transparency: 72 }, line: { color, transparency: 20, width: 1.2 }, rectRadius: 0.12 }); s.addText(header, { x: x + 0.1, y: 1.52, w: 2.75, h: 0.42, fontSize: 11.5, bold: true, color: C.accentGold, align: "center", charSpacing: 0.5, margin: 0 }); s.addShape(pres.ShapeType.line, { x: x + 0.15, y: 2.0, w: 2.65, h: 0, line: { color: C.white, transparency: 55, width: 0.8 } }); s.addText(items.map(t => ({ text: t, options: { bullet: { code: "25B8", color }, breakLine: true } })), { x: x + 0.12, y: 2.08, w: 2.7, h: 3.1, fontSize: 11, color: C.offWhite }); }); s.addShape(pres.ShapeType.roundRect, { x: 0.4, y: 5.25, w: 9.2, h: 0.33, fill: { color: C.accentGold, transparency: 75 }, line: { color: C.accentGold, width: 0.8 }, rectRadius: 0.06 }); s.addText("Key: Myomectomy during pregnancy generally avoided except for pedunculated torsion. Red degeneration managed conservatively.", { x: 0.5, y: 5.27, w: 9.0, h: 0.28, fontSize: 10.5, color: C.white, align: "center", italic: true, margin: 0 }); } // ============================ // SLIDE 15 — COMPLICATIONS & PROGNOSIS // ============================ { let s = pres.addSlide(); addBg(s); addDecoStripe(s); sectionLabel(s, "Complications"); s.addText("Complications & Prognosis", { x: 0.5, y: 0.6, w: 9, h: 0.65, fontSize: 28, bold: true, color: C.white }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 1.27, w: 9, h: 0, line: { color: C.accentGold, width: 1.5 } }); const comps = [ { title: "Anemia", body: "Iron-deficiency from chronic menorrhagia; may be severe requiring transfusion or IV iron", color: C.rosePink }, { title: "Torsion", body: "Pedunculated fibroids → acute abdomen; surgical emergency", color: "C4382A" }, { title: "Infection", body: "Submucous fibroids → pyomyoma; post-UAE necrosis risk", color: C.medPurple }, { title: "Sarcomatous Change", body: "Leiomyosarcoma in <0.5%; rapid growth, post-menopausal bleeding are warning signs", color: C.accentGold }, { title: "Urinary Complications", body: "Hydronephrosis, urinary retention from large fibroids; ureteric injury at surgery", color: C.tealGreen }, { title: "Recurrence", body: "20–30% recurrence at 5 yrs post-myomectomy; rare after hysterectomy", color: C.medPurple }, ]; comps.forEach(({ title, body, color }, i) => { const col = i % 2; const row = Math.floor(i / 2); const x = 0.4 + col * 4.75; const y = 1.38 + row * 1.35; s.addShape(pres.ShapeType.roundRect, { x, y, w: 4.45, h: 1.22, fill: { color, transparency: 72 }, line: { color, transparency: 25, width: 1 }, rectRadius: 0.1 }); s.addText(title, { x: x + 0.12, y: y + 0.06, w: 4.25, h: 0.32, fontSize: 13, bold: true, color: C.white, margin: 0 }); s.addText(body, { x: x + 0.12, y: y + 0.4, w: 4.25, h: 0.75, fontSize: 11, color: C.offWhite, margin: 0 }); }); // Prognosis footer s.addShape(pres.ShapeType.roundRect, { x: 0.4, y: 5.2, w: 9.2, h: 0.4, fill: { color: C.tealGreen, transparency: 70 }, line: { color: C.tealGreen, width: 1 }, rectRadius: 0.08 }); s.addText("Prognosis: Excellent with appropriate management. Spontaneous regression post-menopause is expected. Fertility outcomes improved with timely myomectomy.", { x: 0.5, y: 5.22, w: 9.0, h: 0.36, fontSize: 11, color: C.white, align: "center", italic: true, valign: "middle" }); } // ============================ // SLIDE 16 — SUMMARY / KEY POINTS // ============================ { let s = pres.addSlide(); s.background = { color: C.deepPlum }; s.addShape(pres.ShapeType.ellipse, { x: 7, y: -0.5, w: 4.5, h: 4.5, fill: { color: C.rosePink, transparency: 82 }, line: { color: C.rosePink, transparency: 82 } }); s.addShape(pres.ShapeType.ellipse, { x: -1, y: 3.5, w: 3.5, h: 3.5, fill: { color: C.medPurple, transparency: 82 }, line: { color: C.medPurple, transparency: 82 } }); s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.1, fill: { color: C.accentGold }, line: { color: C.accentGold } }); s.addText("Key Takeaways", { x: 0.5, y: 0.2, w: 9, h: 0.65, fontSize: 32, bold: true, color: C.white, align: "left" }); s.addShape(pres.ShapeType.line, { x: 0.5, y: 0.87, w: 4, h: 0, line: { color: C.accentGold, width: 2 } }); const keys = [ "Most common benign pelvic tumor; affects 20–40% of reproductive-age women", "Hormone-dependent growth — estrogen & progesterone drive proliferation", "FIGO classification (types 0–8) guides treatment strategy", "Ultrasound is first-line; MRI is gold standard for surgical planning", "Management depends on symptoms, size, fertility desires, and location", "GnRH agonists shrink fibroids preoperatively; not curative long-term", "Hysterectomy is the only definitive cure; myomectomy preserves fertility", "Malignant transformation (leiomyosarcoma) is rare (<0.5%)", ]; keys.forEach((key, i) => { const col = i % 2; const row = Math.floor(i / 2); const x = 0.4 + col * 5.0; const y = 1.05 + row * 1.08; s.addShape(pres.ShapeType.roundRect, { x, y, w: 4.7, h: 0.9, fill: { color: i % 4 < 2 ? C.medPurple : C.rosePink, transparency: 72 }, line: { color: C.softLilac, transparency: 60, width: 0.7 }, rectRadius: 0.1 }); s.addShape(pres.ShapeType.ellipse, { x: x + 0.12, y: y + 0.2, w: 0.32, h: 0.32, fill: { color: C.accentGold }, line: { color: C.accentGold } }); s.addText(String(i + 1), { x: x + 0.12, y: y + 0.2, w: 0.32, h: 0.32, fontSize: 10, bold: true, color: C.darkText, align: "center", valign: "middle", margin: 0 }); s.addText(key, { x: x + 0.52, y: y + 0.06, w: 4.1, h: 0.78, fontSize: 11.5, color: C.offWhite, valign: "middle" }); }); s.addShape(pres.ShapeType.rect, { x: 0, y: 5.45, w: 10, h: 0.18, fill: { color: C.rosePink }, line: { color: C.rosePink } }); s.addText("Uterine Myoma (Fibroid / Leiomyoma) · Gynecology", { x: 0, y: 5.45, w: 10, h: 0.18, fontSize: 9, color: C.white, align: "center", valign: "middle", bold: true, charSpacing: 2, margin: 0 }); } // ============================ // SAVE // ============================ const outPath = "/home/daytona/workspace/uterine-myoma-ppt/Uterine_Myoma_Fibroid.pptx"; pres.writeFile({ fileName: outPath }) .then(() => console.log("Saved: " + outPath)) .catch(e => { console.error(e); process.exit(1); });