mkdir -p /home/daytona/workspace/surgical-infection-ppt

~/surgical-infection-ppt/build.js

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

// ── PALETTE ──────────────────────────────────────────────────────────────────
const C = {
  navy:    "0D1B2A",  // dominant dark bg
  teal:    "1B4F72",  // section headers
  accent:  "1ABC9C",  // accent / highlight
  light:   "EAF4FB",  // content bg panels
  white:   "FFFFFF",
  text:    "1C2833",  // dark text on light bg
  subtext: "5D6D7E",  // secondary text
  red:     "E74C3C",  // danger callouts
  gold:    "F1C40F",  // warnings
};

// ── HELPER: accent bar left side ─────────────────────────────────────────────
function accentBar(slide, color) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.15, h: 5.625, fill: { color: color || C.accent } });
}

// ── HELPER: full dark header bar ─────────────────────────────────────────────
function headerBar(slide, title, subtitle) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 1.1, fill: { color: C.teal } });
  slide.addText(title, { x: 0.25, y: 0.08, w: 9.5, h: 0.6, fontSize: 22, bold: true, color: C.white, fontFace: "Calibri", margin: 0 });
  if (subtitle) {
    slide.addText(subtitle, { x: 0.25, y: 0.68, w: 9.5, h: 0.35, fontSize: 12, color: C.accent, fontFace: "Calibri", margin: 0, italic: true });
  }
}

// ── HELPER: content box ───────────────────────────────────────────────────────
function contentBox(slide, items, opts) {
  const { x = 0.25, y = 1.2, w = 9.5, h = 4.0, fontSize = 13, color = C.text } = opts || {};
  const richText = items.map((item, i) => ({
    text: item,
    options: { bullet: { type: "bullet", code: "2022", color: C.accent }, breakLine: i < items.length - 1, fontSize, color, fontFace: "Calibri", paraSpaceAfter: 4 }
  }));
  slide.addText(richText, { x, y, w, h, valign: "top", fill: { color: C.light }, line: { color: C.accent, width: 1 }, margin: 12, shadow: { type: "outer", blur: 4, offset: 2, angle: 45, color: "BBBBBB", opacity: 0.4 } });
}

// ── HELPER: two-column layout ─────────────────────────────────────────────────
function twoCol(slide, leftItems, rightItems, opts) {
  const { yStart = 1.2, h = 4.0 } = opts || {};
  const makeRich = (items, accent) => items.map((item, i) => ({
    text: item,
    options: { bullet: { type: "bullet", code: "2022", color: accent }, breakLine: i < items.length - 1, fontSize: 12, color: C.text, fontFace: "Calibri", paraSpaceAfter: 3 }
  }));
  slide.addText(makeRich(leftItems, C.accent), { x: 0.25, y: yStart, w: 4.55, h, valign: "top", fill: { color: C.light }, line: { color: C.accent, width: 1 }, margin: 10, shadow: { type: "outer", blur: 4, offset: 2, angle: 45, color: "BBBBBB", opacity: 0.3 } });
  slide.addText(makeRich(rightItems, C.red), { x: 5.2, y: yStart, w: 4.55, h, valign: "top", fill: { color: C.light }, line: { color: C.red, width: 1 }, margin: 10, shadow: { type: "outer", blur: 4, offset: 2, angle: 45, color: "BBBBBB", opacity: 0.3 } });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE SLIDE
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  // Full dark bg
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.navy } });
  // Decorative accent shapes
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.5, h: 5.625, fill: { color: C.accent } });
  s.addShape(pres.ShapeType.rect, { x: 0.5, y: 4.8, w: 9.5, h: 0.08, fill: { color: C.accent } });
  s.addShape(pres.ShapeType.rect, { x: 0.5, y: 4.9, w: 9.5, h: 0.08, fill: { color: C.teal } });
  // Title
  s.addText("SURGICAL INFECTION", {
    x: 0.8, y: 1.0, w: 8.8, h: 1.0, fontSize: 40, bold: true, color: C.white,
    fontFace: "Calibri", align: "center", charSpacing: 3
  });
  // Subtitle block
  s.addText([
    { text: "Necrosis · Gangrene · Trophic Ulcer · Fistula", options: { breakLine: true } },
    { text: "Purulent Diseases · Osteomyelitis · General Principles of Treatment", options: { breakLine: false } }
  ], {
    x: 0.8, y: 2.2, w: 8.8, h: 1.2, fontSize: 15, color: C.accent,
    fontFace: "Calibri", align: "center", italic: true
  });
  // Decorative tag line
  s.addText("Surgical Infections — Classification, Pathology & Management", {
    x: 0.8, y: 3.6, w: 8.8, h: 0.5, fontSize: 12, color: C.subtext,
    fontFace: "Calibri", align: "center"
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 2 — CLASSIFICATION OF SURGICAL INFECTION
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.white } });
  accentBar(s);
  headerBar(s, "Classification of Surgical Infection", "Basis: Causative agent, clinical course, tissue involvement");

  // Left column: by pathogen
  s.addText("By Causative Agent", { x: 0.25, y: 1.2, w: 4.55, h: 0.4, fontSize: 13, bold: true, color: C.teal, fontFace: "Calibri" });
  const leftItems = [
    "Aerobic (Staphylococcus, Streptococcus, E. coli, Pseudomonas)",
    "Anaerobic non-clostridial (Bacteroides, Peptostreptococcus)",
    "Clostridial — Gas Gangrene, Tetanus",
    "Specific: Tuberculosis, Actinomycosis, Syphilis",
    "Mixed / Polymicrobial"
  ];
  s.addText(leftItems.map((t, i) => ({ text: t, options: { bullet: { code: "2022", color: C.accent }, breakLine: i < leftItems.length - 1, fontSize: 12, color: C.text, fontFace: "Calibri", paraSpaceAfter: 3 } })),
    { x: 0.25, y: 1.65, w: 4.55, h: 2.4, fill: { color: C.light }, line: { color: C.accent, width: 1 }, margin: 10, valign: "top" });

  // Right column: by course
  s.addText("By Clinical Course", { x: 5.2, y: 1.2, w: 4.55, h: 0.4, fontSize: 13, bold: true, color: C.teal, fontFace: "Calibri" });
  const rightItems = [
    "Acute vs. Chronic",
    "Local (abscess, cellulitis) vs. Systemic (sepsis)",
    "Non-specific (pyogenic) vs. Specific",
    "Endogenous vs. Exogenous source",
    "Superficial, Deep, Cavity, Visceral"
  ];
  s.addText(rightItems.map((t, i) => ({ text: t, options: { bullet: { code: "2022", color: C.red }, breakLine: i < rightItems.length - 1, fontSize: 12, color: C.text, fontFace: "Calibri", paraSpaceAfter: 3 } })),
    { x: 5.2, y: 1.65, w: 4.55, h: 2.4, fill: { color: C.light }, line: { color: C.red, width: 1 }, margin: 10, valign: "top" });

  // Bottom callout
  s.addShape(pres.ShapeType.rect, { x: 0.25, y: 4.15, w: 9.5, h: 0.7, fill: { color: C.teal } });
  s.addText("Key pathogens: S. aureus (most common), Streptococcus pyogenes, E. coli, Clostridium spp., Bacteroides fragilis", {
    x: 0.35, y: 4.18, w: 9.3, h: 0.65, fontSize: 11, color: C.white, fontFace: "Calibri", bold: true, valign: "middle"
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 3 — NECROSIS & GANGRENE
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.white } });
  accentBar(s);
  headerBar(s, "Necrosis & Gangrene", "Pathological death of tissue — types and surgical implications");

  // Necrosis box
  s.addText("NECROSIS", { x: 0.25, y: 1.2, w: 4.55, h: 0.38, fontSize: 13, bold: true, color: C.white, fontFace: "Calibri", fill: { color: C.teal }, align: "center", valign: "middle" });
  const necItems = [
    "Coagulative — dry, firm; ischemic (heart, kidney)",
    "Liquefactive — wet, pus-like; brain/abscess",
    "Caseous — cheese-like; TB, fungal",
    "Fat Necrosis — saponification; breast, pancreas",
    "Gangrenous — advanced ischemic necrosis"
  ];
  s.addText(necItems.map((t, i) => ({ text: t, options: { bullet: { code: "2022", color: C.accent }, breakLine: i < necItems.length - 1, fontSize: 11.5, color: C.text, fontFace: "Calibri", paraSpaceAfter: 3 } })),
    { x: 0.25, y: 1.62, w: 4.55, h: 2.6, fill: { color: C.light }, line: { color: C.accent, width: 1 }, margin: 10, valign: "top" });

  // Gangrene box
  s.addText("GANGRENE", { x: 5.2, y: 1.2, w: 4.55, h: 0.38, fontSize: 13, bold: true, color: C.white, fontFace: "Calibri", fill: { color: C.red }, align: "center", valign: "middle" });
  const gangItems = [
    "Dry Gangrene — arterial occlusion, no infection; mummification; Rx: debridement / amputation",
    "Wet Gangrene — venous + arterial block + infection; foul smell, spreading; EMERGENCY",
    "Gas Gangrene — Clostridium perfringens; crepitation, toxemia; IV Penicillin + surgery",
    "Diabetic Gangrene — peripheral arteriopathy + neuropathy + infection"
  ];
  s.addText(gangItems.map((t, i) => ({ text: t, options: { bullet: { code: "2022", color: C.red }, breakLine: i < gangItems.length - 1, fontSize: 11.5, color: C.text, fontFace: "Calibri", paraSpaceAfter: 4 } })),
    { x: 5.2, y: 1.62, w: 4.55, h: 2.6, fill: { color: C.light }, line: { color: C.red, width: 1 }, margin: 10, valign: "top" });

  // Bottom bar
  s.addShape(pres.ShapeType.rect, { x: 0.25, y: 4.3, w: 9.5, h: 0.55, fill: { color: C.navy } });
  s.addText("Treatment Principles: Remove necrotic tissue (debridement/amputation), antibiotics, improve perfusion, treat underlying cause", {
    x: 0.35, y: 4.33, w: 9.3, h: 0.5, fontSize: 11, color: C.accent, fontFace: "Calibri", valign: "middle"
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 4 — TROPHIC ULCERS & FISTULAS
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.white } });
  accentBar(s);
  headerBar(s, "Trophic Ulcers & Fistulas", "Chronic tissue defects — etiology, features and management");

  s.addText("TROPHIC ULCER", { x: 0.25, y: 1.2, w: 4.55, h: 0.38, fontSize: 13, bold: true, color: C.white, fontFace: "Calibri", fill: { color: C.teal }, align: "center", valign: "middle" });
  const ulcerItems = [
    "Definition: Persistent defect due to impaired tissue nutrition",
    "Causes: Venous insufficiency (most common), arterial ischemia, DM neuropathy, pressure sores",
    "Features: Pale/cyanotic edges, sloughy base, painless (neuropathic), scarring",
    "Rx: Treat cause, debridement, compression therapy, skin grafting, HBO therapy"
  ];
  s.addText(ulcerItems.map((t, i) => ({ text: t, options: { bullet: { code: "2022", color: C.accent }, breakLine: i < ulcerItems.length - 1, fontSize: 11.5, color: C.text, fontFace: "Calibri", paraSpaceAfter: 4 } })),
    { x: 0.25, y: 1.62, w: 4.55, h: 2.8, fill: { color: C.light }, line: { color: C.accent, width: 1 }, margin: 10, valign: "top" });

  s.addText("FISTULA", { x: 5.2, y: 1.2, w: 4.55, h: 0.38, fontSize: 13, bold: true, color: C.white, fontFace: "Calibri", fill: { color: C.teal }, align: "center", valign: "middle" });
  const fisItems = [
    "Definition: Abnormal tract connecting two epithelial surfaces",
    "Complete (external) vs. Internal fistula",
    "Causes: Infection, inflammation (Crohn's), foreign body, radiation, tumor",
    "FRIENDS mnemonic: Foreign body, Radiation, Inflammation, Epithelialization, Neoplasm, Distal obstruction, Specific infection",
    "Rx: Treat infection, excision of tract, eliminate distal obstruction"
  ];
  s.addText(fisItems.map((t, i) => ({ text: t, options: { bullet: { code: "2022", color: C.red }, breakLine: i < fisItems.length - 1, fontSize: 11.5, color: C.text, fontFace: "Calibri", paraSpaceAfter: 4 } })),
    { x: 5.2, y: 1.62, w: 4.55, h: 2.8, fill: { color: C.light }, line: { color: C.red, width: 1 }, margin: 10, valign: "top" });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 5 — GENERAL REACTION TO INFECTION / SEPSIS
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.white } });
  accentBar(s);
  headerBar(s, "General Reaction of the Organism to Infection", "SIRS → Sepsis → Severe Sepsis → Septic Shock");

  // SIRS criteria callout box
  s.addShape(pres.ShapeType.rect, { x: 0.25, y: 1.2, w: 9.5, h: 0.55, fill: { color: C.accent } });
  s.addText("SIRS Criteria (≥2): Temp >38°C or <36°C | HR >90 | RR >20 or PaCO₂ <32 | WBC >12,000 or <4,000 or >10% bands", {
    x: 0.35, y: 1.23, w: 9.3, h: 0.5, fontSize: 11.5, color: C.navy, fontFace: "Calibri", bold: true, valign: "middle"
  });

  // Phases table-like display
  const phases = [
    { label: "Local Infection", desc: "Redness, swelling, heat, pain, loss of function — cardinal signs of inflammation" },
    { label: "SIRS", desc: "Systemic inflammatory response; fever/hypothermia, tachycardia, tachypnea, leukocytosis" },
    { label: "Sepsis", desc: "SIRS + confirmed/suspected infection source; organ dysfunction begins" },
    { label: "Severe Sepsis", desc: "Sepsis + acute organ dysfunction (renal, hepatic, coagulation, CNS)" },
    { label: "Septic Shock", desc: "Sepsis + refractory hypotension despite adequate fluid resuscitation; mortality >40%" },
  ];

  phases.forEach((p, i) => {
    const yPos = 1.88 + i * 0.65;
    const bgColor = i % 2 === 0 ? "EAF4FB" : "D4E6F1";
    s.addShape(pres.ShapeType.rect, { x: 0.25, y: yPos, w: 9.5, h: 0.6, fill: { color: bgColor } });
    s.addShape(pres.ShapeType.rect, { x: 0.25, y: yPos, w: 2.2, h: 0.6, fill: { color: C.teal } });
    s.addText(p.label, { x: 0.3, y: yPos + 0.04, w: 2.1, h: 0.52, fontSize: 11, bold: true, color: C.white, fontFace: "Calibri", valign: "middle" });
    s.addText(p.desc, { x: 2.55, y: yPos + 0.04, w: 7.1, h: 0.52, fontSize: 11, color: C.text, fontFace: "Calibri", valign: "middle" });
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 6 — GENERAL PRINCIPLES OF TREATMENT
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.white } });
  accentBar(s);
  headerBar(s, "General Principles of Treatment", "Local + Systemic approach — the cornerstone of surgical infection management");

  const principles = [
    { icon: "1", title: "Surgical Drainage", desc: 'Incision & drainage (I&D) of pus — "ubi pus, ibi evacua"' },
    { icon: "2", title: "Antibiotics", desc: "Culture-guided; empiric broad-spectrum first — cover Staph, Strep, Gram-negatives, anaerobes" },
    { icon: "3", title: "Debridement", desc: "Remove all necrotic tissue; repeated wound inspection; VAC therapy for large wounds" },
    { icon: "4", title: "Immobilization", desc: "Reduce local spread; splinting of affected limb; elevation to reduce edema" },
    { icon: "5", title: "Supportive Care", desc: "IV fluids, nutrition (enteral preferred), pain management, glycaemic control" },
    { icon: "6", title: "Immune Support", desc: "Tetanus prophylaxis, immunoglobulins if indicated; treat immunosuppression" },
  ];

  principles.forEach((p, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    const xPos = col === 0 ? 0.25 : 5.2;
    const yPos = 1.25 + row * 1.35;
    s.addShape(pres.ShapeType.rect, { x: xPos, y: yPos, w: 4.55, h: 1.2, fill: { color: C.light }, line: { color: C.accent, width: 1 } });
    s.addShape(pres.ShapeType.rect, { x: xPos, y: yPos, w: 0.5, h: 1.2, fill: { color: C.accent } });
    s.addText(p.icon, { x: xPos, y: yPos + 0.35, w: 0.5, h: 0.5, fontSize: 16, bold: true, color: C.navy, fontFace: "Calibri", align: "center" });
    s.addText(p.title, { x: xPos + 0.55, y: yPos + 0.05, w: 3.9, h: 0.35, fontSize: 12, bold: true, color: C.teal, fontFace: "Calibri" });
    s.addText(p.desc, { x: xPos + 0.55, y: yPos + 0.42, w: 3.9, h: 0.7, fontSize: 11, color: C.text, fontFace: "Calibri" });
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 7 — FURUNCLE, CARBUNCLE & HIDRADENITIS
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.white } });
  accentBar(s);
  headerBar(s, "Furuncle · Carbuncle · Hidradenitis", "Folliculitis spectrum and apocrine gland infections");

  const cards = [
    {
      title: "FURUNCLE (Boil)",
      color: C.teal,
      items: [
        "Acute purulent inflammation of hair follicle + surrounding tissue",
        "Organism: S. aureus",
        "Site: neck, face, axilla, buttocks",
        "Rx: Topical antiseptics; I&D if fluctuant; oral antibiotics (cloxacillin)"
      ]
    },
    {
      title: "CARBUNCLE",
      color: C.red,
      items: [
        "Multiple furuncles with interconnecting sinuses",
        "Common: nape of neck, back; diabetics at risk",
        "Systemic toxemia present; necrotic central plug",
        "Rx: Cruciate incision + debridement, IV antibiotics, glycaemic control"
      ]
    },
    {
      title: "HIDRADENITIS SUPPURATIVA",
      color: "8E44AD",
      items: [
        "Chronic inflammation of apocrine sweat glands",
        "Sites: axilla, groin, perineum, submammary",
        "Recurrent abscesses → sinus tracts → scarring",
        "Rx: Long-term antibiotics, anti-androgens, biologic (adalimumab); wide excision for severe"
      ]
    }
  ];

  cards.forEach((card, i) => {
    const xPos = 0.25 + i * 3.25;
    s.addShape(pres.ShapeType.rect, { x: xPos, y: 1.2, w: 3.1, h: 0.42, fill: { color: card.color } });
    s.addText(card.title, { x: xPos, y: 1.22, w: 3.1, h: 0.38, fontSize: 11, bold: true, color: C.white, fontFace: "Calibri", align: "center", valign: "middle" });
    s.addText(card.items.map((t, j) => ({ text: t, options: { bullet: { code: "2022", color: card.color }, breakLine: j < card.items.length - 1, fontSize: 11, color: C.text, fontFace: "Calibri", paraSpaceAfter: 5 } })),
      { x: xPos, y: 1.65, w: 3.1, h: 3.6, fill: { color: C.light }, line: { color: card.color, width: 1 }, margin: 8, valign: "top" });
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 8 — ABSCESS & PHLEGMON (CELLULITIS)
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.white } });
  accentBar(s);
  headerBar(s, "Abscess & Phlegmon (Cellulitis)", "Localized vs. diffuse purulent infections");

  s.addText("ABSCESS", { x: 0.25, y: 1.2, w: 4.55, h: 0.38, fontSize: 13, bold: true, color: C.white, fontFace: "Calibri", fill: { color: C.teal }, align: "center", valign: "middle" });
  const absItems = [
    "Collection of pus within a DEFINED cavity (pyogenic membrane)",
    "Signs: fluctuation, pointing, skin erythema",
    "Common: soft tissue, perianal, breast, liver (amoebic/pyogenic)",
    "Diagnosis: U/S (hypoechoic collection), aspiration",
    "Treatment: I&D — incision at most fluctuant point; packing; drain placement; antibiotics for cellulitis surround"
  ];
  s.addText(absItems.map((t, i) => ({ text: t, options: { bullet: { code: "2022", color: C.accent }, breakLine: i < absItems.length - 1, fontSize: 11.5, color: C.text, fontFace: "Calibri", paraSpaceAfter: 4 } })),
    { x: 0.25, y: 1.62, w: 4.55, h: 3.3, fill: { color: C.light }, line: { color: C.accent, width: 1 }, margin: 10, valign: "top" });

  s.addText("PHLEGMON / CELLULITIS", { x: 5.2, y: 1.2, w: 4.55, h: 0.38, fontSize: 13, bold: true, color: C.white, fontFace: "Calibri", fill: { color: C.red }, align: "center", valign: "middle" });
  const phlItems = [
    "DIFFUSE, spreading inflammation without defined borders; pus infiltrates tissue planes",
    "Causes: streptococcal (spreading) + staphylococcal",
    "Presents: brawny edema, erythema, warmth, fever, lymphangitis",
    "Necrotizing fasciitis: deep rapidly spreading variant — EMERGENCY; finger test positive",
    "Treatment: broad IV antibiotics (vancomycin + piperacillin-tazobactam); aggressive surgical debridement for NF"
  ];
  s.addText(phlItems.map((t, i) => ({ text: t, options: { bullet: { code: "2022", color: C.red }, breakLine: i < phlItems.length - 1, fontSize: 11.5, color: C.text, fontFace: "Calibri", paraSpaceAfter: 4 } })),
    { x: 5.2, y: 1.62, w: 4.55, h: 3.3, fill: { color: C.light }, line: { color: C.red, width: 1 }, margin: 10, valign: "top" });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 9 — PURULENT FINGER DISEASES & MASTITIS
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.white } });
  accentBar(s);
  headerBar(s, "Purulent Diseases of Fingers (Panaritium) & Mastitis", "Common surgical infections requiring prompt diagnosis and drainage");

  // Finger infections left
  s.addText("PANARITIUM (Felon/Paronychia)", { x: 0.25, y: 1.2, w: 4.55, h: 0.38, fontSize: 12, bold: true, color: C.white, fontFace: "Calibri", fill: { color: C.teal }, align: "center", valign: "middle" });
  const panItems = [
    "Skin panaritium — subcutaneous pus, minimal systemic features",
    "Subcutaneous panaritium — deep to skin; most common type",
    "Subungual — under nail plate; throbbing pain; nail removal",
    "Periungual (Paronychia) — around nail fold; S. aureus",
    "Tendinous (Tenosynovitis) — Kanavel signs: finger held flexed, uniform swelling, tenderness along sheath, pain on passive extension",
    "Bone panaritium — osteomyelitis of phalanx",
    "Treatment: I&D under digital block; appropriate antibiotic (cloxacillin / amoxicillin-clavulanate)"
  ];
  s.addText(panItems.map((t, i) => ({ text: t, options: { bullet: { code: "2022", color: C.accent }, breakLine: i < panItems.length - 1, fontSize: 10.5, color: C.text, fontFace: "Calibri", paraSpaceAfter: 3 } })),
    { x: 0.25, y: 1.62, w: 4.55, h: 3.7, fill: { color: C.light }, line: { color: C.accent, width: 1 }, margin: 10, valign: "top" });

  // Mastitis right
  s.addText("MASTITIS", { x: 5.2, y: 1.2, w: 4.55, h: 0.38, fontSize: 12, bold: true, color: C.white, fontFace: "Calibri", fill: { color: C.red }, align: "center", valign: "middle" });
  const mastItems = [
    "Acute Puerperal Mastitis: lactation (1–4 weeks postpartum); S. aureus via cracked nipple",
    "Presents: engorgement → cellulitis → abscess",
    "Non-puerperal: duct ectasia, periductal mastitis, chronic granulomatous",
    "Treatment: Continue breastfeeding; oral dicloxacillin/flucloxacillin; aspiration or I&D if abscess forms",
    "Incision: radial (not circumareolar) to avoid lactiferous ducts",
    "Weaning not necessary; antibiotic-safe for infant (cloxacillin)"
  ];
  s.addText(mastItems.map((t, i) => ({ text: t, options: { bullet: { code: "2022", color: C.red }, breakLine: i < mastItems.length - 1, fontSize: 10.5, color: C.text, fontFace: "Calibri", paraSpaceAfter: 3 } })),
    { x: 5.2, y: 1.62, w: 4.55, h: 3.7, fill: { color: C.light }, line: { color: C.red, width: 1 }, margin: 10, valign: "top" });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 10 — PARAPROCTITIS (ANORECTAL ABSCESS)
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.white } });
  accentBar(s);
  headerBar(s, "Paraproctitis — Anorectal Abscesses & Fistula-in-Ano", "Infection of perirectal spaces; most arise from cryptoglandular source");

  // Classification diagram using shapes
  const spaces = [
    { label: "Perianal", x: 0.5, color: "2ECC71", desc: "Most common (60%); superficial; perianal pain + swelling" },
    { label: "Ischiorectal", x: 3.05, color: C.accent, desc: "Large; induration lateral to anus; may be bilateral (horseshoe)" },
    { label: "Intersphincteric", x: 5.6, color: "F39C12", desc: "Between internal & external sphincter; rectal pain without visible swelling" },
    { label: "Supralevator", x: 8.15, color: C.red, desc: "Above levator ani; pelvic pain; CT/MRI required; rare" },
  ];

  spaces.forEach((sp) => {
    s.addShape(pres.ShapeType.rect, { x: sp.x, y: 1.2, w: 2.2, h: 0.42, fill: { color: sp.color } });
    s.addText(sp.label, { x: sp.x, y: 1.22, w: 2.2, h: 0.38, fontSize: 11, bold: true, color: C.white, fontFace: "Calibri", align: "center", valign: "middle" });
    s.addText(sp.desc, { x: sp.x, y: 1.65, w: 2.2, h: 1.2, fontSize: 10, color: C.text, fontFace: "Calibri", fill: { color: C.light }, line: { color: sp.color, width: 1 }, margin: 6, valign: "top" });
  });

  // Treatment section
  s.addShape(pres.ShapeType.rect, { x: 0.25, y: 3.0, w: 9.5, h: 0.38, fill: { color: C.teal } });
  s.addText("TREATMENT & COMPLICATIONS", { x: 0.3, y: 3.02, w: 9.4, h: 0.35, fontSize: 12, bold: true, color: C.white, fontFace: "Calibri", valign: "middle" });

  const rxItems = [
    "Definitive treatment: Surgical drainage (under anaesthesia) — never treat conservatively alone",
    "Fistula-in-ano develops in 50% after drainage — subsequent fistulotomy / seton placement",
    "Fournier's gangrene: Life-threatening necrotizing fasciitis of perineum — ICU + aggressive debridement + IV antibiotics"
  ];
  s.addText(rxItems.map((t, i) => ({ text: t, options: { bullet: { code: "2022", color: C.accent }, breakLine: i < rxItems.length - 1, fontSize: 11.5, color: C.text, fontFace: "Calibri", paraSpaceAfter: 5 } })),
    { x: 0.25, y: 3.42, w: 9.5, h: 1.8, fill: { color: C.light }, line: { color: C.teal, width: 1 }, margin: 10, valign: "top" });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 11 — OSTEOMYELITIS
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.white } });
  accentBar(s);
  headerBar(s, "Osteomyelitis", "Bone infection — hematogenous, contiguous, or post-traumatic");

  // 3 column layout
  const cols = [
    {
      title: "Classification",
      color: C.teal,
      items: [
        "Acute Hematogenous: children; metaphysis; S. aureus",
        "Subacute: Brodie's abscess — walled-off; less toxic",
        "Chronic: sequestrum + involucrum + cloaca; adults",
        "Post-traumatic / Post-op",
        "Contiguous spread (pressure ulcers, DM foot)"
      ]
    },
    {
      title: "Clinical Features",
      color: C.red,
      items: [
        "Acute: Sudden fever, severe local bone pain, warmth, tenderness, refusal to bear weight",
        "Blood cultures + WBC + ESR + CRP elevated",
        "X-ray: Normal first 10–14 days; then periosteal elevation",
        "MRI: Investigation of choice (earliest, most sensitive)",
        "Bone scan (Tc-99m): sensitive; less specific"
      ]
    },
    {
      title: "Treatment",
      color: "8E44AD",
      items: [
        "Empiric IV antibiotics: Cloxacillin ± Gentamicin (Staph + Gram-neg)",
        "Duration: 4–6 weeks; switch to oral once improving",
        "MRSA: Vancomycin IV",
        "Surgical: sequestrectomy, saucerization, debridement",
        "Chronic: bone grafting, Ilizarov fixator, hyperbaric O₂"
      ]
    }
  ];

  cols.forEach((col, i) => {
    const xPos = 0.25 + i * 3.25;
    s.addShape(pres.ShapeType.rect, { x: xPos, y: 1.2, w: 3.1, h: 0.42, fill: { color: col.color } });
    s.addText(col.title, { x: xPos, y: 1.22, w: 3.1, h: 0.38, fontSize: 12, bold: true, color: C.white, fontFace: "Calibri", align: "center", valign: "middle" });
    s.addText(col.items.map((t, j) => ({ text: t, options: { bullet: { code: "2022", color: col.color }, breakLine: j < col.items.length - 1, fontSize: 11, color: C.text, fontFace: "Calibri", paraSpaceAfter: 5 } })),
      { x: xPos, y: 1.65, w: 3.1, h: 3.6, fill: { color: C.light }, line: { color: col.color, width: 1 }, margin: 8, valign: "top" });
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 12 — SUMMARY / CONCLUSION
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.navy } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 1.1, fill: { color: C.teal } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 5.1, w: 10, h: 0.08, fill: { color: C.accent } });

  s.addText("KEY TAKEAWAYS", {
    x: 0.5, y: 0.15, w: 9, h: 0.75, fontSize: 26, bold: true, color: C.white,
    fontFace: "Calibri", align: "center", charSpacing: 3
  });

  const takeaways = [
    ["Gangrene", "Dry = arterial, Wet = venous+infection (emergency), Gas = Clostridium (penicillin + surgery)"],
    ["Trophic Ulcer", "Treat the underlying cause (venous, arterial, DM); compression; skin graft if needed"],
    ["Fistula", "FRIENDS — eliminate cause; excise tract; fix distal obstruction"],
    ["Sepsis", "SIRS + infection source; escalate: Sepsis → Severe → Shock; early ABX + source control"],
    ["Abscess vs Phlegmon", "Abscess = localized (I&D); Phlegmon = diffuse (ABX ± surgery); NF = EMERGENCY"],
    ["Osteomyelitis", "MRI earliest; IV cloxacillin 4–6 weeks; sequestrectomy for chronic"],
    ["Paraproctitis", "Always drain surgically; 50% → fistula-in-ano; Fournier's = ICU emergency"],
  ];

  takeaways.forEach((row, i) => {
    const yPos = 1.25 + i * 0.57;
    const bgColor = i % 2 === 0 ? "1A2B3C" : "162534";
    s.addShape(pres.ShapeType.rect, { x: 0.25, y: yPos, w: 9.5, h: 0.53, fill: { color: bgColor } });
    s.addShape(pres.ShapeType.rect, { x: 0.25, y: yPos, w: 2.0, h: 0.53, fill: { color: C.accent } });
    s.addText(row[0], { x: 0.3, y: yPos + 0.04, w: 1.9, h: 0.46, fontSize: 11, bold: true, color: C.navy, fontFace: "Calibri", valign: "middle", align: "center" });
    s.addText(row[1], { x: 2.35, y: yPos + 0.04, w: 7.3, h: 0.46, fontSize: 11, color: C.white, fontFace: "Calibri", valign: "middle" });
  });
}

// ── Write the file ────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/surgical-infection-ppt/Surgical_Infection.pptx" })
  .then(() => console.log("DONE: Surgical_Infection.pptx written successfully"))
  .catch(err => { console.error("ERROR:", err); process.exit(1); });

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

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