const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Rasa, Meda & Asthi Dhatu Dushti in Hypothyroidism";
pres.author = "Literature Review Presentation";

// ─── COLOUR PALETTE ───────────────────────────────────────────────────────
const C = {
  darkBg:    "0D1B2A",   // deep navy – title / section dividers
  midBg:     "1B3A4B",   // teal-navy – accent bg
  accent1:   "E8A838",   // warm amber – primary accent / highlights
  accent2:   "5BB8D4",   // sky teal  – secondary accent
  ayur:      "2E7D32",   // deep green – Ayurvedic slides
  ayurLight: "E8F5E9",   // pale green – Ayurvedic card bg
  white:     "FFFFFF",
  offWhite:  "F4F6F8",
  lightGray: "E0E6EC",
  textDark:  "0D1B2A",
  textGray:  "4A5568",
  rasaCol:   "1565C0",   // blue  – Rasa
  medaCol:   "6A1B9A",   // purple – Meda
  asthiCol:  "BF360C",   // burnt orange – Asthi
};

// ─── HELPER: section divider ──────────────────────────────────────────────
function sectionDivider(pres, label, sub, colorBg) {
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}

// ─── HELPER: card box ─────────────────────────────────────────────────────
function card(slide, pres, x, y, w, h, title, body, accentColor) {
  slide.addShape(pres.shapes.RECTANGLE, { x, y, w, h, fill: { color: C.white }, line: { color: C.lightGray, pt: 1 }, shadow: { type: "outer", color: "000000", blur: 8, offset: 3, angle: 135, opacity: 0.1 } });
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}

// ─────────────────────────────────────────────────────────────────────────
// SLIDE 1 – TITLE
// ─────────────────────────────────────────────────────────────────────────
{
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  s.addText("LITERATURE REVIEW", { x: 0.7, y: 0.7, w: 9, h: 0.45, fontSize: 13, bold: true, color: C.accent1, charSpacing: 5, fontFace: "Calibri", margin: 0 });
  s.addText("Rasa, Meda & Asthi Dhatu Dushti\nin Hypothyroidism", {
    x: 0.7, y: 1.25, w: 8.8, h: 1.7, fontSize: 30, bold: true, color: C.white, fontFace: "Calibri", margin: 0
  });
  s.addShape(pres.shapes.RECTANGLE, { x: 0.7, y: 3.05, w: 2.8, h: 0.05, fill: { color: C.accent2 }, line: { type: "none" } });
  s.addText("An Observational Study Framework", { x: 0.7, y: 3.2, w: 9, h: 0.4, fontSize: 13, color: C.accent2, fontFace: "Calibri", italic: true, margin: 0 });
  s.addText("Dept. of Kayachikitsa / Kriya Shareera  ·  Ayurveda College", { x: 0.7, y: 4.0, w: 9, h: 0.35, fontSize: 11, color: "8899AA", fontFace: "Calibri", margin: 0 });
  s.addText("2026", { x: 0.7, y: 4.4, w: 2, h: 0.35, fontSize: 11, color: "8899AA", fontFace: "Calibri", margin: 0 });
}

// ─────────────────────────────────────────────────────────────────────────
// SLIDE 2 – OVERVIEW / OUTLINE
// ─────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
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  s.addText("PRESENTATION OVERVIEW", { x: 0.4, y: 0.15, w: 9, h: 0.42, fontSize: 18, bold: true, color: C.white, fontFace: "Calibri", margin: 0 });

  const sections = [
    ["01", "Functional Anatomy\nof Thyroid Gland",   C.accent2],
    ["02", "Physiology of\nThyroid Gland",           C.accent1],
    ["03", "Hypothyroidism –\nCauses, Features,\nInvestigations", "E53935"],
    ["04", "Rasa Dhatu –\nVriddhi & Kshaya\nLakshanas",           C.rasaCol],
    ["05", "Medo Dhatu –\nVriddhi & Kshaya\nLakshanas",           C.medaCol],
    ["06", "Asthi Dhatu –\nVriddhi & Kshaya\nLakshanas",          C.asthiCol],
    ["07", "Dhatu Dushti &\nHypothyroidism –\nCorrelation",       C.ayur],
  ];

  const cols = [0.25, 1.7, 3.15, 4.6, 6.05, 7.5, 8.95];
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    s.addText(num, { x, y: 0.95, w: 1.35, h: 0.5, fontSize: 22, bold: true, color: "FFFFFF", align: "center", fontFace: "Calibri", margin: 0 });
    s.addText(title, { x: x + 0.07, y: 1.55, w: 1.21, h: 3.8, fontSize: 11, color: "FFFFFF", align: "center", fontFace: "Calibri", valign: "top", margin: 0 });
  });
}

// ─────────────────────────────────────────────────────────────────────────
// SECTION DIVIDER – ANATOMY
// ─────────────────────────────────────────────────────────────────────────
sectionDivider(pres, "PART A: MODERN REVIEW", "Functional Anatomy · Physiology · Hypothyroidism", C.midBg);

// ─────────────────────────────────────────────────────────────────────────
// SLIDE 4 – FUNCTIONAL ANATOMY
// ─────────────────────────────────────────────────────────────────────────
{
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  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.72, fill: { color: C.midBg }, line: { type: "none" } });
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  s.addText("01  FUNCTIONAL ANATOMY OF THE THYROID GLAND", { x: 0.3, y: 0.15, w: 9.4, h: 0.42, fontSize: 14, bold: true, color: C.white, fontFace: "Calibri", margin: 0 });

  // Gross anatomy card
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  s.addShape(pres.shapes.RECTANGLE, { x: 0.2, y: 0.95, w: 4.5, h: 0.07, fill: { color: C.accent2 }, line: { type: "none" } });
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  s.addText([
    { text: "• ", options: { bold: true } }, { text: "Location:", options: { bold: true } }, { text: " Anterior neck; inferior to larynx, anterior to trachea\n", options: {} },
    { text: "• ", options: { bold: true } }, { text: "Structure:", options: { bold: true } }, { text: " Two lateral lobes + isthmus (± pyramidal lobe)\n", options: {} },
    { text: "• ", options: { bold: true } }, { text: "Weight:", options: { bold: true } }, { text: " 20–30 g in adults\n", options: {} },
    { text: "• ", options: { bold: true } }, { text: "Blood supply:", options: { bold: true } }, { text: " Superior thyroid a. (ext. carotid), Inferior thyroid a. (thyrocervical trunk)\n", options: {} },
    { text: "• ", options: { bold: true } }, { text: "Blood flow:", options: { bold: true } }, { text: " 5× gland weight/minute — one of the highest in the body", options: {} },
  ], { x: 0.35, y: 1.42, w: 4.2, h: 1.8, fontSize: 10, color: C.textDark, fontFace: "Calibri", valign: "top", margin: 0 });

  // Microscopic anatomy card
  s.addShape(pres.shapes.RECTANGLE, { x: 5.0, y: 0.95, w: 4.7, h: 2.35, fill: { color: C.white }, line: { color: C.lightGray, pt: 1 } });
  s.addShape(pres.shapes.RECTANGLE, { x: 5.0, y: 0.95, w: 4.7, h: 0.07, fill: { color: C.accent1 }, line: { type: "none" } });
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  s.addText([
    { text: "Follicles", options: { bold: true } }, { text: " (100–300 µm): closed sacs lined by cuboidal thyrocytes\n", options: {} },
    { text: "Colloid", options: { bold: true } }, { text: ": interior filled with thyroglobulin (T3/T4 storage)\n", options: {} },
    { text: "Follicular cells", options: { bold: true } }, { text: ": cuboidal → columnar when active\n", options: {} },
    { text: "C cells", options: { bold: true } }, { text: " (parafollicular): secrete ", options: {} }, { text: "calcitonin", options: { bold: true } }, { text: " → regulates plasma Ca²⁺\n", options: {} },
    { text: "Active gland", options: { bold: true, italic: true } }, { text: ": tall columnar cells, pale fluid colloid", options: { italic: true } },
  ], { x: 5.15, y: 1.42, w: 4.4, h: 1.8, fontSize: 10, color: C.textDark, fontFace: "Calibri", valign: "top", margin: 0 });

  // Lymph / nerve
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  s.addShape(pres.shapes.RECTANGLE, { x: 0.2, y: 3.45, w: 9.5, h: 0.07, fill: { color: "546E7A" }, line: { type: "none" } });
  s.addText("NEUROVASCULAR & LYMPHATICS", { x: 0.35, y: 3.55, w: 9.2, h: 0.3, fontSize: 10, bold: true, color: "546E7A", fontFace: "Calibri", margin: 0 });
  s.addText([
    { text: "Nerve supply: ", options: { bold: true } }, { text: "Sympathetic fibers from superior & middle cervical ganglia (regulate blood flow)    ", options: {} },
    { text: "Venous drainage: ", options: { bold: true } }, { text: "Superior, middle & inferior thyroid veins → internal jugular & brachiocephalic veins\n", options: {} },
    { text: "Lymphatic drainage: ", options: { bold: true } }, { text: "Pretracheal, paratracheal & deep cervical lymph nodes", options: {} },
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  s.addText("Source: Guyton & Hall Textbook of Medical Physiology", { x: 0.2, y: 5.45, w: 9, h: 0.17, fontSize: 7.5, color: "AAAAAA", italic: true, fontFace: "Calibri", margin: 0 });
}

// ─────────────────────────────────────────────────────────────────────────
// SLIDE 5 – THYROID HORMONE SYNTHESIS
// ─────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offWhite }, line: { type: "none" } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.72, fill: { color: C.midBg }, line: { type: "none" } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.72, w: 10, h: 0.06, fill: { color: C.accent2 }, line: { type: "none" } });
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  // Step boxes
  const steps = [
    ["1", "Iodide Trapping", "NIS (Na⁺-I⁻ symporter) concentrates I⁻ 30× plasma; up to 250× when maximally stimulated", C.accent2],
    ["2", "Oxidation", "Thyroid peroxidase (TPO) oxidises I⁻ → I₂ using H₂O₂ from DUOX2", C.accent1],
    ["3", "Organification", "I₂ added to tyrosine residues on thyroglobulin → MIT & DIT", "E53935"],
    ["4", "Coupling", "DIT + DIT → T4 (thyroxine)  |  MIT + DIT → T3 (triiodothyronine)", "7B1FA2"],
    ["5", "Storage", "Iodinated thyroglobulin stored in follicular colloid (weeks supply)", "00695C"],
    ["6", "Secretion", "TSH stimulates endocytosis of colloid → lysosomal cleavage → T3 & T4 released", C.midBg],
    ["7", "Conversion", "Peripheral 5'-deiodinase converts T4 → T3; >90% of nuclear-bound hormone is T3", "6D4C41"],
  ];

  steps.forEach(([num, title, body, col], i) => {
    const row = Math.floor(i / 4);
    const col_i = i % 4;
    const x = 0.2 + col_i * 2.4;
    const y = 0.95 + row * 2.3;
    const w = 2.25;
    const h = 2.0;
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      s.addShape(pres.shapes.RECTANGLE, { x: cx, y, w, h: 0.07, fill: { color: col }, line: { type: "none" } });
      s.addText(`STEP ${num}`, { x: cx + 0.1, y: y + 0.12, w: w - 0.2, h: 0.28, fontSize: 9, bold: true, color: col, fontFace: "Calibri", margin: 0 });
      s.addText(title, { x: cx + 0.1, y: y + 0.42, w: w - 0.2, h: 0.38, fontSize: 11, bold: true, color: C.textDark, fontFace: "Calibri", margin: 0 });
      s.addText(body, { x: cx + 0.1, y: y + 0.82, w: w - 0.2, h: 1.05, fontSize: 9.5, color: C.textGray, fontFace: "Calibri", valign: "top", margin: 0 });
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      s.addShape(pres.shapes.RECTANGLE, { x, y, w, h, fill: { color: C.white }, line: { color: C.lightGray, pt: 1 } });
      s.addShape(pres.shapes.RECTANGLE, { x, y, w, h: 0.07, fill: { color: col }, line: { type: "none" } });
      s.addText(`STEP ${num}`, { x: x + 0.1, y: y + 0.12, w: w - 0.2, h: 0.28, fontSize: 9, bold: true, color: col, fontFace: "Calibri", margin: 0 });
      s.addText(title, { x: x + 0.1, y: y + 0.42, w: w - 0.2, h: 0.38, fontSize: 11, bold: true, color: C.textDark, fontFace: "Calibri", margin: 0 });
      s.addText(body, { x: x + 0.1, y: y + 0.82, w: w - 0.2, h: 1.05, fontSize: 9.5, color: C.textGray, fontFace: "Calibri", valign: "top", margin: 0 });
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  s.addText("Source: Guyton & Hall Textbook of Medical Physiology; Costanzo Physiology 7th Ed.", { x: 0.2, y: 5.45, w: 9, h: 0.17, fontSize: 7.5, color: "AAAAAA", italic: true, fontFace: "Calibri", margin: 0 });
}

// ─────────────────────────────────────────────────────────────────────────
// SLIDE 6 – HPT AXIS REGULATION
// ─────────────────────────────────────────────────────────────────────────
{
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  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.72, fill: { color: C.midBg }, line: { type: "none" } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.72, w: 10, h: 0.06, fill: { color: C.accent2 }, line: { type: "none" } });
  s.addText("02  PHYSIOLOGY – HPT AXIS & REGULATION", { x: 0.3, y: 0.15, w: 9.4, h: 0.42, fontSize: 14, bold: true, color: C.white, fontFace: "Calibri", margin: 0 });

  // HPT axis diagram (drawn with shapes)
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    { label: "HYPOTHALAMUS", sub: "Paraventricular nucleus\n→ Secretes TRH", x: 3.5, y: 0.9, col: C.midBg },
    { label: "ANTERIOR PITUITARY", sub: "Thyrotrophs\n→ Secretes TSH", x: 3.5, y: 2.3, col: "37474F" },
    { label: "THYROID GLAND", sub: "Follicular cells\n→ Secretes T3 & T4", x: 3.5, y: 3.7, col: "4CAF50" },
  ];
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    s.addText(label, { x, y: y + 0.1, w: 3, h: 0.4, fontSize: 11, bold: true, color: C.white, align: "center", fontFace: "Calibri", margin: 0 });
    s.addText(sub, { x, y: y + 0.52, w: 3, h: 0.5, fontSize: 9.5, color: "E0E0E0", align: "center", fontFace: "Calibri", margin: 0 });
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  s.addShape(pres.shapes.RECTANGLE, { x: 4.95, y: 3.4, w: 0.1, h: 0.32, fill: { color: C.accent1 }, line: { type: "none" } });
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  s.addText("TSH", { x: 5.15, y: 3.4, w: 1, h: 0.3, fontSize: 11, bold: true, color: C.accent1, fontFace: "Calibri", margin: 0 });
  // feedback label
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  // Physiological effects right column
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    ["METABOLIC", "↑ BMR, calorigenic effect\n↑ carbohydrate & fat catabolism", "E53935"],
    ["CARDIOVASCULAR", "↑ HR, contractility, cardiac output\n↓ peripheral resistance", C.accent2],
    ["LIPID", "Upregulates LDL receptors\n↓ Total cholesterol & LDL-C", C.medaCol],
    ["BONE", "Regulates osteoblast & osteoclast\nNormal bone remodeling", C.asthiCol],
  ];
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    const ey = 0.9 + i * 1.18;
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    s.addText(body, { x: 7.18, y: ey + 0.4, w: 2.5, h: 0.55, fontSize: 9.5, color: C.textDark, fontFace: "Calibri", valign: "top", margin: 0 });
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  s.addText("Source: Costanzo Physiology 7th Ed.; Guyton & Hall", { x: 0.2, y: 5.45, w: 9, h: 0.17, fontSize: 7.5, color: "AAAAAA", italic: true, fontFace: "Calibri", margin: 0 });
}

// ─────────────────────────────────────────────────────────────────────────
// SLIDE 7 – CAUSES OF HYPOTHYROIDISM
// ─────────────────────────────────────────────────────────────────────────
{
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  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.72, fill: { color: "B71C1C" }, line: { type: "none" } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.72, w: 10, h: 0.06, fill: { color: C.accent1 }, line: { type: "none" } });
  s.addText("03  HYPOTHYROIDISM – CAUSES & CLASSIFICATION", { x: 0.3, y: 0.15, w: 9.4, h: 0.42, fontSize: 14, bold: true, color: C.white, fontFace: "Calibri", margin: 0 });

  const causes = [
    {
      title: "PRIMARY (>95%)", col: "B71C1C",
      items: "• Autoimmune: Hashimoto's thyroiditis (most common in iodine-sufficient regions), Atrophic thyroiditis\n• Iatrogenic: ¹³¹I therapy, thyroidectomy, neck irradiation\n• Drugs: Amiodarone, lithium, PTU, carbimazole, immune checkpoint inhibitors\n• Nutritional: Iodine deficiency (most common worldwide), selenium deficiency\n• Infiltrative: Amyloidosis, sarcoidosis, hemochromatosis, Riedel's thyroiditis\n• Congenital: Thyroid agenesis (65%), dyshormonogenesis (30%), TSH-R mutation (5%)"
    },
    {
      title: "TRANSIENT", col: C.accent1,
      items: "• Silent/postpartum thyroiditis\n• Subacute (de Quervain's) thyroiditis\n• Withdrawal of supraphysiologic T4 therapy"
    },
    {
      title: "SECONDARY (Central)", col: C.midBg,
      items: "• Pituitary disease: adenoma, surgery, Sheehan's syndrome\n• Hypothalamic disorders: tumors, trauma, Prader-Willi syndrome\n• Drugs: bexarotene, mitotane\n• Isolated TSH deficiency (rare)"
    },
  ];

  const xs = [0.2, 0.2, 6.8];
  const ys = [0.9, 3.4, 0.9];
  const ws = [6.4, 6.4, 3.0];
  const hs = [2.3, 2.1, 4.6];

  causes.forEach(({ title, col, items }, i) => {
    s.addShape(pres.shapes.RECTANGLE, { x: xs[i], y: ys[i], w: ws[i], h: hs[i], fill: { color: C.white }, line: { color: C.lightGray, pt: 1 } });
    s.addShape(pres.shapes.RECTANGLE, { x: xs[i], y: ys[i], w: ws[i], h: 0.07, fill: { color: col }, line: { type: "none" } });
    s.addText(title, { x: xs[i] + 0.15, y: ys[i] + 0.12, w: ws[i] - 0.3, h: 0.35, fontSize: 11, bold: true, color: col, fontFace: "Calibri", margin: 0 });
    s.addText(items, { x: xs[i] + 0.15, y: ys[i] + 0.52, w: ws[i] - 0.3, h: hs[i] - 0.65, fontSize: 9.5, color: C.textDark, fontFace: "Calibri", valign: "top", margin: 0 });
  });

  // Hashimoto highlight box
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  s.addText("★ Hashimoto's: CD8⁺ T-cell + anti-TPO Ab mediated progressive thyroid destruction | F:M = 8:1", { x: 6.9, y: 4.9, w: 2.8, h: 0.5, fontSize: 8.5, color: "B71C1C", fontFace: "Calibri", valign: "middle", margin: 0 });

  s.addText("Source: Harrison's Principles of Internal Medicine 22E (2025); Robbins, Cotran & Kumar Pathologic Basis of Disease", { x: 0.2, y: 5.46, w: 9, h: 0.16, fontSize: 7.5, color: "AAAAAA", italic: true, fontFace: "Calibri", margin: 0 });
}

// ─────────────────────────────────────────────────────────────────────────
// SLIDE 8 – CLINICAL FEATURES
// ─────────────────────────────────────────────────────────────────────────
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  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.72, fill: { color: "B71C1C" }, line: { type: "none" } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.72, w: 10, h: 0.06, fill: { color: C.accent1 }, line: { type: "none" } });
  s.addText("03  HYPOTHYROIDISM – CLINICAL FEATURES", { x: 0.3, y: 0.15, w: 9.4, h: 0.42, fontSize: 14, bold: true, color: C.white, fontFace: "Calibri", margin: 0 });

  const systems = [
    { sys: "Constitutional", col: "78909C", items: "Fatigue · lethargy · cold intolerance\nWeight gain · hoarse voice" },
    { sys: "Skin & Hair", col: "E53935", items: "Dry skin · non-pitting myxedema\nPuffy face · diffuse alopecia\nBrittle nails · outer eyebrow loss" },
    { sys: "Cardiovascular", col: C.accent2, items: "Bradycardia · reduced cardiac output\nDiastolic HTN · pericardial effusion\nDyslipidemia (↑ LDL, TG)" },
    { sys: "Neuromuscular", col: C.medaCol, items: "Cognitive slowing · depression\nProximal muscle weakness\nDelayed DTR relaxation · CTS" },
    { sys: "GI / Repro", col: "00796B", items: "Constipation · poor appetite\nOligomenorrhea / amenorrhea\nHyperprolactinemia · infertility" },
    { sys: "Skeletal (Asthi)", col: C.asthiCol, items: "Reduced bone turnover\nReduced BMD (prolonged hT)\nJoint effusions · arthralgia" },
  ];

  const positions = [
    [0.2, 0.88], [3.45, 0.88], [6.7, 0.88],
    [0.2, 2.82], [3.45, 2.82], [6.7, 2.82],
  ];

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    s.addShape(pres.shapes.RECTANGLE, { x, y, w: 3.1, h: 0.07, fill: { color: col }, line: { type: "none" } });
    s.addText(sys.toUpperCase(), { x: x + 0.12, y: y + 0.12, w: 2.86, h: 0.3, fontSize: 10, bold: true, color: col, fontFace: "Calibri", margin: 0 });
    s.addText(items, { x: x + 0.12, y: y + 0.48, w: 2.86, h: 1.22, fontSize: 10, color: C.textDark, fontFace: "Calibri", valign: "top", margin: 0 });
  });

  s.addText("Source: Harrison's Principles of Internal Medicine 22E; The Washington Manual of Medical Therapeutics; Frameworks for Internal Medicine", { x: 0.2, y: 5.46, w: 9, h: 0.16, fontSize: 7.5, color: "AAAAAA", italic: true, fontFace: "Calibri", margin: 0 });
}

// ─────────────────────────────────────────────────────────────────────────
// SLIDE 9 – INVESTIGATIONS
// ─────────────────────────────────────────────────────────────────────────
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  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.72, fill: { color: "B71C1C" }, line: { type: "none" } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.72, w: 10, h: 0.06, fill: { color: C.accent1 }, line: { type: "none" } });
  s.addText("03  HYPOTHYROIDISM – INVESTIGATIONS", { x: 0.3, y: 0.15, w: 9.4, h: 0.42, fontSize: 14, bold: true, color: C.white, fontFace: "Calibri", margin: 0 });

  // First-line tests
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  s.addText("FIRST-LINE / THYROID FUNCTION", { x: 0.35, y: 1.0, w: 4.2, h: 0.32, fontSize: 10, bold: true, color: "B71C1C", fontFace: "Calibri", margin: 0 });
  s.addText(
    "Serum TSH — most sensitive screening test\n  Primary hT: TSH >4.5 mIU/L  |  Overt: TSH >20 mIU/L\n  Secondary hT: TSH low/normal\nFree T4 (FT4) — decreased in overt hT; normal in subclinical\nFree T3 (FT3) — severity assessment",
    { x: 0.35, y: 1.35, w: 4.2, h: 1.48, fontSize: 9.5, color: C.textDark, fontFace: "Calibri", valign: "top", margin: 0 }
  );

  // Autoimmune markers
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  s.addShape(pres.shapes.RECTANGLE, { x: 5.1, y: 0.9, w: 4.6, h: 0.07, fill: { color: C.accent2 }, line: { type: "none" } });
  s.addText("AUTOIMMUNE & IMAGING", { x: 5.25, y: 1.0, w: 4.3, h: 0.32, fontSize: 10, bold: true, color: C.accent2, fontFace: "Calibri", margin: 0 });
  s.addText(
    "Anti-TPO antibodies — elevated in 95% of Hashimoto's\nAnti-thyroglobulin antibodies — elevated ~60%\nTSH receptor antibodies (TRAb) — distinguish Graves'\nThyroid USG — echogenicity, nodules, gland size\nThyroid scan (¹²³I / ⁹⁹ᵐTc) — functional assessment",
    { x: 5.25, y: 1.35, w: 4.3, h: 1.48, fontSize: 9.5, color: C.textDark, fontFace: "Calibri", valign: "top", margin: 0 }
  );

  // Dhatu assessment table
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  s.addText("SECONDARY INVESTIGATIONS FOR DHATU DUSHTI ASSESSMENT", { x: 0.35, y: 3.15, w: 9.2, h: 0.3, fontSize: 10, bold: true, color: "546E7A", fontFace: "Calibri", margin: 0 });

  const invRows = [
    ["RASA DHATU", "CBC, Hb, serum albumin, total protein, ECG (bradycardia), RFT", C.rasaCol],
    ["MEDA DHATU", "Fasting lipid profile (LDL, HDL, TG, TC), fasting glucose, USG liver, BMI, waist circumference", C.medaCol],
    ["ASTHI DHATU", "Serum Ca, PO₄, ALP, Vitamin D (25-OH D₃), PTH, osteocalcin, bone-specific ALP, DEXA scan (T-score & Z-score)", C.asthiCol],
  ];
  invRows.forEach(([dhatu, tests, col], i) => {
    const ry = 3.5 + i * 0.6;
    s.addShape(pres.shapes.RECTANGLE, { x: 0.2, y: ry, w: 2.0, h: 0.52, fill: { color: col + "22" }, line: { type: "none" } });
    s.addText(dhatu, { x: 0.28, y: ry + 0.08, w: 1.84, h: 0.36, fontSize: 9.5, bold: true, color: col, fontFace: "Calibri", margin: 0, valign: "middle" });
    s.addText(tests, { x: 2.35, y: ry + 0.06, w: 7.2, h: 0.4, fontSize: 9.5, color: C.textDark, fontFace: "Calibri", margin: 0, valign: "middle" });
  });

  s.addText("Source: Harrison's Principles 22E; Robbins, Cotran & Kumar; The Washington Manual", { x: 0.2, y: 5.46, w: 9, h: 0.16, fontSize: 7.5, color: "AAAAAA", italic: true, fontFace: "Calibri", margin: 0 });
}

// ─────────────────────────────────────────────────────────────────────────
// SECTION DIVIDER – AYURVEDIC
// ─────────────────────────────────────────────────────────────────────────
sectionDivider(pres, "PART B: AYURVEDIC REVIEW", "Rasa · Meda · Asthi Dhatu – Vriddhi & Kshaya Lakshanas", C.ayur);

// ─────────────────────────────────────────────────────────────────────────
// SLIDE 11 – RASA DHATU
// ─────────────────────────────────────────────────────────────────────────
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  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.72, fill: { color: C.rasaCol }, line: { type: "none" } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.72, w: 10, h: 0.06, fill: { color: C.accent1 }, line: { type: "none" } });
  s.addText("04  RASA DHATU – VRIDDHI & KSHAYA LAKSHANAS", { x: 0.3, y: 0.15, w: 9.4, h: 0.42, fontSize: 14, bold: true, color: C.white, fontFace: "Calibri", margin: 0 });

  // Intro
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  s.addText([
    { text: "Rasa Dhatu ", options: { bold: true, color: C.rasaCol } },
    { text: "= Plasma/lymph/nutritional fluid. Formed from Ahara Rasa by Rasa Dhatwagni. Circulates via ", options: { color: C.textDark } },
    { text: "Rasavaha Srotas.", options: { bold: true, color: C.textDark } },
    { text: "  Upadhatu: Stanya, Aartava  |  Mala: Kapha  |  Ref: Charaka Su. 17", options: { color: C.textGray } },
  ], { x: 0.35, y: 0.97, w: 9.2, h: 0.58, fontSize: 10.5, fontFace: "Calibri", valign: "middle", margin: 0 });

  // Kshaya
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  s.addShape(pres.shapes.RECTANGLE, { x: 0.2, y: 1.75, w: 4.65, h: 0.07, fill: { color: C.rasaCol }, line: { type: "none" } });
  s.addText("RASA KSHAYA (Depletion) Lakshanas", { x: 0.35, y: 1.85, w: 4.35, h: 0.35, fontSize: 10.5, bold: true, color: C.rasaCol, fontFace: "Calibri", margin: 0 });

  const kshayas = [
    ["Hridrava", "Palpitations, cardiac pain"],
    ["Hridayam Tamyati", "Cardiac fatigue, minimal exertion"],
    ["Shrama (Alpacheshtasyapi)", "Fatigue even on minimal activity"],
    ["Sahate Shabdam Na", "Noise intolerance"],
    ["Ruksha Twak", "Dry, rough skin"],
    ["Pandu", "Pallor, anemia"],
    ["Ghattate", "Restlessness, anxiety"],
    ["Daurbalya", "General weakness"],
  ];
  kshayas.forEach(([sk, en], i) => {
    const ky = 2.28 + i * 0.39;
    s.addText(`• ${sk}`, { x: 0.35, y: ky, w: 2.0, h: 0.35, fontSize: 10, bold: true, color: C.rasaCol, fontFace: "Calibri", margin: 0 });
    s.addText(en, { x: 2.4, y: ky, w: 2.3, h: 0.35, fontSize: 10, color: C.textDark, fontFace: "Calibri", margin: 0 });
  });

  // Vriddhi
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  s.addShape(pres.shapes.RECTANGLE, { x: 5.1, y: 1.75, w: 4.65, h: 0.07, fill: { color: C.accent2 }, line: { type: "none" } });
  s.addText("RASA VRIDDHI (Excess) Lakshanas", { x: 5.25, y: 1.85, w: 4.35, h: 0.35, fontSize: 10.5, bold: true, color: C.accent2, fontFace: "Calibri", margin: 0 });

  const vriddhi = [
    ["Agnisadana", "Impaired digestion, poor appetite"],
    ["Praseka", "Excessive salivation / mucosal edema"],
    ["Alasya", "Sluggishness, lethargy"],
    ["Gaurava", "Heaviness of the body (myxedema)"],
    ["Shaithya", "Coldness – cold intolerance"],
    ["Shvaithya", "Pallor, white discoloration"],
    ["Shlathangatva", "Flaccidity, loose body parts"],
    ["Atinidrata", "Excessive sleep / hypersomnia"],
    ["Shwasa / Kasa", "Dyspnea, cough"],
  ];
  vriddhi.forEach(([sk, en], i) => {
    const vy = 2.28 + i * 0.39;
    s.addText(`• ${sk}`, { x: 5.25, y: vy, w: 2.0, h: 0.35, fontSize: 10, bold: true, color: C.accent2, fontFace: "Calibri", margin: 0 });
    s.addText(en, { x: 7.3, y: vy, w: 2.3, h: 0.35, fontSize: 10, color: C.textDark, fontFace: "Calibri", margin: 0 });
  });

  s.addText("Ref: Charaka Samhita, Sutra Sthana 17; Ashtanga Hridayam, Sutra Sthana 11", { x: 0.2, y: 5.46, w: 9, h: 0.16, fontSize: 7.5, color: "AAAAAA", italic: true, fontFace: "Calibri", margin: 0 });
}

// ─────────────────────────────────────────────────────────────────────────
// SLIDE 12 – MEDA DHATU
// ─────────────────────────────────────────────────────────────────────────
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  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.72, fill: { color: C.medaCol }, line: { type: "none" } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.72, w: 10, h: 0.06, fill: { color: C.accent1 }, line: { type: "none" } });
  s.addText("05  MEDO DHATU – VRIDDHI & KSHAYA LAKSHANAS", { x: 0.3, y: 0.15, w: 9.4, h: 0.42, fontSize: 14, bold: true, color: C.white, fontFace: "Calibri", margin: 0 });

  // Intro bar
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  s.addText([
    { text: "Meda Dhatu ", options: { bold: true, color: C.medaCol } },
    { text: "= Adipose/fat tissue. 4th Dhatu formed from Mamsa Dhatu by Meda Dhatwagni.  ", options: { color: C.textDark } },
    { text: "Karma: Sneha (unctuousness), Svedana (perspiration), Balya (nourishes Asthi)  |  Upadhatu: Snayu  |  Mala: Sweda", options: { color: C.textGray } },
  ], { x: 0.35, y: 0.97, w: 9.2, h: 0.58, fontSize: 10.5, fontFace: "Calibri", valign: "middle", margin: 0 });

  // Kshaya
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  s.addShape(pres.shapes.RECTANGLE, { x: 0.2, y: 1.75, w: 4.65, h: 0.07, fill: { color: C.medaCol }, line: { type: "none" } });
  s.addText("MEDA KSHAYA Lakshanas", { x: 0.35, y: 1.85, w: 4.35, h: 0.35, fontSize: 10.5, bold: true, color: C.medaCol, fontFace: "Calibri", margin: 0 });

  const medaK = [
    ["Sphik Shushkata", "Emaciation of buttocks"],
    ["Udara Shushkata", "Abdominal hollowness"],
    ["Stana Shushkata", "Loss of breast tissue bulk"],
    ["Parvakam Graha", "Stiffness of small joints"],
    ["Shrama / Atishrama", "Fatigue, exhaustion"],
    ["Shosha", "Emaciation, wasting"],
    ["Pleeha Vriddhi", "Splenomegaly"],
  ];
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    s.addText(`• ${sk}`, { x: 0.35, y: ky, w: 2.2, h: 0.4, fontSize: 10, bold: true, color: C.medaCol, fontFace: "Calibri", margin: 0 });
    s.addText(en, { x: 2.6, y: ky, w: 2.1, h: 0.4, fontSize: 10, color: C.textDark, fontFace: "Calibri", margin: 0 });
  });

  // Vriddhi
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  s.addShape(pres.shapes.RECTANGLE, { x: 5.1, y: 1.75, w: 4.65, h: 0.07, fill: { color: C.accent2 }, line: { type: "none" } });
  s.addText("MEDA VRIDDHI Lakshanas  ★ Most prevalent in hypothyroidism (78.2%)", { x: 5.25, y: 1.85, w: 4.35, h: 0.35, fontSize: 10, bold: true, color: C.accent2, fontFace: "Calibri", margin: 0 });

  const medaV = [
    ["Sthoulya", "Obesity, weight gain"],
    ["Udara Vriddhi", "Abdominal enlargement"],
    ["Shramena Shwasa", "Exertional dyspnea"],
    ["Daurgandhya", "Foul body odour (Ama)"],
    ["Daurbalya", "Weakness despite bulk"],
    ["Kandu", "Itching, skin changes"],
    ["Medovaha Sroto Dushti", "Dyslipidemia (↑LDL, TG)"],
    ["Yaka-ashrita Meda", "Fatty liver (NAFLD)"],
  ];
  medaV.forEach(([sk, en], i) => {
    const vy = 2.28 + i * 0.45;
    s.addText(`• ${sk}`, { x: 5.25, y: vy, w: 2.25, h: 0.4, fontSize: 10, bold: true, color: C.accent2, fontFace: "Calibri", margin: 0 });
    s.addText(en, { x: 7.55, y: vy, w: 2.1, h: 0.4, fontSize: 10, color: C.textDark, fontFace: "Calibri", margin: 0 });
  });

  s.addText("Ref: Charaka Samhita, Su. 17; JAIMS Observational Study n=100; Fitzpatrick's Dermatology Vol.1", { x: 0.2, y: 5.46, w: 9, h: 0.16, fontSize: 7.5, color: "AAAAAA", italic: true, fontFace: "Calibri", margin: 0 });
}

// ─────────────────────────────────────────────────────────────────────────
// SLIDE 13 – ASTHI DHATU
// ─────────────────────────────────────────────────────────────────────────
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  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.72, fill: { color: C.asthiCol }, line: { type: "none" } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.72, w: 10, h: 0.06, fill: { color: C.accent1 }, line: { type: "none" } });
  s.addText("06  ASTHI DHATU – VRIDDHI & KSHAYA LAKSHANAS", { x: 0.3, y: 0.15, w: 9.4, h: 0.42, fontSize: 14, bold: true, color: C.white, fontFace: "Calibri", margin: 0 });

  // Intro bar
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  s.addText([
    { text: "Asthi Dhatu ", options: { bold: true, color: C.asthiCol } },
    { text: "= Bone tissue (5th Dhatu). Formed from Meda Dhatu. ", options: { color: C.textDark } },
    { text: "Seat of Vata Dosha (Ashraya-Ashrayi).  Mala: Kesha, Loma, Nakha, Shmashru  |  Ref: Ch. Sha. 7/15; Su. Su. 14/10", options: { color: C.textGray } },
  ], { x: 0.35, y: 0.97, w: 9.2, h: 0.58, fontSize: 10.5, fontFace: "Calibri", valign: "middle", margin: 0 });

  // Kshaya
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  s.addShape(pres.shapes.RECTANGLE, { x: 0.2, y: 1.75, w: 4.65, h: 0.07, fill: { color: C.asthiCol }, line: { type: "none" } });
  s.addText("ASTHI KSHAYA Lakshanas  ★ Predominant pattern in hypothyroidism", { x: 0.35, y: 1.85, w: 4.35, h: 0.35, fontSize: 10, bold: true, color: C.asthiCol, fontFace: "Calibri", margin: 0 });

  const asthiK = [
    ["Kesha Patana", "Hair fall (telogen effluvium)"],
    ["Loma Patana", "Loss of body hair"],
    ["Nakha Patana / Bhanga", "Brittle nails, nail loss"],
    ["Shmashru Patana", "Loss of beard / facial hair"],
    ["Asthishula", "Bone pain, arthralgia"],
    ["Asthisphotana", "Joint crackling, crepitus"],
    ["Sandhi Shaithilya", "Joint laxity"],
    ["Asthi Daurbalya", "Bone fragility (low BMD)"],
    ["Shrama", "Fatigue"],
  ];
  asthiK.forEach(([sk, en], i) => {
    const ky = 2.28 + i * 0.39;
    s.addText(`• ${sk}`, { x: 0.35, y: ky, w: 2.3, h: 0.35, fontSize: 10, bold: true, color: C.asthiCol, fontFace: "Calibri", margin: 0 });
    s.addText(en, { x: 2.7, y: ky, w: 2.0, h: 0.35, fontSize: 10, color: C.textDark, fontFace: "Calibri", margin: 0 });
  });

  // Vriddhi
  s.addShape(pres.shapes.RECTANGLE, { x: 5.1, y: 1.75, w: 4.65, h: 1.65, fill: { color: C.white }, line: { color: C.lightGray, pt: 1 } });
  s.addShape(pres.shapes.RECTANGLE, { x: 5.1, y: 1.75, w: 4.65, h: 0.07, fill: { color: C.accent2 }, line: { type: "none" } });
  s.addText("ASTHI VRIDDHI Lakshanas  (less common in hT)", { x: 5.25, y: 1.85, w: 4.35, h: 0.35, fontSize: 10, bold: true, color: C.accent2, fontFace: "Calibri", margin: 0 });
  const asthiV = [
    ["Adhyasthi", "Extra bone / calcification / exostosis"],
    ["Adhidanta", "Hyperdontia, extra teeth"],
    ["Keshatimatra", "Excessive hair growth"],
  ];
  asthiV.forEach(([sk, en], i) => {
    const vy = 2.28 + i * 0.46;
    s.addText(`• ${sk}`, { x: 5.25, y: vy, w: 2.0, h: 0.4, fontSize: 10, bold: true, color: C.accent2, fontFace: "Calibri", margin: 0 });
    s.addText(en, { x: 7.3, y: vy, w: 2.35, h: 0.4, fontSize: 10, color: C.textDark, fontFace: "Calibri", margin: 0 });
  });

  // Asthi Mala interpretation box
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  s.addText("KEY INTERPRETATION: ASTHI MALA", { x: 5.25, y: 3.65, w: 4.35, h: 0.32, fontSize: 10, bold: true, color: C.asthiCol, fontFace: "Calibri", margin: 0 });
  s.addText(
    "Hair (Kesha) & Nails (Nakha) are Mala (waste products) of Asthi Dhatu. Their loss in hypothyroidism is the early clinical marker of Asthi Dhatu Kshaya — visible before bone density changes appear on DEXA.\n\nHypothyroid hair loss = telogen effluvium; brittle nails = reduced matrix cell proliferation.",
    { x: 5.25, y: 4.0, w: 4.35, h: 1.3, fontSize: 9.5, color: C.textDark, fontFace: "Calibri", valign: "top", margin: 0 }
  );

  s.addText("Ref: Charaka Samhita Su. 17; Sushruta Su. 14/10; IJRAP Pilot Study (BMD & Hair Fall)", { x: 0.2, y: 5.46, w: 9, h: 0.16, fontSize: 7.5, color: "AAAAAA", italic: true, fontFace: "Calibri", margin: 0 });
}

// ─────────────────────────────────────────────────────────────────────────
// SLIDE 14 – DHATU DUSHTI CORRELATION FLOWCHART
// ─────────────────────────────────────────────────────────────────────────
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  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.72, fill: { color: C.ayur }, line: { type: "none" } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.72, w: 10, h: 0.06, fill: { color: C.accent1 }, line: { type: "none" } });
  s.addText("07  DHATU DUSHTI IN HYPOTHYROIDISM – CORRELATION", { x: 0.3, y: 0.15, w: 9.4, h: 0.42, fontSize: 14, bold: true, color: C.white, fontFace: "Calibri", margin: 0 });

  // Samprapti chain – boxes
  const chain = [
    { label: "Hypothyroidism\n(↓ T3/T4)", sub: "Nidana activation", col: "B71C1C", x: 0.25, y: 0.9 },
    { label: "Jataragni Mandya\n+ Kapha Vriddhi", sub: "Agni impairment", col: C.midBg, x: 0.25, y: 1.9 },
    { label: "Ama formation\nRasa Dhatu Dushti", sub: "43% of hT cases", col: C.rasaCol, x: 0.25, y: 2.9 },
    { label: "Meda Dhatwagni\nMandya + Meda Vriddhi", sub: "78.2% of hT cases", col: C.medaCol, x: 0.25, y: 3.9 },
    { label: "Asthi Dhatu\nKshaya", sub: "Sequential depletion", col: C.asthiCol, x: 0.25, y: 4.77 },
  ];
  chain.forEach(({ label, sub, col, x, y }, i) => {
    s.addShape(pres.shapes.RECTANGLE, { x, y, w: 2.9, h: 0.82, fill: { color: col }, line: { type: "none" }, shadow: { type: "outer", color: "000000", blur: 6, offset: 2, angle: 135, opacity: 0.15 } });
    s.addText(label, { x: x + 0.1, y: y + 0.04, w: 2.7, h: 0.5, fontSize: 10, bold: true, color: C.white, fontFace: "Calibri", margin: 0 });
    s.addText(sub, { x: x + 0.1, y: y + 0.55, w: 2.7, h: 0.25, fontSize: 8.5, color: "FFD0A0", fontFace: "Calibri", margin: 0, italic: true });
    if (i < 4) {
      s.addShape(pres.shapes.RECTANGLE, { x: x + 1.4, y: y + 0.83, w: 0.1, h: 0.1, fill: { color: col }, line: { type: "none" } });
    }
  });

  // Right column – interpretation cards
  const interps = [
    { title: "RASA DUSHTI", body: "Sama Rasa → poor quality plasma\nFeatures: Gaurava, Alasya, Shaithya, Atinidrata\nModern: fatigue, cold intolerance, myxedema", col: C.rasaCol },
    { title: "MEDA DUSHTI", body: "Medovaha Sroto Dushti (Sanga type)\nFeatures: Sthoulya, dyslipidemia, NAFLD\nModern: ↑LDL, ↑TG, weight gain, fatty liver", col: C.medaCol },
    { title: "ASTHI KSHAYA", body: "Meda Dushti → impaired Asthi formation\nFeatures: Kesha/Nakha Patana, Asthishula\nModern: hair loss, brittle nails, ↓BMD", col: C.asthiCol },
  ];
  interps.forEach(({ title, body, col }, i) => {
    const iy = 0.9 + i * 1.55;
    s.addShape(pres.shapes.RECTANGLE, { x: 3.5, y: iy, w: 6.3, h: 1.38, fill: { color: C.white }, line: { color: col, pt: 1.5 } });
    s.addShape(pres.shapes.RECTANGLE, { x: 3.5, y: iy, w: 0.12, h: 1.38, fill: { color: col }, line: { type: "none" } });
    s.addText(title, { x: 3.75, y: iy + 0.1, w: 5.9, h: 0.35, fontSize: 11, bold: true, color: col, fontFace: "Calibri", margin: 0 });
    s.addText(body, { x: 3.75, y: iy + 0.5, w: 5.9, h: 0.82, fontSize: 10, color: C.textDark, fontFace: "Calibri", valign: "top", margin: 0 });
  });

  s.addText("Source: JAIMS observational study (n=100); Charaka Samhita; Harrison's Principles 22E", { x: 0.2, y: 5.46, w: 9, h: 0.16, fontSize: 7.5, color: "AAAAAA", italic: true, fontFace: "Calibri", margin: 0 });
}

// ─────────────────────────────────────────────────────────────────────────
// SLIDE 15 – SUMMARY TABLE
// ─────────────────────────────────────────────────────────────────────────
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  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.72, fill: { color: C.darkBg }, line: { type: "none" } });
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  s.addText("SUMMARY – DHATU DUSHTI FRAMEWORK IN HYPOTHYROIDISM", { x: 0.3, y: 0.15, w: 9.4, h: 0.42, fontSize: 13, bold: true, color: C.white, fontFace: "Calibri", margin: 0 });

  // Table header
  const headers = ["Dhatu", "Key Lakshana (Ayurvedic)", "Clinical Feature (Modern)", "Investigation"];
  const hws = [1.2, 3.0, 2.7, 2.8];
  let hx = 0.2;
  headers.forEach((h, i) => {
    s.addShape(pres.shapes.RECTANGLE, { x: hx, y: 0.9, w: hws[i], h: 0.4, fill: { color: C.darkBg }, line: { type: "none" } });
    s.addText(h, { x: hx + 0.07, y: 0.93, w: hws[i] - 0.14, h: 0.34, fontSize: 10, bold: true, color: C.white, fontFace: "Calibri", valign: "middle", margin: 0 });
    hx += hws[i];
  });

  const rows = [
    { dhatu: "Rasa\nKshaya", col: C.rasaCol, lakshana: "Hridrava, Pandu, Alasya,\nGaurava, Shaithya, Atinidrata", modern: "Fatigue, pallor, cold\nintolerance, myxedema", inv: "Hb, serum albumin,\nECG, TSH" },
    { dhatu: "Rasa\nVriddhi", col: C.rasaCol + "88", lakshana: "Agnisadana, Praseka,\nShlathangatva, Shwasa", modern: "Poor digestion, mucosal\nedema, flaccidity", inv: "Serum protein, TSH" },
    { dhatu: "Meda\nVriddhi", col: C.medaCol, lakshana: "Sthoulya, Medovaha\nSroto Dushti, Daurgandhya", modern: "Weight gain, dyslipidemia\n(↑LDL, ↑TG), NAFLD", inv: "Lipid profile, USG\nliver, BMI" },
    { dhatu: "Meda\nKshaya", col: C.medaCol + "88", lakshana: "Sphik Shushkata, Atishrama,\nShosha", modern: "Emaciation (severe cases)", inv: "BMI, skinfold" },
    { dhatu: "Asthi\nKshaya", col: C.asthiCol, lakshana: "Kesha/Nakha Patana,\nAsthishula, Sandhi Shaithilya", modern: "Hair fall, brittle nails,\nbone pain, ↓BMD", inv: "DEXA, Vit D, PTH,\nCa, ALP, osteocalcin" },
    { dhatu: "Asthi\nVriddhi", col: C.asthiCol + "88", lakshana: "Adhyasthi, Adhidanta", modern: "Calcification (not typical\nin hypothyroidism)", inv: "X-ray" },
  ];

  rows.forEach((row, i) => {
    const ry = 1.35 + i * 0.7;
    const bg = i % 2 === 0 ? C.white : "F0F4F8";
    s.addShape(pres.shapes.RECTANGLE, { x: 0.2, y: ry, w: 9.6, h: 0.65, fill: { color: bg }, line: { color: C.lightGray, pt: 0.5 } });

    // dhatu cell with color
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    s.addText(row.dhatu, { x: 0.35, y: ry + 0.04, w: 0.95, h: 0.57, fontSize: 9.5, bold: true, color: row.col.length > 7 ? C.textGray : row.col, fontFace: "Calibri", valign: "middle", margin: 0 });

    let cx = 1.4;
    [row.lakshana, row.modern, row.inv].forEach((cell, ci) => {
      const cw = hws[ci + 1];
      s.addText(cell, { x: cx + 0.07, y: ry + 0.04, w: cw - 0.14, h: 0.57, fontSize: 9, color: C.textDark, fontFace: "Calibri", valign: "middle", margin: 0 });
      cx += cw;
    });
  });

  s.addText("Sources: Charaka Samhita Su. 17; Harrison's 22E; Guyton & Hall; Costanzo Physiology; JAIMS Observational Study (n=100)", { x: 0.2, y: 5.46, w: 9.4, h: 0.16, fontSize: 7.5, color: "AAAAAA", italic: true, fontFace: "Calibri", margin: 0 });
}

// ─────────────────────────────────────────────────────────────────────────
// SLIDE 16 – CONCLUSION / THANK YOU
// ─────────────────────────────────────────────────────────────────────────
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  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 5.45, w: 10, h: 0.18, fill: { color: C.accent1 }, line: { type: "none" } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.18, w: 0.45, h: 5.27, fill: { color: C.midBg }, line: { type: "none" } });

  s.addText("KEY CONCLUSIONS", { x: 0.7, y: 0.4, w: 9, h: 0.4, fontSize: 13, bold: true, color: C.accent1, charSpacing: 4, fontFace: "Calibri", margin: 0 });

  const conclusions = [
    ["Meda Dhatu Vriddhi", "is the most prevalent Dhatu Dushti in hypothyroidism (78.2%) — driven by Meda Dhatwagni Mandya and directly correlating with dyslipidemia (↑LDL, ↑TG).", C.medaCol],
    ["Rasa Dhatu Dushti", "is found in 43% of cases. Gaurava, Shaithya, Atinidrata, Shlathangatva map directly to cardinal hypothyroid symptoms via Ama formation and Rasavaha Sroto Dushti.", C.rasaCol],
    ["Asthi Dhatu Kshaya", "represents an underexplored but mechanistically essential finding — Meda Dushti impairs Asthi formation. Hair loss and brittle nails (Asthi Mala) are early clinical markers preceding DEXA changes.", C.asthiCol],
    ["Sequential Samprapti", "validates the Dhatu Poshana Krama: Hypothyroidism → Agni Mandya → Rasa Dushti → Meda Vriddhi → Asthi Kshaya — all three Dhatus are simultaneously involved via a chain mechanism.", C.accent1],
  ];

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    s.addText([
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      { text: body, options: { color: C.white } },
    ], { x: 0.9, y: cy + 0.1, w: 8.8, h: 0.77, fontSize: 10.5, fontFace: "Calibri", valign: "middle", margin: 0 });
  });
}

// ─── WRITE FILE ───────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/hypothyroid-pptx/Rasa_Meda_Asthi_Hypothyroidism_Literature_Review.pptx" })
  .then(() => console.log("✅ Presentation saved successfully."))
  .catch(err => { console.error("❌ Error:", err); process.exit(1); });

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/hypothyroid-pptx/build.js'